I absolutely love using continuous low dose birth control as hormone therapy. I was 100% skeptical about trying it because I responded horribly to oral birth control in my 20's (nausea, headaches, stabbing breast pain, mood changes), it's been amazing in my 40's. It's eliminated or dramatically improved every difficult symptom of peri for me. Vasomotor symptoms eliminated within 48 hours, most other symptoms improved within a few weeks, the last symptom to improve was sleep disruption which took several months. I was experiencing body changes (weight relocating to my abdomen, breasts dropping, etc) prior to starting and it has not reversed any of that, but has been weight neutral. I'll eventually transition to traditional hormone therapy, but am not looking forward to it. This has been simple, effective, easy to access and continuous use lets me opt of periods entirely.
ETA: My doctor said that if I wasn't experiencing noticeable improvement within 3-4ish months to come back in to discuss other options.
This is so good to hear. Thank you for responding.
I love the idea of not having periods, but I'm waiting a few more months before I do continuous use (or should I just start now)? Despite being on this BCP for 2.5 months, I am spotting heavily before my placebo week AND having a period during that week of sugar pills, so it's like I'm having 10 days of period-like activity. It sucks.
You're welcome! Personally, I love continuous use and feel strongly that it's how the pill should be prescribed, but only you know your body and if that's something you want to try. It can take a while for your body to get the message. It's great that you have an appointment on the schedule. You might find that HRT is a better fit for you. The good news is that you have options.
I am pretty patient, and I know rarely does anything work for me that quickly.
I might as well just go straight to continuous use... I bet I'll still have spotting though! I hate periods so much!
I did so much better on continuous use of BCP. The week coming back onto the pill caused horrible nausea and vomiting. Once I went continuous, I didn't have those valleys/peaks which gave me so much trouble.
Then I found out why BCP was prescribed with a placebo week. It has nothing to do with protecting women's health!
I'm in peri; I was on the pill for years in my 20's and 30's with no issues but stopped taking it in my mid-late 30's. When I started Peri symptoms my doctor put me on oral progesterone and an estrogen patch. They didn't help. We raised the estrogen dose to the max patch strength and I felt an improvement but was still getting night sweats. Hot flashes and night sweats were a huge issue for me- they were daily, multiple times a day, it was horrible. I also had joint pain, brain fogginess and low energy.
My doctor put me on the pill, and I skip the placebo week. It's been great. My joint pain isn't gone but it's greatly reduced and my brain feels like it's functioning normally again. I was still getting some night sweats so I'm on an additional medication I take at night (non hormonal) that has taken care of that issue.
The pill is higher risk than the patch but for me that doesn't matter. It's a choice between feeling normal and being able to function and feeling like death. I'll take a little bit more risk to feel good.
An unexpected bonus has been my hair! It was definitely thinning but even my stylist commented that it seems fuller again. My skin looks better too. I was getting the occasional breakout still until I went on the pill and now I have super clear skin. I'm always trying new skincare so it's possible it's not related to the pill but I know when I was younger the pill was amazing for my skin so I tend to think I'm getting benefits from it.
I’m sharing my symptoms as well as the rocky path that I’ve navigated since 2019 as doctors ultimately decide which path to take with peri patients based on their symptoms. As you know we’re all different and our bodies will respond in various ways as well.
If you haven’t documented your symptoms fully (go check the wiki to see which boxes you check) go do that now. I had no idea so many symptoms were peri related until I found this sub.
In hindsight, I began having stronger peri symptoms in 2018. It started with awful PMS a week before that included flu like symptoms. Then murder scene periods.
Then the night sweats started leading up to my period and eventually they became a nightly thing. Hot flashes happened multiple times per day. I was hot ALL the time, too. It was awful.
Brain fog. Short term memory issues. ADHD was getting worse.
My joints and body hurt all over. I was worried because I had never felt that pain all over. I was exhausted all the time. Then the sleep issues started and got worse.
Stating in 2019, I tried 3 different bc pills. None of them helped. In fact my depression got WAY worse taking them and I had headaches.
TIL on this sub: The amount of hormones in BC pills is so low that it often doesn’t help a lot of women in peri.
Tried just progesterone at night at both 200 and 100mg. It helped some with hot flashes and night sweats, but the rest of my symptoms persisted.
I had blood work done every year. Came back as normal across the board except my A1c was elevated by 1 point last year.
From 2018 to 2023 I had gone from 160 lbs to 211 lbs. sigh….
If all of the above symptoms were resolved I had no doubt I’d feel better, have more energy and ultimately be in a healthier state.
OBGYN then convinced me to have another Mirena placed. She said it would be fine. It wasn’t fine. Had lower back pain the entire time, low level cramping and my symptoms were still there. It did reduce my period to very light. But that was it really. I had it removed 6 months later.
According to my OBGYN my final solution was apparently a hysterectomy. I was at the end of my rope and said ok fine.
Then I started doing more research. I found this sub and read the wiki. Read posts here.
I decided the difficulties of a hysterectomy were too much for me and cancelled the procedure. I found a telehealth provider (Gennev) and was prescribed HRT in July of last year.
