Possible therapies to treat perimenopausal symptoms include: * Oral contraceptives. These are often the most effective treatment to relieve perimenopausal symptoms — even if you don't need them for birth control. Low-dose pills can regulate periods and reduce hot flashes and vaginal dryness. * Progestin therapy. If you have irregular periods, but you can't — or choose not to — use oral contraceptives, cyclic progestin therapy may regulate your periods. Some women with heavy bleeding during perimenopause may find relief from a progestin-containing intrauterine device (IUD). * Endometrial ablation. Endometrial ablation may provide relief from the heavy bleeding some women experience during perimenopause. During the procedure, the lining of the uterus (endometrium) is destroyed using a laser, electrical energy or heat, which effectively reduces menstrual flow or ends menstruation. This procedure isn't the right choice for everyone, so talk with your doctor about what is best for you.