Contraception in women over 40

March 4, 2013

Despite declining fertility, women over age 40 still require effective contraception if they wish to avoid pregnancy. A review article outlines the risks and benefits of various contraceptive options for these women. The article, based on current evidence and published in CMAJ (Canadian Medical Association Journal), is aimed at helping physicians find the best methods for their patients.

The benefits of use outweigh the risks for most contraceptive methods used by women over 40. Even for women with risk factors for complications, methods are available that can be safely used to prevent unintended pregnancy. Several methods are considered "top-tier" by the , including copper IUDs, progestin implants and sterilization.

Contraceptives containing estrogen should be used with caution in women over 40 who have , because of the increased risk of blood clots. Although some patients are concerned about an increased risk of cancer, studies have not shown a negative link between oral contraceptive use and cancer. Use of oral contraceptives is associated with a reduced risk of endometrial and ovarian cancer.

In addition to preventing pregnancy, can have some additional noncontraceptive benefits for women over age 40 years, such as alleviating heavy menstrual bleeding and diminishing hot flashes in perimenopausal women.

Condoms and diaphragms may also be effective, because failure rates are lower among older women than among younger women.

" will be required to balance the risks and benefits when a woman has multiple medical conditions," writes Dr. Rebecca Allen, Warren Alpert Medical School of Brown University, Women and Infants Hospital, Providence, Rhode Island, US. "The availability of safe, effective options suggests that estrogen-containing methods should increasingly be used with caution in older women who have cardiovascular risk factors."

Explore further: Risk of blood clots two-fold for women with polycystic ovary syndrome on combined pill

More information: www.cmaj.ca/lookup/doi/10.1503/cmaj.121280

Related Stories

Recommended for you

Technique for 'three-parent baby' revealed

April 3, 2017

Details of a pioneering IVF technique using mitochondrial replacement therapy (MRT) have been revealed, giving hope to those families with inheritable mitochondrial disorders that they may be able to have healthy children ...

Technology to screen embryos before implantation falls short

March 31, 2017

The healthy development of an embryo created through in vitro fertilization (IVF) depends on whether most, if not all, of the cells have the proper number of chromosomes. With pre-implantation genetic screening (PGS) technology, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.