Zoely for perimenopause: what to know

Perimenopause is the transition before menopause, when ovulation and hormone levels become less predictable. Zoely is a combined pill containing oestrogen and a progestogen. It can prevent pregnancy while you are still potentially fertile and may make bleeding more predictable. It may also reduce hormone-related symptoms for some people, but it is not the same as menopausal hormone therapy and may not suit every symptom. It does not establish whether menopause has occurred because pill hormones can alter bleeding patterns.

Give the prescriber a full history, including migraine with aura, previous blood clots, high blood pressure, smoking, liver disease, breast conditions and medicines or supplements. Discuss whether contraception is still needed and whether hot flushes, night sweats, heavy periods, irregular periods or mood changes are your main concern. Take the pill exactly as prescribed and ask what to do after a missed tablet or vomiting. Do not start or stop it based on bleeding changes alone.

Get urgent medical help for sudden chest pain, breathlessness, coughing blood, one-sided leg swelling or pain, or new neurological symptoms such as weakness or difficulty speaking. Contact your clinician about very heavy or prolonged bleeding, severe headache, persistent high blood pressure, or troublesome mood changes. A missed period may have several explanations; take a pregnancy test and seek advice if pregnancy is possible or bleeding is unexpectedly absent.

Ask whether your age, blood pressure, migraine history and clot risk make Zoely appropriate, how it compares with other options, how symptoms will be monitored, and when contraception can safely stop.