Many women are on hormonal contraceptives or birth control pills from when you're in your twenties to avoid pregnancy in your thirties and even into your forties. I have many patients that have remained on hormonal contraceptives into the perimenopause and even menopause. So once you become menopausal, you do not need to be on hormonal contraceptives. And in fact, many women that remain on hormonal contraceptives into the perimenopause and menopause will become more symptomatic because the amount of estrogen and progesterone that's in the pill, that's is in the hormonal contraceptive, is drastically lower than that of a young reproductive age woman. Now, when you're young and reproductive age, that low estrogen doesn't impact you as much as when you're perimenopausal and menopausal. So frequently perimenopausal and menopausal women that are on hormonal contraceptives, not to avoid pregnancy, but they stay on them continually to avoid symptoms, I will shift them off of hormonal contraceptives and replace that with therapeutic levels of bio-identical hormones.
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