Women who are perimenopausal or who have premature ovarian insufficiency do still need contraception as the hormone levels can be very variable. It is advisable that contraception is continued for 2 years after the last natural period in women under age 50 and for 1 year after the last natural menstrual period if over age 50. If menopause cannot be confirmed (for example you do not have periods as you using hormonal contraception) then contraception should be continued till age 55.
HRT is not a method of contraception. You can use methods of contraception such as barrier methods, progestogen only pill, progestogen Implant, copper IUD or Mirena IUS alongside HRT. The combined hormonal methods and DepoProvera injection should be stopped at age 50. The Mirena IUS is an ideal choice as it has the added benefit of controlling heavy periods and can be used as the progestogen part of HRT with minimal side effects. You can discuss your contraception options with us at Highland Sexual Health or with your GP.