All women that nonetheless require contraception and never want to become pregnant should always be supplied

Whenever is contraception don’t recommended?

Information regarding preventing contraception tend to be summarised in desk 2.

Ladies who aren’t making use of a hormone technique of contraception are encouraged to keep using contraception after their own LMP for: 1

  • one year if they’re elderly over half a century
  • 24 months if they’re elderly under 50 years.

Where timing of menopause try ambiguous because of use of contraception or HRT, female can continue using contraception until era 55 right after which end (impulsive conception only at that age try uncommon although a female will continue to have actually monthly period bleeding). 1 If a lady wishes to continue using a method of contraception for non-contraceptive causes after get older 55 or menopause, this can be examined on a person basis. 1 Intrauterine contraception shouldn’t be remaining in situ forever as it can certainly being a focus of issues, 1 or confuse the clinical picture when the girl afterwards provides with post-menopausal bleeding.

The standard promotes professionals to assess and treat women based on their unique discomfort and requires instead their particular serum hormone indicators. 1 including, a female elderly 53, amenorrhoeic with a 52 mg LNG-IUS placed three years in the past for contraception and HMB will keep the unit and now have it eliminated after get older 55; there isn’t any indicator for hormonal examination. But if neccessary, just one FSH degree >30 IU/L in a lady over 50 is sufficient to ensure ovarian insufficiency and contraception can be ceased 12 months later. Progestogen-only types of contraception don’t avoid the menopausal rise in FSH values. 1 FSH amount are often repressed in women utilizing CHC or HRT and are generally not consequently scientifically useful. 1


Stop contraception after 2 years of amenorrhoea

End contraception after 12 months of amenorrhoea.

Matched hormonal contraception

Could be carried on

Visit era 50 and switch to a non-hormonal system or IMP/POP/LNG-IUS, next stick to proper pointers.

Progestogen-only injectable

Can be continuous

Women a‰?50 is counselled with regards to using alternative means, after that adhere proper advice.

Progestogen-only enhancement (IMP)

Progestogen-only tablet (POP)

Levonorgestrel intrauterine system (LNG-IUS)

Is generally proceeded to ageing 50 and beyond

Take a look at get older 55 whenever all-natural losing virility is generally presumed for most ladies:

A Mirena LNG-IUS placed a‰?45 can stay in situ until get older 55 if useful for contraception or hefty monthly period bleeding.

IMP=progestogen-only implant; POP=progestogen-only capsule; LNG-IUS=levonorgestrel intrauterine system; FSH=follicle-stimulating hormones; IU=international device

Reproduced with permission

Contraception and HRT

Sequential HRT just isn’t a very good form of contraception since it does not easily suppress ovulation. 1 women that try not to desire to conceive should utilize contraception alongside HRT. Table 3 summarises the contraceptive options you can use in conjunction with HRT.

Hormone replacing treatments may produce cyclical bleeding in postmenopausal girls but it does not restore fertility. Ladies who are post-menopausal don’t need to start contraception when utilizing HRT, regardless of if bleeding resumes. 1

Levonorgestrel intrauterine program (LNG-IUS)

Protected to utilize as contraception alongside oestrogen of choice.

Mirena are certified for endometrial defense whenever along with oestrogen. Its the sole LNG-IUS authorized for this purpose.

It could be used up to 5 years for endometrial protection and needs to get changed frequently when useful this function, irrespective of age at insertion.

Progestogen-only injectable

Protected to use as contraception alongside sequential HRT but think about switch to lower-dose progestogen-only means.

Definitely more likely efficient for endometrial defense with oestrogen as an element of HRT but should not be ideal as unlicensed with this sign.

Progestogen-only enhancement (IMP)

Safe to use as contraception alongside sequential HRT.

Are not suggested at the escort Long Beach present time for endometrial security as part of HRT as no facts to compliment efficacy.

Progestogen-only pill (POP)

Secure to utilize as contraception alongside sequential HRT.

Can’t be recommended presently for endometrial coverage as part of HRT as no evidence to support effectiveness.

Merged hormone contraception (CHC)

Avoid using in combination with HRT.

Can be used in qualified lady

Females must be urged to switch to a progestogen-only method of contraception at era 50; see above for approach choice because they relate to HRT.

LNG-IUS= l evonorgestrel intrauterine system; HRT=hormone substitution treatment; IMP=progestogen-only implant; POP= p rogestogen-only supplement; CHC=combined hormone contraception

Reproduced with permission