The Faculty of Sexual and Reproductive Healthcare (FSRH) has updated its clinical guideline on contraception for women aged over 40 years.

The 2017 update provides a comprehensive overview of each contraceptive method and its eligibility, benefits, and risks for women of this age group. In particular, it is recommend that once women reach 50 years of age, they should no longer use combined hormonal contraception as there are greater risks compared with oestrogen-free methods, which are at least as effective for contraception at this stage. There is also new information on when women no longer require contraception.

Originally published in 2010, the guideline brings together evidence and expert opinion on:

  • when contraception is needed
  • what contraception is available the suitability and safety of each method
  • how it should be used and when it can be stopped.

Although women over the age of 40 years experience a natural decline in fertility, they will still require contraception until they reach menopuase if they wish to avoid unplanned pregnancy. Women in the perimenopause often have symptoms relating to fluctuating hormone levels and have different background risks than younger women, therefore it is important that healthcare professionals consider contraceptive options speciffcally with this population in mind.