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Constance Zimmer was on birth control “for way too long.”
“My general practitioner had told me I should get off my birth control at 50,” she told The Post. “I had an IUD, so I was like, ‘Oh, next year, next year, next year.’”
The 55-year-old star, known best for her roles in “Entourage” and “UnREAL,” had gotten pregnant at 36 when she was told it was impossible — so even in her early 50s, she was hesitant to come off it.
But what she didn’t realize was that the hormones from her IUD were masking the fact that she was in perimenopause. And when she finally got it removed, the change was staggering.
“I never had the ramp-up. I had the f – – king ‘drop you off the cliff,’ which I do not recommend to anyone, because you do basically feel like it’s over,” she said.
How birth control affects perimenopause
According to the CDC, about 15% of women aged 40 to 49 are on hormonal birth control, whether it be the pill or a more long-term method like IUDs or implants.
Hormonal birth control uses estrogen, progestin or a combination of both to stop women from getting pregnant. The body produces these hormones on its own, but introducing more into the system — and at a steady level throughout the month — can disrupt the natural reproductive processes.
In perimenopause — the period before women stop menstruating completely, when their cycles are irregular and they have symptoms like hot flashes, brain fog and mood swings — those added hormones can also cover up the changes in your natural hormones.
It can keep your period regular when it might be naturally coming less often, and can also stop estrogen levels from dipping and leading to hot flashes and mood swings.
That’s what happened to Constance, who felt pretty normal — except for one small change.
“The only reason why I knew something was wrong was because I couldn’t sleep,” she said. “And I can sleep anywhere, sleep for 10 hours — and all of a sudden I couldn’t sleep.”
Still, she brushed it off as anxiety, depression and even COVID before getting answers. “I never thought it was hormonal. I thought it was external,” she said.
Finally, her doctor insisted she lose the IUD.
“My GP was like, ‘No, you really need to get off of it. You don’t even know what your body is doing right now,’” she said. “So I took my IUD out, and within three months, I basically was hit with everything all at once.”
She describes herself as “one of the unlucky ones” who “basically got every single symptom all in one day at the same time.”
“There shouldn’t be any shame. There shouldn’t be fear about talking about the stage that you’re in or the age that you are.”
Constance Zimmer
It’s not necessarily bad to stay on birth control into your 50s. According to Dr. Heather Hirsch, author of The Perimenopause Survival Guide, many women can be on it until they’re 55 — and they might find it gives them relief from perimenopause, as it initially did for Constance.
“It may ease the symptoms,” Hirsch told The Post. “However, some women find that they will experience symptoms through the pill and may need to transition to menopausal hormone therapy.”
MHT, also called hormone replacement therapy or HRT, often works better than birth control for this purpose, she said.
While birth control uses high doses of synthetic hormones to suppress reproductive function, MHT uses much smaller doses of body-identical hormones that are meant to simply replace what your body has stopped producing naturally. That means it can often better target specific symptoms of perimenopause.
Celebs speaking out
In the past couple of years, menopause and perimenopause have exploded in the media.
Stars like Gwyneth Paltrow, Halle Berry and Salma Hayek have talked about their experiences. Many have even created or teamed up with menopause brands, like Naomi Watts and her Stripes Beauty brand, Kim Cattrall with Natural Cycles and Jenna Bush Hager with Midi Health.
But that discourse nearly popped up overnight. In the decades — and centuries — prior, anything related to “the change” was largely taboo and hush-hush.
“Everything was a surprise, because a year ago, no one was talking about it,” Constance said. “The only thing that wasn’t [a surprise] was hot flashes, because that’s what’s in the movies, because that’s what storytellers are allowed to attach to a woman in menopause. It’s the only thing I saw from my mom.”
Since then, she’s turned to other hormones to help with her symptoms.
“I’m on HRT, I’m on the patch. I have progesterone, I take testosterone. I changed my diet [to pescatarian]. I take more vitamin D,” she said.
“You have to take the time to take care of yourself. Nobody is going to do it for you … When you go through perimenopause, menopause, midlife, it’s the first time in your life that you put yourself first, because you don’t have a choice.”
She’s now speaking about her experience so other women feel less surprised — and she’s using film to get the message out, working on projects to tell honest stories.
“I’m not afraid of talking about it. And I think that is where we need more people to show up — there shouldn’t be any shame. There shouldn’t be fear about talking about the stage that you’re in or the age that you are,” she said.
“Women carry so much shame — period, end of sentence,” she added.
“It’s all about that [idea that] younger is supposed to be better. And I think that this generation is changing that narrative and saying it’s not. Stronger is better, healthier is better, awareness is better, and us not hiding in the shadows — but instead us coming out into the light so that we can have the next generation be a lot more prepared for this time.”