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Guerin J, Engelmann A, Mattamana M, et al. Use of Hormonal Contraceptives in Perimenopause: A Systematic Review. Pharmacotherapy. 2021;doi: 10.1002/phar.2657.
Guerin, J., Engelmann, A., Mattamana, M., & Borgelt, L. (2021). Use of Hormonal Contraceptives in Perimenopause: A Systematic Review. Pharmacotherapy, . https://doi.org/10.1002/phar.2657
Guerin, Julie, et al. "Use of Hormonal Contraceptives in Perimenopause: A Systematic Review." Pharmacotherapy vol. (2021). doi: https://doi.org/10.1002/phar.2657
Guerin J, Engelmann A, Mattamana M, Borgelt L. Use of Hormonal Contraceptives in Perimenopause: A Systematic Review. Pharmacotherapy. 2021 Dec 30; doi: 10.1002/phar.2657. Epub 2021 Dec 30. PMID: 34967466.
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Pharmacotherapy. 2021 Dec 30; doi: 10.1002/phar.2657. Epub 2021 Dec 30.

Use of Hormonal Contraceptives in Perimenopause: A Systematic Review.

Pharmacotherapy

Julie Guerin, Alexandra Engelmann, Meena Mattamana, Laura Borgelt

Affiliations

  1. University of Colorado Anschutz Medical Campus Skaggs School of Pharmacy, Aurora, Colorado, USA.
  2. The University of Colorado Anschutz Medical Campus Skaggs School of Pharmacy, Aurora, Colorado, USA.
  3. Present address: Superior Compounding Pharmacy, Plymouth, Michigan, USA.
  4. University of Colorado Anschutz Medical Campus Skaggs School of Pharmacy, 12850 E. Montview Blvd. Box C238, Aurora, CO, 80045, USA.

PMID: 34967466 DOI: 10.1002/phar.2657

Abstract

INTRODUCTION: Hormonal contraceptives have been used in perimenopausal women to manage a variety of symptoms and prevent unintended pregnancy. However, it is unclear what contraceptive regimen is best for these women.

OBJECTIVE: To evaluate hormonal contraceptive methods in women experiencing perimenopause using two prespecified outcomes: perimenopausal symptom management and long-term effects.

METHODS: A literature search of PubMed and EMBASE databases was performed (January 1990 to October 2021) using search terms "perimenopause" and "contraception." Relevant full-text articles in English were included.

RESULTS: Fifteen clinical articles were reviewed. Fourteen were internationally-based and one study was conducted in the United States. Nine articles evaluated symptom resolution, and six of these nine reported statistically significant changes in favor of treating perimenopausal women with hormonal contraceptives compared with no treatment. Seven studies evaluated long-term outcomes including bone loss and metabolic parameters, and six of these seven showed statistically significant improvements with hormonal contraceptives. Based on limited data and a lack of comparative studies, the use of a levonorgestrel intrauterine device with supplemental low-dose menopausal estrogen has positive results for the management of disruptive perimenopausal symptoms and long-term outcomes.

CONCLUSION: Hormonal contraception in perimenopausal women improves symptom management and long-term outcomes if patients do not have contraindications. When selecting a contraceptive for women in perimenopause, clinicians and pharmacists need to address specific patient risk factors, symptom profiles, long-term risks and benefits, and patient preferences.

This article is protected by copyright. All rights reserved.

Keywords: Contraception; Contraceptive Agents; Estrogens; Female; Patient Care; Perimenopause; Progestins

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