Perimenopause  is the time when a women naturally starts having menopausal symptoms.  This natural change usually lasts about a year and is often referred to as the 'menopause transition'.  At  this time, fertility declines but a woman may still get pregnant, and effective birth control should be used if she does not want to have a mid-life baby.  Generally, after a year of no menses, a woman can be considered infertile and menopausal.

There are several appropriate birth control methods recommended for perimenopausal women:

• Hormonal oral contraceptives
• Non-oral hormonal contraceptives (ring, patch, injection)
• Intrauterine devices (IUD)
• Sterilization
• Barrier Methods (diaphragm, spermicide, sponge, condoms) though these require some discipline to be effective.

Natural family planning method (rhythm) is not recommended during perimenopause because women have irregular periods during this phase and it is hard to predict ovulation.  Emergency contraception is a back up option but it should not be considered as a regular birth control method.

Hormonal oral contraceptives have some benefits during this time including more regular cycles, less cramps and bleeding during periods, decreased risk of certain cancers and maintenance of bone strength.  It may also help with hot flashes and acne outbreaks that are common when hormones are fluctuating.   There are also some risks of oral contraceptives during perimenopause.  They include increased risk of blood clots (especially if a smoker or diabetic), some withdrawal bleeding, and delayed confirmation when menopause is reached.

To learn more about menopause, visit menopauseNU.org

Source:  North American Menopause Society