The choice of birth control pill during perimenopause and menopause can be confusing. As hormone levels fluctuate and decline, finding the right hormonal balance is important for managing symptoms. There are a few key factors to consider when choosing the best birth control pill option for this stage of life: Low-dose estrogen pills may be preferable to help minimize side effects. As the body becomes more sensitive to hormones during menopause, high-dose estrogen pills often worsen symptoms like breast tenderness, bloating, and mood swings. Low-dose estrogen pills containing 20-25 mcg of ethinyl estradiol are less likely to cause these issues. Progestin-only pills (mini-pills) are another option since they do not contain estrogen. The mini-pill prevents pregnancy by thickening cervical mucus and thinning the uterine lining. While they have risks like irregular bleeding, they can be a good choice for women who cannot take estrogen. Monophasic versus multiphasic pills - Monophasic pills provide the same level of hormones in each active pill. Multiphasic pills vary the dose through the monthly cycle. While evidence is limited, monophasic pills may stabilize hormones more consistently. When evaluating birth control pills, the type of progestin is important to consider as well. The progestin drospirenone has anti-androgenic and antimineralocorticoid effects that may help relieve hot flashes and night sweats for some women. Other factors to discuss with your healthcare provider include:
