Contraception during Menopause and Menopause – Brook

When considering contraception during perimenopause, there are a few things to discuss with a healthcare professional about the method you are currently using or the method you want to start:

• HRT (hormone replacement therapy) is not compatible with all methods of contraception, so if this is something you plan to use, some methods will not be recommended. The Mirena coil can also be used as the progestogen component of HRT
• Certain health conditions or risk factors may mean that certain methods are not suitable
• Your age may limit the methods available to you
• You may be able to use birth control to help with menopause symptoms

It’s helpful to understand more about the different methods and how they interact with perimenopause while exploring your options.

Combined Methods

• What is? Combined methods contain progesterone and estrogen. They include the combined pill, vaginal ring and patch
• What benefits might they have? The estrogen in these methods can help with hot flashes and other symptoms of menopause and can help improve bone density that decreases during perimenopause.
• Can they be used with HRT? These methods cannot be used at the same time as HRT as the hormone levels in these methods are much higher. But they can work as a substitute for HRT as they can help with symptoms.
• Who can use them? You can use these methods up to the age of 50 if you do not have health risks that you should discuss with a health professional.

With combined methods you will still have a period-like withdrawal bleed which can make it difficult to tell when you have reached menopause. However, the blood test that is sometimes given to help you determine if you are still fertile will not be accurate if you are using combined methods.

Progestogen-only methods

• What is? Progestogen-only methods include the injection, the implant, the progestogen-only pill, and the hormonal coil (LNG-IUC). Unlike combined methods, they do not contain estrogen.
• What benefits can they bring? These methods are a good choice if you have heavy periods that may be a symptom of perimenopause, as it is common to have no bleeding or light, infrequent bleeding.
• Can they be used with HRT? Progestogen-only methods can be used safely with HRT, and the Mirena coil (a type of hormonal coil) can be used as a form of HRT.
• Who can use them? You can take progestogen-only methods if you have certain health conditions or risk factors that mean you can’t use combined methods of contraception.

Since you don’t have a period with these methods (although you may have some bleeding), it can be difficult to know when you’ve reached menopause.

If you’re not sure and you’re using a progestogen-only method, you may be able to have a menopause test at your GP surgery which will measure the levels of follicle-stimulating hormone (FSH) in your blood. This is not 100% reliable, especially if you are over 45.