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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• Birth Control Pills vs...

[@heatherhirschMD]

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

[@dominikatanianis7132]

One more complexity with BCP is the issue of UTIs. I'm still trying to understand the connection but basically anytime I was off of BCP I got frequent UTIs. None when on it. Recently transitioned to local estrogen but it's not helping at all. Do some ppl need higher doses to manage? I'm so confused.

[@wilderbydesign]

I repeated the 10x stronger info (about birth control vs HRT) - my doctor told me I was wrong and read of the 20~ microgram dosage of a low dose birth control vs a 2 mg dosage of HRT … can you explain this? When you say 10x higher are you not talking about low-dose birth control? (Thank you!)

[@sophiechina73]

I'm 50 I was on 20/ 150 I had achy joints, tiredness etc my doctor moved me on to HRT lenzetto spray ( 2 sprays) and progesterone. I've been on it nearly 2 weeks and I feel worse in all areas. Was my pill stronger with estrogen than the hrt I'm now taking, I'm wondering if I should go back on the pill?

[@sophiechina73]

​@wilderbydesign it's so confusing isn't it, my doctor changed me from 20/150 low birth control pill to hrt with lenzetto spray I have 2 sprays but each spray is 1.53mg so I get just over 3mg I feel worse with symptoms of joint aches, tiredness etc, so would prefer to go back. Why put me on a less dose when she thought it was low estrogen hormones, makes no sense lol x

[@scc8728]

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.

[@marianneporter26]

I used bcp for peri menopause symptoms because I didn’t know about HRT. I lost my libido and eventually I had other symptoms that the bcp wasn’t working anymore. I researched BHRT and started on them 7 mos ago. I wish I had been told this may be an option much earlier as I am doing soooo much better now!

[@yensounta6501]

Any updates? On the same boat

[@jennifermoffitt4635]

@@marianneporter26 i've been on pill for anemia and now having side effects like you.. going to try HRT now - almost 50 -- have no clue if i'm menopausal but somewhere in that phase or peri stilll

[@mariedawn-]

I agree the bcp is not a good solution now I’m approaching 50, the side effects are just awful, taking it when I was younger was ok though for me (I think, from what I remember)

[@tesiemarie8942]

Are you on HRT pills?

[@audracapriola9243]

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.

[@dominikatanianis7132]

always wondered about this. great explanation

[@mariedawn-]

Thank you for this super informative and helpful video 🎉

[@mylissagraham4078]

So helpful!

[@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!

[@heatherhirschMD]

I totally agree, keep advocating!

[@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.

[@buildthebusinessyoulove]

After fibroids surgery i am also having issues with perimenopause. This started right after my surgery. even though they tell you that surgery doesn’t effect the hormone… it does

[@brookebenton8192]

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.

[@Carolinagirl1028]

I am 42 and also suffering from endometriosis. I am looking to get on birth control both to help with the endo, and hopefully with the perimenopause symptoms and because I am tired of using barrier method birth control. Which birth control do you take?

[@Taylor-ip4lf]

Hello there! Can you treat patients in South Carolina?

[@Corrans]

I guess one could try many brands with differing progestin components to see which one fits best?

[@lorrainecaruso9903]

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

[@sunny12341000]

Hello Doctor. Are you licensed in Washington DC?.

[@triviamolemais7253]

Question: I m 45 years. Parcial Hysterectomie due to endometriosis but choose keep my ovaries. Never wanted take birth control pill never all my life. So is more secure for someone that never take birth control to start HRT ?

[@sincerethoughts1912]

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!

[@kristinahamilton1505]

I have the same question ❤

[@livenlaugh3925]

Me too...hoping she will response

[@danahall1300]

I am 49 and I have been on Simpesse birth control for at least 8 years. I have been having heart palpitations, night sweats, severe back and joint pain, weight gain. My doctor just told me one month ago that I was too young for menopause. She is in her early 40s. I was planning to stay on BC until 55 because my doctor said that we will never know if I am menopausal unless I get off the pill.

[@user-gs2um2wm5x]

We need your telemedicine in TEXAS!!! Please!

[@heatherhirschMD]

Working so hard on this!

[@denise3432]

@@heatherhirschMDlet us here know if we can help!! Texas needs you!! 😢

[@chicken9369]

Mary Claire Haver is in TX. She’s someone else I’ve been following on KZbin for perimenopause info. But it seems you can see Dr. Hirsch virtually now!

