Contraception in your 40s and 50s

Fertility falls as you get older, but it does not switch off overnight. Periods can become irregular long before they stop, and ovulation can still happen from time to time. So you can still get pregnant during perimenopause.

When can you stop?

• Aged 50 or over: keep using contraception for 1 year after your final period.
• Aged 40 to 49: keep using contraception for 2 years after your final period.
• Menopause is confirmed after 12 months with no period, if you are not using hormonal contraception.
• Many UK clinicians say contraception can stop at 55 for everyone, because pregnancy is then extremely unlikely. Ask your GP or nurse about your own situation.

What can make this tricky

Hormonal methods can hide the signs. The progestogen-only pill, hormonal coil, implant and injection can make periods lighter, irregular or stop. The combined pill gives regular bleeds, so it can hide the menopause altogether. Because of this, it can be hard to know when you have actually reached menopause.

What suits you now

• The combined pill, patch and ring are not recommended from age 50, because the risks usually outweigh the benefits. They are also not usually suitable if you smoke and are 35 or over, have high blood pressure, or get migraine with aura.
• A hormonal coil (IUS) can make heavy perimenopause periods lighter and can also be used as the progestogen part of HRT. A coil fitted at 45 or over can often stay in until you no longer need contraception. Ask your nurse.
• The copper coil is hormone-free and works for 5 or 10 years.
• The implant and progestogen-only pill are other options if you cannot take oestrogen.
• Condoms still protect against STIs, which do not stop at 50.