When was contraception no longer recommended?
Ideas concerning stopping contraception are summarised in desk 2.
Women that are not utilizing a hormonal technique of contraception should keep using contraception after their unique LMP for: 1
- 1 year if they are aged over half a century
- 24 months if they are aged under half a century.
In which time of menopausal is ambiguous because of utilization of contraception or HRT, ladies can keep using contraception until years 55 following stop (natural conception at the get older was uncommon even though a lady continues to has menstrual bleeding). 1 If a female wishes to continue using an approach of contraception for non-contraceptive factors after years 55 or menopause, this could be evaluated on a specific factor. 1 Intrauterine contraception should not be kept in situ forever as it could become a focus of problems, 1 or confuse the medical picture in the event that lady later on provides with post-menopausal bleeding.
The guide promotes professionals to assess and address females based on their unique disorders and requires instead of their particular serum hormones markers. 1 For example, a lady elderly 53, amenorrhoeic with a 52 milligrams LNG-IUS placed 36 months in the past for contraception and HMB can keep werkt livelinks the product and also it eliminated after years 55; there’s no indicator for hormonal examination. But if needed, an individual FSH degree >30 IU/L in a lady over 50 is sufficient to ensure ovarian insufficiency and contraception may be ceased one year later. Progestogen-only ways of contraception don’t avoid the menopausal increase in FSH degree. 1 FSH values are often repressed in women making use of CHC or HRT and are perhaps not consequently clinically beneficial. 1
Quit contraception after 2 years of amenorrhoea
Prevent contraception after one year of amenorrhoea.
Merged hormonal contraception
May be continuing
Visit years 50 and change to a non-hormonal means or IMP/POP/LNG-IUS, then adhere proper suggestions.
Could be continuous
Ladies a‰?50 must certanly be counselled concerning switching to approach methods, after that follow suitable advice.
Progestogen-only implant (IMP)
Progestogen-only product (POP)
Levonorgestrel intrauterine system (LNG-IUS)
May be continued to age 50 and beyond
Visit era 55 when organic lack of virility can be believed for some people:
A Mirena LNG-IUS placed a‰?45 can stay static in situ until age 55 if used for contraception or hefty menstrual bleeding.
IMP=progestogen-only enhancement; POP=progestogen-only product; LNG-IUS=levonorgestrel intrauterine system; FSH=follicle-stimulating hormonal; IU=international product
Reproduced with permission
Contraception and HRT
Sequential HRT is certainly not a successful kind of contraception whilst doesn’t reliably control ovulation. 1 Women who dont desire to conceive should make use of contraception alongside HRT. Table 3 summarises the contraceptive solutions which you can use along with HRT.
Hormones replacing therapies may produce cyclical bleeding in postmenopausal female although it does not restore fertility. Ladies who become post-menopausal don’t need to start contraception when utilizing HRT, even in the event hemorrhaging resumes. 1
Levonorgestrel intrauterine system (LNG-IUS)
Protected to make use of as contraception alongside oestrogen of choice.
Mirena was registered for endometrial safeguards whenever coupled with oestrogen. Really the just LNG-IUS accepted for this specific purpose.
It might be consumed to 5 years for endometrial security and requires is replaced on a regular basis when used for this reason, despite get older at installation.
Secure to utilize as contraception alongside sequential HRT but consider change to lower-dose progestogen-only method.
Highly apt to be efficient for endometrial safety with oestrogen included in HRT but are not advised as unlicensed for this sign.
Progestogen-only enhancement (IMP)
Safe to utilize as contraception alongside sequential HRT.
Can not be ideal presently for endometrial coverage included in HRT as no facts to guide efficacy.
Progestogen-only medicine (POP)
Secure to make use of as contraception alongside sequential HRT.
Can’t be suggested currently for endometrial safeguards as an element of HRT as no research to aid effectiveness.
Merged hormone contraception (CHC)
Do not use in combination with HRT.
Can be used in eligible female
Female is suggested to change to a progestogen-only way of contraception at era 50; see above for alternative choices while they relate solely to HRT.
LNG-IUS= l evonorgestrel intrauterine system; HRT=hormone replacing treatment; IMP=progestogen-only enhancement; POP= p rogestogen-only pill; CHC=combined hormonal contraception
Recreated with authorization