What Is The Best Contraception As I Approach Menopause?

Woman still require contraception until they have not had a period for one year (if over 50 years) or two years (if under 50 years).
Contraception can have risks and benefits at all ages, therefore this article attempts to summarise what these are.
Combined Hormonal Contraception ('the pill') has now been said to be safe for use up to the age of 50 years, however there are many contra-indications so a medical review to discuss your personal risks would be advised. There are lower dose hormone contraceptive pills which may be of benefit to the older woman.
However, there is a evidence that the combined contraceptive pill has benefits such as it helps maintain your bone density and delays the development of osteoporosis. It also controls periods, with less bleeding and pain associated with those who take the contraceptive pill. The combined contraceptive pill can help control menopausal symptoms and tricycling (taking pill packs back to back) can provide continuous benefit.
There is a protective effect against cancers such as endometrial cancer and ovarian cancer and there may be a reduction in colorectal cancer, which continues for up to 15 years after the contraceptive pill is stopped.
The risks include a small increase in breast cancer risk and a risk of cardiovascular problems including thrombosis. This is higher in smokers and hence smokers are not recommended the combined pill after the age of 35 years old.
Progesterone Only Contraceptives: This includes a daily pill, an injection every 3 months, the levonorgestrel releasing coil or implants.
These have many advantages for the older woman. There are no links with cancer, either benefits or risks. There also appears to be no effects on cardiovascular disease or thrombosis, although there is some evidence that your cholestrol may increase. The side effect of often preventing periods is usually seen as a positive outcome and the levonorgestral releasing coil is now the treatment of choice for heavy painful periods.
Non Hormonal Contraception:
• Copper coil - this is sometimes associated with heavier periods and pain therefore has been replaced by the hormone containing coil unless hormones are contraindicated or personal preference is for a non hormonal alternative.
• Condoms - remain an effective form of contraception if properly used and also prevent sexually acquired infections so should remain the contraceptive of choice in individuals who are in short term relationships. Remember however if you are also requiring a lubricant - use water based only as an oil based lubricant ruptures the rubber.
• Diaphragms also remain a popular choice
If on hormonal contraceptives, lack of periods is not a reliable indicator of the menopause. A blood test will be required, but will only be helpful if you have stopped your contraceptive for a period of time.
HRT does not work as a contraceptive. If HRT is required in addition to contraception - the progesterone only contraceptive pill can be a useful addition. The type of HRT taken should take into account the contraceptive you are using.