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Review
. 2025 Sep 2:103:102655.
doi: 10.1016/j.bpobgyn.2025.102655. Online ahead of print.

Hormonal contraception in perimenopausal women

Sara Whitburn  1 , Kathleen McNamee  2 , Clare Boerma  3 , Deborah Bateson  4
Affiliations
Free article
Review

Hormonal contraception in perimenopausal women

Sara Whitburn et al. Best Pract Res Clin Obstet Gynaecol. .
Free article

Abstract

Contraception can be an overlooked aspect of perimenopausal healthcare. While background fertility is low, pregnancies in those aged over 40 years present a higher risk both to the fetus and mother, and have a higher chance of ending in miscarriage or abortion, compared to pregnancies in younger women. This chapter provides a review of key issues related to hormonal contraception in the perimenopause and evaluates each method's effectiveness and safety at a stage of life when venous and cardiovascular disease risks increase. Suitability is assessed considering the person's needs, circumstances and contraindications. Attention is also given to non-contraceptive advantages of certain methods, such as management of perimenopausal symptoms, heavy bleeding and reduction of risks for certain cancers. By highlighting current research and clinical guidelines, this chapter aims to equip healthcare providers with knowledge to support perimenopausal women in making informed reproductive health decisions.

Keywords: Contraception; Hormone therapy; Perimenopause; Reproduction.

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Conflict of interest statement

Declaration of competing interest SW is employed by, and KM was formerly emplyed by, Sexual Health Victoria which received fees for consultative advice given by KM from Mayne Pharma and funding for educational courses and training from Bayer Australia and New Zealand, Besins, Mayne Pharma and Organon Australia. DB has provided clinical education at events sponsored by Bayer Healthcare, Besins and Mayne Pharma and received support to attend an educational event from Organon Australia. CB is employed by Family Planning Australia which received fees for consultative advice from Mayne Pharma and clinical education sponsored by Bayer Healthcare, Mayne Pharma and Organon Australia.

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