How to Tell If You’re In Perimenopause When You’re on Birth Control

One of the biggest challenges when transitioning into perimenopause is figuring out whether you’ve actually begun perimenopause – especially if you’re on birth control.

Birth control is fine until it isn’t. It can suddenly start to leave you with uncomfortable, even painful symptoms and make it difficult to determine what kinds of hormone changes your body is undergoing.

These are both important times to stop and take stock in your symptoms, which likely stem from your body sending you alarm signals that a bigger problem is forming from imbalanced hormones.

Many women use birth control pills to handle painful periods, heavy periods, and lack of periods. When your hormone levels aren’t right, you can experience symptoms like these and so many more.

These issues are increasing among women from my observation. In my patient population, I’m seeing more neurological and hormonal issues, and they are more problematic than they used to be.

As your hormones change, you may need to adjust your birth control dosage to better manage your hormonal symptoms so you can function. I see women of all ages for all types of problems, and their hormones will likely fluctuate past normal levels at some point in their life – especially during perimenopause. Too much or too little estrogen can create issues like cancer or clots.

You are often told to just wait and stay on your low dose estrogen birth control because of our bogged down medical system.  It may take a couple months for an ultrasound to confirm cysts, fibroids, or thickening uterine lining. It may take another month to see your doctor to decide whether you need to stop taking birth control.

This cycle creates a crisis in healthcare around hormones because women are looking for more answers and solutions for their health but are often met with long wait times that threaten your health or providers who don’t take your symptoms seriously. Meanwhile, women have an increasingly high amount of medical anxiety because of a system that struggles to have more answers around your hormones.

Many providers aren’t doing their due diligence when adjusting your hormone levels once symptoms appear, which increases your odds of a more serious problem forming. The longer you wait to address the warning signals, or symptoms, your body is sending, the harder it will be for you to fix your health problems.

I’ve had patients who were unsure whether they were in menopause suddenly experience breakthrough bleeding while on the birth control pill. This led to even more confusion surrounding whether she was in menopause and what she needed to do next to protect her health.

Another one of my clients is on the Mirena coil with low dose progesterone. Her provider has her taking estrogen orally and assumes that this coil is still giving her an adequate amount of progesterone to balance her hormones. There’s a high likelihood that the coil has expired, and she needs a different form of progesterone to balance her hormones. 

I suggested she go into her provider portal and explain her symptoms, then request a possible adjustment by adding progesterone orally while removing her coil. She is 54 and likely does not need this coil anymore for birth control.

This is a huge issue. Has she finished going into menopause or is she still going through perimenopause? Many women in their early 50’s are still having regular cycles, making identifying perimenopause even harder. The changes in your hormones go up and down as you go through perimenopause and menopause and require careful monitoring.

Increasingly, my patients are turning to hormone replacement therapy hoping it will restore their function. You can resolve these issues with herbs and supplements without having to turn to hormone replacement therapy, which may be unsafe depending on your hormone fluctuations. 

I find that the overwhelming societal narrative is that hormone replacement therapy is a necessary solution that has helped many women. For all the women it has helped, there are many that have had side effects or developed health issues from taking hormone replacement therapy. This is made worse by a bogged down system that does not adjust dosages quickly enough to prevent the side effects, clots, and cancer.

How do you figure out whether you’re in perimenopause then? Or whether you should keep taking birth control?

Every health solution should be individual for you and your body’s needs. There’s no magic solution that fits every woman, and the right course of action should be decided with care and consideration. It’s crucial to have a healthcare provider in your corner that listens to your symptoms and makes prompt adjustments to ensure the protection of your health.

Treating with this approach is my specialty. I love helping my patients understand what their next step is, fixing hormones naturally with herbs and supplements, and integrating different treatments like detoxes to optimize balance in the body. 

We’ll continue to “figure it out” – all of us together as women, as providers, as a society. The main thing to do is to keep communicating your symptoms and changes to your doctor and any natural health care providers you work with. 

Keep journaling any symptoms alongside your cycles. Keep track of the data so you can help your provider to be clear about what options are available to help you with the transition into perimenopause and menopause.

I have a lot of options that can help you regardless of where you are on your perimenopause journey. If you’re ready to safely handle your symptoms and regain your quality of life, schedule an appointment and we can come up with a tailored plan for you and your needs.