Birth control pills may help mask menopause symptoms

Published March 28, 2006

All women can expect to enter menopause sooner or later, but women taking birth control pills may not notice, at least for a while.

In the meantime, they can expect several benefits from the pill beside avoiding an unwanted pregnancy: They will avoid some of the most conspicuous signs of menopause, such as hot flashes, night sweats and irritability.

"A woman on the birth control pill is getting hormones at a level above what her ovaries would produce,'' said Dr. Catherine Lynch, director of General Obstetrics and Gynecology at the University of South Florida College of Medicine in Tampa.

"When a woman goes into menopause, the ovaries basically shut down and no longer produce estrogen or progesterone in any significant amounts, so a woman taking the birth control pill in the standard fashion of three weeks on active pills, followed by one week of inactive pills, often won't have any symptoms of menopause until that pill-free week. She may not even realize she's in menopause because she's getting adequate estrogen and still cycling.''

During the week when she is not taking active birth control pills, the woman may even have a "withdrawal bleed" caused by the sudden drop in estrogen. A withdrawal bleed is easily mistaken for a normal period. And if the woman is taking continuous-use birth control pills, she will take inactive pills only one week out of every 12 instead of every four, so she will have a withdrawal bleed no more than once every four months.

"So a woman who's, say, 51 and taking Seasonale one of the continuous-use birth control pills isn't going to have hot flashes or night sweats for 12 weeks, because she's having estrogen provided for her by the pills,'' Dr. Lynch said.

"She may experience symptoms during the week she takes inactive pills, but just as symptoms start to climb, she starts taking active pills again, and she won't appreciate that these are symptoms of menopause.''

But that's not all. Taking birth control pills also seems to reduce bone loss. In fact, if the woman is also doing weight-bearing exercises and getting plenty of calcium, low-dose birth control pills may even help build bone density.

Women on the pill also experience less iron deficiency anemia, and some studies suggest that the pill protects against benign breast disease, endometrial cancer and epithelial ovarian cancer.

The Cancer and Steroid Hormone Study, the largest to investigate this last issue, found a 40 percent decrease on average of ovarian cancer in women who had taken oral contraceptives. The risk decreased as the amount of time on the pill increased, so women who had taken the pill for seven years or longer experienced a reduction in the risk of ovarian cancer of 60 to 80 percent. Some

Women on the pill also experience less iron deficiency anemia, and some studies suggest that the pill protects against benign breast disease, endometrial cancer and epithelial ovarian cancer.

studies suggest that oral contraceptives might even protect against colorectal cancer, uterine fibroid tumors, Alzheimer's disease and rheumatoid arthritis.

Taking the pill has always meant an increase in the risk of blood clots, which can cause a stroke. But a woman who does not smoke, does not have high blood pressure, and takes a low-dose oral contraceptive can almost eliminate that additional risk.

So why not just stay on the pill and enjoy all the benefits of hormone-replacement therapy, known as HRT?

Because even low-dose birth-control pills deliver five to seven times as much estrogen as HRT.

HRT simply gives the body back what the ovaries were producing before they were shut down by menopause. The birth control pill delivers a dose of hormones large enough to shut down the ovaries, and it's pointless for a woman to keep taking hormones after menopause has begun and she has stopped ovulating. She would be better off with hormone-replacement therapy, which would provide her with the same benefits but a lower dose of hormone.

"The trick is figuring out when she is in menopause,'' Dr. Lynch said. "There are a couple of ways to test this, but they're not 100 percent reliable. She can go off the pill and see if she's still cycling, but if she's sexually active, there's an outside chance she could get pregnant.

"While it's rare for pregnancy to occur at the age of 50 or 51, it can happen if you're still ovulating.''

Tom Valeo is a freelance writer specializing in medical and health issues. Contact him c/o Seniority, St. Petersburg Times, P.O. Box 1121, St. Petersburg, FL 33731, or e-mail features@sptimes.com.