+ DOCTOR’S ORDERS

CONTRACEPTION FOR THE OVER 40S

One of the commonest questions that I ask in my surgery is ‘what contraception are you using?’, and often as women get into their late 40s and early 50s, they reply something along the lines of ‘oh nothing, I don’t need it now, right?’.

It’s true your fertility declines as you get older, but you can still get pregnant and many women do!

So if you wish to prevent pregnancy you need to consider contraception, potentially for longer than you might think. In fact, we cannot say you have gone through the menopause until you have not bled for one year.

If you go through the menopause under the age of 50 you need to use contraception for two years after your last period; if you go through the menopause after 50 you need to use contraception for a further one year after the last period. After the age of 55, the risk of pregnancy is so small that even if you haven’t gone through the menopause you can stop using contraception.

There are lots of choices, from barrier methods, such as condoms, to short-acting methods, such as the combined oral contraceptive pill and the progesterone-only pill. As long as you don’t have other risk factors or contraindications, you can continue on the oral contraceptive pill until 50, and the two hormones involved in the pill can work as hormone replacement at the same time. After the age of 50 you would need to change to another form of contraception. Long-acting reversible forms of contraception, such as a contraceptive implant, a contraceptive injection, a copper coil and a progesterone coil, can also be used. There are lots of options, so speak to your GP.