What to Know About Birth Control and Menopause

Medically Reviewed by Nivin Todd, MD on August 29, 2022
3 min read

When you’re in perimenopause, or the time before your body shifts into menopause, you may be unsure if you still need to use birth control to avoid pregnancy. If you’re worried about pregnancy, you shouldn’t stop birth control until your doctor has told you it’s safe to do so.

There are many birth control choices to choose from if you’re near menopause. You can use hormonal or nonhormonal options:

  • Birth control pills
  • Hormonal injection
  • Skin patch
  • Vaginal ring
  • IUDs
  • Sterilization for either men or women, which isn’t reversible
  • Barrier methods such as condoms, diaphragms, or sponges

The rhythm method, also called natural family planning, is not as effective as other birth control methods if you’re in perimenopause. This is when you track your menstrual pattern to know when you’re most likely to get pregnant. When you’re in perimenopause, you’ll have irregular periods that make it hard to track your menstrual cycle. If you can’t tell when your next period will come, the rhythm method won’t help you avoid pregnancy.

Hormonal birth control can help you in many ways when you’re in perimenopause:

  • Helps maintain bone strength
  • Treats acne, which may get worse when you’re in menopause
  • Lowers your chances of ovarian and uterine cancer
  • Lessens hot flashes
  • Eases period pain and bleeding
  • Makes your periods more regular

Hormonal birth control is usually safe for women in perimenopause. But using birth control after age 35 can raise your risk of blood clots, heart attacks, strokes, and breast cancer. Hormonal methods may not be safe options for you if you smoke or if your doctor has diagnosed you with:

There’s no test to tell if you’ve gone through menopause yet or not. The best way to tell is through your period.

You’ve most likely gone through menopause if you’re over 50 years old and haven’t had a period in more than 1 year, or if you’re under 50 years old and haven’t had a period in more than 2 years. But you may not be able to tell if you’ve reached menopause if you’re still on birth control.

Hormonal birth control may hide some of the symptoms of menopause, such as an abnormal period, hot flashes, or night sweats. If you take combination pills (pills that have estrogen and progestin), even after menopause, you may continue to bleed similarly to how you would on your period. This can make it hard to tell if you’ve gone through menopause and whether you’re still able to get pregnant.

In most cases, you should stop the combined pill when you’re at the age of 50. Women in this age group may have other health issues that could make it dangerous to use. Talk to your doctor to see if it’s safe for you to use it if you’re 50 or older.

If you don’t want to be on the combined pill anymore but still want protection against pregnancy, you can use a progestogen-only pill or other forms of birth control, like condoms. If you’re over the age of 55, you can probably stop hormonal methods since your chances of pregnancy are very low. But to be safe, don’t stop any type of birth control until you haven’t had a period for a full year.