Contraception in the menopause – when is it safe to stop using contraception & other questions

Read the full video transcript below

Today's topic

Hello, and welcome to my weekly video blog. And today, on A.Vogel Talks Menopause, I'm going to be discussing "When is it safe to stop using contraceptives in the menopause. Now, I get asked this a lot, and sometimes, it can be very confusing. It can also be very difficult to know exactly when the right time is. So I thought I would go through some of the questions on this particular topic that I get asked.

Can you get pregnant during menopause?

The first one is "Can I get pregnant in the menopause?" Yes, you can. It's amazing. Here in the UK, the number of pregnancies in women over 40 have quadrupled since the 1980s, and a lot of women think that just because they've started to miss a few periods here and there that they can no longer get pregnant. 

And they do say that there is a rise in the number of menopause babies going on all the time, so you can very easily get pregnant in the menopause. And also, symptoms of the menopause like nausea, breast tenderness, and bloating can also be the same symptoms of pregnancy and sometimes, it's not easy to tell which is what.

When do I know it's time to stop using contraception?

When do you know it's time to stop using contraceptives? Again, this is another really difficult question. If you have been using a type of contraceptive that hasn't affected your periods at all, then as soon as you have got to the two-year mark without any periods at all, then you're considered to be safe from pregnancy. 

Now, I know there are some schools of thought that say you're safe from pregnancy after one year without a period, but in our experience, especially over the last few years, quite a large number of women will go for a year or even a year and a bit without periods, and then they will suddenly get one back or they will start for a few months again. 

So just to err on the side of caution, it's better to wait until the two years is up before you can stop your contraceptives.

How do I know I've reached menopause if I'm on the pill?

Now, I also get asked, "How on earth would I know if I've reached the menopause if I'm on the pill?" Now, here, we're mainly talking about the progesterone-only pill or the POP for short. 

This is the pill with just progesterone in it, and very often, this will stop your periods completely. So it's very difficult to tell if you are in the menopause or if it's just the pill that's causing you to not have any periods. In this case, all you can do is maybe go to your doctor and see if they will do a hormone test for you. 

But they're not particularly accurate because your own natural hormones can fluctuate every day. So very often, you will get a test coming back saying you're not in the menopause, when, in fact, you really are starting the menopause. So again, in this situation, all you can really go by are symptoms of the menopause. 

So if you are starting to get the common ones such as hot flushes, night sweats, anxiety, low mood, maybe palpitations, joint aches, vaginal dryness, you would need to keep a diary, and just check if you have been getting these symptoms for roughly two years. Then again, and also if you're in maybe your late 40s or early 50s, that may then be an indication that you're coming towards the end of the menopause.

Are birth control pills the same as hormone replacement therapy? 

I also get asked, "Are birth control pills the same as HRT?" They're doing different things. Your birth control pills are altering your levels of hormones to stop you getting pregnant, and HRT is just raising your hormones to the point where your body thinks there's plenty, and you're not getting menopause symptoms anymore. 

But they are both artificially changing the levels of your hormones, and so, as I've mentioned before, using either a contraceptive or HRT, especially if you've started HRT before your periods stopped, then it can be quite difficult to know when you've actually reached that two-year mark.

Do birth control pills delay menopause?

And the last question I often get asked is "Do birth control pills delay the menopause?"  Again, this can be quite a difficult one to answer. The pill, like HRT, is keeping your hormones artificially high. Your own natural hormone levels will fall. You can't stop the menopause. It's just one of these facts. You can't stop you going through the menopause, but you can put it on hold through contraceptives and HRT. 

The problem is not so much when you're taking them, but when you come off them because if your own natural hormone levels are quite low, you may end up having a hormonal fall of some kind or another, which could trigger menopause symptoms such as hot flushes, night sweats, and anxiety. 

But this doesn't happen with everybody. You know, a number of women have contacted me and said that they have gone through the menopause on the pill, come out the other end, and they've been absolutely fine. So unfortunately, again, this is one of these situations where you won't really know what's happened until you've gone through it and you're out the other side. 

So I hope this has given you a little bit of insight. It is a very confusing one, and unfortunately, there is not just one answer for all these particular questions. But if you have any other questions on contraceptives during the menopause, or if you found a great way to tell that you were through the menopause when you were on the pill or HRT, then please do let us know and share with us. 

And until then, I'll see you next week for another edition of A.Vogel Talks Menopause.