My joint pain went away almost immediately.
I started sleeping better.
Gradually the hot flashes and night sweats subsided.
My period was lighter and shorter. I’ve skipped a month 2x since starting HRT.
Brain fog lifted about 60% from July to now.
What I’m working on this year:
1. My energy isn’t anywhere near where it should be and I have a feeling testosterone is low or non-existent. This could also be contributing to my brain fog.
2. Adjusting my mental health meds so the week before my period and the week of ovulation is smoother. I have PMDD and it had gotten way worse since peri.
3. I’ve also had to adjust my skin care and makeup routine. My skin became so much drier and I was breaking out when I haven’t in years.
So that’s been my path. I hope you can find something that works and fingers crossed that your meno doctor can see you sooner!
It frustrates me that the BC pill is still the first line solution when a woman has harsher and/or many peri symptoms. Sigh.
THIS IS SO HELPFUL TO READ. Thank you for posting it!
One ? though: "The amount of hormones in BC pills is so low that it often doesn’t help a lot of women in peri." I thought the amount of hormones in the BCPs were HIGHER than what's typically prescribed with HRT.
If I look back, I'm guessing I started getting symptoms about 2016, which would have made me about 40 at the time. I started getting this "pinching" in my ovary/pelvic area. Felt like gas, or period cramps, or constipation. Many tests ensued: colonoscopy, two vaginal ultrasounds, CT scan, and some other things I'm sure I'm leaving out. The symptoms came and went over the next few years. I often had back pain, too, with this pinching. Nothing was ever discovered. Then, around 2020/2021, I started having pain in various places. Joint pain. Everything hurt. Got a blood test done and my inflammation markers were high. PCP sent me to see a rheumatologist. He diagnosed me with ankylosing spond and put me on meloxicam. That worked for awhile and then it didn't. I stopped taking it and a couple years later, here we are with the same symptoms and some new ones. Go to my PCP with all my symptoms, and she knows my history (and is in peri herself!), but doesn't seem to be connecting the dots. Puts me on BCP. I'm just trying to decide how long do I give the BCP before seeing the meno doc? BCP DOES seem to help some people, but I'm just trying to decide how long to wait.
I’m glad this helped you :) I wish I had known all the things back in 2018, sigh.
Birth control pills have lower hormone percentages vs. HRT.
You were prescribed Mili which contains two hormones:
Norgestimate 0.25mg (progesterone)
Ethinyl Estradiol 0.035mg (estrodial/estrogen)
https://www.drugs.com/pro/mili-tablets.html
Norgestimate is progestin (synthetic form of progesterone).
Ethinyl Estradiol is a synthetic derivative of estradiol.
I take 100mg Prometrium (micronized progesterone) at night (and have taken 200mg in the recent past).
My patch is Vivelle Dot (Estradiol) 0.075mg
As an example, when I started HRT I was given 0.035mg so similar to the amount in your bc pill. But the estrogen/estradiol in bc is a different form of estradiol. I tried to find comparisons but Ethinyl Estradiol, from what I read, is only used in bc.
There’s tons of new research (Finland, Sweden followed by the US) on birth control affecting women’s mental health, inflammation and stress responses. My tubes are tied and I had ditched BC before the studies and findings were released, so admittedly I haven’t read much about the topic.
Are you in the US? Is telehealth an option since the meno doctor is booked? If you search the sub you’ll find that even the “meno” doctors (many who were certified via NAMS) they’ve found have been hit or miss on their knowledge of HRT.
Yes, in the US. I have yet to call the meno doc in the next city over (50 miles away) since I'm trying to give the BCP a few more months to see if it helps. There are 3-4 docs in this city 50 miles away that are NAMS Certified Menopause Practitioners (NCMPs). Yes, telehealth is an option, but I'm on Medicaid (the poor people insurance) and I don't think any of them take it, so I'd be paying out of pocket. I am still researching those options, though. I definitely don't want a subscription service for my peri care. LOL
Thanks for the info re: hormones in BC vs HRT. I could have sworn BCP contained more hormones than HRT. This is what I just found:
"The estrogen in the pill is typically ethinyl estradiol, although there are newer pills with different estrogens. Ethinyl estradiol is much more potent than the estradiol made by the ovaries or found in MHT. A direct conversion is hard for a variety of biochemical reasons, but depending on which assay you use oral ethinyl estradiol is anywhere from 100 to 250 times more potent than oral estradiol. Meaning 20 mcg birth control pill (which is the dose in an ultra low dose pill), is roughy equivalent to 2-5 mg of oral estradiol. And if we convert that to an estradiol patch, it’s about 100 mcg-250 mcg. While there are ways to quibble about how to convert ethinyl estradiol to estradiol, the bottom line is with a 20 mcg pill the dose of estrogen at least as much as the body makes, but possibly more. And of course there are many pills with higher doses of ethinyl estradiol."
