How do I know if I am in menopause if I am still on the pill?

oa5599kowalskiJanuary 27, 2008

I am 45 years old and take the birth control pill Demulen (Zovia). I have been on it for ten years. How do I know if I am in menopause and do I still need to take the pill to avoid pregnancy?

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stonyriver

Go to google.com and type in menopause birth control pill.

I found a bunch of hopeful-looking websites when I did that. I'm sorry I don't have any first-hand experience to pass on. Thanks for a good question.

    Bookmark   January 30, 2008 at 9:19AM
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stonyriver

Birth control pills may help mask menopause symptoms

By TOM VALEO
Published March 28, 2006

All women can expect to enter menopause sooner or later, but women taking birth control pills may not notice, at least for a while.

In the meantime, they can expect several benefits from the pill beside avoiding an unwanted pregnancy: They will avoid some of the most conspicuous signs of menopause, such as hot flashes, night sweats and irritability.

"A woman on the birth control pill is getting hormones at a level above what her ovaries would produce,'' said Dr. Catherine Lynch, director of General Obstetrics and Gynecology at the University of South Florida College of Medicine in Tampa.

"When a woman goes into menopause, the ovaries basically shut down and no longer produce estrogen or progesterone in any significant amounts, so a woman taking the birth control pill in the standard fashion of three weeks on active pills, followed by one week of inactive pills, often won't have any symptoms of menopause until that pill-free week. She may not even realize she's in menopause because she's getting adequate estrogen and still cycling.''

During the week when she is not taking active birth control pills, the woman may even have a "withdrawal bleed" caused by the sudden drop in estrogen. A withdrawal bleed is easily mistaken for a normal period. And if the woman is taking continuous-use birth control pills, she will take inactive pills only one week out of every 12 instead of every four, so she will have a withdrawal bleed no more than once every four months.

"So a woman who's, say, 51 and taking Seasonale one of the continuous-use birth control pills isn't going to have hot flashes or night sweats for 12 weeks, because she's having estrogen provided for her by the pills,'' Dr. Lynch said.

"She may experience symptoms during the week she takes inactive pills, but just as symptoms start to climb, she starts taking active pills again, and she won't appreciate that these are symptoms of menopause.''

But that's not all. Taking birth control pills also seems to reduce bone loss. In fact, if the woman is also doing weight-bearing exercises and getting plenty of calcium, low-dose birth control pills may even help build bone density.

Women on the pill also experience less iron deficiency anemia, and some studies suggest that the pill protects against benign breast disease, endometrial cancer and epithelial ovarian cancer.

The Cancer and Steroid Hormone Study, the largest to investigate this last issue, found a 40 percent decrease on average of ovarian cancer in women who had taken oral contraceptives. The risk decreased as the amount of time on the pill increased, so women who had taken the pill for seven years or longer experienced a reduction in the risk of ovarian cancer of 60 to 80 percent. Some

Women on the pill also experience less iron deficiency anemia, and some studies suggest that the pill protects against benign breast disease, endometrial cancer and epithelial ovarian cancer.

studies suggest that oral contraceptives might even protect against colorectal cancer, uterine fibroid tumors, Alzheimer's disease and rheumatoid arthritis.

Taking the pill has always meant an increase in the risk of blood clots, which can cause a stroke. But a woman who does not smoke, does not have high blood pressure, and takes a low-dose oral contraceptive can almost eliminate that additional risk.

So why not just stay on the pill and enjoy all the benefits of hormone-replacement therapy, known as HRT?

Because even low-dose birth-control pills deliver five to seven times as much estrogen as HRT.

HRT simply gives the body back what the ovaries were producing before they were shut down by menopause. The birth control pill delivers a dose of hormones large enough to shut down the ovaries, and it's pointless for a woman to keep taking hormones after menopause has begun and she has stopped ovulating. She would be better off with hormone-replacement therapy, which would provide her with the same benefits but a lower dose of hormone.

"The trick is figuring out when she is in menopause,'' Dr. Lynch said. "There are a couple of ways to test this, but they're not 100 percent reliable. She can go off the pill and see if she's still cycling, but if she's sexually active, there's an outside chance she could get pregnant.

