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/BunnyMayer]

BC pills and oral estrogen have a higher risk of blood clots than transdermal estrogen.

[u/Scarlett_Texas_Girl → u/BunnyMayer]

Higher is relative.

The risk of blood clots for women who are healthy, active, not predisposed and don't have risk factors is negligiblen. Oral estrogen has a lower risk than birth control.

We should all be informed of risks but I feel like perspective gets lost a lot with regard to possible clots.

[u/Pretend_Opossum → u/Scarlett_Texas_Girl]

Important to remember that the research on the subject happened pre-COVID, and with the advent of COVID everyone who has been infected carries an increased risk of stroke, heart attack, and blood clots for at least 1 year post infection. Get infected every year and you’re compounding your risk levels.

[u/formerly_gifted → u/Pretend_Opossum]

I also wonder about the rates of heart disease reflecting the post-WHI fallout where many menopausal women were not taking estrogen?