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Feature Article

Contraception for women aged over 40: an important but neglected area

Deborah Bateson, Kathleen McNamee, Caroline Harvey, Mary Stewart

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Abstract

Older women need to be provided with evidence-based advice to guide their decision on whether to use contraception, and the method to use. Regular review of contraceptive options is important because a woman’s preferred method at the time of the perimenopause may be very different from that chosen in her early 40s.

Key Points

  • Women over 40 require evidence-based information about their need, and options, for contraception to reduce the risk of an unintended pregnancy.
  • Oestrogen-containing contraceptives and depot medroxyprogesterone acetate injections can be used by women up to the age of 50; after this age, women should switch to an alternative progestogen-only or non-hormonal method until contraception is no longer required.
  • Women over 50 who are using a non-hormonal contraceptive can be advised that contraception is no longer required after 12 months of amenorrhoea; those below the age of 50 should wait for two years of amenorrhoea.
  • Women over 50 who are amenorrhoeic while using progestogen-only contraception can be advised to continue using the method for only another 12 months if they have two follicular stimulating hormone levels of 30 IU/L or above taken six weeks apart.

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