Contraception and the Menopause
As age increases, fertility declines in women. Many women would consider an unplanned pregnancy over the age of 40 years a “disaster”. Other women are tempted to abandon contraception as they get older as they think they are unlikely to conceive. Pregnancy rates in those not using contraception are 10-20 per 100 women at 45years, 5 per 100 women years at 50years.
Older women have a higher risk of hypertension induced by pregnancy and gestational diabetes. The risk of fetal abnormalities, maternal mortality and an increase in chromosomal disorders such as Down’s Syndrome increases with maternal age. Hence, there is a need for effective, acceptable contraception in older women The normal recommendations is to continue contraception after the final menstrual period for at least two years if the woman is younger than 50 years and at least one year if she is older than 50 years. HRT is not a contraception. Contaceptive choice may be influenced by many factors and women should seek advice on all suitable long term methods available to enable them to make a choice.