"While it's rare for pregnancy to occur at the age of 50 or 51, it can happen if you're still ovulating.''

Tom Valeo is a freelance writer specializing in medical and health issues. Contact him c/o Seniority, St. Petersburg Times, P.O. Box 1121, St. Petersburg, FL 33731, or e-mail features at sptimes dot com.

[Last modified March 28, 2006, 08:52:07]

Here is a link that might be useful: from a Florida online newspaper

    Bookmark   January 30, 2008 at 9:24AM
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cindy57

Wow where were you Stoneyriver back in July when I needed you most. I was 50 when I went off the pill after being on it for 30 years. I still had a period once a month and had no perimenopause symptoms. I wrote in back in Aug "going off the pill at 50" looking for answers. Only one or two people wrote back. It seemed like most other women just didn't stay on the pill for that long.

In December of 06 I went to my Internest for occasional bleeding during intercourse (she had been prescribing the pill to me for over 10 years) and advised doing an ultrasound that came back abnormal, she then advised i see a specialist. The gyn's tests (ultrasound and biopsy came back normal). The long and short of it was that the 2nd doctor told me my bloodpressure was high and I had to stop taking the pill asap. I had never really thought about the day when I would stop taking the pill (my internest kept saying oh you will know when it's time you won't have a period anymore). From what I have found out about the pill that is incorrect. Anyway this immediately threw me into hot flashes, night sweats and vaginal dryness like you wouldn't believe. It took 6 months after going off the pill to finally have a normal period in Jan 08. After seeing yet another gyn to finally find out I have Vaginal atrophy and that was the cause of my problem back in 06 (I was having a perimenopusal symptom on the pill and didn't know it) I'm now taking vagifem, replens, herbal remedy called "hot flash" and "natural progesterone cream" to control the perimenopause symptoms.

I know all the benifits of being on the pill but if I knew at 45 what I know now at 50, I would have gone off the pill sooner than later. I would have let my body go into the perimenopausal experiense normally rather than be thrown in by going off the pill cold turkey.

Hope my experience can help the original poster, the down side to going off the pill is birth control. We tried several things mostly barrier methods but with my vaginal dryness I just gave up using contraceptives the begining of Jan 08 and am hoping that I'm not ovulating anymore.

Cindy57

    Bookmark   February 3, 2008 at 3:25PM
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stonyriver

Hi Cindy -- I wasn't on this forum then -- wasn't facing a hysterectomy (scheduled for tomorrow morning at 7:30). It's too bad, but quite understandable, that forums such as these don't have many long-term members who stick around to help with repeat questions. Much gratitude to Mrs. H, who takes the time to return and reach out to women (me, for instance) who are floundering! :) I've found search engines such as google are really helpful, so keep typing in different combinations of clues and see what you can find. The hystersisters website has been a helpful read, as are some pages on webmd.

Best of luck!

    Bookmark   February 3, 2008 at 10:37PM
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cathy6756

I had been on the pill for the last 6 years-or-so to prevent ovarian cysts. When I turned 51 my Gyno had me come in for a blood test on the Monday after I was to start a new pack of Birth Control Pills, which was 8 days of being off of them. (I began that cycle of pills after I had the test run.) A few weeks later I got the results of the test, which showed that I am postmenopausal, so I got off the Pill. That was 10 days ago.

    Bookmark   April 9, 2008 at 8:17PM
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cindy57

What kinda of test was it? and what was your score Cathy6756? Mine was 46 and my gyn told me I was memopausal, but I am confused about the rating system. So many woman here have written with much higher scores.

Cindy57

    Bookmark   April 27, 2008 at 12:28PM
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coffeehaus

The test is probably FSH levels (follicle stimulating hormone). The higher the number, the more likely you are in menopause. I think it's customary to do 2 FSH tests a couple of weeks apart to confirm that you have entered menopause, and to ensure that you no longer need contraception. You have to be off The Pill for a while before the blood test is done. You should ask your GYN about it. Remember, just because you might be menopausal, doesn't mean that you no longer need regular GYN check-ups.

    Bookmark   April 27, 2008 at 9:49PM
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