Contraceptives from 40: which one to choose? – Blog Dexeus Woman

Until the age of 40, almost 80% of women use some form of contraception. But from that age on, use begins to decline, and among those who have already reached 45, it stands at 60%. Many leave it because they begin to have irregular periods and believe that they have already entered menopause or perimenopause and do not need it because they can no longer become pregnant. But we must not lower our guard, since, precisely for this reason, the risk of an unwanted pregnancy is higher in older women than in younger women, because often menstruation becomes more erratic and it is not possible to know for sure when ovulation occurs.

But can you keep taking the pill? Yes, but you have to assess each case, since contraceptives that contain estrogens can increase the risk of having cardiovascular problems if you have other risk factors, such as hypertension, high cholesterol, obesity or a family history of thrombosis, stroke, or other diseases. . If you smoke and are over 35 years old they are also contraindicated. In these cases, there are other alternatives, such as progestin-only hormonal contraception, which does not carry these cardiovascular risks for your health, and which can be administered through different routes: oral, subcutaneous (implants), injectable or intrauterine.

Other women consider giving up contraception because they believe that it is bad to continue taking hormonal contraceptives for many years or that continuing to take it when you are older is dangerous for your health. But it is not true. What is certain is that we are entering a new stage, in which we must take better care of ourselves, because the passing of the years and the hormonal decline that menopause entails have an impact on our body and it is more frequent that some imbalances appear, or health problems, so it is a good time to get a check-up and consult our gynecologist if it is convenient to change the contraceptive method and assess which may be the best option.

In this post, Dr. María Suárez, expert gynecologist in contraception at Dexeus Mujer, answers some frequent questions.

Can you continue taking estrogen birth control after 40? TRUE

Yes, as long as they have assessed your personal risk. It is necessary to study if there is any risk factor that advises against its use, such as high cholesterol, hypertension, obesity, being a smoker and having diseases – or a family history – of diseases such as diabetes, myocardial infarction, thromboembolism, stroke, breast cancer or severe liver disease. In addition, they should always be taken under the prescription and control of a qualified professional.

Is it bad to take the pill for many years? FAKE

Many women are reluctant to continue taking it because they believe that it increases the risk of cancer and other diseases, and that it promotes weight gain, or that it will decrease their fertility, but it is not true. Oral contraceptives reduce the incidence of ovarian and endometrial cancer. Other long-term benefits are that they promote greater bone density and reduce premenstrual symptoms and the incidence of cysts and fibroids in the breasts. The goal of hormonal contraception is to improve a woman’s quality of life. If you are healthy, the combined hormonal treatment can be continued until the age of 50, and the progestin-only treatment until menopause.

It is better to choose methods with low hormonal dosesFAKE

Currently the combined hormonal contraceptive pills already have very tight and very low estrogen doses, even so there are several doses on the market. Tablets with slightly higher doses of estrogen tend to control the cycle better and better prevent loss of bone density.

Are there different types of estrogens? TRUE

There are currently several types of estrogens on the market, some of which are considered natural estrogens, which may have fewer cardiovascular risks and fewer side effects, such as estradiol valerate or nomegestrol, but this risk reduction is still under study.

If you have been a mother and do not want to have more children, is the IUD the ideal method? IT MUST BE VALUED

The ideal method is the one that suits each woman. There are two types of intrauterine devices or IUDs, the hormonal and the non-hormonal. There are women who do not want hormones, and the only method we have, apart from the condom, is the copper IUD. The hormonal IUD is used a lot in women who have already had children and seek the comfort of not having to remember to take a pill every day. It also has the advantage that many times you are left with very little or no rule, which is super comfortable for women.

If I am breastfeeding, should I avoid estrogen contraceptives? TRUE

Yes, because they can pass into breast milk and decrease its production. During quarantine, sexual intercourse is discouraged. Starting at six weeks postpartum, if you are breastfeeding, you can start taking contraceptives only with gestagens, insert a copper or hormonal IUD, or insert an implant.

If I continue to take birth control, I will not know if I am already in menopauseFAKE

Menopause usually occurs between 45-55 years. Through a blood test, follicle-stimulating hormone (FSH) can be measured, which helps control the menstrual cycle and stimulates the growth of eggs in the ovaries, but only if you are taking contraceptives that only contain gestagens. In any case, women are not prescribed estrogen contraceptives after the age of 50.

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Contraceptives from 40: which one to choose? – Blog Dexeus Woman


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