Oral contraceptive use in perimenopause

Perimenopause represents a transition period lasting about 5 years before t he permanent cessation of spontaneous menses, During this transition, the e mphasis of clinical care changes. Although women still need effective contr aception during perimenopause, Issues Including loss of bone mineral densit y, menstrual cycle changes, and vasomotor Instability also need to be addre ssed. Hormone replacement therapy is not the first-line treatment for women with symptomatic perimenopause because hormone replacement therapy neither suppresses ovulation nor provides contraception; also, it will not prevent and in fact may aggravate unpredictable perimenopausal bleeding. Oral cont raceptives offer many benefits for healthy, nonsmoking, perimenopausal wome n. Oral contraceptive use by women in their 40s has been found to decrease the risk of postmenopausal hip fractures and regularize menses in women wit h dysfunctional uterine bleeding, reducing the need for surgical interventi on for benign menstrual conditions. Use of oral contraceptives also can red uce long-term risk of endometrial and ovarian cancers. There is also good e vidence that oral contraceptives relieve vasomotor symptoms in perimenopaus al women. Oral contraceptives can be viewed as a strategy not only to impro ve perimenopausal symptoms, provide effective contraception, and reduce som e long-term health risks, but also to enhance the quality of life for perim enopausal women.