[Fertility and contraception in women older than 40 years]

Women in their later reproductive years constitute a large proportion of contraceptive users. Although increasing age is accompanied by a general decline in fecundity, each individual needs to know her own risk or possibility of becoming pregnant and when it is safe to stop using contraceptives. Women over 40 need special consideration since pregnancy and childbirth is sometimes associated with higher health risks both for mother and infant. Women over 40 are more likely than younger women to have medical problems, menstrual disorders and previous experience that may affect their choice and use of contraceptive methods. Recommendations for counselling, health screening and choice of contraceptive method in women in their later reproductive years are given.