Contraception

If you’re a woman over 40 who has sworn by the 30-day hormonal pill pack for years, it might be time to reconsider your ideal form of birth control. Your sex life might be the same, but your bodily needs have changed in many ways.

The conversation about sexual health and pregnancy tends to revolve around younger women at the most fertile time of their lives, but pregnancy is still possible for women over 40, and they still require contraception to maintain a worry-free sex life.

A new study brings these issues to the forefront, exploring the most and least effective forms of contraception for women over 40 and the risks associated with each. Dr. Rebecca Allen of the Warren Alpert Medical School at Brown University and fellow researchers published their findings in the Canadian Medical Association Journal.

What Are the Risks and Benefits of Contraception for Older Women?

Because the medical risks of pregnancy increase with age, contraception for women over 40 is just as immediate a concern as it is for younger women. There are risks and benefits associated with each form of contraception, especially in conjunction with women’s changing bodies.

"Clinical judgment will be required to balance the risks and benefits when a woman has multiple medical conditions," Allen says. "The availability of safe, effective options suggests that estrogen-containing methods should increasingly be used with caution in older women who have cardiovascular risk factors."

This is particularly true for oral contraceptives, which can also prove less effective for women as they grow older. The risks of oral contraceptive use in women over 40 include cardiovascular complications, such as blood clots, and bone fracture risks.

But the benefits can’t be overlooked, either. Women who use oral contraceptives generally enjoy menstrual regularity, regulation of vasomotor symptoms, such as hot flashes and night sweats, and a decrease in the risk of endometrial cancer. The researchers suggest non-hormonal and progestin-only birth control methods for women who have been advised to avoid contraceptives containing estrogen.

According to the study, the World Health Organization names copper intrauterine devices (IUDs), progestin implants, and sterilization as the most effective forms of birth control. The ideal for women over 40 is generally long-acting, reversible contraception, such as an IUD.  This does not discount the effectiveness of short-term methods, such as oral contraceptives, but these options should be assessed on an individual basis.

In addition, while there are women over 40 who are able to conceive without complications, all women should be aware of the possible consequences. As the report states, “[t]he risk of spontaneous abortion and chromosomal abnormalities increases markedly after age 40. Older age is also associated with an increased risk of obstetric complications, including gestational diabetes, hypertension, placenta previa, cesarean delivery, perinatal death, and maternal death.”

Why Is This Study Important?

With so many birth control options, choosing the most age-appropriate form of contraception can be challenging. Unintended pregnancies are an issue for women of all ages, so they must be informed about what works and what doesn’t, especially if they’ve trusted the same form of contraception for years.

It comes as no surprise that women over 40 are still having sex, which comes with the same risks as sexual intercourse among any age group. But as women’s bodies change, so do their contraceptive needs and preferences. Fortunately, the number of options available for older women is increasing.

There’s a contraceptive option for everyone. Comfort, safety, and preference will help determine your ideal type so that you can enjoy a long and healthy sex life.

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