[@emmacharlenedostal]

@@chicken9369she doesn’t offer telehealth gotta be in Houston

[@teklapeterson8126]

I am more confused now! So I thought birth control pills were lower doses of estrogen than HRT.....I'm 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!

[@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!

[@Carolinagirl1028]

I would love to know the same thing

[@AgnieRF]

I appear to be in early perimenopause at 51 and I was put on the pill 1.5 months ago. So far tolerating it rather well but my concern is the testosterone - can it be supplemented (as testosterone or maybe DHEA) if the pill decreases it significanlty? Another question: are estrogen levels in the body higher on the (low-dose) pill or on HRT (on average)? I am interested in having the highest safe levels of estrogen for overall benefits.

[@bpressy]

I didnt get properly diagnosed with endometriosis until about 29-30, but I was on birth control from 21-27, and birth control did a great job hiding most of my pain. However, when I got off bc to try getting pregnant that is when I all of my symptoms and then some came back. I had spotting for a week before every period, periods were very painful as I remembered (sitting in hot bath was the only solution), extreme cystic acne. I pushed to have more hormonal testing done to find our my amh level had dropped low and very fast, making me perimenopausal at the age of 33. When asking the doc what to do, i was prescribed bc. Which elevated all of these symptoms but eliminates my low odds of getting pregnant. I just missed my first period last month. So now i think im nearing pure menopause at 36. Life stinks lol. Do i stay on bc because of my age? Sharing my story because i was misdiagnosed for years.. many docs said periods are supposed to hurt. Bc worked well but didnt make me research further until it was too late!!

[@bpressy]

Eliminated all of my symptoms not elevated! Woops

[@cozinha8945]

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?

[@user-qw8no5bl5m]

I’m very curious too

[@cozinha8945]

@user-qw8no5bl5m eight months after stopping the contraceptive pill, my periods returned. The flow inconsistent but frequent, every 2 to 3 weeks.

[@mariedawn-]

It may be the oral estrogen that’s the problem

[@sarahkhalil6922]

Hi Doctor! You mentioned some patients can start with just an estrogen patch, is that ok to use without progesterone during peri? I have regular periods but low estrogen symptoms like night sweats. I know they always say you need progesterone to protect uterus, but if I’m still cycling I guess the lining is shedding so it should be ok to take “unopposed” supplemental estrogen?

[@athenachloewoodrow6356]

She answers your question in this video

[@Catherine-f8i]

Definitely take progesterone! You raise your risk of uterine cancer with just the estradiol alone. We are already higher risk for that in perimenopause anyway:(

[@Coley996]

Okay ladies, please share your thoughts with me because I feel so alone in this journey. I began the bc combination pill at the young age of 15. All my life I suffered from depression & anxiety as a result however I wasn’t aware that my bc was to blame. When I hit 35 I began noticing a lot of vaginal dryness & low libido. Now, I’d always had low libido on the pill but never experienced the vaginal dryness until I got older. It made sex painful & I have IC so I’m used to painful sex but this was a different pain right at the opening of my vagina. So dry that sex would cause microscopic tears at the entrance. Additionally, I began to notice my sleep was off. I couldn’t sleep for nothin! Then I began spotting a week before my period which was very uncommon for me on the pill. I google causes of this & of course first thing I read was lowering of hormone levels. The doc told me if I want my libido back & want to get rid of the painful sex, that I need to come off the pill. So I did. A little over 4 months & my period still hasn’t returned. Doc prescribed me a testosterone cream at an extremely low dose. It’s helped my libido tremendously. She also prescribed me the prometrium pill 100mg & it was the most amazing experience because it made me sleep like a baby!! So you can imagine how much of a devastation it was that I discounted it because my hair was shedding at an alarming rate. I’m still pissed about not being able to take that prometrium pill!! Has anyone else experienced hair fall with the prometrium pill? If so, did you adjust the dosage & did that work? I really want to be able to take it. I had never been so calm & relaxed in my entire life!! Of course I had to have an adverse reaction. It’s not even a known symptom of it either!!! As soon as I discontinued the prometrium my hair stopped shedding. I was on bc for so long that I still find myself contemplating going back on it but WHY!? It actually caused me so many issues that I never even realized. I have another question. Can a woman’s body produce more estrogen & progesterone than any synthetic birth control pill could ever provide? I’m still searching for answers. Still not sure I’ve done the right thing by coming off the pill & I truly believe that comes from a fear of being without it. Is it best for our bodies NOT to be on birth control IF you don’t have Endo or PCOS, or anything similar?

