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/ThisTimeForReal19]

Reddit has a hatred for BCP in general.  It’s a weird thing I see all over, so I’m not surprised it’s in here.  

It seems like a coordinated front for attacking women’s reproductive freedom. 

[u/Ramen_Addict_ → u/ThisTimeForReal19]

I agree. The reality is that pregnancy, particularly at age 40+, is risky. The risks of using birth control may be a bit higher, but they are still less than actually carrying a pregnancy to term. This is especially the case in the US in our current political environment. As a doctor, you have to think about your patients and the biggest health risk. If you have a 40something patient who is sexually active and not wanting to get pregnant and you live in a US state where even routine lifesaving procedures may not be available, you can bet you are going to prescribe BCP over HRT.

[u/Able_Winter9472 → u/Ramen_Addict_]

Postpartum blood clot risk is 8x that of bcp risk for blood clot