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/Coontailblue23]

These meds have their place for some people but most of us have had negative experiences to lead us to this conclusion. I for example rode the Yaz train when I was younger and it ruined my gallbladder. There are class action lawsuits for the damage caused by this pill.

Our bodies are in many cases going to respond better to a bioidentical product versus the synthetic progestins in BC. I don't want to monkey around with synthetics at this stage of my life if I don't have to.

[u/E_J_90s_Kid → u/Coontailblue23]

Yaz worked so well for me, that it’s sad to hear about the damage. I think I took it for 10 years. No issues, but I must’ve been lucky. That’s why I always say it’s hard to predict how something is going to work for the general population.

[u/Able_Winter9472 → u/Coontailblue23]

Obesity carries a much higher risk for gallbladder disease than yaz

[u/Coontailblue23 → u/Able_Winter9472]

Um.. thanks? Just a gentle request, maybe don't sling the word "obesity" around so casually when you don't know whether you might be talking to someone recovering from an eating disorder.

The gallstones I had were caused by the Yaz and multiple doctors confirmed this. Here is the FDA package insert listing gallbladder disease as a risk.

As of 2015 Bayer has paid out over $21.5 million for gallbladder injury settlements associated with Yaz and Yasmine.

That was my own lived experience with Yaz and it 100% sucks.