The best method of contraception for women of over 40 years of age can be influenced by many factors, such as sexual intercourse frequency, decreased fertility, sterility, menstrual disorders, or general health.
As women get older, the fertility is starting to fade out. Although, women need to use birth control after 40, too, if they do not want to become pregnant. Between ages of 30 and 40 years, fertility will decline by about 50%, however, pregnancy can still occur until menopause, so it is important to be informed about the contraceptive options that reduce the risk of an unplanned pregnancy.
Now, it may be the right time to re-evaluate your options of birth control after 40. Women who do not want children could consider long-term methods of contraception or permanent.
Another aspect to consider is that some contraceptive methods offer supplementary non-contraceptive benefit, which may be useful in this stage of your life. Some contraceptives help to regulate the menstruation and can relieve from menstrual pain or discomfort. This could be especially beneficial for women experiencing irregular menstrual bleeding due to an ovarian function disorder.
Birth control over 40
Birth control methods may be influenced by several factors in women of over 40 years, such as regulating menstrual bleeding, change in marital status (separation, divorce, a new relationship), effective contraceptive method, possible side effects, protection against sexually transmitted infections, impact on other health problems or tolerance to certain substances.
Combined oral contraceptives
Combined oral contraceptive pills consist of a combination of estrogen and progestin. Women who are not at risk of any cardiovascular disease and who does not smoke may continue to use this form of birth control until menopause or until they reach the age of 51 years.
The combined oral contraceptives pill can bring other benefits besides the contraception effect:
- regulating menstrual bleeding
- reducing the incidence of gynecological diseases, such as pelvic infections, ovarian cysts and ovarian and uterus cancers
- reducing the menopause symptoms, such as hot flashes and vaginal dryness
Some of the side effects may be breast enlargement, hypersensitivity, nausea, bloating, loss of libido and increased risk of breast cancer.
The use of combined oral contraceptives is associated with an increased risk of cardiovascular complications in women who smoke or suffer from hypertension, diabetes, or who suffer from obesity.
The benefits of taking oral contraceptives, however, are numerous in nonsmoking women aged between 40 and early menopause age, not incurring any additional risk for cardiovascular disease.
The Mini-Pill (progesterone based – POP)
This pill contains a low dose of a synthetic progestogen.
Women who can not take the combined pill (nursing, women who smoke, or have cardiovascular risks, or have unpleasant side effects caused by the administration of estrogen) can appeal to this type of progesterone-based pill, the Mini-Pill.
Mini-Pill must be taken every day to ensure its effectiveness, without a break, not even during menstrual bleeding. A pill is considered inefficient if there is a delay in the administration of more than 3 hours.
Side effects may include irregular menstrual bleeding, headaches and breast tenderness. Mini-pill does not offer additional non-contraceptive benefits, such as those offered by the combined pill and no protection against sexually transmitted diseases, or against sexually transmitted infections.
Condoms provide an effective contraceptive only if used correctly and consistently. Condoms are a suitable choice for those entering a new relationship because besides contraception, reduce the risk of sexually transmitted infections or diseases, being the only birth control method that protects against the infection with HIV.
Lubricated condoms may be useful for women of over 40 years old that are experiencing vaginal dryness.
A big advantage in using condoms is the lack of side effects. Condoms can be used during pregnancy or breastfeeding, but some women may be allergic to the latex the condoms are made of, this allergy being manifested by the appearance of itching, rash, urticaria or asthma.
Copper IUD (Intrauterine Device)
A copper Intrauterine Device (IUD) is a small, flexible device made of plastic and copper that provides a highly effective birth control after 40.
It is inserted into the uterus through the cervix. Some IUD can be used continuously for up to ten years.
A copper intrauterine device fitted in women of over 40 may remain valid until menopause. The mechanism of action is given by limiting the ability of sperm to cross the uterus, canceling the fertilization process.
A hormonal IUD is a small plastic device that also provides a highly effective contraception. It is inserted through the cervix into the uterus and releases a low constant dose of progesterone. It is guaranteed to work for up to five years.
It is ideal for women experiencing menstrual problems such as heavy bleeding.
Intrauterine Devices (both copper IUD and Hormonal IUD) can be installed only by a gynecologist.
In the cases of women who have more sexual partners, the IUD is not the best contraceptive method because it does not protect against sexually transmitted disease.
Also, there is a risk of uterine perforation and infections, but which can be detected in the first 20 days of use by observing specific symptoms such as abdominal discomfort, fever, abnormal vaginal bleeding or discharge.
Tubal ligation birth control after 40 methods is a form of an irreversible contraceptive method, that became very popular among women of over 40 years.
