No, You Cannot Take Birth Control for Menopause
When hot flashes, night sweats and mood swings first start creeping in, many women wonder if they can simply stay on or switch to birth control pills to ease the transition. After all, both hormonal birth control and hormone replacement therapy (HRT) involve estrogen and progestin, so they must work the same way, right?
Not exactly.
While the two share some hormonal overlap, their formulations, doses and risks are designed for very different purposes. Confusing the two can leave women unprotected, symptomatic or even at increased health risk. This is why experts stress that birth control is not an appropriate substitute for HRT during menopause.
Let’s break down why.
The Differences in Hormone Levels and Formulations
One of the key issues lies in the hormone dosages found in birth control pills.
“Birth control pills are primarily for women with regular menstrual cycles and typically contain higher doses of synthetic estrogen and or progestin,” Dr. Linda Huynh at Mochi Health, tells Flow Space. “The main purpose of these pills is to suppress ovulation and thereby prevent pregnancy.”
On the other hand, HRT is prescribed as a way to treat unwanted menopausal symptoms using lower, more tailored doses of estrogen, to replace hormones that the body may be missing.
The estrogen dose in a typical combination birth control pill usually ranges from 20 to 35 micrograms of ethinyl estradiol. In contrast, hormone therapy prescribed for menopause often involves higher doses of less potent estrogen—sometimes up to one milligram of estradiol. Despite containing more milligrams when comparing dose-for dose, birth control’s ethinyl estradiol is 10–100 times more potent than estradiol, the most common form of estrogen used in HRT.
Potential Risks of Using Birth Control as HRT
Taking birth control pills during menopause without proper medical supervision can lead to several health complications. Since many women in menopause are over 50 and have increased risk factors for blood clots, heart disease or stroke, incorrectly using contraceptives can exacerbate these risks.
“For example, as women age, their cardiovascular and metabolic risks change, which means that high doses of estrogen and progestin can increase the risk of blood clots and/or stroke,” says Huynh. “When there is an excess of estrogen relative to progesterone, there is also a higher risk of weight gain, fibroids, worsening PMS symptoms and uterine and breast cancer.”
Furthermore, birth control pills typically contain progestins, which may not be suitable long-term in menopausal women who no longer need contraception but require symptom relief or bone health support.
And birth control pills, in general, do not provide the same type of hormonal balance needed for menopausal women. HRT is designed to release estrogen into the body in steady, low amounts which helps with bone health and managing of symptoms without the highs and lows of higher-dose contraceptives.
“Taking birth control to manage a delicate hormonal balance can cause side effects like breast tenderness, bloating, mood changes or more serious complications depending on the individual,” adds Huynh.
When Is Hormone Therapy Appropriate?
If birth control pills aren’t the right answer for menopause relief, where does hormone therapy fit in? Experts emphasize that hormone therapy is specifically designed for women who are experiencing disruptive menopausal symptoms—such as persistent hot flashes, night sweats, vaginal dryness or sleep disturbances—that interfere with daily life.
According to the North American Menopause Society (NAMS), hormone therapy is considered the most effective treatment for menopausal vasomotor symptoms and genitourinary syndrome. It can be administered through various forms—pills, patches, gels or vaginal creams—and adjusted based on each woman’s health profile.
Timing is also an important factor. Starting hormone therapy before age 60 or within 10 years of menopause is considered the safest window, according to current guidelines. Beginning it later—when risks of heart disease, blood clots and stroke are already higher—may outweigh the benefits.
Not everyone is a candidate, however.
Women with a history of breast cancer, blood clots, liver disease or uncontrolled high blood pressure are generally advised against systemic hormone therapy. In those cases, localized treatments, such as low-dose vaginal estrogen or non-hormonal medications may be recommended instead.
Importance of Proper Medical Guidance
Experts agree that managing menopause symptoms requires personalized treatment plans developed by knowledgeable healthcare providers. The risks of self-medicating or following unverified advice are significant.
The National Institute on Aging and other health authorities recommend that women consult their healthcare providers to discuss the benefits and risks of HRT options tailored to their individual needs.
Huynh says that for women who have heard that birth control pills can help with menopause, the best advice is to bring this up with a clinician rather than trying it on their own. In some cases, low-dose contraceptives may be used in the years leading up to menopause, but once true menopause is reached, treatment strategies shift.
“Every woman’s health history, family history and symptoms are different,” says Huynh. “Only a provider can properly evaluate whether or not HRT, non-hormonal options or lifestyle changes are necessary to treat your symptoms. While self-treating symptoms with birth control pills may seem convenient, it can worsen the symptoms and hormonal balances in your body.”
