When should menopausal women stop taking the pill? Experts warn they may need it longer than they think

Many middle age women experiencing symptoms of the menopause wonder when they can safely stop birth control.

Now experts at the Mayo Clinic have provided clear guidance on the matter.

They warn women to heed their advice as they say birth control is often something women, perhaps in their forties or early fifties, stop worrying about a little too soon.

Indeed, research that shows 75 per cent of pregnancies in women over 40 are unplanned.

Furthermore, some pregnancy complications and risk of miscarriage go up with age.

Here, gynecologist Dr Petra Casey from the clinic addresses some of thecommon questions older women ask of their gynecologists.

What age does the menopause start?

The menopause is when a woman stops having periods and is no longer able to get pregnant naturally.

Periods usually start to become less frequent over a few months or years before they stop altogether. Sometimes they can stop suddenly.

The menopause usually occurs between 45 and 55 years of age, as a womans oestrogen levels decline. In the UK, the average age for a woman to reach the menopause is 51.

When is it safe to stop birth control?

Signs of menopause can occur up to several years before a womans final period, a transition time known as perimenopause.Once you have missed your period for a year, you are considered menopausal and may safely stop birth control.

But be warned, if you reach 11-and-a-half months of no periods, then have a period, the clock starts all over again and youre still not in menopause.

Sometimes lab tests are also performed to confirm menopause, but most women dont need them.

About 90 to 95 per cent of women will be menopausal by 55 and may stop birth control then. But if you dont want to become pregnant, using effective birth control until you are truly menopausal is very important.

What birth control is best for women over age 35 or 40?

IUDs are recommended as the most protective form of birth control

If you are at a healthy weight, dont smoke, dont have high blood pressure or history of blood clots, you can probably continue the oral contraceptive pill, patch or ring well into your 50s.

Hormonal oral contraceptives can provide a number of benefits for perimenopausal women beyond preventing pregnancy.

These include reduced hot flashes, reduced menstrual bleeding and decreased risk of ovarian and uterine cancer.

What if I want to avoid hormones?

Perimenopausal women should not use estrogen-containing contraceptives if they smoke or have a history of estrogen-dependent cancer, heart disease, high blood pressure, diabetes, or blood clots.

If you would like to avoid hormones as you transition into menopause, you can use the copper IUD, barrier methods like condoms, cervical cap, diaphragm or sponge, or have a minor surgical procedure to tie or block your fallopian tubes.

Other great options which dont contain the hormone estrogen include IUDs, implants, shots and minipills.

Some IUDs contain the hormone levonorgestrel, a kind of progestin, which helps decrease or even eliminate heavy menstrual bleeding, a common problem for women in their 40s.These types of IUDs last three to five years.

Another kind of IUD is made of copper, does not contain hormones and can last up to 10 years.They are more effective than pills in preventing pregnancy.

What if Ive had unprotected sex?

Just in case you had unprotected sex and you dont wish to become pregnant, there are also several kinds of emergency contraception.

There are morning after pills thatcontain the hormone levonorgestrel, such as Levonelle, which work by delaying ovulation or release of an egg. They do not interfere with an established pregnancy or cause a miscarriage.

It is most effective when taken within 12 hours of unprotected sex, although it can be effective for up to 72 hours after sex.

Most women will experience menopausal symptoms.

Some of these can be quite severe and have a significant impact on your everyday activities.

Common symptoms include:

Menopausal symptoms can begin months or even years before your periods stop and last around four years after your last period, although some women experience them for much longer.

Source: NHS Choices

Another option which is more effective, especially if you are heavier, is ellaOne. Ella is effective in decreasing the risk of pregnancy up to five days after unprotected sex.

A copper IUD inserted within five days of unprotected sex is the most effective option for emergency contraception but requires an appointment with a health care provider. You can keep it for birth control for up to 10 years.

Can I combine hormone replacement therapy and contraception?

You can start on menopausal hormone therapy using an estrogen patch to help manage symptoms and use one of the progestin-only birth control options for contraception and to protect the uterine lining from growing too much with the estrogen.

The progestin-containing IUD, implant, shot or minipill all work well for this. If you have had a hysterectomy, you can take estrogen alone.

Your GP can help guide you in choosing the best birth control option for you during the menopausal transition.

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Mayo Clinic say menopausal women need the pill for longer - Stock Daily Dish

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