Abstract

PIP: Most clinicians advise women to continue using contraception for 12 months after menstruation has ceased. Some recommend that women less than 45 years old continue contraception for 2 years after menstruation has ceased. A fertility specialist says that women can stop taking nonhormonal methods after 6 months of amenorrhea if women experience hot flushes. If there are no classic menopausal symptoms, however, they should wait for 12 months before stopping contraception use. Hormonal methods may mask menopausal signs. If a woman has no contraindications, she can use them safely until age 50, however. Women should still use contraception after menopause because irregular ovulation may occur. In older women, the most useful measure of ovarian history is perhaps a good menstrual history rather than a high level of follicle stimulating hormone. A woman needs to consider her age, health status, menstrual history, sexuality, risk of sexually transmitted diseases, past contraception use, lifestyle, obstetric history, and attitude toward abortion when choosing a contraceptive method during the perimenopausal years. Options may include male or female sterilization, combined oral contraceptives, the progestogen-only pill, Depo-Provera, IUD, female barrier methods (diaphragm, cervical cap, contraceptive sponge, and female condom), condoms, spermicides, and postcoital contraception. Assuming the mucus signs can be reliably determined, natural family planning is an alternative for some older women. Depending on coitus interruptus can be stressful for older women because it is not easy to distinguish between a possible pregnancy and an irregular menses.