What Are Birth Control Options For Women Over 40
After the age of 40, the same birth control methods you used when you were in your 20s and 30s may not be your best options anymore, depending on changes in your health. However, if you are healthy and dont smoke, you may be able to continue using the same method youve relied on in the past. Its best to review your contraceptive options with your doctor.
If you are perimenopausal, you should avoid trying to use natural birth control methods such as tracking ovulation and periodic abstinence, because during this time your periods may be irregular and your ovulation unpredictable.
Birth control options for women over 40 include:
Barrier methods of birth control involve the use of physical barriers to block sperm. Different types of barriers include male or female condoms, diaphragms and spermicides. Condoms also provide some protection against sexually transmitted diseases.
Hormonal methods of contraception involve taking hormones on a regular basis and are a safe and reliable way to prevent pregnancy for many people. Hormonal birth control options use a combination of the two female sex hormones, estrogen and progesterone . The synthetic form of progesterone is known as progestin.
Hormonal contraceptive options include:
What Hormonal Changes Happen During Menopause
The traditional changes we think of as “menopause” happen when your ovaries no longer produce high levels of hormones. The ovaries are the reproductive glands that store eggs and release them into the fallopian tubes. They also produce the female hormones estrogen and progesterone as well as testosterone. Together, estrogen and progesterone control menstruation. Estrogen also influences how your body uses calcium and maintains cholesterol levels in the blood.
As menopause nears, your ovaries no longer release eggs into the fallopian tubes, and youll have your last menstrual cycle.
When Does Menopause Usually Happen
Menopause happens when you have gone 12 months in a row without a period. The average age of menopause in the United States is 52. The range for women is usually between 45 and 58. One way to tell when you might go through menopause is the age your mother went through it.
Menopause may happen earlier if you:
- Never had children. Pregnancy, especially more than one pregnancy, may delay menopause.
- Smoke. Studies show smoking can cause you to start menopause up to two years earlier than women who dont smoke.
can also cause you to start menopause earlier.
Menopause usually happens on its own. However, you may enter menopause earlier than you normally would if you have had chemotherapy or surgery to remove both ovaries. Learn more about early menopause on our page.
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At What Age Will I Stop Being Fertile
The time of menopause varies tremendously between women. Before your periods stop altogether, it is likely that your periods will become irregular and unpredictable. Although you are less likely to produce an egg every month, your ovaries will still be producing some eggs and, for this reason, it is important that you consider using contraception. So, although there is a natural decline in your fertility after the age of about 37 years, effective contraception is still required to prevent an unplanned pregnancy. Most women will no longer be fertile by the age of 55 years. However, a few women will still be having periods at this age and may need contraception. The average age at which women get to their menopause in the UK is 51 years.
Determining Your Menopause Age
Theres no simple test that can tell you when youll reach menopause, but researchers are working on creating one.
Examining your family history may be the most accurate way to help you predict when you might experience the change. Youll likely reach menopause around the same age as your mother and, if you have any, sisters.
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What Are The Signs Of Menopause
For some women, a change in their periods is all they notice as they go through menopause. However, because the female hormones affect other parts of your body, you may also have any of the following symptoms:
- Hot flushes these feel like someone has poured hot water into your veins. They can start in your face and neck and spread all over your body or be a sudden feeling of heat all over. Many people feel embarrassed and think others will notice, but it’s usually not noticeable.
- Sweats, which often go with flushes and are common at night.
- Loss of libido .
- Dryness in your vagina and around your urethra can lead to uncomfortable sex, bladder infections or wetting your pants sometimes.
- Sleep problems.
- Palpitations your pulse or heart may feel like they are racing, or you may feel faint or dizzy from time to time or get ringing in your ears.
- Mood changes you may feel tired, irritable, depressed, tearful or angry this can be from hormonal changes, because you are not sleeping well or because you are adjusting to change.
- Skin your skin may look more tired and be less firm, and the hair on your head, armpits and legs may get thinner.
- Bones you won’t feel it, but your bones may start getting thinner . Much later you may break them more easily or start to get shorter or find it hard to straighten up.
Note: if you have very heavy periods or bleeding between your periods you must contact your doctor.
Symptoms Of The Menopause
Most women will experience menopausal symptoms. Some of these can be quite severe and have a significant impact on your everyday activities.
Common symptoms include:
- reduced sex drive
- problems with memory and concentration
Menopausal symptoms can begin months or even years before your periods stop and last around 4 years after your last period, although some women experience them for much longer.
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Are There Any Other Emotional Changes That Can Happen During Menopause
Menopause can cause a variety of emotional changes, including:
- A loss of energy and insomnia.
- A lack of motivation and difficulty concentrating.
- Anxiety, depression, mood changes and tension.
- Aggressiveness and irritability.
