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The difficulty at perimenopause comes if you might be using hormonal contraception, such as pill, the patch, or vaginal ring and others. Good question, as its not all birth control pills contain the identical quantity of estrogen and progestin. I thought a good reference in your case is a number of low dose and ultra low dose pills to help you at the least discuss the pros and cons with the doctor to see if you're an good candidate to maneuver from say, a small dose 0.035mg estrogen pill as a result of an ultra low dose 0.020mg estrogen pill. You will find you have fewer or reduced unwanted effects. Generic brands in low dose birth control pills are offered also. PROGESTIN only pills (the 'mini pill') don't contain estrogen and simply have a very bit of progestin included. Breastfeeding women will often be prescribed these 'mini pills' (estrogen could cause a decrease in milk supply) along with ladies who cannot take synthetic estrogen for medical reasons. 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Alesse: Cheapest Without A Prescription