HOT FLASHES are the undisputed tell. And sometimes, while on hormonal contraception, the period does not appear or reminds us of when we first started menstruating - hardly more than a spotting. If she is on Seasonale or other that eliminates the periods for a long time,w e switch back to the monthly pill.

I tend to keep patients on the pill because pregnancy has occurred during menopause several months after the last real period. And then we talk about hormone replacement therapy. Controversial, yes, but with my first hot flas I wrote myself a script.

Do not presume anything. Menopause is only a bit less predictable and uncomfortable than puberty. I have see women go six months, give up contraception and wind up pregnant.

Especially being on the shot, which I do not recommend, it takes a while to get the stuff out of her system. She should have a good chat with her doctor and maybe get out her old diaphragm (or, better, a new one) for a few months.

Might wish to talk to your Mom about switching off the Depo. and on to oral BCPs. This was the first step a Gyn took with me for Hormone supplement and since I also required BC.

Later, after no period and the physical symptoms had disappeared fully [hot flashes, no real period happening, etc.]; I was put on HRT which is a lower dose of the combo BCP [Estrogen & Testosterone] and was told to take the Progest. daily [rather than 12 days a month only] when the physician had monitored me for long enough. He said the Combo of the two HRT daily [Progest. in one first pill, with combined Est. & Testosterone in the second pill] was sufficient at that time to prevent a pregnancy & obviously since single [condoms were recommended].

Well, so far so good & no issue. I was very concerned myself about his recommendations since the potential for a pregnancy is present yet would be a disaster due to the eggs being bad, if one did release. I knew there was no options other than to term. the preg. However, I have been fine on the lower dose over the BCP's and feel much better. I would have your Mom discuss options with her Gyn when the Depo is wearing out. Also much has to due with if she is able to take estrogen based contraceptives secondary to any family history of breast CA. If this is a positive risk, the good old barrier method and nature doing what it does on its own [going through the change of life] it what needs to be. Brandye is having a better time than I with the symptoms than I!

At best I could say days I felt jittery, hot flashes, nervous, lack of sleep, occasional mood swing which mimicked insanity [to me] until I sought medical care for them...the key was the skipped periods accompanying all this. And well; Estratest is my best friend after taking it honestly 6 months...and adding the Progest. helped mimic a normal hormone level which a woman at my age [just after 40] should have...the libido followed. The BCP's were okay for a temp measure but the Estratest was the best relief for me since I was "absent", such as, "no detectable traces of serum hormone measures present" on several occasions confirmed by Medical Centers & Docs. Present were hot flashes, mood swings, no cycle, and no libido...the dx? Premature Ovarian Failure at a late age since it's more often seen in younger women!

Bear with your mother...some day you will see what it feels like. Hopefully you both "transition" more as Brandye has v. myself! One significant point is when women hit this point, realize there is help. The first symptom was lack of libido [rather mow the lawn than look at a man] accompanied with hot flashes to BEAT the band! Later the cycle went askew--followed by some "nuttiness". Be open with your Mom & keep a good dialogue happening she is happy to have you! My Mom was ready to sent me to the Psych ward first!!! I also agreed if there were no real physical findings I would seek psych treatment! Thankfully, it was just hormones for me at a early age.

B:

What I was told by the Gyn was take the pills and if I did not get a period just begin the new pack if I did [or did not] get a period. Take the pills wait and re-start at the usual time. The BCP is fine...

Over a few months, some symptoms eased some did not...loss of libido was a killer for me...so I was put on the HRT which is a lower dose of BCP's; however, I had testosterone in mine. Rare bleeding but the hot flashes a wild-ass mood swings finally left. Now about a year and half later? No period. I was told to take the HRT daily [both pills for BC] and add a condom being single. Now back to my usual very sexual self.

I did not know what was wrong with me since I was very young...I had no need to look at a man! I'd rather go & mow the lawn. Had the onset of mild then progressive hot flashes with a odd period, skipped days or months. Then felt like a psychopath who was sweating even out to dinner w/family. I went to the gyn begging for lab work. I thought it would come back normal...I was ready to go see a psychiatrist...the doc called about the hormones & levels...and back in for a repeat visit--welcome menopause & it takes about 4-6 months until. you feel better with hormones [yes, they help initially but not to the extent you thought]. How one gets the hormones? BCP or HRT? Does not matter...preventing an unwanted pregnancy during this phase is essential and either will help with ovulation prevention. Let her period do whatever it chooses, not a big deal assuming all else is ruled out. No period does not=no ovulation!

Honestly; she needs to see her gyn...why? There are risk factors associated with Hormone use; DVT, smoking history, chance for failure of the pill, history of breast cancer in the family, etc. Only she & her doc can make the choice...I would, at over 40 if in her shoes, choose an IUD either w/ or without synthetic hormones based on my medical history.

Only she can choose what is best for her...with all the information given by her MD.

The main risk when going through or beginning the onset of menopause is you may or may not ovulate. Just because you are missing a period for 3 months does not mean the next month you may not get one or there is no indicator as to if you will/will not ovulate. Hence, Brandye's warning. Generally most Gyn's say no period for one year and menopause is here & it's confirmed with labs as well. There is no guarantee.

BCP's suppress [stop ovulation] if taken properly. Yet they also still have a failure rate and some medications interfere with the efficacy of the Pill. Remember someone has to be the margin of error while using the pill and taking it 100% correctly.

Lack of ovulation is the same if it's via BCP use or due to the ovaries shutting down when at the end of child bearing years; it's just how it's induced. However, there are a few who believe they are "home free" and find out an unpleasant & unplanned surprise. The main issue with those who are older, or as myself, the eggs even if you are to ovulate are too old & a pregnancy is risky for the unborn child; it has to do with having a child with Downs or other birth defects.

If a woman who is young becomes pregnant while on the pill, they have viable eggs & the pregnancy has other issues but not close to those who are older. I honestly believe women should not have children after 40 and believe even pushing close to 40 is too risky. Your body is intended to reproduce earlier on. I know how science can make "miracles", as they say, but the only real option is through someone else's eggs and pumped up full of hormones. Then chase a toddler around? No way! Thinking at 46 say; there would be a child born and when that child is 16; I would be 62 teaching them to drive? And when I am 64 they graduate from HS? NOPE!

If you want to learn more, there is a great deal of info on the Internet of Menopause...look under any Women's health sites, your mom may love you for it! Good luck!

You are adding significant facts. That is the reason physicians want a full medical history for anything. I do hope that she is being guided through the withdrawing of the anti-depressants.