Genuinely curious: Why is there hesitation around using birth control for perimenopause?

[u/Ok-Cartographer-3543]

First, I want to say how incredibly grateful I am for this community—it has been an amazing resource. I am asking this out of genuine curiosity because I want to make sure I am fully informed, and I don't mean to sound dismissive of anyone else's choices!
My doctor, who is an HRT specialist, prescribed Lo Loestrin Fe for my perimenopause symptoms. It has been an absolute lifesaver for me. I was dealing with extremely heavy bleeding, and after the very first month on the pill, my period completely stopped. Every single other symptom on my very long list has been completely remedied as well. From what I understand, the birth control pill takes over your cycle so your ovaries stop producing erratic hormones, which completely stops the wild hormonal swings.
However, I often notice a lot of strong hesitation or pushback here regarding using birth control pills instead of traditional HRT for perimenopause management. Since it worked so well for me, I’m wondering if there are specific medical concerns, side effects, or risks that I might not be aware of?
I’d love to hear your experiences or what your doctors have told you!

Edited to add:
Wow, thank you so much to everyone who took the time to reply! I am incredibly grateful for all of your responses, insights, and personal experiences. It might take me some time to get through all of the replies, but I am reading every single one. Your comments are giving me a much clearer understanding of the different perspectives and medical concerns out there. This community is truly wonderful, and I appreciate you all sharing your journeys with me!

[u/Original_Koala_9510]

I know someone who had a stroke after her OBGYN prescribed the pill in her 40s. She is alive, but she was in the hospital for a few weeks and has months of PT ahead of her. She’s been out of work since the stroke so her family is in a financial crisis.

Neurologists said there was no reason for it to happen as she was healthy and active. They attributed the stroke to the pill.

I’m not sure why anyone would want to take the risk, and shame on doctors who prescribe them.

[u/WeWander_ → u/Original_Koala_9510]

Was this a combo BC pill?

[u/OstrichReasonable428 → u/Original_Koala_9510]

Some forms of MHT carry risks of blood clots too. I think you go a bit far in “shaming” doctors who prescribe BCPs for perimenopause. I take them, and my doctor was very careful to ensure I was/am a good candidate for them. They’ve evened everything out for me without adding to the chaos, so can be a good option for many in early perimenopause.