Contraception & The Menopause

You may have spent your teens or 20s worrying about not getting pregnant, some years worrying about getting pregnant and then a period of time worrying about not getting pregnant again!

Yet in my daily discussion with women in their 40s and 50s, it seems like contraception is often not thought about, and yet many of us know someone who fell pregnant around the age of 50 as a surprise!

Although you may be having symptoms relating to the menopause years before your periods end, your ovaries may still be working, all be it sporadically, and they can continue to do so for a while after the menopause.  So we need to think about safe sex, and by that, I mean safe, both from the risk of pregnancy and sexually transmitted infections.

The golden rules are these:

You are considered to have ‘gone through’ the menopause if you have not had a period for over a year.

If you go through the menopause under the age of 50, you will need to use contraception for a further two years.

If you go through the menopause after the age of 50, you will need to use contraception for a further one year only.

Contraception is no longer needed after the age of 55.

You need to use contraception even if you are taking HRT!

But, even when there is no risk of getting pregnant, there is still a risk of STDs, so unless you will need to continue using condoms unless you and your partner have agreed otherwise!

HRT

So what should I use?

There are lots of options, from the short-term to permanent, and what is most suitable for you will depend on your medical history, any other medication and, of course, your own personal choice.

Options include:

Barrier contraception – male condom, female condom, diaphragm and cervical cap. Of these, the male condom is the most effective and protects against sexually transmitted infections.

Pills – the combined oral contraceptive pill can be used up until the age of 50 and can be used as HRT as it contains both oestrogen and progesterone. Or a progesterone-only pill can be used until age 55.

Long-acting reversible contraception – these are all extremely effective, over 99% effective – they work!

Progesterone injections – given every 12 weeks.

Progesterone implant – can last up to three years. Intrauterine device – copper coil – licensed for 10 years, but if it is inserted after the age of 40 can be used until you go through the menopause. The copper coil doesn’t contain any hormones but tends to make your periods slightly heavier and longer.

Intrauterine system – hormone coil (generally a Mirena is used), containing the smallest amount of hormone of any form of contraception. The Mirena is licensed for 5 years, can help with heavy bleeding as by one year 90% of women have no bleeding at all AND can be used as the progesterone part of HRT, so is a great multitasker!

Permanent methods – male and female sterilisation.

So there you have it, a whistle-stop tour of contraception around the time of the menopause.  See your GP or local family planning clinic for more information and advice so that you can keep having sex, free of the worry of pregnancy and infections!

There is also lots of information on Dr Philippa Kaye's website.


Dr Philippa Kaye is a GP, author, journalist and mother.  She knows that one of the core skills of medicine is being able to translate ‘medicalese’ into English and has used this skill to write five books on subjects ranging from pregnancy to child health and development. 

She is the medical expert for Woman,  My Weekly Special and Smallish magazines and regularly contributes to the print and online press. She has previously been the medical expert for various magazines such as Junior, Sugar and Prima Mother & Baby and websites such as raisingkids.com

As with many working mums, Dr Philippa has a second job – parenthood, which truth be told is often tougher than the doctor day job! Most of her spare time is taken up with family and she is happiest cooking in her kitchen surrounding by family and friends, talking, eating and laughing, a lot.
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