Best Birth Control Methods for Perimenopausal Women

Perimenopause is that brief few years in a woman's life just before she hits full menopause. Since the average age for women reaching menopause in America is 51, the perimenopausal years are typically in the mid to late 40s. Although women's fertility declines sharply after age 40, that doesn't mean we can't get pregnant. So how should perimenopausal women handle contraception? What are the best birth control methods for us?

Unintended pregnancies in older women

According to the 2007 book Contraceptive Technology, as many as 30% of pregnancies in women over age 40 are unintended. Yes, today's 40-year-old is far younger in mind and body compared to the 40-year-olds from a few generations ago, but a pregnancy in this age range still presents many challenges. Regardless how healthy we are, we still have less energy than we did in our 20s and 30s. And we are less likely to have good support systems since many of our peers already had their children or decided a long time ago to be childless.

Sterilization

The most common form of birth control for women over age 30 in America is sterilization. And this is the best birth control method for perimenopausal women. By the time we have reached our 40s, we have either had our children or made the decision to not have them at all. So a permanent birth control method like sterilization is our best choice since we are less likely to change our minds about pregnancy in this decade of life. As for which method of sterilization is best, vasectomy or tubal ligation, that decision is best made after a discussion with our partners.

The pill

Oral contraceptives are one of the most effective and easiest to use birth control methods for perimenopausal women in their 40s who do not smoke and are not obese. In addition to its effectiveness, the pill helps decrease any irregular spotting or bleeding that can occur during perimenopause. For women over 35 and who smoke regularly, the FDA recommends you do not use a combination pill which contains synthetic estrogen and a synthetic progesterone called progestin. The added estrogen in these combination pills can increase the risk of cardiovascular problems.

Progestin IUD

Intrauterine devices, or IUDs, are also one of the most effective forms of birth control. They are inserted into the uterus by a health care professional and continue to release progestin anywhere from 5 to 10 years depending on which IUD is chosen. And much like the pill, a progestin IUD can decrease the amount of irregular bleeding that occurs during perimenopause.

Sources:

Planned Parenthood website

Food and Drug Administration website

Murray, Sharron Smith and McKinney, Emily Sloan, (2010), Foundations of Maternal-Newborn and Women's Health Nursing (5 ^th ed), Saunders-Elsevier, Maryland Heights, Missouri, pp 589, 842, 844, 849

R.A. Hatcher, J Trussell, A.L. Nelson, W. Cates, F.H. Stewart, and D. Kowal, (2007), Contraceptive Technology (19^th ed), Ardent Media, New York, pp 699-754