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Menopause

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Original poster

The Pill and peri

32 replies

SheilaFentiman · 24/02/2023 16:00

I'm mid-40s and still on the combined pill. I don't want to come off, because it's helpful to know when my periods are etc, and it suits me really well as contraception. But does this mean I won't know when I am in peri menopause?

OP posts:
Lottapianos · 24/02/2023 16:04

I have exactly the same issue. I need to stay on it for contraception and it's also convenient. Over the last few months, my bleeds have changed, become a bit lighter and shorter, and I've had some sweaty nights in my pill free breaks. But that last month, none of that happened so who knows?!

Haven't yet found an answer to how to work out the onset of peri when you're on the Pill, so watching with interest!

alltalknobaby · 24/02/2023 16:06

Also watching with interest as I’m in the exact same situation.

rcat74 · 24/02/2023 16:08

I knew because of the symptoms I was having. You can use the menopause questionnaire to check if you are having symptoms.

knittingaddict · 24/02/2023 16:12

I was on cerazette and didn't bleed at all while on that pill. My GP surgery did a blood test at some point (I think I was around 50) and after the results said to come off the pill in a years time. I did, never had another period and was obviously post menopausal.

I'm sorry, I can't remember what levels the blood test showed. It wasa few years ago now.

knittingaddict · 24/02/2023 16:14

I have to say that coming off the pill was a bit of a revelation. It had severely impacted my libido and I wasn't really aware of it. I'm a bit sad that I was on it for so long.

Lottapianos · 24/02/2023 16:17

'I knew because of the symptoms I was having. You can use the menopause questionnaire to check if you are having symptoms.'

I know what peri symptoms are, but surely taking a daily dose of hormones will mask or somehow affect those symptoms?

Original poster
SheilaFentiman · 24/02/2023 17:06

I did the balance questionnaire in august and again today. Psychological symptoms got worse, physical are minimal.

OP posts:
rcat74 · 24/02/2023 17:43

It didn’t mask it with me and a close relative was the same. My GP told me that I was getting a higher level of oestrogen from the pill than I would get with HRT anyway. My specialist GP said although that is true HRT is different for some reason and has a different effect. I was having awful symptoms.

Melroses · 24/02/2023 17:56

I had to come off it at 49. I had been having shorter lighter bleeds for a couple of years, drier skin (but no spots - it is the best my skin has ever been!) and a tendency to oestrogen withdrawal headaches towards the end of the week off. I also had night sweats for some years that worsened.

I went on a pop but never got on with it and then hrt. Combined pill definitely killed my libido and tablet hrt to a lesser extent.

No idea when I reached The Menopause 🤷‍♀️

Melroses · 24/02/2023 18:02

There are a couple of COC that use the same sort of oestrogen as hrt. Zoelly & Qlara. I am not up to date on the current thinking on them though.

Original poster
SheilaFentiman · 24/02/2023 18:37

Thank you PPs 🙂

OP posts:
Lottapianos · 24/02/2023 22:11

'tendency to oestrogen withdrawal headaches towards the end of the week off'

I've started having bad headaches during my week off for past few months. Didn't know that oestrogen withdrawal headaches were a thing. Interesting, thanks 👍

Prometheus · 24/02/2023 22:30

Watching with interest as I’m in the same boat. Been on the pill for almost 30 years.

Xrays · 24/02/2023 22:35

The amount of oestrogen in the combined pill is tiny - if you go into menopause whilst taking it the oestrogen won’t be enough to replace the drop so you’ll have symptoms (unless you’re one of the lucky women who don’t ever have any). (For comparison the amount of oestrogen in HRT is about 3 or 4 times the amount compared to what’s in the combined pill).

Original poster
SheilaFentiman · 24/02/2023 22:41

thank you @Xrays

OP posts:
knittingaddict · 25/02/2023 03:45

Lottapianos · 24/02/2023 16:17

'I knew because of the symptoms I was having. You can use the menopause questionnaire to check if you are having symptoms.'

I know what peri symptoms are, but surely taking a daily dose of hormones will mask or somehow affect those symptoms?