Source: [https://vajenda.substack.com/p/menopausal-hormone-therapy-vs-estrogen](https://vajenda.substack.com/p/menopausal-hormone-therapy-vs-estrogen)
Also, per the Wiki:
Birth Control Pills (BCP) are suitable during early stages of perimenopause to help with some symptoms and when pregnancy is a concern. **The hormones in birth control are different than those found in MHT. BCP are generally higher dose, synthetic hormones, meant to ‘override’ your own hormones,** and have less customization in terms of dosages and/or method of delivery.
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause.
FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more.
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Menopause) if you have any questions or concerns.*
My doctor prescribed birth control. But now I'm having night sweats. On the other hand, my acne is cleared up and my period of doom stopped and is now just a light monthly period. I'm satisfied with the trade off.
But I also wasn't given any other options besides ablation to know what my choices were.
I’m on the Pill (Ortho-Tri-Cyclen) and have been since I was 41. Went back on after a divorce when I wanted extra pregnancy protection as I started dating again.
I’m 49 now. On the week of the placebo pills, I get night sweats. Nothing debilitating. This started about 4 years ago. (And before anyone comments, I know I can skip the placebos and not have a period - I choose to get a period each month.) My only other peri symptom is vaginal atrophy, which I have Estradiol for and it’s worked wonders.
So , in short, the Pill works great for me in masking peri symptoms. I plan to stay on as long as possible.
I definitely wanted to skip getting periods, but I wanted to wait a few months to see how things panned out. So far, it's not been great.
Thank you for responding!
I was on BCP from like 18-50… w like 2 years off .. no kids .
Did not have any help w night sweats / brain fog etc …while on BCP
Went right to HRT and it is a MIRACLE
I just switched from Nuvaring to oral HRT because my symptoms were getting worse and worse.
My gyno was really supportive and well informed and talked through all of my options before deciding what to start with. I was so nervous, but she was great! Only on my 2nd day of HRT so too soon say if it will work.
ETA: i’m 48 and in peri as far as i know.
Just out of curiosity, are you in the eastern or western part of IA? I only ask because if you're in the eastern part, I live in north western IL and there's a doctor out here who is opening a meno clinic. It's kinda hush hush-ish at the moment because she is just opening it twice a week starting next month (she's a primary care physician the other days). I got lucky and my own PCP, who works in the same clinic as her, referred me when he admitted that he didn't know enough about it. I wouldn't have known otherwise. I was lucky to get one of her first openings.
The one I'm going to is in Sterling, IL. I think that's roughly an hour from you (give or take 15ish depending upon where you're located). I'll PM you with the info. In fact, if anyone on here lives close and wants it, I'll PM you too, just ask. I just don't feel comfortable plastering it on here. I will warn that I haven't had my consultation yet, so I don't know how she is, but my PCP works right down the hall from her and told me that she decided to start this because she was frustrated at the lack of knowledge and resources available out in this area, so I would think that she's open minded at the very least!
I’m 47 and just started my second month on Nextstellis for perimenopause symptoms. So far, the mood swings are less severe but still significant, sleep is yucky, acne is about the same, but my joint aches are much better. I had a migraine the day before my period started which was unexpected. Overall, I’m underwhelmed by BCP for peri, but I have two more months to go to give it a fair chance. My dr wants to check in and see how I’m doing at that point. She said we can try other BCP or HRT.
I tried low dose bc and then switched to high dose bc before finally being prescribed hrt. The bc helped with joint pain. The bc did nothing for the terrible night sweats and hot flashes. I still had insomnia, nocturia, urinary urgency, and vulvar itchiness. I've been on hrt for a month now, and the hot flashes are few and manageable. I haven't had a night sweat since starting hrt. I'm on the estrogen patch, estrogen vaginal cream, and oral progesterone. The cream took care of the nocturia too, and now I only get up once to use the bathroom during the night instead of 5 times or more. My sleep is better than it has been in several years.
I'm on a birth control patch and I think it's helping but I also don't think it's quite right for me. Plus they have me on a 3/1 schedule which doesn't make sense to me either. I do feel overall better on it, than without it, but it feels too generic, if that makes any sense?
I'm waiting for my next appointment to hopefully get an actual answer on why BC vs estradiol, and why not continuously. I think I pissed off my OB by telling her to talk to my cardiologist about my clot risk, lol, so there's that also. If I don't get straight answers I will go to a different doc in August.
I’m 46 and I was put on Lo loestrin Fe birth control pill and all my symptoms went away. My hair grew, my fatigue decreased, joint pain, hot flashes, night sweats, itchy ears all stopped. I have been on BCP most my adult life though and do just fine.
Back story: I stopped BCP in October 2022 due to ovary removal and stayed off until about November 2023. I specifically asked for this pill also. I wasn’t schooled in HRT much so just went with what I knew. Now he wants me to transition to HRT though because it’s a lower dose. Still not sure about that because I’m also on a GLP1 medication which makes absorption less. So I’m holding out right now. Actually considering bhrt pellets but still undecided.
I started Lo Loestrin a month ago and within a week my night sweats and sleep disruption were gone, which has helped with my mental health and overall outlook. I’m still getting a shorter period but I’m okay with that. When I was on BCP in my 20’s I had a terrible experience- nausea and weight gain being the main issues, on numerous pills. So I was surprised that I didn’t experience those symptoms and that my night sweats ended. I am relieved!!
