Birth Control Pills vs. Postmenopausal Hormone Therapy To Treat Perimenopause ... Which is Better?

Birth Control Pills vs. Postmenopausal Hormone Therapy To Treat Perimepoause... Which is Better? // I am often asked what is the best way to treat perimenopause. Many women are given the option of birth control pills, but wonder about the side effects or wonder if postmenopausal hormone therapy is better in perimenopause. Here I explain the pros and cons of both and what I tend to recommend for women with symptoms in perimenopause looking for treatment.

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[heatherhirschMD]

Did this explanation help? And what ultimately helped you treat perimenopause?

[scc]

Im 47 and started the pill and it really mad me cranky and emotional. I had to talk my dr into prescribing HRT and i finally started it today.

[audracapriola]

Thank you Dr! I am in Illinois and have one of those clinicians :(I have shared with her your information and other knowledgeable doctors that I have been learning from- confirming that HRT is acceptable in perimenopause. She has agreed to discuss it with others in her practice. Again, thank you so very much for this information! I do not readily take medication, but I’m ready to help my body “even out” and get back to feeling “normal “ again😁 I do not believe that women should have to suffer as so many of us to do from these symptoms.

[brookebenton]

I'm in perimenopause at 41 ugh. I have to take birth control pills because I have Endo and PCOS. It's the only thing that rescues me from my absolutely horrific periods😭 I tried compounded natural progesterone but it made me gain weight and ended up making my symptoms worse.

[cozinha]

Great information; thank you! I was prescribed ocp for perimenopausal symptoms. My body responded poorly and after 3 different pills and 8 mos i came off. The symptoms flooded back with a vengeance. I began hrt soon after and my body adjusted beautifully to the estradiol patch and micronized progesterone. My period never returned. Is it possible that the pill is the culprit? I have menstrual cramps 2x/mo like i am about to ovulate and then cycle, but nothing. At 43 I don't believe i am in full menopause yet. Any thoughts?

[justjenene]

I'm in early perimenopause. After my fibroids were removed, I had normal regular periods. That was 11 years ago. At 45 and just recently, during one cycle it came 2 weeks early. Nevered had a period that early. Next cycle came normal. The last cycle didn't come at all. My first missed period ever and not preggers but i was under a lot of stress a week before my period was to start. I think that's what knocked off my normal cycle. I called my doctor. She prescribed me BC pills. I hate taking meds and have never taken bc pills in life. I didn't know they cause blood clots until watchingthis video. Doc tild me to only take it for 5 days. I won't be taking them. Hopefully my cycle goes back to normal this next time since I've been a little more calm.

I've always had anxiety and pvc but a few days ago I experiencing really bad anxiety with horrible heart flutters. Blood pressure was normal and so was my heart rate but those flutters were horrible. I'm 5 days from my next cycle. When I did the neck message dr harsh said, it actually worked and stopped the flutters! I was shocked and happy! Thanks for these videos and tips cause this is all new to me. My body is just going through life changes and I have to accept that and learn new ways to handle it.

[KDdevidasi]

Thank you for addressing this topic! A (young-ish) nurse practitioner prescribed bc pills... it really doesn't feel like the right choice. I've had to go through the biopsy, and ultrasound; now scheduled for an information appointment for a hysteroscopy... I will be advocating for personalized options!! Really grateful for the info!

[EphesianRose]

Among the minipills avail in the US: do you recommend Norethindrone 0.35mg or Drosperinone (Slynd) 4mg and why? Any and all insight re: these 2 progestins would be appreciated!

[stephnelsen]

I came off BC pills after 20 plus years, and I am 45. A month after stopping I had horrible pelvic floor problems and severe vaginal irritation. I went to 3 different gynecologists, and they told me it was NOT from coming off BC pills having those symptoms. I went to a hormone Doctor and was given vaginal estrogen, which helped with the burning within a week. 6 months later, I am still doing pelvic physical therapy and have some discomfort down below. I wonder if I need any other forms of hormone therapy? This has been a awful experience and had to leave my job sadly.

[sincerethoughts]

Thank you, Dr. Hirsch! What about for women in perimenopause who’ve had total hysterectomies (both ovaries still intact) and who also have endometriosis? Is the recommendation still HRT over BCP? Can HRT help quell endo side effects too? Thanks again! Your videos are super helpful!

[LT-ppje]

I’m turning 50 soon. In perimenopause. With regular cycles. Suffering nainiy from insomnia and anxiety. Been to 3 doctors. I get sane story-go on birth control pills or nuvaring because hrt dosages are too low for someone my age 😡 I don’t want to take birth control pills due to fear of clots/stroke. I had mini stroke during pregnancy and I’m still scared to this day. Not fan of progestins either. What I want is bioidentical estrogen patch or gel with oral promethium. I asked couldn’t you double the dose? To which answer is no. I’m so confused why not? Two drs were on nams site!!

Dr hirsch cost $850 a visit. That’s just too expensive considering you’ll have to have follow up visits.

Functional medicine drs are also expensive and require all these labs. Plus I assume they give you compounded hormones. There’s no regulation around compounded hormones.

So Im still lost and confused. Seeing 4th dr soon.

[mariedawn-]

Thank you for this super informative and helpful video 🎉

[wilderbydesign]

One confusion I have is where you say you may just prescribe one hormone -- estrogen, for example -- and most everything out there says that if you still have a uterus, you should always take both estrogen and progesterone (to protect your uterus lining)...?

[lifequestbeauty]

My insurance does not cover any HRT. They only provide BC pills and antidepressants as a standard. I'm sure I'm not alone

[teklapeterson]

I am more confused now! So I thought birth control pills were lower doses of estrogen than currently on 30mcg of estrogen (estrodiol) using my birth control pill, that seems pretty low to me when I compare to HRT stuff I read about online. Or do I have it backwards? thank you so much!

[littleminna]

Just accidentally discovered this video. I was wondering though, I was told there are different kinds of bc pills. I've been on one kind for years but started having a lot of issues, like waking up at night, anxiety attacks, pain in my legs, emotional. The doctor switched me to a different bc pill because she said the hormone composition is different and more suitable for my age (48) and that many women having perimenopausal symptoms thought this pill worked much better, when it came to symptoms. Also a difference she said is that most pills have a 7 day when you're off the pill period. With this one it's just 4 days your off the pill (they places placebo pills in there so you won't forget to take it). She said that might also help since it's less days of not taking hormones.

[annelovesadoption]

My ovaries were removed when I was 15. On birth control for 19 years then off for 3 and back on to help post menopause symptoms. Need to lose 20 pounds. Help! Is the pill the right way to go?

[lorrainecaruso]

I thought the updated term is menopausal hormone therapy vs hrt. Do you address terminology in another place?

[MartyTidwell-vo]

We need your telemedicine in TEXAS!!! Please!

[tresjolieme]

Thank you I have two options the Yasmin 28 or the Estrodial patch .05 with 200mg prometrium in a cyclic dose. Having hair loss too, so which should I go for when it comes to perimenopause?