All of these emotional changes can happen outside of menopause. You have probably experienced some of them throughout your life. Managing emotional changes during menopause can be difficult, but it is possible. Your healthcare provider may be able to prescribe a medication to help you . It may also help to just know that there is a name to the feelings you are experiencing. Support groups and counseling are useful tools when dealing with these emotional changes during menopause.
How Can I Treat The Symptoms
There are a bunch of ways.
Lifestyle changes. A healthy diet and regular exercise program will help manage your symptoms and boost your health. This is a great time to finally kick any old, unhealthy habits like smoking or drinking too much alcohol. To help with hot flashes, dress lightly and in layers. Avoid triggers like caffeine and spicy foods. And if you stay sexually active, that may help preserve your vaginal lining.
Prescription medication for hot flashes. If you still have your uterus, your doctor might prescribe treatment with estrogen and progesterone. This is called combination hormone therapy or hormone replacement therapy . It helps with hot flashes and night sweats, and it may help prevent osteoporosis. If you donât have a uterus, you might get estrogen alone.
Hormone therapy isnât for everyone. Donât take it if you’ve ever had breast cancer, uterine or “endometrial” cancer, blood clots, liver disease, or a stroke. Also don’t take it if you might be pregnant or you have undiagnosed vaginal bleeding.
If you can’t or don’t want to take hormones, other medications can ease symptoms. They include antidepressants, antiseizure drugs, or blood pressure medications to help with hot flashes and mood swings.
Prescription and OTC medication for vaginal dryness and sleep problems. You can try topical estrogen, lubricants, and non-estrogen prescriptions for dryness and painful sex. OTC or prescription sleep aids can help if you have trouble falling asleep.
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How Do You Know When You Have Reached Menopause
While theres no definitive test that can confirm menopause, your gynecologist can help you determine whether you are near menopause by reviewing your symptoms along with your medical and menstrual history.
With changing levels of hormones during perimenopause, you may experience symptoms such as:
- Heavy and irregular periods
How Long Do Menopause Symptoms Last
Menopause symptoms are reported to last for an average of 7.4 years with some women experiencing them for only a few months or for over a decade.
In general, women suffer from menopause symptoms up to a few years into postmenopause. However, this depends on the individual as some women report experiencing hot flashes well into their 70s and 80s.
Having said that, all postmenopausal women are at an increased risk of developing other serious health complications, such as osteoporosis and cardiovascular disease, and they should have their hormone levels monitored for a proper treatment plan.
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Hormone Levels Fluctuate Leading To Menopause
As you approach menopause, the production of female hormones by the ovaries starts to slow down. Hormone levels tend to fluctuate, and you may notice changes in your menstrual cycle such as:
- period cycles may become longer, shorter or totally irregular
- bleeding may become lighter
- bleeding may become unpredictable and heavy .
Eventually, your hormone levels will fall to a point where your ovaries stop releasing eggs, your periods stop and menopause is reached.Although fertility after the age of 45 is low, you still need to use contraception to prevent pregnancy. Its recommended to continue contraception until you have had one year without a natural period if youre over 50 years old, or two years without a natural period if youre under 50.
Choosing The Right Hrt For You
Finding the right type of HRT can be tricky.
A low dose of HRT hormones is usually recommended to begin with. It is best to start with the lowest effective dose, to minimise side effects. If necessary, you can increase your dose at a later stage.
Persevere with HRT and wait a few months to see if it works well for you. If not, you can try a different type or increase the dose. Talk to your GP about any problems you have with HRT.
While there are more than 50 different preparations of HRT, the three main types are discussed below.
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What Are Hot Flashes And How Long Will I Have Them
Hot flashes are one of the most frequent symptoms of menopause. It’s a brief sensation of heat. Hot flashes arent the same for everyone and theres no definitive reason that they happen. Aside from the heat, hot flashes can also come with:
- A red, flushed face.
- A chilled feeling after the heat.
Hot flashes not only feel different for each person, but they also can last for various amounts of time. Some people only have hot flashes for a short period of time during menopause. Others can have some kind of hot flash for the rest of their life. Typically, hot flashes are less severe as time goes on. The intensity, frequency and duration of hot flashes differ for each individual.
How Is Perimenopause Treated
There isnt any treatment to stop perimenopause. Perimenopause is a natural part of life. The cure for perimenopause occurs when your periods stop and you enter menopause.
But your healthcare provider may recommend over-the-counter or prescription perimenopause treatment to help ease symptoms. Your provider may recommend:
- Antidepressants: These medications help with mood swings or depression.
- Birth control pills. These medications stabilize your hormone levels and typically relieve symptoms.
- Estrogen therapy: This treatment stabilizes estrogen levels. You may take estrogen therapy as a cream, gel, patch or swallowable pill.
