title: Contraception for the older woman: an update.
abstract: Although fertility declines with advancing age as the woman approaches the menopause, some risk of pregnancy persists, and effective contraception needs to be offered to avoid an unintended pregnancy. An older woman may have menstrual dysfunction or climacteric symptoms and these factors would need consideration when making the choice of contraception. Low-estrogen dose combined oral contraceptives may be prescribed to healthy non-smoking women up to about 50 years of age. The progestogen-only pill may be an appropriate option in an older woman with declining fertility. The copper intrauterine device is an optimal method for parous women free of pre-existing menstrual problems. The levonorgestrel-releasing intrauterine system is considered the contraceptive method of choice for perimenopausal women with menstrual dysfunction. The woman should be provided with individualized advice so that she has a choice between the newer, effective, largely safe, reversible methods and sterilization.
authors.affiliation: Department of Obstetrics and Gynaecology, Petit Parsee General and Masina Hospitals, Bombay, India.
authors.forename: R K
authors.initials: RK
authors.lastname: Bhathena
authors.forename: J
authors.initials: J
authors.lastname: Guillebaud
mesh_terms: D000279:Administration, Cutaneous; D000375:Aging; D003267:Contraception; D003271:Contraceptive Agents, Female / Q000008:administration & dosage; D003274:Contraceptive Devices, Female; D003277:Contraceptives, Oral, Combined; D003281:Contraceptives, Postcoital; D003692:Delayed-Action Preparations; D004343:Drug Implants; D005260:Female; D006801:Humans; D007267:Injections; D007435:Intrauterine Devices, Copper; D008875:Middle Aged; D011372:Progestins / Q000008:administration & dosage; D013089:Spermatocidal Agents; D013245:Sterilization, Reproductive; D014599:Uterus
chemical_list: D003271:Contraceptive Agents, Female; D003277:Contraceptives, Oral, Combined; D003281:Contraceptives, Postcoital; D003692:Delayed-Action Preparations; D004343:Drug Implants; D011372:Progestins; D013089:Spermatocidal Agents