Contraception during Perimenopause

Perimenopause, the transition before your final period can bring many changes. One thing that often surprises women is that fertility is still possible during perimenopause, even though menstrual cycles become irregular. That’s why thinking about contraception during perimenopause is still important for preventing unintended pregnancy and protecting your health.

In this newsletter, we will share more insights on this topic and answer your heart-throbbing questions.

Why Contraception Remains Important

Even as periods become less predictable, pregnancy can still occur. Some of the risks include complications during pregnancy and higher maternal health demands as women get older. Practising contraception in perimenopause helps avoid these risks, ensures you retain control over your reproductive choices, and can ease anxiety knowing you’re covered.

Safe Options: Hormonal & Non-Hormonal Methods

When considering contraception during perimenopause, there are several effective methods, each with pros and cons:

Hormonal options (combined oestrogen + progestogen) – like the combined pill, vaginal ring, patch. These can also help with symptoms such as hot flushes and irregular bleeding. However, combined hormonal methods may increase the risk of blood clots, so it’s important to get medical guidance.

Progestogen-only options – Progestin-only pills, hormonal intrauterine devices (IUDs), or implants. These are good choices if oestrogen isn’t suitable, for example, in women at higher risk or with certain medical histories.

Non-hormonal methods – Copper IUDs are hormone-free and effective, especially for those who prefer or require non-hormonal contraception.

Sterilisation options (for woman or man) – Permanent solutions if family planning is complete and confident decisions have been made.

When Can You Stop Using Contraception?

Knowing when to consider stopping contraception is as important as knowing when to use it.

General recommendations suggest:

• If you are over 50 and you have had one year without menstrual bleeding, and no other causes for bleeding are present.

• If you are under 50 but have had two years without periods, assuming no other health reason accounts for the absence of bleeding.

Contraception during perimenopause does more than protect against pregnancy. It can relieve symptoms, provide hormonal balance benefits (like bone protection, reducing bleeding), and offer peace of mind. Everyone’s body and risk profile are different, so talking to a healthcare professional will help you choose what’s right for you.

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