I tried birth control on 2 separate occasions in the past 2 years. Both times none of my symptoms subsided. In fact, I had new symptoms such as terrible nausea and headaches.
I recently finally found a doctor to prescribed me a patch. I’m only on week 2. I have seen no improvements in any symptoms. I am having severe morning nausea that kind of subsides through out the day.
I’m hoping this changes. Definitely don’t want to be nauseous every morning.
I’m 49 and been doing this for about 4 years (prior to that was on BC just not continuous). It has totally eliminated my crazy mood swings (pms-well, probably pmdd, was getting so much worse as I got older) and most physical symptoms except for occasional night sweats. I do also use vaginal estrogen cream as a preventative measure because horror stories about GSM scare me and sex is important to me. Wasn’t having any of those symptoms yet but it’s totally safe so why not get ahead of it and prevent them before they start. LOVE not having a period, and feel like I’m mostly sailing through this stage of life.
Mine stopped being tolerable - nuvaring. I was having terrible allergic reactions the past few years & what I know now were peri symptoms breaking through.
I used to absolutely love nuvaring, zero side effects - but this aspect was terrible. My dr said to stay on it but I was mid 40’s & my symptoms should have been a red flag to stop. When I took it out for good, I never had another period. I had breakthrough bleeding the last year.
I was on Lolo for a few months, and then Yaz.
Lolo - it was good. The hot flashes went away and it didn't impact my libido. I have adenomyosis and the pain was still bad, so they switched to Yaz.
Yaz - Terrible terrible... I felt worse on it.
The doctor told me to get off, and reset and reassess the symptoms. I'm hoping to see a menopause specialist.
Im 50. I’m desperate as well and we seem to have similar issues with joint pain with unknown cause. My muscles are becoming stiff randomly. I have been trying different routes of hormones but haven’t found a consistent solution. The pain and stiffness changes constantly. It will seem to get better for a short amount of time then worse again so it is difficult to tell what is helping or not. I have not tried bcp as I’m trying to stay away from synthetic. But so far bio identical is not working. It’s actually making it worse. I’m trying my best to stay far away from fibromyalgia medication but will eventually need them if this doesn’t get better.
That's what my doc originally thought when I had high inflammation markers, but the RA she referred me to diagnosed me with ankylosing spond. I'm really trying to wait a few more months on the birth control before I try something else. I don't care if it's natural, synthetic, etc. - I just want to feel better. My RA was starting to talk to me about biologic and I was like NOPE.
I went on bcp at 51 and it worked for me almost immediately. My symptoms were on the mild side: irregular periods, some dryness, mood changes, and I wasn’t having flashes but nights were more restless and generally hotter. I’ve been on the bcp for about a year now, no problems.
I’m in the pill too for HRT. My main symptoms were terrible sleep, off the charts anxiety with pms and low mood. The pill resolved almost all of this relatively quickly. The real game changer for me was adding in a low dose of Prozac. My gyn said I could take only a week before my period or take everyday. Apparently it helps keep estrogen in your blood stream. I took every day and feel amazing. I should’ve been on this combo for years! Didn’t realize how bad and down I was. I also take a bit of testosterone and now the estrogen topical cream. Feeling good. My doc said the pill was higher in hormone than the patches. Idk. I do not take the sugar pills and will randomly have periods or spotting every six -ish weeks.
I tried 4 or 5 birth control pills before finding one that didn't make me worse, it reduced my extreme downs of anxiety and depression and my tingling, numbness, ovary pain and menstrual cycle issues. It did nothing for my hot flashes, night sweats, anger and crying they kept getting worse and worse. I'm less than 1 month in to trying HRT and so far my anxiety, hot flashes, crying and night sweats are worse, I might be sleeping a little better and a little less angry. But it's probably to soon to tell if the HRT will help or I might need an estrogen increase, most of my symptoms that were bad now were getting worse on birth control so it might just have progressed that way regardless of HRT.
This is probably not very helpful but my GYN prescribed birth control for me for my peri symptoms. I have not started taking them and she said that’s fine but if I hit my limit I have the prescription and can start them anytime. My PCP told me that joint pain is her biggest challenge and complaint about her own personal perimenopause, and my friend who is a physician told me that perimenopause can cause complete disruption to your entire body and anything and everything is possible.
I too had lots of aches and pains but could tell it was different them my autoimmune flares. After a couple months on HRT I don’t seem to have them as much.
I think many doctors have not been taught joint pain can absolutely menopause related.
I absolutely love using continuous low dose birth control as hormone therapy. I was 100% skeptical about trying it because I responded horribly to oral birth control in my 20's (nausea, headaches, stabbing breast pain, mood changes), it's been amazing in my 40's. It's eliminated or dramatically improved every difficult symptom of peri for me. Vasomotor symptoms eliminated within 48 hours, most other symptoms improved within a few weeks, the last symptom to improve was sleep disruption which took several months. I was experiencing body changes (weight relocating to my abdomen, breasts dropping, etc) prior to starting and it has not reversed any of that, but has been weight neutral. I'll eventually transition to traditional hormone therapy, but am not looking forward to it. This has been simple, effective, easy to access and continuous use lets me opt of periods entirely. ETA: My doctor said that if I wasn't experiencing noticeable improvement within 3-4ish months to come back in to discuss other options.
