From the age of 40, some women have questions about their contraception. Should it be changed? Which one to choose ? Our expert will enlighten you.
Estrogen-progestin or progestin pill, IUD, patch… Choosing and finding a suitable method of contraception is not an easy task. In your forties, fertility declines. Some women think about stopping the pill, removing their IUD… But can we do without contraception from the age of 40? “No, certainly not, unless there is no connection, exclaims Professor Fauconnier, obstetrician-gynecologist. The risk of pregnancy exists throughout life before menopause. Indeed, as long as there are cycles, contraception is necessary. There are few guarantees of never getting pregnant without contraception. And 40-year-old women who are expecting an unwanted child are generally in a distressed situation. If a woman feels she doesn’t need it, don’t push her. However, you must inform them that you can get pregnant even after 40 years.“
Should you change contraception after 40?
For Professor Arnaud Fauconnier, obstetrician gynecologist, “there is no need to change contraception. If there is no cardiovascular risk, the patient can, for example, continue to take the pill. If there is, however, contraception must be modified. Regarding the IUD, there is no risk, regardless of age..
► Various non-hormonal contraceptive methods. In recent years, many voices have been raised against hormones. The pills have in particular been at the heart of several controversies. Thus, more and more women have questioned themselves and now want hormone-free contraception. “You should know that contraception is not bad for your health if you take risk factors into account. It is essential that women can access it without being afraid. By questioning methods of contraception, we lose women’s freedom. Contraception must be considered as a means of preventing unwanted pregnancies.
What is the best contraception after 40?
There is no contraception particularly recommended after the age of 40. “It is not that simple. It’s not age that matters, it depends on the case. However, from the age of 40, there is a greater risk of pathologies (cardiovascular diseases, etc.), fertility decreases, the demand for pregnancy is different… Before implementing contraception, it is necessary to take into account that the patient is a smoker, has factors of risk of cardiovascular disease…“, explains Professor Fauconnier. Indeed, a woman over 35 who smokes cannot take the estrogen-progestin pill as a contraceptive. This is also the case for women who present cardiovascular risks. In this case, non-hormonal or progestin contraception will be indicated. On the other hand, if the patient does not smoke and does not have cardiovascular risk factors, she can take an estrogen-progestin pill until age 50. The objective is to advise contraception so that the risk is as low as possible for the patient. “For women who want hormone-free contraception, it is possible to choose a non-hormonal IUD, which is a safe method of contraception if it is inserted correctly and the uterus is normal. It is a good means of contraception, inert and reliable.” THE condom is also a possibility that is adopted by many women over 40. Alone Tubal ligation is now available for women who no longer wish to have children. This is a surgical procedure called “sterilization”, performed under general anesthesia, which consists of closing access to the fallopian tubes. Whatever the case, you should know that there is always a suitable contraceptive solution, even after the age of 40.
What about Essure implants?
Previously, women who wanted permanent contraception could use ligation using the Essure method which consisted of the insertion of a small spring into each fallopian tube through natural channels, which permanently blocked the tube. However, this technique has suffered from numerous reviews from patients in particular, who complained about the deterioration of their state of health (pain, fatigue, bleeding, etc.) following the installation of this spring. In France, 1,087 women experienced a malfunction or the occurrence of adverse effects between 2003 and February 2017 out of nearly 200,000 women with an Essure implant, according to the National Medicines Safety Agency. (ANSM). The European Union thus decided in August 2017 to suspend the marketing of Essure implants for a period of three months. Since August 2017 the implant has no longer been used in France and since At the end of 2018, it is no longer sold in any country.
Thanks to Professor Arnaud Fauconnier, obstetrician-gynecologist.