Combined pill during perimenopause

It contains an oestrogen and a progestogen. It may also ease painful periods and some cycle-related symptoms, yet it is not the same treatment as menopausal hormone therapy and should not be taken alongside it unless a clinician has specifically planned this.

Ovulation can still occur during perimenopause, even when periods become irregular, so contraception may still be needed. The combined pill suppresses ovulation and creates a scheduled withdrawal bleed during pill-free or inactive-pill days, depending on the product and regimen.

A clinician will consider migraine history, blood pressure, smoking, previous blood clots, heart or liver problems, breast cancer history, current medicines and other factors before prescribing. Hormonal contraception can also mask the natural bleeding pattern, so periods alone cannot show whether menopause has occurred.

Take tablets in the order and at the time shown in your pack instructions. If a pill is missed, vomiting occurs soon after a dose, or severe diarrhoea continues, follow that product's missed-pill guidance and ask a pharmacist whether temporary additional contraception is needed.

Before starting or renewing it, share your full medicine and supplement list and have your blood pressure checked. Arrange a medication review if bleeding becomes troublesome, new migraines appear, or changing symptoms make the current option hard to tolerate.

Seek urgent medical care for sudden chest pain, unexplained breathlessness, coughing blood, a painful swollen leg, sudden weakness or numbness, difficulty speaking, loss of vision, or a new severe headache. These symptoms can signal a blood clot or another serious problem.

Contact a clinician promptly about very heavy bleeding, bleeding after sex, persistent bleeding between scheduled bleeds, a new breast change, jaundice, or a marked change in migraine pattern. Do not stop essential medication without advice, but do mention that you use a combined hormonal contraceptive.

Ask whether your blood pressure, migraine pattern, smoking status and personal or family clot history affect eligibility; which regimen suits your bleeding pattern; how your other medicines interact; and how contraception will eventually be reviewed as menopause approaches.