Second spring, hot flirt – suddenly contraception is again an issue. So you can live out your desire even during menopause without risk.
1. Which method of birth suits me?
The optimal method for all women does not exist. It is always important to find the method that best suits your personal life situation. This is especially true for women over 40. “For example, it is crucial if you find a late pregnancy unacceptable and which risk factors or illnesses are present,” says Regina Wegmann from Pro Familia in Hamburg.
And of course, how often you have sex. “Especially in this phase of life new partnerships are often closed,” says the consultant. “Then the topic of contraception suddenly becomes completely topical again.” But even so, many women at this age are worried about how their body changes at the onset of menopause. Then often comes the previous method of contraception to the test.
2. Do I still have to prevent?
The likelihood of getting pregnant is fairly low for women from early to mid 40’s. The hormone level starts to fluctuate, the cycle becomes irregular. There are always cycles without ovulation, bleeding is delayed, or it comes to bleeding. Nevertheless, a pregnancy is still possible at this age, because in between an ovulation can take place. In 2010, just under 600 women in Germany received over 45 children, 67 women were older than 50 years.
Hormone tests usually do not help to determine if you can still become pregnant. A blood test is just a snapshot. Even with a low hormone level in between ovulation may occur. The fertile phase of life is considered to be safely terminated when no bleeding has occurred for a year. However, if you take the pill, this rule will not help you. Every month, during the intake break, there is a so-called withdrawal bleeding, which has nothing to do with the natural cycle. You will not get definitive certainty until you drop the pill.
3. Should I continue to take hormones for contraception?
It used to be said that women over 40 should stop using the pill (or other hormonal methods). Most doctors do not see it that much anymore. Whether the pill still comes into question for you, you have to decide for yourself. “For most women, the question is ‘hormones – yes or no?’ a fundamental decision, “says pro-family doctor Regina Wegmann. “Some prefer to take the pill until 50, others do not want to use hormones and prefer barrier methods like the diaphragm.”
4. Can I take the pill until the end of menopause?
That is quite possible. If you want, you may even be able to seamlessly switch to hormone therapy for menopausal symptoms. However, the risk of thrombosis increases with age. If you are at particular risk of developing a thrombosis, heart attack or stroke, you may want to use other methods of contraception. This also applies to hormone preparations that are absorbed through the skin and mucous membranes, for example via hormone patches or a vaginal ring.
Risk factors are mainly smoking, obesity, varicose veins, high blood pressure, high blood lipid levels, migraine and diabetes. In addition, a hereditary tendency to thrombosis as in the so-called factor V (five) -Leid mutation can be dangerous. About every 20th woman has this genetic predisposition. This can be determined by the doctor, but there is also a do-it-yourself test in the pharmacy (about 80 euros).
5. What alternative is there if the pill is too risky?
One possibility could be the so-called mini pill. It contains no estrogens, only progestogen. However, it must always be taken very reliably at the same time of day. There are also other pure Gestagenhaltige contraceptive methods, such as the contraceptive stick (hormone implant, about 200 euros plus medical expenses). It is implanted on the arm under the skin and protects against pregnancy for three years.
All preparations containing progestin often cause bleeding or the rule is completely eliminated. Even side effects such as headache, irritability and weight gain, especially through water retention, are not uncommon. This also applies to the hormonal spiral, which can lie in the uterus for five years and continuously delivers a small amount of progestin there. It thickens the mucus in the cervix and thus blocks the sperm from entering the uterus; At the same time, it changes the lining of the uterus so that a fertilized egg can no longer implant itself.
“The hormonal spiral seems to many to be a good compromise,” said Regina Wegmann, “because it is safer than the pill, but it has a lower risk of thrombosis and compensates for the lack of progestin at the beginning of menopause.” The spiral costs about 350 to 500 euros with insertion to the doctor, their correct position must be checked annually with ultrasound. If you decide to use the spiral in your mid-40s, you have very often regulated contraception definitively until after the menopause.
6. How can I prevent if I want to avoid hormones?
An alternative is a diaphragm that is inserted into the vagina and closes the cervix with a thin latex or silicone membrane. You need to combine a diaphragm with a sperm-killing gel. Experienced women who are familiar with their body usually handle it well. However, if you have a uterine sink or pelvic floor weakness, you may have trouble placing the diaphragm properly. There are different sizes that are customized; Recently, a diaphragm is available that fits almost every woman (for about 35 euros in pharmacies, plus 10 euros per tube gel). It is especially practical and easy to handle because it has a small handle for removal from the vagina.
Another option is a copper spiral , which reliably protects against pregnancy for three to five years. It consists of a plastic piece in T-shape, which is wrapped with a fine copper wire. This releases copper ions in the uterus, which inhibit sperm motility. The spiral also changes the mucosa in the uterus, so that a fertilized egg can not implant there. Especially in the first three to six months, however, the copper spiral can lead to bleeding, menstrual pain or a prolonged and increased menstrual period. If you have severe bleeding anyway, it is less suitable for you.
7. How well do condoms protect me?
Although condoms are not as safe as the pill. But for women over 40, who are less likely to get pregnant and who may rarely have sex, they are still a good choice. And they are also completely hormone-free and guaranteed harmless. However, condoms can be problematic if the partner is older and may have erectile problems.
8. Can not I just measure my temperature?
Natural contraception by measuring morning body temperature, possibly using a minicomputer, is also safe in menopause. If the temperature rises, you can reliably read that the infertile phase has started after ovulation. However, if ovulation is delayed or if it stops altogether, there are long periods of insecurity. During this time, you must additionally use condoms, for example. Therefore, the temperature measurement is only a good method as long as the cycle is reasonably regular.
9. Is sterilization useful?
A sterilization, ie the separation of the fallopian tubes, is final and thus a very safe method of contraception. But although it is only a relatively “minor” procedure, the doctor opens the abdominal cavity and you need a general anesthetic. A newer method without surgery, in which the fallopian tubes are closed from the inside out of the uterus, is apparently not as safe as the conventional procedure. In addition, the costs for the intervention are quite high (around 600 to 1000 euros).
Therefore, if you live in a stable relationship, it would be more appropriate for your partner to choose sterilization. In men, the procedure is easier and much cheaper. And after many decades of pill swallowing, maybe it’s his turn.
10. What can I do with a contraceptive injury?
For such emergencies, two preparations of the “morning after pill” are approved in Germany. They should prevent or postpone ovulation, so that the sperm can not meet with a fertilizable egg. For both funds, however, they must be taken as early as possible. Then, the probability of ovulating is highest. So get in touch quickly with your doctor.