Disclaimer: Not everyone who goes through menopause identifies as a woman and not all people who identify as women go through menopause. At Jayla, our core audience is people who identify as women, so we primarily use the word “women.” However, we’re working on specific content for people going through menopause who might not identify women. Inclusivity is a key value of ours, so bear with us!
If you’re in your late 30s or 40s and still taking hormonal birth control, it’s normal to wonder: Would I even know if I was in perimenopause?
That little daily pill (or IUD, or patch, or shot) that’s been regulating your cycle and easing cramps for years might also be hiding something bigger: the slow hormonal shift that signals the beginning of the end of your reproductive years.
So does hormonal birth control delay perimenopause? Or does it just keep the symptoms out of sight?
The answer isn’t straightforward, and understanding it can help you feel more in tune with your body during this transition.
Talk to the younger women in your life. Your daughters, nieces, goddaughters. You might end up closer, and they’ll be more prepared.
What Is Perimenopause, Exactly?
Perimenopause is the natural transition leading up to menopause, marked by shifting hormone levels as your ovaries gradually produce less estrogen and progesterone. (1) It’s a slow wind-down of the reproductive system, not an overnight change, and it usually unfolds over several years.
This phase can bring an unpredictable mix of symptoms: irregular periods, hot flashes, night sweats, mood swings, brain fog, fatigue, poor sleep, and changes in libido. Some people breeze through it. For many, however, it can feel like an uninvited guest who shows up early, stays too long, and insists on rearranging your furniture.
There isn’t one specific test or specific age cutoff that neatly marks the start of perimenopause. That ambiguity can make it harder to connect your symptoms to perimenopause. Hormone test kits and expert guidance from providers like Jayla can help you understand what’s happening inside your body and support you through the transition with more clarity and confidence.
Can Birth Control Delay Perimenopause or Just Disguise It?
Hormonal contraception works by using hormones to stop ovulation, thin the uterine lining, or thicken cervical mucus. (2) The impact varies depending on the method you use, whether it’s a daily pill, an IUD, or an injection. That directly affects how perimenopause shows up, or doesn’t.
Hormonal Contraception Mechanisms at a Glance
Mechanism
How It Works
Applications
Stopping Ovulation
Prevents the release of an egg
Combined pills, implants, injections, ring, patch
Thinning Uterine Lining
Makes the uterine lining too thin for implantation
Hormonal IUDs, progestin-only pills, combined pills
Thickening Cervical Mucus
Creates a sperm barrier
Progestin-only pills, hormonal IUDs, implants, injections
Hormonal birth control uses synthetic estrogen and progestin, hormones closely linked to those that regulate the natural reproductive cycle. Since perimenopause involves changes in these same hormones, it’s normal for birth control to affect how perimenopause symptoms show up, sometimes masking or altering them. (3)
The important thing to know is this: birth control does not delay menopause itself. Menopause still happens, typically around age 51.
But what birth control can do is mask the symptoms of perimenopause, making them harder to notice. It can:
- Keep your periods artificially regular or stop them entirely, so you might miss the tell-tale early sign of perimenopause: irregular cycles.
- Prevent the usual hormonal fluctuations from being felt as intensely, so mood swings, hot flashes, and other symptoms can fly under your radar.
- Interfere with hormone testing, making it harder for doctors to accurately track where you are in the perimenopause journey.
You might be in the thick of perimenopause and not even realize it. Some would call that lucky (and believe us, we get it), but actually knowing where your body stands can be empowering and a whole lot more useful when you’re trying to figure out what’s really going on with your symptoms.
How Different Methods of Birth Control Interact With Perimenopause
The way hormonal contraception affects your experience of perimenopause depends on which method you’re using. Here’s how they tend to show up in real life:
Combined Oral Contraceptives (COCs)
These pills contain both estrogen and progestin. They suppress ovulation and create predictable withdrawal bleeding, which can make your cycle seem regular. They often reduce hot flashes, cramps, and mood swings, making perimenopause symptoms nearly invisible. However, as you move through perimenopause, you may start to experience lighter or skipped withdrawal bleeds even while taking the pill. These are a normal reflection of shifting hormone levels.(4)
Progestin-Only Pills
These don’t always stop ovulation, but can disrupt your cycle. That might mean irregular bleeding, spotting, or no period at all. It becomes harder to tell if changes are due to the pill or perimenopause. (5)
Hormonal IUDs
These don’t always stop ovulation, but do thin the uterine lining. Many women stop having periods, which is convenient but can hide signs of the transition. (6)
Implants and Injections (like Depo-Provera)
These methods often shut down ovulation and stop periods completely. That can mimic a menopause-like state even if you’re still years away from it. (7)
Vaginal Ring or Patch
These deliver hormones similar to combination pills and often suppress perimenopausal symptoms in the same way. (8)
No matter the method, hormonal birth control tends to keep symptoms in check, but that control can also make it tricky to tell what’s really happening as your hormones shift. You might be dealing with things like insomnia or low libido and not even realize it’s perimenopause quietly sneaking under the radar because the more obvious signs are being masked.
