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Related Experiment Videos

The perimenopause and contraception

M M Shaaban1

  • 1Department of Obstetrics and Gynecology, School of Medicine, Assiut University, Egypt.

Maturitas
|March 1, 1996
PubMed
Summary

Pregnancy in women over 40 carries increased risks, but safe contraceptive options exist. Reviewing these choices, including combined oral contraceptives and long-acting reversible methods, is crucial for informed decision-making.

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Area of Science:

  • Reproductive Health
  • Maternal-Fetal Medicine
  • Contraception

Background:

  • Pregnancy in women over 40 is associated with elevated risks of maternal mortality, spontaneous abortion, fetal anomalies, and perinatal mortality.
  • These risks are exacerbated in developing countries due to high parity and limited access to medical care.

Purpose of the Study:

  • To review the implications of pregnancy in women in their forties.
  • To evaluate the contraceptive options available for this demographic.

Main Methods:

  • Literature review utilizing Medline and Popline databases.

Main Results:

  • Combined oral contraceptives (COCs) are considered safe for women up to menopause, especially low-dose formulations, offering protection against cardiovascular disease risk factors.
  • COCs provide high reliability, prevent climacteric symptoms and menstrual irregularities, and reduce the risk of ovarian and endometrial cancers.
  • Progestogen-only contraceptives, including pills, depot injections, implants (e.g., Norplant), and intrauterine devices (IUDs) like the levonorgestrel-releasing IUD (LNG-IUD), offer effective long-term contraception. LNG-IUDs also reduce menstrual bleeding. Barrier methods and sterilization are other options, with condoms offering STD protection.

Conclusions:

  • Expanding contraceptive choices for premenopausal women can improve counseling and patient adherence.
  • Balancing the risks and benefits of each contraceptive method is essential for appropriate selection in women over 40.

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