Perimenopause, such as postmenopause, is a physiologic condition that could be accompanied by several symptoms that may need a medical intervention. Women need to be informed about the available therapeutic options, including no treatment at all if not necessary. Oral hormonal contraceptives represent a valid and safe option in healthy premenopausal women with complaints. They guarantee a safe and reliable contraception in women without contraindications. The alternatives to oral hormonal contraceptives are injectable progestagens, oral progestagen-only preparations, progestagen implants or progestagen-loaded IUD's. It is highly important to inform correctly the patient and make her to participate actively in the therapeutic decision. This educational process helps in building a solid relationship and improves patient adherence with better clinical results.