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Although irregular periods during the premenopause are a sign of the age-related decline in fertility it is still possible to become pregnant right up until the
last period.
Your doctor can give you important help with choosing a suitable form of contraception, but he cannot make the decision for you.
In principle hormonal methods of contraception are just as suitable as non-hormonal methods. However there are some special things to be considered.
Hormonal methods of contraception
Most women over 40 have completed their family planning and contraceptive effectiveness is therefore a high priority. Hormonal contraceptives offer this effectiveness. They must always be prescribed by a doctor. Before writing the prescription the doctor will perform an individual benefit-to-risk assessment, i.e. he will weigh up the advantages of the hormone preparations against the possible risk in your particular case.
The modern low-dose pills contain particularly small amounts of hormones and can also be prescribed for women over 40.
Women in menopause also benefit from the
positive side-effects of the pill. In addition, the pill can alleviate
beginning menopausal symptoms and prevent irregular bleeding.
The frequently discussed risk of thrombosis is considerably greater during pregnancy or abortion than in women taking the pill.
The intrauterine system (IUS) is particularly suitable for women in menopause. This system is a T-shaped intrauterine device which contains a hormone reservoir. It is placed in the uterine cavity where it releases small amounts of a progestin continuously for up to 5 years. The IUS is very well tolerated.
A particular advantage of the IUS is that the build-up of the uterine lining decreases steadily in the course of its use. The longer the intrauterine system is in place the lighter, shorter and less painful the monthly periods become. Periods often stop completely. The IUS is therefore also suitable for treatment of abnormal menstrual bleeding, which is particularly common during menopause.
Non-hormonal methods of contraception
In principle all non-hormonal methods of contraception are suitable. The only exception are all forms of natural family planning (e.g. temperature method, calendar method), as women in the premenopause have unstable cycles. The contraceptive computer is also unsuitable for menopausal women.
Methods of male contraception
The particular value of the condom is that it also gives relative protection against sexually transmitted diseases.
Many couples in the second half of life turn back to coitus interruptus (withdrawal) as the older man has often developed the experience and self-control that the method requires. Nevertheless it should be emphasized that coitus interruptus interferes with the quality of love-making and also has a high failure rate.
Sterilization
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