Beyond the Pill: Dr. Karen Pike’s Insight on Menopause and Birth Control

Today, we touch upon another important topic: the connection between birth control pills and menopause. What we are to discuss here specifically is the impact birth control pills have on menopause. A particular query has been doing the rounds for a long “Does birth control pill delay menopause”? 

To answer this question and other doubts regarding birth control, we had renowned medical expert Dr. Karen Pike give us a detailed insight. Before we present excerpts of the interesting and informative interview, here are a few words about her. 

Dr. Pike is a board-certified ER doctor and a senior physician administrator. Besides her role in managing patients actively, she is also the founder of the site Simply Menopause. Through her writings, Dr. Pike aims to reach a maximum number of women and increase their awareness of menopause, which she thinks most are lagging. 

Without further delay, let’s take a look at what Dr Pike has to say about the link between menopause and birth control pills. Take a look. 

Q. What is the Effect of Birth Control Pills on Menopause? 

Many of my patients keep asking me if there is a relationship between birth control pills and menopause. More specifically, they are keen to know the role of birth control pills in menopause

The quickest and simplest answer to this question is NO. Birth control pills don’t delay menopause but often mask or conceal most of the symptoms, like hot flashes and irregular periods. You may have entered into the menopause transition phase but wouldn’t be aware when you are on the pills. This is more applicable to those on the combination pills – an estrogen-progestin combination. 

To know if you are in perimenopause or menopause, you will have to stop taking the pills and observe if you experience any of the symptoms or not. Those who have been on combination pills will know that they come with mild side effects, which mimic some of the symptoms of menopause. These include mood fluctuations, tender breasts, headaches, and nausea. So, while on pills, understanding if menopause has begun or not could be pretty challenging. 

Q. Does Birth Control Pills Come With Any Advantage? 

A patient once said that since the time she had her menses, her periods weren’t regular most of the time, and the menstrual cramps were troublesome as well.

Since the time she was on birth control pills in her early 30s, she was surprised to see that her periods were better than before, and the cramps had lessened in severity. Well, this is one of the main benefits of the birth control pills. If I were to be more specific, the minipill or progestin-only pill is more effective for women with heavy periods.

There are other benefits as well. Let’s take a look at them: 

  • Maintains your bone strength 
  • Is effective in lessening acne; the combination pill is more effective in controlling acne than the minipill or progestin-only pill.
  • Is beneficial for hot flashes
  • Lessen menstrual pain and bleeding
  • Minimizes risks of ovarian, breast, and endometrial cancers 
  • Reduces bone thinning (which is one of the most common symptoms of menopause) 

Q. Which Pill is Better for Menopausal Women – Combination Pill or Minipill? 

Both have their pros and cons. While the minipill contains the progestin hormone only, the combination pill is a blend of both estrogen and progestin. 

  • If you are aged 50 and above, which means you are of menopausal age, then the progestin-only pill is a better option than the combination pill. The progestin-only pills do not mask the symptoms of menopause, unlike the combination pills. 
  • For those who have heart ailments and are susceptible to blood clots, the progestin-only pill is a more appropriate option. This is because combination pills come with side effects like headaches, nausea, and breast tenderness. In rare cases, it could result in fatal blood clots. 
  • If you are in your  mid-30s and smoke, then the minipill would be a better option. The reason is that the blood vessels get constricted due to smoking. Adding to this, the combination of pills thickens your blood. This could put you at risk of heart attacks or strokes. 
  • One aspect where the combination pill is advantageous over minipills is that it is better in controlling pregnancy than the latter. So, if you are nearing menopause and want to be on combination pills due to the fear of an unwanted pregnancy, then it is always advisable to go for other birth control options. You can even have a word with your healthcare provider and discuss the option that would suit you the best. 
  • The estrogen-progestin mix pills come in different combinations, like in 21 active, and seven inactive, 24 active, and four inactive. Contrastingly, the minipills do come in varied combinations. 
  • Those who wish to avoid estrogen because it may interact with the medications they take or due to any other reason can opt for progestin-only pills. 

Q. How Do I know if I am in Menopause While on Pills? 

As I mentioned, if you are on the combination pills and do not have any symptoms of menopause even after you have reached the mean menopausal age, then the first thing you need to do is stop taking the pills. 

It is also advisable to talk to your doctor before you do the same. If perimenopause has started or you have entered into menopause, it will not happen immediately once you are off the pills. You must give your body time to resume the natural cycle – perhaps a few months. 

If your periods become irregular and you start experiencing other menopausal symptoms once you’ve ceased taking the pills, then it means the transition phase has begun. 

Q. What are the Other Birth Control Options Apart From Pills? 

If you are nearing the menopausal age and aren’t too confident about the pills, then there are other available options as well. These include: 

  • Skin patches 
  • Vaginal rings 
  • IUDs (intrauterine devices placed in the uterus)
  • Barrier methods (like condoms for both males and females, cervical caps, contraceptive sponges, diaphragms)
  • Sterilization (permanent birth control methods available for both sexes) 
  • Contraceptive implants

When the patches, pills, or rings are used properly, they’ll be effective in preventing pregnancy. However, IUDs and implants are more foolproof methods. 

Q. When Can You Stop Taking Birth Control Pills Completely? 

A fellow doctor once said that non-smoking, healthy women can take the combined pills till they are 50. To continue the pills after that until 55, the progestin-only pills are a better option. However, it is unsuited for women with breast cancer or those who have suffered from it before. It is also not apt for those with liver disease, have uterine bleeding, or have undergone weight loss surgery. People having drugs for conditions like seizures, aids, and tuberculosis should avoid the minipills as well.


Here are some final words from Dr. Pike. “I hope this article will help you in understanding the connection between birth control pills and menopause. If you are nearing menopause and are planning to stop the pills to ensure the transition phase has begun, make sure you take other precautions, especially if your periods haven’t stopped completely. Else, you could run the risk of getting pregnant. If you wish for my input on other aspects of menopause, you can read my articles”.