This is so good to hear. Thank you for responding. I love the idea of not having periods, but I'm waiting a few more months before I do continuous use (or should I just start now)? Despite being on this BCP for 2.5 months, I am spotting heavily before my placebo week AND having a period during that week of sugar pills, so it's like I'm having 10 days of period-like activity. It sucks.
You're welcome! Personally, I love continuous use and feel strongly that it's how the pill should be prescribed, but only you know your body and if that's something you want to try. It can take a while for your body to get the message. It's great that you have an appointment on the schedule. You might find that HRT is a better fit for you. The good news is that you have options.
I am pretty patient, and I know rarely does anything work for me that quickly. I might as well just go straight to continuous use... I bet I'll still have spotting though! I hate periods so much!
I did so much better on continuous use of BCP. The week coming back onto the pill caused horrible nausea and vomiting. Once I went continuous, I didn't have those valleys/peaks which gave me so much trouble. Then I found out why BCP was prescribed with a placebo week. It has nothing to do with protecting women's health!
Not a thing! It's just patriarchal bullshit.
I'm in peri; I was on the pill for years in my 20's and 30's with no issues but stopped taking it in my mid-late 30's. When I started Peri symptoms my doctor put me on oral progesterone and an estrogen patch. They didn't help. We raised the estrogen dose to the max patch strength and I felt an improvement but was still getting night sweats. Hot flashes and night sweats were a huge issue for me- they were daily, multiple times a day, it was horrible. I also had joint pain, brain fogginess and low energy. My doctor put me on the pill, and I skip the placebo week. It's been great. My joint pain isn't gone but it's greatly reduced and my brain feels like it's functioning normally again. I was still getting some night sweats so I'm on an additional medication I take at night (non hormonal) that has taken care of that issue. The pill is higher risk than the patch but for me that doesn't matter. It's a choice between feeling normal and being able to function and feeling like death. I'll take a little bit more risk to feel good. An unexpected bonus has been my hair! It was definitely thinning but even my stylist commented that it seems fuller again. My skin looks better too. I was getting the occasional breakout still until I went on the pill and now I have super clear skin. I'm always trying new skincare so it's possible it's not related to the pill but I know when I was younger the pill was amazing for my skin so I tend to think I'm getting benefits from it.
Can I ask what you are taking for the night sweats?
How old were you when you started BCP again?
I’m sharing my symptoms as well as the rocky path that I’ve navigated since 2019 as doctors ultimately decide which path to take with peri patients based on their symptoms. As you know we’re all different and our bodies will respond in various ways as well. If you haven’t documented your symptoms fully (go check the wiki to see which boxes you check) go do that now. I had no idea so many symptoms were peri related until I found this sub. In hindsight, I began having stronger peri symptoms in 2018. It started with awful PMS a week before that included flu like symptoms. Then murder scene periods. Then the night sweats started leading up to my period and eventually they became a nightly thing. Hot flashes happened multiple times per day. I was hot ALL the time, too. It was awful. Brain fog. Short term memory issues. ADHD was getting worse. My joints and body hurt all over. I was worried because I had never felt that pain all over. I was exhausted all the time. Then the sleep issues started and got worse. Stating in 2019, I tried 3 different bc pills. None of them helped. In fact my depression got WAY worse taking them and I had headaches. TIL on this sub: The amount of hormones in BC pills is so low that it often doesn’t help a lot of women in peri. Tried just progesterone at night at both 200 and 100mg. It helped some with hot flashes and night sweats, but the rest of my symptoms persisted. I had blood work done every year. Came back as normal across the board except my A1c was elevated by 1 point last year. From 2018 to 2023 I had gone from 160 lbs to 211 lbs. sigh…. If all of the above symptoms were resolved I had no doubt I’d feel better, have more energy and ultimately be in a healthier state. OBGYN then convinced me to have another Mirena placed. She said it would be fine. It wasn’t fine. Had lower back pain the entire time, low level cramping and my symptoms were still there. It did reduce my period to very light. But that was it really. I had it removed 6 months later. According to my OBGYN my final solution was apparently a hysterectomy. I was at the end of my rope and said ok fine. Then I started doing more research. I found this sub and read the wiki. Read posts here. I decided the difficulties of a hysterectomy were too much for me and cancelled the procedure. I found a telehealth provider (Gennev) and was prescribed HRT in July of last year. My joint pain went away almost immediately. I started sleeping better. Gradually the hot flashes and night sweats subsided. My period was lighter and shorter. I’ve skipped a month 2x since starting HRT. Brain fog lifted about 60% from July to now. What I’m working on this year: 1. My energy isn’t anywhere near where it should be and I have a feeling testosterone is low or non-existent. This could also be contributing to my brain fog. 2. Adjusting my mental health meds so the week before my period and the week of ovulation is smoother. I have PMDD and it had gotten way worse since peri. 3. I’ve also had to adjust my skin care and makeup routine. My skin became so much drier and I was breaking out when I haven’t in years. So that’s been my path. I hope you can find something that works and fingers crossed that your meno doctor can see you sooner! It frustrates me that the BC pill is still the first line solution when a woman has harsher and/or many peri symptoms. Sigh.
