By Womaness Editors 2-Minute Read
Welcome to ASK AN EXPERT, a series where we pose your real questions to our menopause experts for the intel you need. Need an answer? Post your question on The After Party, our private Facebook Group.
“I'm in perimenopause and I'm taking the birth control pill. How do I know I've reached menopause if I'm on the pill? I'm still getting light periods, but I'm afraid I won't know what hormonal or menopausal stage I'm in if I'm on it.”
From Dr. Ekta Kapoor, endocrinologist, Mayo Clinic: "That's a very good point. Oftentimes when you are on the birth control pill, you basically do not experience any symptoms of menopause because you're also getting these hormones in the birth control pill.
In these situations, a couple of options exist. If you really want to know whether or not you are in menopause, we can stop the pill and see what happens to your periods (some patients even request blood work to check that out, and we can do that). But if you stop the pill and the period doesn't come back, or if you start experiencing symptoms of menopause, then you have your answer, right?
"Oftentimes when you are on the birth control pill, you basically do not experience any symptoms of menopause because you're also getting these hormones in the birth control pill."
Some women use the pill only for contraception; some use it for other reasons, like regulating their cycles because they're having heavy periods. So depending upon what the goal is, they sometimes don't want to come off the pill. In that situation, we sometimes tell the patient to continue taking it, and we lower those estrogen birth control pills until age 55. (And where does a number 55 come from? The normal age range of menopause is 46 to 55.)
When you are approaching menopause, chances of pregnancy are very low, but they're not zero. I've had patients who've gotten pregnant even in that age range. So if the goal of the pill is contraception, you can either continue until age 55 or swap it for a different contraceptive. If you do swap, you can then know whether or not you're having menopause symptoms.
Now, it's rare occurrence, but sometimes I will see patients start experiencing menopause symptoms even when they are on the pill. That's a sign right there that for some reason the birth control pill is not controlling their menopause symptoms. In that case, I then stop the pill and see what's happening to their cycle and their symptoms."