- Gabapentin : This medicine is a seizure medication that also relieves hot flashes for some women.
- Vaginal creams: Your provider can tell you about prescription and over-the-counter options. Treatment can decrease pain related to sex and relieve vaginal dryness.
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Menopause And Complementary Therapies
Some women can benefit from using complementary therapies for menopause. But it is important to remember that natural herb and plant medications can have unpleasant side effects in some women, just like prescribed medications. A registered naturopath may provide long-term guidance and balance through the menopausal years.Herbal therapies can often be taken in conjunction with hormone therapy. It is important to let both your doctor and naturopath know exactly what each has prescribed, and to consult your doctor before taking any herbal treatments or dietary supplements for menopause. Some natural therapies can affect or interact with other medications you may be taking.
What Is Premature Menopause
Menopause, when it occurs between the ages of 45 and 55, is considered “natural” and is a normal part of aging. But, some people can experience menopause early, either as a result of surgical intervention or damage to the ovaries . Menopause that occurs before the age of 45 is called early menopause. Menopause that occurs at 40 or younger is considered premature menopause. When there this no medical or surgical cause for premature menopause it’s called primary ovarian insufficiency.
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What Age Is Considered Early For Menopause
If you reach menopause before age 40, that is considered premature menopause, says Faubion. This occurs in about 1 to 2 percent of women, she says.
Experiencing menopause at 40 to 45 years of age is called early menopause, and that occurs in about 5 to 7 percent of the population, so its safe to say that at least 7 percent of women are going to go through menopause early or prematurely, says Faubion. Menopause at age 46 or older is considered normal, she says.
Other Drugs Used For Menopausal Symptoms
Despite its risks, hormone therapy appears to be the most effective treatment for hot flashes. There are, however, nonhormonal treatments for hot flashes and other menopausal symptoms.
The antidepressants known as selective serotonin-reuptake inhibitors are sometimes used for managing mood changes and hot flashes. A low-dose formulation of paroxetine is approved to treat moderate-to-severe hot flashes associated with menopause. Other SSRIs and similar antidepressant medicines are used “off-label” and may have some benefit too. They include fluoxetine , sertraline , venlafaxine , desvenlafaxine , paroxetine , and escitalopram .
Several small studies have suggested that gabapentin , a drug used for seizures and nerve pain, may relieve hot flashes. This drug is sometimes prescribed “off-label” for treating hot flash symptoms. However, in 2013 the FDA decided against approving gabapentin for this indication because the drug demonstrated only modest benefit. Gabapentin may cause:
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General Recommendations For Ht
Current guidelines support the use of HT for the treatment of severe hot flashes that do not respond to non-hormonal therapies. General recommendations include:
- HT may be started in women who have recently entered menopause.
- HT should not be used in women who have started menopause many years ago.
- Women should not take HT if they have risks for stroke, heart disease, blood clots, and breast cancer.
- Currently, there is no consensus on how long HT should be used or at what age it should be discontinued. Treatment should be individualized for a woman’s specific health profile.
- HT should be used only for menopause symptom management, not for chronic disease prevention.
Before starting HT, your doctor should give you a comprehensive physical exam and take your medical history to evaluate your risks for:
- Heart disease
- Breast cancer
While taking HT, you should have regular mammograms and pelvic exams and Pap smears. Current guidelines recommend that if HT is needed, it should be initiated around the time of menopause. Studies indicate that the risk of serious side effects is lower for women who use HT while in their 50s. Women who start HT past the age of 60 appear to have a higher risk for side effects such as heart attack, stroke, blood clots, or breast cancer. HT should be used with care in this age group.
Women who should not take hormone therapy include those with the following conditions:
How Postmenopause Affects The Body
We dont fully appreciate the natural hormone estrogen until its gone. This humble hormone is essential for maintaining health throughout a womans body not just the reproductive system. With a decrease in estrogen, your bodys major systems can be affected too.
Heres how estrogen relates to the rest of your body once youre postmenopause.
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Are You Headed Toward Early Menopause
There are many negative health consequences linked to early menopause, including a higher risk of osteoporosis and fracture, heart disease, cognitive impairment and dementia, and early death, says Dr. Faubion.
If you have questions about when youll experience menopause and if you can do anything to change it, keep reading for answers.
What Are The Signs Of Menopause Ending
In the lead up to the menopause, a womans periods may become less regular. She may also notice changes in their heaviness or duration of bleeding.
Once a woman has not had a period for 12 months or more she has officially gone through the menopause. After this, any symptoms she has been experiencing should gradually begin to reduce. However, in many cases, they can still persist for several years.
Women who are suffering from severe menopausal symptoms should arrange a consultation with their physician. They will be able to discuss the various treatment options available and how they might offer some relief.