Dr. MJ Bazos MD,
Control Pills for Perimenopausal Women
What are very-low-dose birth control
Very-low-dose birth control
pills (brand names: Estrin 1/20, Alesse) have less estrogen than regular birth
control pills. These pills have 20 micrograms of estrogen, compared with 30 to
50 micrograms in regular birth control pills.
What does perimenopause mean?
When your periods stop completely,
it's called menopause. Perimenopause means "around the time of menopause." The
perimenopausal years are the few years before your periods stop. The timing of
menopause is different for each woman. Although some women stop having periods
in their 30s, the average age is the early 50s. So, perimenopausal women are
usually in their 40s or early 50s.
Why would I use very-low-dose birth
control pills during perimenopause?
If you're still having periods,
you could still get pregnant. Very-low-dose birth control pills prevent
pregnancy and may also have some health benefits. They can help regulate your
periods if they are heavy or irregular. They may also prevent bone loss, which
helps protect you from osteoporosis. Another potential benefit is protection
from cancer of the ovary and uterus. The lower dose of estrogen in these pills
(compared to regular birth control pills) is believed to be safer for women who
take very-low-dose birth control pills?
Perimenopausal women who have a
history of deep blood clots, breast cancer or heart disease should not take
very-low-dose birth control pills. Perimenopausal women who smoke probably
should not take them, either.
How are very-low-dose birth
control pills taken?
birth control pills are taken the same way as other birth control pills. They
are usually started on the first Sunday after your period starts. If you're
perimenopausal but you aren't having regular periods, you can probably take a
hormone called medroxyprogesterone acetate (brand name: Provera) to start your
period. (Your doctor will check you for pregnancy first.)
These pills are taken for 21 days in a
row and then not taken for 7 days. During the 7 days without medicine, your
period will start. Seven days later (this will be on a Sunday), you'll start
taking the very-low-dose birth control pills for another cycle.
Do very-low-dose birth control
pills have any side effects?
hormone doses in these pills are so low that most women don't have side effects.
You might have breast tenderness, nausea, higher blood pressure or headaches.
It's also possible that these very-low-dose birth control pills may not regulate
your periods. If you're having any abnormal bleeding, it might get worse. There
may be some risk that estrogen increases the risk of breast cancer, but this
hasn't been proved.
If I'm taking
birth control pills, how will I know when menopause starts?
You and your doctor will decide
together how long you should take this medicine. You can stop taking
very-low-dose birth control pills any time, or you can change to regular
estrogen replacement therapy. The decision to change from the low-dose birth
control pills to estrogen replacement therapy is usually made around the age of
49 to 52. Your doctor can also measure a hormone called FSH
(follicle-stimulating hormone) to see if you're in menopause. If the FSH
measurement is over 30, you've probably entered menopause.
Talk to your doctor to see if
very-low-dose birth control pills might be a good idea for you during your