Ten reasons why menopause hormone therapy is preferred over birth control pills in perimenopausal women.
As women transition into perimenopause, they often face the challenge of managing a variety of symptoms related to fluctuating hormone levels. Two common hormonal treatments available to them are menopause hormone therapy (MHT) and oral contraceptives (birth control pills). While both options involve the administration of hormones, they serve different purposes and are tailored to the distinct needs of women at different life stages. MHT is specifically designed to alleviate menopausal symptoms, such as hot flashes, night sweats, vaginal dryness, and to support bone health by supplementing or replacing the declining levels of estrogen and progesterone in perimenopausal and postmenopausal women. On the other hand, oral contraceptives are primarily used to prevent pregnancy, utilizing higher doses of synthetic estrogen and progestin (a synthetic form of progesterone) to suppress ovulation and alter the uterine lining. Although birth control pills can also help regulate menstrual cycles and manage symptoms like acne or heavy bleeding, they are not specifically designed to address the unique hormonal needs and symptoms experienced during perimenopause.
Given these differences, many perimenopausal women may find MHT to be a more suitable option. Below are ten reasons why MHT is often preferred over birth control pills during this transitional phase:
1. More Effective Relief of Menopausal Symptoms
MHT is specifically designed to target menopausal symptoms, particularly vasomotor symptoms like hot flashes and night sweats, which are common during perimenopause. Unlike birth control pills, which are not tailored to manage these symptoms, MHT provides hormone levels that better match the needs of perimenopausal and menopausal women, leading to more effective symptom relief [1].
2. Lower Hormone Doses
MHT typically involves lower doses of hormones compared to birth control pills. These lower doses are sufficient for managing menopausal symptoms without the higher hormone levels required for contraception, thus reducing the risk of side effects commonly associated with higher doses found in birth control pills [2].
3. Better Bone Health Protection
As women transition into menopause, bone loss accelerates, increasing the risk of osteoporosis and fractures. MHT has been shown to be more effective than birth control pills in maintaining bone density and reducing this risk, offering better protection for bone health during perimenopause [3].
4. Improved Cardiovascular Health
Starting MHT early in the menopausal transition can confer cardiovascular benefits, such as reducing the risk of heart disease. In contrast, birth control pills, particularly in women over 35, may increase cardiovascular risks like hypertension and thromboembolism. MHT offers a safer profile in this regard for perimenopausal women [4].
5. Lower Risk of Venous Thromboembolism
Transdermal forms of MHT (such as patches) are associated with a lower risk of venous thromboembolism (VTE) compared to oral contraceptives, which carry a higher risk of blood clots, especially in women over 40. This makes MHT a safer option for managing symptoms in perimenopausal women [5].
6. More Flexible Dosing Options
MHT offers a range of dosing options, allowing for more tailored treatment plans to suit individual symptoms and needs. In contrast, birth control pills have standardized doses that may not address the specific needs of perimenopausal women, making MHT a more adaptable and personalized option [6].
7. Better Management of Irregular Bleeding
MHT is often more effective at regulating the irregular bleeding that can occur during perimenopause. It directly targets the hormonal fluctuations causing the issue, whereas birth control pills may not always adequately address this problem [7].
8. Reduced Risk of Certain Cancers
MHT may reduce the risk of certain cancers, such as colorectal and endometrial cancers. While birth control pills are primarily known for reducing ovarian cancer risk, they do not provide the same level of protection against these other cancer types. [8]
9. Improved Sexual Function
MHT is often more effective at treating symptoms like vaginal dryness and sexual dysfunction, which are common in perimenopause and menopause. These symptoms are less likely to be effectively managed with birth control pills, making MHT a better option for improving sexual function. [1].
10. Easier Transition to Postmenopause
Starting MHT during perimenopause can make the transition to postmenopausal hormone therapy smoother. This approach avoids the need to switch medications or adjust to new regimens, which is often required when transitioning from birth control pills to MHT [10].
REFERENCES:
[1] Hormone therapy for sexual function in perimenopausal… https://pubmed.ncbi.nlm.nih.gov/37619252/
[2] “Low-dose” birth control pills for perimenopause symptoms — Gennev. https://www.gennev.com/learn/birth-control-pills-for-perimenopause
[3] At what age should you stop taking birth control pills? — Health Partners. https://www.healthpartners.com/blog/birth-control-and-menopause/
[4] A Review of Hormone and Non-Hormonal Therapy Options for the https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10226543/
[5] Risks, Benefits, and Treatment Modalities of Menopausal Hormone https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8034540/
[6] seeking optimal management of the perimenopause — PMC — NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4540404/
[7] Hormone Therapy in Menopause: Concepts, Controversies, and… https://pubmed.ncbi.nlm.nih.gov/33858012/
[8] Oral contraceptives and menopausal hormone therapy — PubMed. https://pubmed.ncbi.nlm.nih.gov/25534509/
[9] Menopausal Hormone Replacement Therapy and Reduction of All… https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9178928/