This method involves blocking the fallopian tubes by cutting, burning or using clamps that will prevent the movement off the ovule into the uterine cavity, where the fertilization occurs.
Tubal ligation is performed using a laparoscopic procedure under general anesthesia.
Tubal ligation has no effect on sex drive, and most women do not suffer from menstrual disorders after this procedure.
It is important to be aware that tubal ligation method is completely irreversible.
Male sterilization or vasectomy involves the cutting and tying or blocking the canal that carries the sperm from the testicles to the seminal stream. The procedure is performed through small incisions in the scrotum and it usually requires only a local anesthetic.
A vasectomy does not affect a man’s sex life, the only difference being the absence of valid sperm.
Side effects of male sterilization include bruising and discomfort for several days after the procedure. Vasectomy is not effective immediately after the procedure and there are recommended other forms of contraception for three months after the surgery. After three months, semen samples should be tested to confirm that no longer carries sperm and vasectomy was successful.
Combined vaginal ring
The combined vaginal ring is a combined hormonal contraceptive that is inserted into the vagina for three weeks and is removed in the 4th week of every month. It is made of plastic and it constantly releases a low dose of estrogen and progesterone which acts as ovulation inhibitors.
The vaginal ring is a viable birth control after 40 until menopause because it contains a low dose of estrogen and provides effective control on the menstruation.
Women who use the vaginal ring can experience the usual side effects of the combined pill, such as breast enlargement and tenderness, nausea, bloating, loss of the libido, migraines, or the appearance of a slightly increased risk of breast cancer. The expulsion of the ring can occur in women who suffer from low muscle tone in the pelvic area, or obesity.
The diaphragm is a soft rubber membrane, dome-shaped, that once placed in the cervix is blocking the sperm way to penetrate the uterine cavity. It is mounted before intercourse and should stay inside the vagina for at least 6 hours after the last vaginal intercourse. Note that a diaphragm should not be kept for more than 24 hours inside the vagina. The diaphragms are used in combination with spermicide – a gel that neutralizes sperm and prevents the fertilization of the egg.
On first use of the diaphragm, it is advisable to seek the help of a specialized physician who will insert the diaphragm and also will provide a briefing for later use. Contraceptive diaphragm needs to fit women’s anatomy and any relevant body modification (weight loss, or weight gain of over 5 kg) requires a medical examination to adjust the diaphragm measurements.
Some women may experience an allergic reaction to the latex or the spermicide. The diaphragms are also associated with a slightly increased risk of urinary tract infections.
Progestogen contraceptive implants
A progestin contraceptive implant is actually a small rod, about 4 cm long and 2 mm wide, which is inserted under the skin in the upper arm by a specialist. It provides very effective contraception for up to three years.
Since they do not depend on a regular administration, progestogen contraceptive implants are among the most effective birth control after 40 that allow a normal sexual activity.
The rod slowly releases a dose of progestin and protect against pregnancy for three years.
Side effects of progesterone implant include a slight weight gain, decreased libido and mood swings. This method of contraception is reversible and can only be removed by a physician.
Coitus interruptus (withdrawal method)
This method involves the withdrawal of the penis from the vagina before ejaculation. It is important to realize that even if the penis is withdrawn in time, the pre-ejaculatory fluid often can contain sperm that can cause a low success rate in using this method. The effectiveness of this method is 81-96%.
Natural family planning methods
These methods involve determining the fertile days and non-fertile using the calendar method.
While natural methods can be effective for younger women with regular menstruation periods, they can be a problematic birth control after 40 years. Normally fertile period begins 5 days before ovulation and lasts until one day after ovulation. To determine the day of ovulation must count 14 days from the first day of menstruation. Irregular menstrual periods and hormonal fluctuations of women of over 40 years of age make it harder to calculate the ‘safe days’.
If a contraceptive method fails or is overlooked, emergency contraception can be used as an alternative method. The main forms of emergency contraception available are copper IUD and the emergency contraceptive pill.
Inserted within five days of unprotected sex, the copper IUD prevents pregnancy and will provide long-lasting protection for women who choose to continue using it.
The emergency contraceptive pill can be taken within 72 hours after the unprotected intercourse. It can be obtained without a prescription.
Women who use hormonal birth control after 40 that causes irregular menstrual periods can switch to a non-hormonal form of birth control to see if menstrual periods regulate.
Women who use birth control pills are advised to discuss their options with the physician in order to switch to another method of contraception around the age of 50, given the fact that contraceptive methods benefits will become outweighed by the risks incurred, such as blood clots or the occurrence of cardiovascular diseases.
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