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Will I start menopause even though I am on the pill?

Asked by Teresa, New Jersey

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I am 49 years old and take Seasonique. Will I start menopause even though I am on birth control?

Expert Bio Picture

Living Well Expert Dr. Jennifer Shu Pediatrician,
Children's Medical Group

Expert answer

Thank you for your question. Also called a woman's "change of life," menopause marks the time in which one's periods stop (defined in retrospect after having no menstrual cycles for a full year) and eggs are no longer produced by the ovaries. Most women reach menopause after age 45, with the average age being around 51 years old. During the time around menopause, the body gradually makes less estrogen and progesterone. Symptoms associated with decreases in these hormones include hot flashes, night sweats, difficulty sleeping, trouble focusing and mood swings, and they may occur for months or years after menopause, although some women have no symptoms at all other than the loss of menstrual periods.

I consulted with Dr. Gary Glasser of Atlanta Gynecology and Obstetrics about the effects of birth control pills (also called "the pill") such as Seasonique on menopause. He explains that the pill suppresses ovulation and as such may be an option for healthy women before menopause (in "menopause transition") desiring to prevent pregnancy or control one's menstrual cycle.

As far as how the pill affects menopause, the timing of a woman's menopause is determined by factors such as genetics, and the pill will not change this already-determined "endpoint" of fertility. It can, however, make it difficult to assess whether a woman has reached menopause because her menstrual cycles cannot be evaluated accurately. Depending on the formulation of the pill, a woman may or may not have a monthly "bleed" that simulates a regular menstrual period. The estrogen and progesterone hormones in the pill may also prevent typical menopausal symptoms such as hot flashes.

Confirming menopause can be done only after the woman discontinues the pill (while using a nonhormonal method to prevent unplanned pregnancy). Options include checking a hormone marker for menopause (called follicle stimulating hormone, or FSH) several weeks after stopping the pill, or waiting for 12 months of no menstrual periods. The testing can be done at any age; by age 55, more than 90 percent of women will have reached menopause.

For any questions or more information, I encourage you to consult with your own physician.

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