When and How to Stop Birth Control to See What’s Really Going On
So, how do you know you’ve reached menopause if your birth control is doing such a good job at covering the signs?
Often, you don’t know until you stop using it.
Health guidelines often recommend stopping hormonal birth control around age 50 to 55. (9) This is because natural menopause usually occurs by then, making pregnancy unlikely and reducing the need for added hormones that could increase health risks.
Before that point, however, pregnancy is still possible. Ovulation can happen sporadically during perimenopause, so if you’re not trying to conceive, it’s important to continue using contraception. Fun fact: for the first time, more women over 40 are having babies than teenagers in many countries, including the U.S. and the U.K. While advances in fertility science are part of the story, some of these pregnancies are unplanned.
Once you’re off hormonal contraception, your natural hormone rhythms can return. That’s when you may notice:
- No return of your period, which could mean menopause
- An onset of symptoms like hot flashes or mood swings
- A shift in how your body feels day to day
Coming off birth control doesn’t have to be abrupt or confusing. The best approach is to work with a provider who can guide you through the transition, monitor symptoms, and support you in adjusting your plan as needed. Sometimes, switching to a lower-dose option or moving toward non-contraceptive hormone support makes the most sense. (10)
The Bottom Line About Birth Control and Perimenopause
Hormonal birth control has empowered so many women to take charge of their reproductive health (though, let’s be real, the burden, and all those charming symptoms, still fall mostly on women’s shoulders). As you enter midlife, it’s worth checking in with yourself about how it’s serving you now.
If you’re over 40 and wondering whether you might be in perimenopause, even if your periods seem regular or have disappeared thanks to contraception, it’s a valid and important question. You might feel nervous or in denial about finding out. It’s only natural, in a society that so often (still) places women’s worth on their fertility.
But here’s the reality: birth control doesn’t freeze time. It just changes how the passage of time shows up in your body. Being informed, aware, and proactive about this transition is almost always more empowering than pretending it’s not happening.
And we’re here to help!
At Jayla Health, we’re here to support you through this transition. Whether you’re considering stopping birth control, looking for clarity about your symptoms, or exploring hormone-aware care, you don’t have to figure it out alone.
References
1. Office on Women’s Health, 2021. Perimenopause. U.S. Department of Health & Human Services. Available at: https://www.womenshealth.gov/menstrual-cycle/perimenopause
2. Rivera, R., Yacobson, I. and Grimes, D., 1999. The mechanism of action of hormonal contraceptives and intrauterine contraceptive devices. American Journal of Obstetrics and Gynecology, 181(5 pt 1), pp.1263–1269.
3. North American Menopause Society (NAMS), 2021. The 2022 Hormone Therapy Position Statement of The North American Menopause Society. Menopause, 29(7), pp.767–794. Available at: https://www.menopause.org/docs/default-source/professional/nams-2022-hormone-therapy-position-statement.pdf
4. Faculty of Sexual and Reproductive Healthcare, 2019. Clinical Guidance: Combined Hormonal Contraception. Available at: https://www.fsrh.org/standards-and-guidance/documents/combined-hormonal-contraception/
5. Royal College of Obstetricians and Gynaecologists, 2020. Progestogen-Only Pills: Information for Women. Available at: https://www.rcog.org.uk/en/patients/patient-leaflets/progestogen-only-pills-information-for-women/
6. American College of Obstetricians and Gynecologists, 2021. Long-Acting Reversible Contraception: Intrauterine Devices and Implants. Available at: https://www.acog.org/womens-health/faqs/long-acting-reversible-contraception-iuds-and-implants
7. Mayo Clinic, 2022. Depo-Provera Injection: What You Should Know. Available at: https://www.mayoclinic.org/tests-procedures/depo-provera/about/pac-20384610
8. NHS, 2023. Hormonal Contraception: Pill, Patch, Ring. Available at: https://www.nhs.uk/conditions/contraception/hormonal-contraception/
9. Centers for Disease Control and Prevention (CDC), 2024. U.S. Selected Practice Recommendations for Contraceptive Use, 2024. Available at: https://www.cdc.gov/mmwr/volumes/73/rr/rr7303a1.htm
10. American College of Obstetricians and Gynecologists (ACOG), 2021. Management of Menopause: Hormone Therapy and Alternatives. Available at: https://www.acog.org/womens-health/faqs/menopause-hormone-therapy-and-alternatives
