Menopause and Pregnancy

“Even though menstrual cycles become irregular or even stop, women in perimenopause can still get pregnant unless they have taken steps not to get pregnant”.¹

Umbrella
What may the Menopause and Pregnancy Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

Perimenopause

What is the possibility of pregnancy during perimenopause?

In Menopause FAQs: An Introduction To Menopause – Q. Now that my periods have stopped, can I discontinue contraceptives? the North American Menopause Society (NAMS) elaborate on:

“A. Even though menstrual cycles become irregular or even stop, women in perimenopause can still get pregnant unless they have taken steps not to get pregnant. It’s advisable to use birth control until 1 year after the final menstrual period”.²

In Sex & Relationships: Managing Contraception During Menopause the (Australian) Jean Hailes for Women’s Health (JH) elaborate on:

“…the fertility of individual women is extremely variable. Perimenopausal women can ovulate twice within one cycle, and women can still ovulate up to three months before their final period, so contraception remains an important consideration”.³

Pregnancy 45-49 Years

What is the possibility of pregnancy in women 45-49 years?

In Sex & Relationships: Managing Contraception During Menopause the JH elaborate on:

“The possibility of pregnancy in women 45-49 years is estimated to be 2-3% per year”.⁴

Pregnancy After Age 50

What is the possibility of pregnancy in women after age 50?

In Sex & Relationships: Managing Contraception During Menopause the JH elaborate on:

“After the age of 50, it is less than 1%.”.⁵

Contraception Younger Than Age 50

When may women younger than age 50, stop using contraception?

In Sex & Relationships: Managing Contraception During Menopause – When Is It Safe To Stop Contraception? the JH elaborate on:

“For women younger than 50, contraception is recommended for at least two years after the final period”.⁶

Contraception Age 50 and Above

When may women age 50 and above, stop using contraception?

In Sex & Relationships: Managing Contraception During Menopause – When Is It Safe To Stop Contraception? the JH elaborate on:

“For women 50 and older, contraception is recommended for at least one year after the final period”.⁷

Oestrogen Containing Contraception

When may women stop using oestrogen containing methods (combined oral contraception and the vaginal ring)?

In Contraception: Key Points the Australasian Menopause Society (AMS) explain:

“Oestrogen containing methods (combined oral contraception and the vaginal ring) and the contraceptive injection are generally not recommended after 50 years as the cardiovascular risks outweigh the benefits”.⁸

In Contraception for Perimenopausal Women the author notes:

“…some perimenopausal women cannot safely use the pill, patch, or ring (each of these methods contain estrogen and progestin). Specifically, older reproductive-aged women who smoke; have hypertension, diabetes, or migraines; or are obese should not use these estrogen-containing methods of birth control”.⁹

Non Oestrogen Contraception

In Contraception for Perimenopausal Women the author also notes:

“In the last decade, more and more US women who are using contraceptives are using intrauterine devices (IUDs) and the contraceptive implant—these methods are more effective and convenient than condoms or the pill. Furthermore, because IUDs (hormone-releasing models as well as a copper IUD are available) and the implant do not contain estrogen, they can be used by women who are not good candidates for the pill, patch, or ring”.¹⁰

Hormone Therapy and Pregnancy

Is hormone therapy (HT) or menopause hormone therapy (MHT) a contraceptive?

No. The JH caution:

“Please note that MHT is not a contraceptive”.¹¹

Condoms

What is the only form of birth control to provide some protection against sexually transmitted infections?

The NAMS remind us:

“Remember that only one form of birth control—condom use—provides some protection against HIV and other sexually transmitted infections”.¹²

Female Condoms

Are female condoms available?

DotC (Depending on the Country) they may be. In Female Condom the (United States) Mayo Clinic provide an image of and explain female condoms.

In Your Contraceptive Guide: Female Condoms the NHS Choices (National Health Service England) also provide an image of and explain female condoms.

Emergency Contraception

Is emergency contraception available?

DotC emergency contraception may be available. For the United States in Emergency Contraception: FAQs the American College of Gynecologists answer questions about emergency contraception.

For Australia, in Contraception: Key Points the AMS explain:

“Women should be informed about the availability of the Emergency Contraceptive Pill without a prescription at pharmacies and its effectiveness up to 96 hours after unprotected intercourse”.¹³

Health Care Provider

What if I would like to find out about suitable contraceptive options?

If you would like to find out about suitable contraceptive options, it may be your best interest choose to talk to your health care provider about this. In Contraception: Key Points the AMS note:

“Women should be provided with evidence-based information about all contraceptive options in order to support informed decision making”.¹⁴

The NAMS also note:

“The bottom line is that you need to use an effective, safe, and appropriate method of birth control until menopause is confirmed if you don’t want to get pregnant at midlife”.¹⁵

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Topic Last Updated: 09 May 2020 – Topic Last Reviewed: 09 May 2020