Do I Still Need Birth Control During Perimenopause?

Picture this: You’re in your mid-40s, crushing life, feeling like you’ve finally got it all figured out, but you’re starting to notice some changes. Maybe your periods are playing musical chairs with your calendar, or you’re experiencing the occasional hot flash that makes you want to shut yourself in the freezer. You might be thinking, “Finally! I can stop thinking about contraception now!”. Well, hold onto your horses, because your fertility might not be ready to retire just yet. We’re going to debunk some myths and get real about contraception during perimenopause - because now is not the time for an unexpected plot twist. 

Perimenopause - What’s actually going on? 

Perimenopause is your body’s gradual transition into menopause - kind of like your reproductive system’s ‘sunset phase’. The start of perimenopause isn’t clearly defined, so it can be difficult to tell when you’re perimenopausal and the arrival of symptoms can be a bit of a rude surprise. During perimenopause, hormone levels begin to fluctuate, especially oestrogen. This can lead to a number of symptoms such as irregular menstrual cycles, hot flushes, mood swings, and sleep disturbances. You might have a few months without any periods, and then suddenly aunt flow might decide to show up when you least expect it. If you’re having your periods, this means you’re most likely still ovulating - meaning you can still get pregnant. 

When Can You Stop Using Contraception? 

The Faculty of Sexual and Reproductive Healthcare (FSRH)’s guidelines on contraception for over 40 year olds recommends:

* If you are under 50, you should use contraception for at least two years after your last period

* If you are over 50, you should use contraception for at least one year after your last period

* At 55, you can stop using contraception even if you still have the odd intermittent period, as the chance of pregnancy is extremely rare at this age

Remember, pregnancy isn’t the only purpose of contraception. For some, perimenopause can create a false ‘sense of safety’ and the possibility of contracting sexually transmitted infections is forgotten. A barrier method, such as condoms protect you from both STIs and pregnancy, even if you’ve gone through menopause - if you’re having sex with new partners, you should use condoms and get tested regularly. 

What Are Your Contraception Options? 

Let’s break down some perimenopause-friendly choices: 

Hormonal Options: 

• Combined hormonal contraceptives (If you’re under 50 and don’t have any risk factors) 
• Progesterone-only pill (great if you can’t take oestrogen) 
• Hormonal IUD (bonus: can help with heavy perimenopausal bleeding!) 

Non-Hormonal Options:

• Copper IUD (perfect if you’re team no-hormones!) 
• Barrier methods e.g. Condoms, diaphragms etc. (P.S. Our best–selling condoms are natural, gynae-designed and contain no nasty chemicals so you don’t have to worry about any irritation or UTIs) 
• Vasectomy (If your partner’s up for it) 

The Extra Benefits 

Fun fact: some contraceptive methods can actually help manage those pesky perimenopause symptoms, think of it as a two-for-one deal: 

• Hormonal methods can help regulate unpredictable bleeding 
• They might help with hot flashes 
• Can protect against bone loss 

The Bottom Line 

Just because your body’s going through changes doesn’t mean you can throw caution to the wind. Think of contraception during perimenopause like an umbrella - you might not need it every day, but you’ll be really glad you have it when you do! 

Remember: your healthcare provider is your best friend in this journey. They can help you choose the best option based on your personal situation, health history, and whether you’re dating, in a relationship, or living your best single life. Everyone is different, and what contraception works best for you might be completely different for someone else. 

Want more? 

• Find out why sex might feel different post-menopause.
• Try our all-natural supplement Menopause Support designed to help manage perimenopausal, and menopausal symptoms.
• Looking to manage your weight during menopause? Find out if you're eligible for the weight management programme at HANX.