How do I know I have reached the menopause if I am using the contraceptive pill?

The menopause is the time when your periods permanently cease. The average age for the menopause is 50-51, with the perimenopause (the years preceding menopause) starting around the age of 46-47.

Contraception is necessary until the menopause. It is advised that contraception should continue to be used until you have not had a period or any bleeding for two years if you are aged under 50, and for 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. Therefore, it may be difficult to assess when you are no longer fertile.

There is no test that can absolutely define when the menopause has occurred. However, your doctor can measure the level of the hormone, oestrogen - which is low - and the hormone FSH - which is raised - in perimenopausal and menopausal women. This blood test should be planned for the last day of the pill-free interval.

If you are taking the combined contraceptive pill, it does not change the time of your menopause, but withdrawal bleeds will continue for however long 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 over 35 and smoke.

The progestogen-only pills (POPs) can be taken until the menopause if you are a smoker. However, as they do not contain oestrogen, they will not control or mask any menopausal symptoms.

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