The symptoms I had definitely weren't masked by being on the pill. Anxiety, hot flushes were all present and correct. I was lucky that those were my only symptoms really, although the anxiety is crippling. No night sweats.

nomorechoco · 25/02/2023 04:36

I was on Ovranette (or Cerazette?) - can't remember now but the one that they recommend when you are older. I came off it last year as 51 to see if I was still getting periods. Hormones fell off a cliff, terrible muscle aches, teary, anxious, racing heart, insomnia. Everything but hot flashes basically.

HRT has helped massively plus a general health overhaul but I had no symptoms until I stopped the pill and then had an avalanche. I've not had a period in 10 months so the pill must have masked peri for me.

Xrays · 25/02/2023 08:22

nomorechoco · 25/02/2023 04:36

I was on Ovranette (or Cerazette?) - can't remember now but the one that they recommend when you are older. I came off it last year as 51 to see if I was still getting periods. Hormones fell off a cliff, terrible muscle aches, teary, anxious, racing heart, insomnia. Everything but hot flashes basically.

HRT has helped massively plus a general health overhaul but I had no symptoms until I stopped the pill and then had an avalanche. I've not had a period in 10 months so the pill must have masked peri for me.

It would have been Ovranette (for anyone reading the thread) as that’s a combined pill - Cerazette is a pop, progesterone only pill (I take this as part of my HRT, I take this for progesterone, utrogestan for additional progesterone and oestrogel).

Some women are fairly sensitive to oestrogen, even in lower doses and it seems perhaps this was enough to mask your symptoms. (There is 30 micrograms of oestrogen in it. The same as Yasmin pill for example; which is a fairly commonly prescribed one).

Lottapianos · 25/02/2023 09:08

'The amount of oestrogen in the combined pill is tiny - if you go into menopause whilst taking it the oestrogen won’t be enough to replace the drop so you’ll have symptoms'

Useful info, thanks

Xrays · 25/02/2023 09:24

Not sure if this is helpful to anyone but a quick google shows Oestrogel (HRT form of oestrogen) contains 750 micrograms of oestrogen per pump, most women use 2-4 pumps every day. Most combined pills have approx 30 micrograms of oestrogen per pill. Huge difference.

Original poster
SheilaFentiman · 25/02/2023 16:11

gosh, that’s huge!

OP posts:
Melroses · 25/02/2023 21:44

Yes that is a huge difference.

In retrospect I was wondering if I was short of oestrogen all my 40s with the night sweats. I have never had a problem with that since I came off the pill.

The worst bit of coming off the pill was my periods came back after about 5 months but I wasn't ovulating (I did the old fashioned temperature thing) so they were variously heavy and random, and I would wake up out of the blue with joint pains and be hobbling to the loo.

I would also recommend an overhaul of diet and exercise alongside hrt (or on its own if you are not taking hrt) . I found I was short of vitamin D due to a test for arthritis so take that in the winter along with magnesium and K2. I also do yoga and pilates to keep supple.

HeartshapedFox · 25/02/2023 21:53

Reading with interest as I’m currently on ovranette and went to my gp before Xmas with peri symptoms. She told me I may as well stay on the pill as it had just as much oestrogen in it as HRT! So now I’m feeling very fobbed off 😠

helleborus · 25/02/2023 22:03

My understanding is that the types of estrogen in the combined pill and HRT are very different and their weights are not comparable. The type in the combined pill is more potent and makes the combined pill stronger which is why they normally stop prescribing it when you hit 50.

Melroses · 25/02/2023 22:04

The oestrogens are of a different sort. The estradiol in hrt is similar to our own, but the ones in the pill like ethinylestradiol are less like our own and are made to have a strong effect on the feedback system that stops ovulation.

I don't know if the actual amounts are directly comparable, but they do work slightly differently.

An alternative I was offered was mirena with oestrogen patches or gel as this gives you contraception and also you can use the right patch or amount of gel to help with symptoms. I didn't take this up because I never liked the idea of a IUD/IUCD.