I'm in my 40s and still have regular menstrual periods. What are my options for birth control?

Answers from Shannon K. Laughlin-Tommaso, M.D.

If you don't intend to have any children in the future, one option is permanent sterilization for either you or your partner. Otherwise, if you're generally in good health, and you don't have any medical conditions that might preclude their use, hormonal forms of birth control may be an option, too.

For a woman during perimenopause, birth control options include:

  • A combination estrogen-progestin pill or ring, if you don't have a medical reason not to take contraceptive-strength doses of estrogen.
  • A progestin-only contraceptive, such as the levonorgestrel intrauterine system (Mirena, Skyla), the etonogestrel subdermal implant (Nexplanon), or the progestin-only minipill, which also provide protection from cancer of the endometrium — the tissue that lines your uterus.
  • An estrogen-progestin skin patch, if you're not at risk of blood clots or other bleeding disorder. However, caution is needed when using this form of birth control. A patch that contains both estrogen and progestin, such as the skin path containing norelgestromin and ethinyl estradiol (Ortho Evra), increases blood clot risk compared with other forms of estrogen-progestin contraception, such as a pill or vaginal ring.
  • A sterilization procedure, such as vasectomy or tubal ligation, which provides a permanent form of birth control.

Whichever method you choose, doctors generally recommend that you continue birth control during perimenopause and for about 12 months after your menstrual periods naturally stop.

With

Shannon K. Laughlin-Tommaso, M.D.

Nov. 07, 2014 See more Expert Answers