[@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)...?

[@annmarie3573]

I don't think she said she'd just prescribe estrogen. She said she could just prescribe progesterone. And she can adjust the levels of each hormone independently based on symptomology.

[@irislambert-ff9fu]

Can you please make a video about the new stury linking HRT to higher risk of dementia?

[@kathrynlouiseberman7919]

Can you provide the PMID for the study you're inquiring about?

[@jennieoh8543]

Check out Dr. Lisa Mosconi Neuroscientist from Italy. She is brilliant . She debunked that study . She is doing a study scanning brains of women in peri and menopause and without hormones the brain deteriorates. Check her out.@@kathrynlouiseberman7919

[@chicken9369]

Interesting, I actually saw some info from Andrew Huberman indicating the opposite - that loss of estrogen is linked to Alzheimer’s, but more research is needed. I’m thankful that Biden recently announced more funding for research in women’s health! 🎉

[@jennieoh8543]

It is!!!! Check out Dr. Lisa Mosconi. She is a neuroscientist from Italy and she is studying brains and estrogen loss. She actually uses a scan and follows women through pre peri and post menopause and the matter changes dramatically. She also has a book out. She started this because her Mother and Aunt got dementia and alzheimers. Her mission is to help woman know srategies to help them. Bidens health initiative has alot to do with menopause!!! Maria Shriver is replacing her missing hormones as well. @@chicken9369

[@mariedawn-]

I think you’ll find it’s the opposite way round

[@tresjolieme81]

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?

[@heatherhirschMD]

I find that postmenopausal doses work better.

[@tresjolieme81]

Yea Heather within 24 hours of wearing the patch my headaches stopped, brain fog went away, and I could thinking clearer. I def need this for life. Its been two weeks and he hair fall has decreased dramatically. I havent tried the Prometrium so I'm hoping it doesnt give me any adverse affects because I'm loving this outcome so far.@@heatherhirschMD

[@Coley996]

@@tresjolieme81did you ever try the prometrium? I came off birth control after 21 years & was given some prometrium 100mg pill. I was having a lot of hair fall on it which is unfortunate because omg that pill helped me so much!!! I had never slept so good!! Due to the hair fall I had to discontinue it. Please share your experience with me!!

[@LT-pp1je]

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.

[@athenachloewoodrow6356]

My visit with Dr Hirsch did not cost $850, more like 250. And whatever she prescribes will go through your insurance.

[@LT-pp1je]

@@athenachloewoodrow6356 how long ago was this visit? Her website states $850 for Telehealth new patient 45 min appointment and $1k for in person. And you must pay in advanced.

[@Roshe73]

I am in the same situation 🥹

[@misvideos76]

@@athenachloewoodrow6356 Now it’s $875. Check her website 👍🏼

[@doctoralisonjohnson]

Hi! Have you tried Alloy Women's Health?

[@samlyndley2501]

Can I ask - my monthly bleed has shifted to every two weeks sometimes and then to every 5 weeks, would taking the contraceptive pill help?

[@EmA-gb9cv]

I'm not a doctor but I understand that yes it would help. I'm actually experiencing exactly the same thing 😢 and I want to try the pill

[@angelaneale6957]

I'm 49 and just came off the BCP and started estrogen patches and progesterone. What is commonly used for birth control at this point? I used the caya diaphragm with spermicide last night and my partner said he could feel the rim of the caya. Now I'm panicking that I didn't have it in correctly and I'm going to get Plan B. Also, it was very hard to remove. What are the best options for birth control as I don't want to get pregnant.

[@heatherhirschMD]

an IUD with the estrogen patch! talk to your doctor more about this!

[@Coley996]

Doctor, have you heard of a woman using a combination pill, a prometrium pill & a T cream? This couldn’t be good for the body right?

