Dear MHI reader

The pill was an important milestone in the sexual revolution of the 1960s. It strengthened the feminist movement’s demands for equal rights and women’s self-determination over their bodies. Clearly a major achievement.

Today we want to look into the question of what happens to the pill during the menopause.

What are the potential benefits of the pill during the menopause?

Yes, there are women who still take the pill during the menopause. Women hope that this will relieve hot flushes and night sweats, improve mood swings and sleep disorders and protect against osteoporosis and cardiovascular disease.

But you should know that the pill is purely an ovulation suppressant and is basically a burden on your body. If your cycle is irregular, the problem lies with your own hormones.

What are the potential disadvantages of the pill during the menopause?

The disadvantages can be considerable and clearly outweigh the advantages. The pill contains the active ingredient ethinylestradiol. During the menopause, the pill is therefore only suitable for contraception to a limited extent. This is because the combination of oestrogens with progestogens such as dienogest, chlormadinone or desogestrel increases the risk of thrombosis and therefore the risk of heart attack and stroke. This is already increased during the menopause.

The pill is also not suitable for people with pre-existing conditions such as diabetes or obesity.  The pill also increases the risk of developing breast cancer.

So what now?

If you weigh up the pros and cons, you will probably come to the conclusion that you should not take the pill during the menopause.

Ok and when should I stop taking the pill?

Many doctors recommend stopping the pill from the age of 40 and recommend other contraceptive methods.

This is because the pill suppresses symptoms such as menstrual irregularities. It is therefore not so easy for you to determine whether the menopause has already started.

The so-called FSH value in the blood provides an indication. The follicle-stimulating hormone helps to regulate the menstrual cycle. Its value increases during the menopause. The higher it is, the lower the function of the ovaries. In the postmenopause, the FSH value is above 20 IU/ml. However, the value can only be determined correctly if you have stopped taking the pill for at least one month.

Can I even get pregnant during the menopause?

Yes, it is possible to get pregnant during the menopause, even if the chances of doing so decrease as you get older.

You should therefore be aware of and consider the following points in particular:

• During the perimenopause, ovulation still takes place so that a natural pregnancy is possible. The transition to infertility takes place gradually.
• At the age of 40, many women notice the first signs of the menopause, but can often still get pregnant for several years.
• From the mid-40s, fertility decreases continuously as fewer and fewer eggs develop into follicles. At the age of 45-49, the probability of pregnancy is still around 5%.
• From the age of 50, natural pregnancy is very unlikely, as ovulation no longer occurs in the postmenopause. Pregnancy would then only be possible with hormone treatment and sperm donation.
• You should continue to use contraception until the final menopause (1 year after your last period) in the event of an unwanted pregnancy, as ovulation can never be completely ruled out

In summary, although pregnancy during the menopause is rare, it is certainly possible. The chances decrease significantly with increasing age.

Which alternative contraceptive methods are recommended during the menopause?

Yes, they do exist – alternative contraceptive methods during the menopause. Hormone-free contraceptive methods are particularly recommended:

Copper IUD

The copper IUD is a very safe and long-term contraceptive method during the menopause. It can remain in the uterus for up to 10 years and is reversible.

Condom

The condom is a safe barrier method without hormones. It also protects against sexually transmitted diseases.

Sterilization

Female sterilization (cutting the fallopian tubes) is a very effective permanent contraceptive method. However, it should be carefully considered as refertilization is difficult. Male sterilization can be a good alternative for couples.

Other barrier methods such as diaphragms or cervical caps are less reliable, but can be used in combination with spermicides.

Natural methods such as cycle monitoring are no longer safe due to the irregular cycles during the menopause.

We hope this information will help you to better understand the menopause and take practical steps to deal with it. If you need personal advice or support on your journey through the menopause, contact The Women Circle here.

In our next edition, again on Saturday at 9am, we will cover more aspects of the menopause and women’s health. Stay informed and feel good in this special phase of life.