Birth Control/HRT vs BCP


I need to give you a brief history for my question to make any sense

5 years ago, when I was 34, i started seeing a fertilely dr to try and get pregnant. My ovaries were not always producing follicles and my uterus was not producing enough progesterone to keep the lining. i was having periods every 20-23 days.

3 years ago my fertility dr put me on 2mg estrodiol because of migraines and severe hot flashes. during the time i was taking a break from trying to conceive and was also on the pill to control my 20 day cycles.

1 year ago my GP ran all my levels while checking my standard panel. My estrodiol came back 23 and she said i was in menopause and to stop the pill and start HRT. At that time i started to see a menopause specialist. She put me on Elestrin and progesterone. My levels have been checked twice since than and my estrodiol level is now a 72.

6 mons ago i needed to explore BC options. My meno Dr suggested the Paraguard IUD since it was hormone free. Last week I had to have it removed because i was bleeding very very heavy for as long as 10 days and i still have a cycle every 20-23 days. I asked about going back on the bill so control the periods since they are 20 days apart. Both my GYN and my Meno dr have not been able to explain why I cannot be on the HRT and take the pill to manage my periods at the same time - esp when I was taking Estrogen and the pill a few years ago.

I am afraid to get off the HRT because I feel like a new woman when I started the estrogen 3 years ago. Each time my estrodiol was low i gained wait fast. 20 pounds each time, even though i workout 3-5 times a week. It was very very hard each time to get the weight off and I don't want to risk that again.

All I can find on the internet about HRT v BCP is that the pill has more estrogen then HRT. But how much more? My dose was just increased again in Oct. What is the reason for not doing both?

thank you for your time

The reason for not doing both is that the pill contains more estrogen than HRT, so you would get too much estrogen by doing both.  Since you're having periods, I think the pill would be best.  It's the best way to control periods.  It sounds to me like your ovaries may still be working somewhat.

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Norman Solberg


I am an OB-GYN physician. I can answer almost any question related to women's health.


35 years in an active OB-GYN practice.

Fellow, American College of Obstetrics and Gynecology

MD OB-GYN specialist

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