[@patriciapyper4617]

What causes skin tags down there how can you get them taking away please thanks ♥️🌹

[@itsme_shanti]

Laser removal ... had it done on my 13year old. It didn't return

[@brittanyb5942]

Please go to the doctor and make sure it’s not HPV. HPV causes skin tag like warts.

[@annmarie3573]

The problem with doctors today is they don't want to take the time or effort to customize an approach. I was basically told to tough it out and come back when my periods have been gone for a year.

[@lf9341]

Hi Dr. Hirsch, I went through menopause at 54. As soon as my period stopped I took 0.5 of the estriol patch and a mirena IUD progesterone. Loved that I had no hot flashes, but I have a bad a case of melasma so I was told to go off them. Now at 57, what else can I take to increase my estrogen. I hate melasma.

[@LT-pp1je]

I hate melasma too. I got bad case when I took low dose birth control at 35 for a year. Stopped but melasma still there after 15 yrs. In my 20s on the pill, I had No melasma. Weird. I’m definitely going to be on bhrt in menopause snd I know my melasma will get even worse. Im stressed just thinking about it. I’m still doing it because the benefits outweigh the risks. From everything I’ve researched, nothing natural will give you enough estrogen to protect your heart, brain and bones like hormones.

[@lf9341]

@@LT-pp1je I never had melasma from birth control or having a kid. Only from HRT and I hate it. TY for responding.

[@itsme_shanti]

​@@lf9341I think the progesterone drop is what aggravates melasma. Personal experiences, I'm struggling to it. It started during peri-menopause when progesterone drops first and Estrogen levels are still normal. It could be that or Testosterone levels which are tied to progesterone levels. I'll knock for sure if you get Testosterone because it's not available here

[@Roshe73]

@@LT-pp1jeI have melasma hyperpigmentation and I’m trying everything to make it less noticeable 🥹

[@rhiannonchavez5124]

I stopped taking bc 15 yrs ago because I got a tubal by filshie clips which my body rejected therfore I got a reversal and never got back on bc. I'm 45 now and my periods are nonstop. I think I've had only 2 wks of no bleeding in the last 50 days. I was wondering which route would be best bhrt or bc? Overall healthy and no prescription meds, was just curios. My doc appt is next week.

[@Coley996]

Hi, what did you & your doctor decide on? Also, how is it working?

[@stephnelsen6772]

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.

[@MH-yh8rz]

I have pelvic floor dysfunction and have been to physical therapy. In addition to exercises, 2 things also help when I have a flare-up: vaginal suppositories with diazepam and baclofen, and Flexeril (muscle relaxant pill). I tend to prefer the suppositories because they don’t make me tired like the Flexeril. But for severe flare-ups, the Flexeril will knock out the pain in one shot usually. It’s hard to find a doctor that even knows about the suppositories and how to write the rx (and you have to go to a compound pharmacy), but so worth it if you can find a doctor who will prescribe it. I talked to my ob/gyn and he had to call up another doctor to figure out how to write the rx. It’s been a lifesaver and might help your continued discomfort!

[@stephnelsen6772]

Thanks for this Information

[@dragonfly1955]

I’m 45 been off pill For 6 months, went to HRT Dr who gave me progesterone, I’ll see how I do w that but I’m very close to getting back in the pill. I’m only good for like 4-5 days out of the month I can’t live like this

[@Coley996]

@@dragonfly1955hi, can I ask how you’re progress is coming along? Did you go back on the pill or did you find that HRT was helpful? I turned 37 recently & decided to come off of birth control because I had been on it since the age of 15 & kept hearing that it’s not good for our bodies. It’s been a little over 4 months & still haven’t had a period. I was prescribed the prometrium pill 100mg which omg was AMAZING. I slept through the night which is rare for me because I have interstitial cystitis & always getting up to pee. Not only that I was already having trouble sleeping, this began at age 35 while still on the pill. The prometrium was given to me to help get my period back after discontinuing the birth control. I love the prometrium pill for many reasons but was having a lot of hair fall with it so I devastatingly had to discontinue it. All I’m using now is a bio identical testosterone cream at a very low dose of 1/4gm daily. It’s really helped with my libido. Would give anything to be able to take the progesterone in conjunction with it. Have you tried the prometrium pill? If so, what was your experience? I hope everything is going well for you. I have almost broken down & gone back to the birth control pill many times but I’m trying to stay strong because I know it can be hard on our bodies.