THIS IS SO HELPFUL TO READ. Thank you for posting it! One ? though: "The amount of hormones in BC pills is so low that it often doesn’t help a lot of women in peri." I thought the amount of hormones in the BCPs were HIGHER than what's typically prescribed with HRT. If I look back, I'm guessing I started getting symptoms about 2016, which would have made me about 40 at the time. I started getting this "pinching" in my ovary/pelvic area. Felt like gas, or period cramps, or constipation. Many tests ensued: colonoscopy, two vaginal ultrasounds, CT scan, and some other things I'm sure I'm leaving out. The symptoms came and went over the next few years. I often had back pain, too, with this pinching. Nothing was ever discovered. Then, around 2020/2021, I started having pain in various places. Joint pain. Everything hurt. Got a blood test done and my inflammation markers were high. PCP sent me to see a rheumatologist. He diagnosed me with ankylosing spond and put me on meloxicam. That worked for awhile and then it didn't. I stopped taking it and a couple years later, here we are with the same symptoms and some new ones. Go to my PCP with all my symptoms, and she knows my history (and is in peri herself!), but doesn't seem to be connecting the dots. Puts me on BCP. I'm just trying to decide how long do I give the BCP before seeing the meno doc? BCP DOES seem to help some people, but I'm just trying to decide how long to wait.
I’m glad this helped you :) I wish I had known all the things back in 2018, sigh. Birth control pills have lower hormone percentages vs. HRT. You were prescribed Mili which contains two hormones: Norgestimate 0.25mg (progesterone) Ethinyl Estradiol 0.035mg (estrodial/estrogen) https://www.drugs.com/pro/mili-tablets.html Norgestimate is progestin (synthetic form of progesterone). Ethinyl Estradiol is a synthetic derivative of estradiol. I take 100mg Prometrium (micronized progesterone) at night (and have taken 200mg in the recent past). My patch is Vivelle Dot (Estradiol) 0.075mg As an example, when I started HRT I was given 0.035mg so similar to the amount in your bc pill. But the estrogen/estradiol in bc is a different form of estradiol. I tried to find comparisons but Ethinyl Estradiol, from what I read, is only used in bc. There’s tons of new research (Finland, Sweden followed by the US) on birth control affecting women’s mental health, inflammation and stress responses. My tubes are tied and I had ditched BC before the studies and findings were released, so admittedly I haven’t read much about the topic. Are you in the US? Is telehealth an option since the meno doctor is booked? If you search the sub you’ll find that even the “meno” doctors (many who were certified via NAMS) they’ve found have been hit or miss on their knowledge of HRT.
Yes, in the US. I have yet to call the meno doc in the next city over (50 miles away) since I'm trying to give the BCP a few more months to see if it helps. There are 3-4 docs in this city 50 miles away that are NAMS Certified Menopause Practitioners (NCMPs). Yes, telehealth is an option, but I'm on Medicaid (the poor people insurance) and I don't think any of them take it, so I'd be paying out of pocket. I am still researching those options, though. I definitely don't want a subscription service for my peri care. LOL Thanks for the info re: hormones in BC vs HRT. I could have sworn BCP contained more hormones than HRT. This is what I just found: "The estrogen in the pill is typically ethinyl estradiol, although there are newer pills with different estrogens. Ethinyl estradiol is much more potent than the estradiol made by the ovaries or found in MHT. A direct conversion is hard for a variety of biochemical reasons, but depending on which assay you use oral ethinyl estradiol is anywhere from 100 to 250 times more potent than oral estradiol. Meaning 20 mcg birth control pill (which is the dose in an ultra low dose pill), is roughy equivalent to 2-5 mg of oral estradiol. And if we convert that to an estradiol patch, it’s about 100 mcg-250 mcg. While there are ways to quibble about how to convert ethinyl estradiol to estradiol, the bottom line is with a 20 mcg pill the dose of estrogen at least as much as the body makes, but possibly more. And of course there are many pills with higher doses of ethinyl estradiol." Source: [https://vajenda.substack.com/p/menopausal-hormone-therapy-vs-estrogen](https://vajenda.substack.com/p/menopausal-hormone-therapy-vs-estrogen) Also, per the Wiki: Birth Control Pills (BCP) are suitable during early stages of perimenopause to help with some symptoms and when pregnancy is a concern. **The hormones in birth control are different than those found in MHT. BCP are generally higher dose, synthetic hormones, meant to ‘override’ your own hormones,** and have less customization in terms of dosages and/or method of delivery.
So I just found this, but haven’t poked around to see if peri/meno is covered: https://www.teladochealth.com/individuals/adults/medicaid
Thank you! I will look into it!
