As you age, your body gradually slows its production of estrogen. Your periods will also become irregular. When this happens, it’s known as perimenopause.

After you’ve gone a full year without having a menstrual period, you’ve reached menopause. Symptoms like hot flashes and sleep disturbances are common during this time.

But if you’re taking birth control pills, you might not associate these symptoms with menopause. Hormonal birth control — such as the pill — often causes symptoms like these.

Keep reading to learn why this is, symptoms you should watch for, and more.

Birth control pills are a form of hormonal contraception. Combination pills contain synthetic forms of estrogen and progesterone, two naturally occurring hormones. Minipills contain only progestin, which is the synthetic version of progesterone.

In addition to preventing pregnancy, birth control pills help regulate your body’s hormone levels. As you approach menopause, your body’s natural estrogen levels will start to decrease — but the pill’s synthetic hormones prevent your body from recognizing this decline.

You’ll also continue to experience a monthly bleed, though this will depend on the type of pill you’re taking. For example, women who take combination birth control pills will continue to have a week of period-type bleeding each month. Women who take the minipill may experience more irregular bleeding.

Birth control pills also have side effects that are similar to menopause symptoms. These include:

The average American woman will reach menopause around age 51, but perimenopause can begin in your early 40s or even earlier. You may suspect that your body is changing due to decreased breast fullness or a slowed metabolism, but your doctor won’t be able to tell you for sure.

There’s no test to determine if you’re menopausal, so watching for changes in your body is essential.

There are some benefits to taking birth control pills during perimenopause, so speak to your doctor about when and how to stop taking your pills. You may need to switch to a different form of hormonal contraception or use barrier methods, like condoms, to continue to prevent pregnancy.

If you do decide to stop taking the pill, it can take anywhere from four weeks to several months for your body’s natural hormones to take over.

During this time, you’ll need to communicate with your doctor about what to expect in terms of side effects. If it turns out you’ve already reached menopause, your period might not come back at all.

As you approach menopause, your periods will become sporadic. Your period may skip a month or two before returning, and you may have breakthrough spotting in between. Once you’ve gone a whole year without getting your period, you’ve reached menopause.

In addition to period irregularity, you may experience:

Having less estrogen also increases your risk for certain health conditions, such as obesity, heart disease, and osteoporosis. You should talk to your doctor about these conditions as well as any family history of high blood pressure or cancer.

Keeping up with your regular health screenings can help reduce your risk for further complications, as well as help with symptom management.

If your menopause-related symptoms are severe, your doctor might suggest targeted treatments to help improve your quality of life.

There are a number of things you can do to ease menopause symptoms.

For example, you might want to try home remedies — like cutting back on caffeine, lowering the temperature in your home, or sleeping on a cool gel pad — to help with hot flashes.

Trying to eat healthier, take nutritional supplements, and exercise regularly can also impact how you feel.

If your symptoms are severe, your doctor may prescribe you hormone replacement therapy gels or pills or a low-dose antidepressant to help balance your hormone levels.

The average woman experiences perimenopause symptoms for around four years before menstruation stops completely. Keep in mind that this time frame can vary, so this period may be shorter or longer for you.

If you think you’re approaching menopause, talk to your doctor. They can help determine whether you should continue taking your pill, switch to a different hormonal therapy, or stop using contraception all together.

Treatment options are available, so don’t hesitate to tell your doctor how you’re feeling.

Remember that this phase is only temporary, and that your symptoms will subside completely once your body adjusts to your new hormone levels.