[@valerie4912]

Anyone try Nextstellis? I don’t know what to dooooo!😢

[@DanielleBlake600]

I am 46 and taking progesterone only pill,is this suitable to take during the peri menopause,I haven’t had a period for a couple of years because of my pill so I don’t know what stage of peri menopause im in,i have mood related symptoms,anxiety and depression and struggle with oral allergies a tightness in the throat frequently which has really ruined my life,i have cut out most food groups to try and manage this,and I always feel unwell probably due to malnutrition

[@DanielleBlake600]

I would be greatful for any advice

[@heatherhirschMD]

You probably need to add estrogen and get off the mini-pill

[@JC-ve8vd]

Re: food allergies, you may want to talk to your Dr. about switching to a patch. My overall quality of life improved when I stopped taking BC pills because taking *lactose* (which is in *all* BCPs in the USA) daily was keeping systemic inflammation ramped up & making me much more sensitive to dairy & other allergens. I went from weekly allergic reactions to now only a few a year when I accidentally have a large exposure (and even then, symptoms are milder). Edit: In other words, the lactose in BCPs may be making you ill, causing or exacerbating your allergy symptoms.

[@Aki-wq6xh]

I have decided, despite having paid Dr Barbie for a pricy consult… to go against her advice and opt for transdermal HRT rather than Birth control.. I just think I much prefer Bioidentical and bypassing my liver at the end of the day. And although she said HRT would NOT be enough to protect me from the three diseases (dementia etc) but I am really hoping it can 😢 the more I think about it the less I think that makes sense and I want to go with my own instincts….

[@niebieskimotyl3308]

There are also patches birth control, so they go around liver. Also bioidentical is a marketing, not medical name

[@Aki-wq6xh]

@@niebieskimotyl3308 haha by the time I read this I have changed my mind again. On Birth control Now and I am in bliss!!

[@gilbertamtalao5154]

Hi a new ob of mine change my tibolone to lizelle pills..i seem to feel betterbwith tibolone..tnx

[@NewYork-ly9yy]

Was just put on Lo Loestrin (46 yr) for perimenopause including hot flashes, night sweats, and Brain Fog. We'll see how it goes. But I feel adding estradiol vaginally will be great for me too.

[@sewhat4040]

How are you doing on Lo Loestrin? I’m 42, and start this same pill tonight. I’m taking mine for super heavy 3 week long bleeds for the past 8 years. I hope it works well with no side effects. Can we just talk about the cost of this pill? $200+ per pack because most insurance companies don’t want to cover it since it’s a name brand 😮. Apparently you can get a prior approval or something to convince them to cover it. But wow, the cost is insane. I grabbed a coupon from the manufacturers website to cover the cost down to $25.

[@brookebenton8192]

I just started the mini pill (Norethindrone by itself) and a vaginal estradiol cream. So far so good!! I've taken loestrin before but the oral estrogen made me feel anxious and overwhelmed all the time for some reason. I hope it works for you!!:)

[@sacred_waterstarot]

I was prescribed low estrin as well to relieve symptoms of peri menopause and its not working

[@CCC-qx2gz]

Have PMDD, every change in phase of menstrual cycle, cause severe cramps, late 40’s started passing out from pain 2-3 time a month, went on Lo Loestrin fe, felt great, back to being myself, after 3 months my hair started falling out, gave 6-8 months to see if it would level off, lost so much hair, went on a different brand of birth control, don’t feel as energetic & want to eat more but my hair grew back

[@jennifermoffitt4635]

i was on that from 43-now (started on it for heavy bleed/anemia) - now almost 50. At 49 my libido and other issues started.... started vag cream at 49.... i am going to try lower doses b/c i think the bc pills are killing my testosterone and having issues if you know what i mean.

[@Corrans]

When you treat perimenopause with HRT do you prescribe higher doses of estradiol than for menopausal women?

[@tracycollins9413]

I have the same question. I’m on the highest dosage of estradiol and still feel like I need more.

[@TheShumoby]

​@@tracycollins9413how much are you taking?

[@heatherhirschMD]

It all depends! Truly it is individualized!

[@jennifermoffitt4635]

i started lo loestrien early peri--- stayed on and i'm 49 now... going to try lower dose HRT (its still estradiol and progestin together though)-- wondering if i need testosterone too --not sure.