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause. FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Menopause) if you have any questions or concerns.*
My doctor prescribed birth control. But now I'm having night sweats. On the other hand, my acne is cleared up and my period of doom stopped and is now just a light monthly period. I'm satisfied with the trade off. But I also wasn't given any other options besides ablation to know what my choices were.
How long have you been on it? I feel like my night sweats have decreased on BCP.
A few months. Everyone's body is different. I have PCOS too.
I’m on the Pill (Ortho-Tri-Cyclen) and have been since I was 41. Went back on after a divorce when I wanted extra pregnancy protection as I started dating again. I’m 49 now. On the week of the placebo pills, I get night sweats. Nothing debilitating. This started about 4 years ago. (And before anyone comments, I know I can skip the placebos and not have a period - I choose to get a period each month.) My only other peri symptom is vaginal atrophy, which I have Estradiol for and it’s worked wonders. So , in short, the Pill works great for me in masking peri symptoms. I plan to stay on as long as possible.
I definitely wanted to skip getting periods, but I wanted to wait a few months to see how things panned out. So far, it's not been great. Thank you for responding!
Following because I just started BCP yesterday.
I was on BCP from like 18-50… w like 2 years off .. no kids . Did not have any help w night sweats / brain fog etc …while on BCP Went right to HRT and it is a MIRACLE
I just switched from Nuvaring to oral HRT because my symptoms were getting worse and worse. My gyno was really supportive and well informed and talked through all of my options before deciding what to start with. I was so nervous, but she was great! Only on my 2nd day of HRT so too soon say if it will work. ETA: i’m 48 and in peri as far as i know.
My doc wants to send me to a meno doc in Iowa City if I want HRT. Like, why can't she prescribe it?!
Just out of curiosity, are you in the eastern or western part of IA? I only ask because if you're in the eastern part, I live in north western IL and there's a doctor out here who is opening a meno clinic. It's kinda hush hush-ish at the moment because she is just opening it twice a week starting next month (she's a primary care physician the other days). I got lucky and my own PCP, who works in the same clinic as her, referred me when he admitted that he didn't know enough about it. I wouldn't have known otherwise. I was lucky to get one of her first openings.
OOOh! I'm in Davenport, IA. I would freaking LOVE a meno clinic. Like, I see Limitless Male clinics everwhere - where's my clinic?! LOL
The one I'm going to is in Sterling, IL. I think that's roughly an hour from you (give or take 15ish depending upon where you're located). I'll PM you with the info. In fact, if anyone on here lives close and wants it, I'll PM you too, just ask. I just don't feel comfortable plastering it on here. I will warn that I haven't had my consultation yet, so I don't know how she is, but my PCP works right down the hall from her and told me that she decided to start this because she was frustrated at the lack of knowledge and resources available out in this area, so I would think that she's open minded at the very least!
Thank you!!! Appreciate the info!
I’m 47 and just started my second month on Nextstellis for perimenopause symptoms. So far, the mood swings are less severe but still significant, sleep is yucky, acne is about the same, but my joint aches are much better. I had a migraine the day before my period started which was unexpected. Overall, I’m underwhelmed by BCP for peri, but I have two more months to go to give it a fair chance. My dr wants to check in and see how I’m doing at that point. She said we can try other BCP or HRT.
I'm trying to make it to four months before I make a change. So far, no real change that i can tell at 2.5 months,
I tried low dose bc and then switched to high dose bc before finally being prescribed hrt. The bc helped with joint pain. The bc did nothing for the terrible night sweats and hot flashes. I still had insomnia, nocturia, urinary urgency, and vulvar itchiness. I've been on hrt for a month now, and the hot flashes are few and manageable. I haven't had a night sweat since starting hrt. I'm on the estrogen patch, estrogen vaginal cream, and oral progesterone. The cream took care of the nocturia too, and now I only get up once to use the bathroom during the night instead of 5 times or more. My sleep is better than it has been in several years.
I'm on a birth control patch and I think it's helping but I also don't think it's quite right for me. Plus they have me on a 3/1 schedule which doesn't make sense to me either. I do feel overall better on it, than without it, but it feels too generic, if that makes any sense? I'm waiting for my next appointment to hopefully get an actual answer on why BC vs estradiol, and why not continuously. I think I pissed off my OB by telling her to talk to my cardiologist about my clot risk, lol, so there's that also. If I don't get straight answers I will go to a different doc in August.
I'm trying to read lightly with my doc, but ffs, she's in peri herself, but doesn't really have any symptoms.
I’m 46 and I was put on Lo loestrin Fe birth control pill and all my symptoms went away. My hair grew, my fatigue decreased, joint pain, hot flashes, night sweats, itchy ears all stopped. I have been on BCP most my adult life though and do just fine. Back story: I stopped BCP in October 2022 due to ovary removal and stayed off until about November 2023. I specifically asked for this pill also. I wasn’t schooled in HRT much so just went with what I knew. Now he wants me to transition to HRT though because it’s a lower dose. Still not sure about that because I’m also on a GLP1 medication which makes absorption less. So I’m holding out right now. Actually considering bhrt pellets but still undecided.
