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Contraception for women over 40: A comprehensive guide
Michelle Emerson1, Alex Polyakov2
1BMedSci, MBBS, Reproductive Biology Fellow, Reproductive Services Unit, The Royal Women@s Hospital, Melbourne, Vic.
Background:
Women in their 40s experience significant reproductive health changes, requiring personalised contraception to avoid unintended high-risk pregnancies and adapt to changing health conditions.
Objective:
This article examines optimal contraceptive choices for women in their 40s, considering effectiveness, ease of use, non-contraceptive benefits, side effects, contraindications and re-evaluation or discontinuation timings.
Discussion:
Contraceptive choices for women in their 40s vary depending on their family planning status, underlying health conditions and risk factors. Long-acting reversible contraceptives, permanent sterilisation and progestogen-only methods (excluding depot medroxyprogesterone acetate) are preferred options for women who have completed their families. Hormonal contraceptives can help manage menstrual disorders and bone health issues while providing endometrial protection during menopause. Regular contraceptive reviews should be conducted, and options adapted as needed.
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