[@christinaangotti4288]

Hi..I was just prescribed the same birth control . How has the birth control helped you? I have anxiety, depression,and horrible brain fog

[@Coley996]

I’m sorry, just want to make sure I’m understanding. Are you on birth control now or not? What are you using now?

[@Coley996]

@@christinaangotti4288I was on birth control for 21 years & always dealt with depression + anxiety. It was bad. Never even imagined that it could potentially be the bc causing it all!! When I hit 35 I began noticing a lot of vaginal dryness & of course low libido. I had always had low libido on the pill but never dealt with the vaginal dryness until I got older. It made sex painful & I have IC so I’m used to painful sex but this was a different pain right at the opening of my vagina. I know TMI, sry! Lol but something else I began to notice was my sleep patterns. I couldn’t seem to get any sleep!! Then I began spotting a week before my period which was very uncommon for me on the pill. The doc told me if I want my libido back & want to get rid of the painful sex, that I need to come off the pill. So I did. A little over 4 months & my period still hasn’t returned. I’m using a testosterone cream at an extremely low dose. It’s helped my libido tremendously. I’m so used to the bc from where I was on it for 21 years & find myself still wanting to give in to it but why!? It actually caused me so many issues that I never even realized. I need to share this in the comments section because I could use all the responses I can get. We need help sometimes lol. I would love to know your experience & how things are going.

[@meganpatterson1653]

I have been told I’m in peri menopause for the last few years now (I’m 46). I have all the symptoms other then my period is still every 28 days. Can I still be in perimenopaus with a consistent period?

[@heatherhirschMD]

Yes absolutely !

[@meganpatterson1653]

@@heatherhirschMD just started HRT. Estradiol patch and progesterone pill at night. Already feeling better other then my tummy is so bloated. Which hormone is the cause of that? I’ve always severely bloated before my period

[@denise3432]

@@meganpatterson1653how is it going for you? I’m 45 and still searching for a Dr 😮

[@jennifermoffitt4635]

i was also -- maybe still am at 49

[@jackievillalta]

If taking menopausal HRT during perimenopause, i am assuming that other forms of birth control is needed as there is still occasional ovulation?

[@athenachloewoodrow6356]

They often recommend an IUD which can also provide the necessary progestin to the uterus

[@itsme_shanti]

If you choose a IUD remember it doesn't prevent osteoporosis and may may increase risk during peri-menopause/menopause

[@athenachloewoodrow6356]

They use the IUD for the progesterone component of HRT, you would also take estrogen

[@itsme_shanti]

@@athenachloewoodrow6356 yes. It is. But be aware. Progestin protects the uterus, that's it. It leaches bone, if you're not going through stages of Menopause, it will grow back. But during Menopause, you're already going to experience bone loss. Menopause Taylor has more detailed information

[@pattyhernandez5432]

Sooo frustrating!! Why won't doctors listen to us!!??

[@brittanyb5942]

I’m 38 and starting birth control pills again for ovarian cyst.

[@patriciapyper4617]

What causes neausa vertigo ❤🌹 on evorol Conti patches please thanks

[@itsme_shanti]

If your Estrogen dose is too low, it could explain those symptoms..... unless symptoms started after HRT then you need to change your method of use.

[@tonyadionne]

Can I drink a glass of red wine during the day or afternoon, but still take my Progesterone 200 mg prescription before bed? 👀

[@belindasedberry9479]

i There is no such thing as Peri, It is either pre or post...

[@akferren1]

Both are toxic and horrible for your health

[@HalfwayJac]

Who gives a fuck at this point. If I don’t get relief from these symptoms someone’s gonna die.

[@Roshe73]

Hi doctor I’m 49 years old and soon to be 50. The gynecologist prescribed Progultan for me but it’s not helping. When I approach the red pills I get so miserable. My cycle is every 28 days when I get to the 7 days tablet free. But I suffer with unbearable anxiety and mood issues. Yes I have pms and also body is on fire 🔥 🙈especially towards cycle time. I am not feeling my best at all 😢 I’m also having hormonal acne. I am feeling fatigued and not sleeping well. I am so tired as I went to 4 gynecologist and no one is prescribing HRT for me. I feel I’m aging much faster and it’s scaring me.🥹 how can I feel better and what should I take to balance my hormones?