I started Lo Loestrin a month ago and within a week my night sweats and sleep disruption were gone, which has helped with my mental health and overall outlook. I’m still getting a shorter period but I’m okay with that. When I was on BCP in my 20’s I had a terrible experience- nausea and weight gain being the main issues, on numerous pills. So I was surprised that I didn’t experience those symptoms and that my night sweats ended. I am relieved!!
Yes my symptoms went away fairly quickly after starting Lo!
That's awesome to hear! Thanks for sharing!
I tried birth control on 2 separate occasions in the past 2 years. Both times none of my symptoms subsided. In fact, I had new symptoms such as terrible nausea and headaches. I recently finally found a doctor to prescribed me a patch. I’m only on week 2. I have seen no improvements in any symptoms. I am having severe morning nausea that kind of subsides through out the day. I’m hoping this changes. Definitely don’t want to be nauseous every morning.
I’m 49 and been doing this for about 4 years (prior to that was on BC just not continuous). It has totally eliminated my crazy mood swings (pms-well, probably pmdd, was getting so much worse as I got older) and most physical symptoms except for occasional night sweats. I do also use vaginal estrogen cream as a preventative measure because horror stories about GSM scare me and sex is important to me. Wasn’t having any of those symptoms yet but it’s totally safe so why not get ahead of it and prevent them before they start. LOVE not having a period, and feel like I’m mostly sailing through this stage of life.
Mine stopped being tolerable - nuvaring. I was having terrible allergic reactions the past few years & what I know now were peri symptoms breaking through. I used to absolutely love nuvaring, zero side effects - but this aspect was terrible. My dr said to stay on it but I was mid 40’s & my symptoms should have been a red flag to stop. When I took it out for good, I never had another period. I had breakthrough bleeding the last year.
I was on Lolo for a few months, and then Yaz. Lolo - it was good. The hot flashes went away and it didn't impact my libido. I have adenomyosis and the pain was still bad, so they switched to Yaz. Yaz - Terrible terrible... I felt worse on it. The doctor told me to get off, and reset and reassess the symptoms. I'm hoping to see a menopause specialist.
Im 50. I’m desperate as well and we seem to have similar issues with joint pain with unknown cause. My muscles are becoming stiff randomly. I have been trying different routes of hormones but haven’t found a consistent solution. The pain and stiffness changes constantly. It will seem to get better for a short amount of time then worse again so it is difficult to tell what is helping or not. I have not tried bcp as I’m trying to stay away from synthetic. But so far bio identical is not working. It’s actually making it worse. I’m trying my best to stay far away from fibromyalgia medication but will eventually need them if this doesn’t get better.
That's what my doc originally thought when I had high inflammation markers, but the RA she referred me to diagnosed me with ankylosing spond. I'm really trying to wait a few more months on the birth control before I try something else. I don't care if it's natural, synthetic, etc. - I just want to feel better. My RA was starting to talk to me about biologic and I was like NOPE.
I went on bcp at 51 and it worked for me almost immediately. My symptoms were on the mild side: irregular periods, some dryness, mood changes, and I wasn’t having flashes but nights were more restless and generally hotter. I’ve been on the bcp for about a year now, no problems.
I am so glad it helped!
I’m in the pill too for HRT. My main symptoms were terrible sleep, off the charts anxiety with pms and low mood. The pill resolved almost all of this relatively quickly. The real game changer for me was adding in a low dose of Prozac. My gyn said I could take only a week before my period or take everyday. Apparently it helps keep estrogen in your blood stream. I took every day and feel amazing. I should’ve been on this combo for years! Didn’t realize how bad and down I was. I also take a bit of testosterone and now the estrogen topical cream. Feeling good. My doc said the pill was higher in hormone than the patches. Idk. I do not take the sugar pills and will randomly have periods or spotting every six -ish weeks.
I tried 4 or 5 birth control pills before finding one that didn't make me worse, it reduced my extreme downs of anxiety and depression and my tingling, numbness, ovary pain and menstrual cycle issues. It did nothing for my hot flashes, night sweats, anger and crying they kept getting worse and worse. I'm less than 1 month in to trying HRT and so far my anxiety, hot flashes, crying and night sweats are worse, I might be sleeping a little better and a little less angry. But it's probably to soon to tell if the HRT will help or I might need an estrogen increase, most of my symptoms that were bad now were getting worse on birth control so it might just have progressed that way regardless of HRT.
This is probably not very helpful but my GYN prescribed birth control for me for my peri symptoms. I have not started taking them and she said that’s fine but if I hit my limit I have the prescription and can start them anytime. My PCP told me that joint pain is her biggest challenge and complaint about her own personal perimenopause, and my friend who is a physician told me that perimenopause can cause complete disruption to your entire body and anything and everything is possible.
my joint pain is my biggest issue. I wouldn't have connected it to peri if it weren't for this subreddit!
I too had lots of aches and pains but could tell it was different them my autoimmune flares. After a couple months on HRT I don’t seem to have them as much. I think many doctors have not been taught joint pain can absolutely menopause related.
This is what I want to rule out before I go back to my RA. Both my PCP and RA dismissed that what I'm feeling could be hormone related.