Contraception guide

How do I know I've reached menopause if I'm on the pill?

The menopause is the time when your periods permanently stop. In the UK the average age at menopause is 52. The years before the menopause, when symptoms may begin to develop, are known as the perimenopause.

If you're having sex and want to avoid pregnancy, contraception is necessary until you reach the menopause.

It is also sensible to use a barrier method of contraception, such as condoms, to avoid getting sexually transmitted infections (STIs), even after the menopause.

It's advised you use contraception until you've not had a period or any bleeding for two years if you're under 50, or one year if you are over 50.

Taking the combined contraceptive pill may mask the menopause by controlling menopausal symptoms, such as hot flushes and night sweats. It may therefore be difficult to tell when you are no longer fertile.

Hormone test for the menopause

There is no test that can absolutely define when the menopause has occurred. Your doctor can arrange a test to measure your levels of a hormone called follicle stimulating hormone (FSH). This blood test should be taken on the last day of the pill-free interval.

However, the test is usually only used in women over 50 who are using the progestogen-only pill. It is not a reliable indicator that ovulation has stopped in women using the combined contraceptive pill.

If you are taking the combined contraceptive pill, it does not change the time of your menopause, but you will continue to have period-type bleeds during the seven-day pill-free intervals for as long as you take the pill.

The combined pill can be taken until the menopause if you are healthy and a non-smoker. However, it shouldn't be taken if you are 35 or over and smoke.

The progestogen-only pill (POP) can be taken until the menopause if you are a smoker. As the progestogen-only pill does not contain oestrogen, it will not control or mask any menopausal symptoms such as hot flushes.

The Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists has produced guidance on contraception for women over 40.  

Page last reviewed: 24/07/2015

Next review due: 24/07/2017

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