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[Contraception in perimenopause].

G S Merki-Feld1

  • 1Department für Frauenheilkunde, UniversitätsSpital Zürich. gabriele.merki@fhk.usz.ch

Therapeutische Umschau. Revue Therapeutique
|November 18, 2000
PubMed
Summary

Perimenopausal women can use various contraceptives for symptom relief and bone protection. Cardiovascular risks necessitate careful method selection, favoring sterilization, barrier methods, progestin-only options, or intrauterine devices (IUDs).

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Area of Science:

  • Reproductive Endocrinology
  • Women's Health
  • Contraception

Context:

  • Perimenopausal women remain fertile, facing elevated maternal and perinatal mortality risks during pregnancy.
  • Climacteric symptoms like hot flashes and vaginal dryness are common.
  • Cardiovascular risk increases with age, particularly in perimenopausal women using oral contraceptives.

Purpose:

  • To review contraceptive options for perimenopausal women.
  • To highlight the dual role of contraception in managing climacteric symptoms and bone loss.
  • To emphasize risk stratification for selecting appropriate contraceptive methods.

Summary:

  • Low-dose oral contraceptives (OCs) manage climacteric symptoms and protect against bone loss.
  • For women with cardiovascular risk factors, sterilization, barrier methods, progestin-only methods, and intrauterine devices (IUDs) are preferred.
  • The levonorgestrel-releasing IUD or injectable progestogens can treat heavy menstrual bleeding. Estrogen therapy can be combined with certain contraceptive methods.

Impact:

  • Provides guidance for selecting safe and effective contraception in perimenopause.
  • Supports individualized patient counseling to improve adherence to chosen methods.
  • Contributes to reducing maternal and perinatal risks associated with perimenopausal pregnancy.

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