Experiencing hot flashes before your time? You might be going through perimenopause, the period of hormonal changes leading up to menopause, usually beginning in a woman's late 40’s. Perimenopause is basically a low-grade version of menopause itself — you experience most of the same symptoms, but they are less severe. A distant hot flash here or there, trouble sleeping, irregular periods, or subtle changes to your body or sexual function may be signals that you've entered perimenopause.
However, there is one area in which perimenopause is distinctly different from full-fledged menopause: your fertility. Birth control is a must until you've reached the one-year anniversary of your last menstrual period. Until then, you may still be able to conceive. So, unless conceiving is part of the plan, you should definitely play it safe. Thankfully, when it comes to preventing pregnancy, women have a lot of options.
Low-dose birth control pills
Low-dose birth control pills are often prescribed during this period for pregnancy prevention, as well as to minimize perimenopausal symptoms. In fact, low-dose pills have been found to significantly reduce hot flashes and improve bone density, which begins declining more rapidly in the years leading up to menopause.
The NuvaRing is a hormonal ring that you insert into your vagina monthly. Like birth control pills, the NuvaRing contains estrogen and progesterone, and these hormones work together to prevent the body from releasing mature eggs for fertilization. The woman removes the NuvaRing monthly for her cycle, and then inserts a new one when her cycle ends. It is 99 percent effective and has fewer side effects than the birth control. If you have been on the pill and experienced lower libido as a result, the NuvaRing might be a good fit for you. The NuvaRing is locally delivered to your reproductive organs and is believed to have fewer sexual side effects because the hormones are minimally absorbed into the blood stream.
The intrauterine device (IUD)
The IUD is another excellent option, since it can remain in place for years. Most forms of IUD are free of hormones and the benefits of this fact cannot be underestimated in a time of mass confusion about hormones. The IUD, a T-shaped copper device, works by blocking sperm from reaching the fallopian tubes and by altering the lining of the uterus to make it uninhabitable for a fertilized egg. Your doctor can insert an IUD during a regular office visit, and the device stays put for ten years. A little cramping is normal at the time of insertion, but it's a quick procedure. While age is not a concern, IUDs are recommended only for women in monogamous relationships. If you contract a sexually transmitted disease while on an IUD, it may increase the severity of the infection, which could lead to terrible consequences, including infertility. So fidelity is a requirement if you're going to use this method.
There are other options you can discuss with your doctor, including diaphragms and contraceptive sponges. Otherwise, condoms will still do the trick. Just make sure you're using something!