So you're in your late forties, or your fifties. Your body is acting differently. You aren't sure if the changes are your birth control or your body, how do you react? If you are still getting your period, you can still get pregnant. You should still use birth control until a year after your last period, because often periods become irregular and have a longer time between them during perimenopause. If you have been relying on fertility awareness based methods of birth control, they will no longer work, because you will no longer be able to track your cycle accurately. If you are using barrier based methods of birth control, then you can continue using your regular method (diaphragm, sponge, condoms, etc). The difficulty at perimenopause comes if you are using hormonal birth control, such as the pill, the patch, or the vaginal ring among others.

Some doctors recommend switching birth control pills to a low-dose birth control pill at perimenopause. This would mean switching to a pill that has 20 micrograms of estrogen (such as Alesse or Loestrin), instead of the normal 30 to 50 micrograms of estrogen in a combination pill. The benefits of changing to a lower dose hormonal birth control are that you will still be protected against pregnancy, and your final periods will probably be more regular. Many women find that their side effects are fewer with lower doses of estrogen. NuvaRing is a vaginal ring that is inserted once a month and removed 21 days later; it also has a lower dose of estrogen than most birth control pills.

You are going to have to stop taking birth control at some point in your life. In the past, doctors would randomly choose when to stop you on birth control and when to begin you on hormone replacement therapy for menopause. This often happens around the age of 50. Now, doctors can measure your FSH, or follicle-stimulating-hormone to tell if you are in menopause. This way you can switch hormone therapies directly when it suits your body.

However, being medicated on hormones your entire life is not appealing to many women. You might choose to change to alternative forms of birth control. These include getting an IUD, or switching to a barrier method of birth control (like a cervical cap, condoms, etc.).

Going off birth control can cause difficulties for some women. A woman's body can become accustomed to being on contraceptive pills for years. It will take months for the pill to leave your body. Your body will learn to create different hormone levels for you.

There are many natural ways to deal with the side effects of perimenopause. The most important thing to remember is to maintain a balanced diet and exercise. It sounds overly simple, but for most of us, it can be one of the biggest challenges we face in our busy lives. Proper diet and exercise can help minimize side effects of perimenopause, and it will help you to feel better about yourself.

If you want to try going off birth control pills, you can stop at any time (though many women choose to finish one monthly cycle before ending. Try lowering your caffeine and alcohol intake. Other women use progesterone-cream to help lessen their side effects.

Perimenopause and menopause is a time of great change in a woman's life. This is a time to step back and begin listening to your body. Many women rush around their lives putting everyone else first: take this time to improve your own life by talking to your doctor and making informed decisions about your hormone use during perimenopause.