After 35 years
In 35-39 years, the female reproductive system begins to fade. Ovaries reduce the production of progesterone and estrogen, increase the risk of thrombosis and cardiovascular diseases, exacerbate chronic diseases, therefore oral contraception should be reliable, safe, with a minimum of side effects and a good tolerability profile. At this age, it is preferable to take low-dose COCs ( Yarina , Lindineth , Janine ). In addition to the profile action, combined oral contraceptives lower the frequency of uterine bleeding caused by adenomyosis and uterine myoma, prevent the development of osteoporosis, reduce insulin resistance.
After 40-45 years
The probability of pregnancy in 40-45 years is only 10%, why is contraception so important in this age? According to statistics, 25-30% of women in this age group have a part of menstrual cycles with ovulation, and sudden pregnancy with a high probability will have a pathological course that is fraught with congenital anomalies of the fetus. Medical interruption of pregnancy can lead to the emergence of severe climacteric syndrome and become a background for the development of oncology of genital organs. The use of COCs at the age of 40-45 years is limited by certain conditions: periodic ovulation should be noted, the characteristics of cycles should be changed (menstruation delayed, shortened).
Approach to contraception after 40-45 years:
- women 40-45 years old with early menopause can take micro-dosed COC until they fully meet the criteria under which their use is not contraindicated for women after 35. Advantages: regular menstruation, bone tissue protection, treatment and prevention of urogenital symptoms;
- women 40-45 years old with periodic ovulation against the background of pronounced PMS, dysfunctional uterine bleeding, profuse menstruation to take COC without consulting a gynecologist can not. The specialist should assess the risk of taking hormonal contraceptives and, if necessary, offer hormone replacement therapy.
Contemporary contraceptive preparations LINDINET , JES are well tolerated, give 100% contraceptive effect, stop the manifestations of menopause, are the prevention of endometrial cancer, ovaries, uterus. In the absence of risk of thrombosis, obesity and cardiovascular pathologies, non-smokers can apply them up to 50 years.
After 50 years and with menopause
Women in the period of perimenopause and late reproductive age are at risk for pregnancy, labor activity usually takes place against a background of chronic extragenital pathology, which in 10-15% of cases ends with perinatal and maternal mortality. That is why a competent selection of contraception after 50, provided a regular sexual life is a necessary condition. Hormonal contraceptives should solve several tasks: to provide reliable protection against unwanted pregnancy, to possess curative and preventive qualities. COCs (gestagen + estrogen) meet all the requirements that are required for contraception in women after 50. They are reliable, neutralize the symptoms of menopause, do not disrupt the metabolic processes, eliminate ovulatory pain, regulate the menstrual cycle, slow the aging of the female body.
The question of stopping the COC in the perimenopause is decided individually. The average age of onset of menopause is 51 years, experts recommend taking hormonal contraceptives within a year after the last menstruation, and then stop using COC and begin substitution therapy.