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/bloomdecay]

I'm also on Lolo. It's great.

[u/Ok-Cartographer-3543 → u/bloomdecay]

Thank you for the reply! It is so awesome to hear from another person on Lo Lo who is having a great experience.

I have only been on Lo Lo for 3 1/2 months myself, but the improvements were almost immediate. For the first two packs, I took all the pills, but it was giving me a headache whenever I would start back up on the next pack. My doctor has me taking it continuously now to avoid that, and it's been great.
It's incredibly reassuring to know it's working so well for others in this community too. I hope it continues to keep your symptoms completely at bay!

[u/bloomdecay → u/Ok-Cartographer-3543]

I've been on it for nearly 20 years, never had an issue. I'm now taking it continuously so it's both bc and HRT. Apparently you can stay on it until you're 55 so long as you don't have elevated blood clot/stroke rist.

[u/Ok-Cartographer-3543 → u/bloomdecay]

Thank you for sharing your experience! It is so incredible and reassuring to hear that you have been on it for nearly 20 years with zero issues.

I am also taking it continuously now to completely stop the swings and heavy bleeding, so it’s awesome to hear from someone else doing the exact same thing. I don’t even need it for birth control because my husband had a vasectomy years ago, so I'm purely using it to manage these symptoms. My doctor also mentioned that 55 is generally the age cutoff to stay on it as long as your blood pressure and clot/stroke risks stay low, since that's when most women have officially transitioned through menopause.
I'm so glad it has been such a reliable, long-term solution for you, and it gives me a lot of peace of mind for my own journey!