title: The contraception needs of the perimenopausal woman.
abstract: Perimenopausal women have low fertility but must still be advised to use contraception until natural sterility is reached if they are sexually active. Patterns of contraceptive use vary in different countries worldwide. Long-acting reversible contraceptive methods offer reliable contraception that may be an alternative to sterilisation. Hormonal methods confer significant non-contraceptive benefits, and each individual woman should weigh up the benefits and risks of a particular method. No method of contraception is contraindicated by age alone, although combined hormonal contraception and injectable progestogens are not recommended for women over the age of 50 years. The intrauterine system has particular advantages as a low-dose method of effective hormonal contraception, which also offers control of menstrual dysfunction and endometrial protection in women requiring oestrogen replacement. Condoms are recommended for personal protection against sexually transmitted infections in new relationships. Standard hormone replacement therapy is not a method of contraception.
authors.affiliation: NHS Lothian Sexual and Reproductive Health Services, Chalmers Centre, Edinburgh, UK.
authors.forename: Sarah M R
authors.initials: SM
authors.lastname: Hardman
authors.affiliation: NHS Lothian Sexual and Reproductive Health Services, Chalmers Centre, 2A Chalmers Street, Edinburgh EH3 9ES, UK. Electronic address: ailsa.gebbie@nhslothian.scot.nhs.uk.
authors.forename: Ailsa E
authors.initials: AE
authors.lastname: Gebbie
mesh_terms: D017280:Condoms; D003267:Contraception / Q000009:adverse effects / Q000379:methods*; D003271:Contraceptive Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage; D019049:Developed Countries; D003906:Developing Countries; D004343:Drug Implants; D016889:Endometrial Neoplasms / Q000517:prevention & control; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D007436:Intrauterine Devices, Medicated; D008297:Male; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control; D010051:Ovarian Neoplasms / Q000517:prevention & control; D047648:Perimenopause; D011247:Pregnancy; D018570:Risk Assessment; D014659:Vasectomy; D054556:Venous Thromboembolism / Q000209:etiology; D014944:World Health Organization
chemical_list: D003271:Contraceptive Agents, Female; D003277:Contraceptives, Oral, Combined; D004343:Drug Implants
keywords: hormonal contraception; hormone replacement therapy; intra-uterine contraception; non-contraceptive benefits; perimenopause