Using Hormonal Contraception After Age 40

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It's no secret that there are more birth control options available than ever before for women who want to actively avoid becoming pregnant. But the way many of these methods are marketed, many women may believe they're only suitable for adolescents or women in their 20s and 30s. This is hardly the case.

Until a woman reaches menopause, it's not possible to know exactly when the risk of becoming pregnant is eliminated. As such, it's important for all women to actively protect themselves if they are certain they no longer wish to have children.

In the past, it was commonly believed that for women over 40, birth control options were limited to non-hormonal methods such as condoms, diaphragms, and even tubal ligation. However, research shows that the benefits of oral contraceptives containing progestin and/or estrogen outweigh the risks and are considered to be safe methods of birth control for healthy women over 40.

Other Benefits for Women Over 40

The benefits of hormonal birth control aren't limited to simply preventing pregnancy. Many women also may prefer the pill because it can:

  • Reduce irregular menstrual bleeding
  • Help control hot flashes
  • Help reduce hip fractures
  • Reduce the risk of ovarian, endometrial, and colorectal cancer

Risks for Women over 40

Just like for women of any age, hormonal contraceptives come with risk factors that vary among women depending on their age and various lifestyle factors.

One factor to consider if taking birth control over age 40 is that the risk of dangerous blood clots does sharply rise at age 40 for women who use estrogen-containing birth control pills, with an estimated incidence of eight to 10 cases per 10,000 people.

The risk of venous thromboembolism is nearly twice as high among obese women as it is among non-obese women who use oral contraceptives.

Additionally, if you are a 40-plus-year-old woman who is obese, smoke cigarettes, have migraines headaches, high blood pressure, or diabetes, research suggests that the risk factors associated with combination birth control use are considered to outweigh the benefits.

Use of Birth Control in Women Age 40 and Older

Research shows that 40-plus aged women are the least likely to use birth control. However, it's important for this population of women to have access to reliable birth controls for many reasons, but mainly because some are choosing to put off childbearing until a later age, and some are purposely choosing not to bear children at all. Because the exact age at which pregnancy is not possible is not known, it's important for these women to be able to protect themselves and their choices. Women over 40 with higher risk factors could also be excellent candidates for the Paragard IUD, or for progestin-only contraception options.

Not surprisingly, having more contraceptive options available will allow many 40-plus women to enjoy satisfying sexual relationships without the need to worry about getting pregnant.

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Article Sources

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  1. Allen RH, Cwiak CA, Kaunitz AM. Contraception in women over 40 years of age. CMAJ. 2013;185(7):565-73. doi:10.1503/cmaj.121280

  2. Guttmacher Institute. Contraceptive use in the United States. Updated July 2018.

  3. Centers for Disease Control and Prevention. When Women Can Stop Using Contraceptives. Updated February 1, 2017.