Birth Control Options When Childbearing is Over

The older you get, the more you know, right?

In most cases, yes, but in terms of contraception, it’s a different story. Some women think that after they turn 40, getting pregnant is no longer a concern.

The truth is…if you can get a period – no matter how erratic your cycle is – you can get pregnant. The odds clearly decrease with age, but it can and does happen.

So, maybe it’s time to re-evaluate your method of birth control.

A study shows that on average women age 18 to 45 years will change their birth control method 10 times, says Michele Curtis, MD, professor of obstetrics and gynecology at The University of Texas Medical School at Houston.

The key is to find a method that works for your current lifestyle.

“Birth control is like a pretty pair of shoes you overpaid for and aren’t wearing,” says Dr. Curtis. “If they look great in the closet but aren’t comfortable, they’re worthless. You’ve got to find a method of birth control that fits, that you’ll use.”

Which method is right for you?

Choosing a method of contraception as you age depends on your medical conditions, lifestyle, and goals. Some women know they’re done with childbearing but don’t want the finality of sterilization. Others don’t like having to remember to take a pill each day so they choose a long-acting reversible contraceptive. Still others have health conditions that rule out certain forms of birth control.

Here’s a rundown of some popular forms of birth control for women in perimenopause.

Oral contraceptives. “There’s this idea that once over 35 you can’t take the Pill,” says Dr. Curtis. That’s only true if you smoke or have a history of diabetes or hypertension. A low-dose birth control pill is not only effective contraception but will help with hot flashes and regulate unpredictable bleeding.

Sterilization, or tubal ligation, is the most common form of contraception. This surgical procedure involves cutting or tying the fallopian tubes to permanently prevent fertilization. The procedure can now be done in a doctor’s office without sedation using Essure, an FDA-approved, permanent technique.

NuvaRing is a vaginal ring that releases a low dose of a progestin and estrogen over 3 weeks and is then removed. These are the same hormones found in the Pill, making it just as effective — 99%. “Women like not having to think about it for 3 weeks,” says Dr. Curtis.

ORTHO-EVRA® is a small patch that sticks to your skin and releases progestin and estrogen. You place a new patch on the skin once a week for 3 weeks followed by a patch-free week. The patch is as effective as the Pill. If you swim with the patch and it gets loose, take it off, wave it gently to air dry and then reapply.

Intrauterine device (IUD). Two types of intrauterine device are FDA-approved: the copper IUD (ParaGard®, which is hormone-free) and Mirena (which releases progesterone). “We’re seeing an increase in the use of the IUD, because many women are looking for a long-acting reversible method of contraception that they can put in and forget about.” The Mirena IUD is good for use for 5 years and ParaGard for 10 years.

Vasectomy. That’s right – the onus of contraception is not completely on you, girlfriend. This brief outpatient procedure – meant to be permanent — is quick, effective and safe. “It’s underutilized and underappreciated as a form of contraception,” says Dr. Curtis.

Depo-Provera is a shot that prevents pregnancy for up to 3 months with each injection. Depo-Provera is a drug that is very similar to progesterone. “Some women love it,” says Dr. Curtis. After 2 years of use, you may begin to lose some of the calcium in your bones that may not be regained.  “Women need to take 1000 mg calcium/day,” she says.

What method is right for you? Be sure to talk with your doctor about the risks of each method and what works with your lifestyle.



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