Do we have to stop the contraceptive pill during pre-menopause?

Stopping your birth control pill should be based on the symptoms that you feel and based on the recommendation of gynecologist. In the perimenopause periods are irregular.

You may still be fertile during menopause

Yet this does not mean free sex because women does not stop to be fertile directly.
This is why we advice to follow recommendation of gynecologist in the first period of entry to menopause.

As the women fertility does not stop right away, the first recommendation is to consult gynecologist and in case there is no possibility to see gynecologist in short period, recommendation would be to keep up with the pill in the peri-menopause.

Here is WHY in more details

The peri-menopause or pre-menopause, the transitional period that precedes menopause, can last from a few months to several years.
It is defined by hormonal fluctuations that causes irregular periods.
Having a hormonal check or treatment in peri-menopause is not advised because hormones levels vary so much from one moment to another, it’s making interpretation rather challenging and possibly incorrect. Hence, staying on a  effective contraceptive method is the safest option because fertility may still be on point.

After 50, the risk of pregnancy is rare but local contraception remains recommended.
We suggest women stop their birth control pill to see if their menstruation cycle returns or not. Once menopause has occurred, the ovaries no longer produce follicles or hormones, making pregnancy impossible.

A diminution in ovarian follicles starts from age 35, which speeds up in pre-menopause, and causes a loss in fertility. Although this varies hugely from one woman to another, the probability of a woman becoming unexpectedly pregnant after 45 is around 15%.
For this reason contraception is recommended to women in peri-menopause with an active sex life(1).

Key elements to remember:
• You dont become unfertile directly as you enter in premenopause.
• Pregnancy after 45 is around 15%

Quick tip:
● follow regularly with gynecologist so to know when to stop birth control pills

REFERENCE
1. Lambert M, Begon E, Hocké C. La contraception après 40 ans. RCP Contraception CNGOF 2018.