Do I need contraception during menopause?

Perimenopause can be a confusing time. It’s the time when a woman might start to notice symptoms as her body changes and moves towards menopause and the end of her periods.

But while many women tell us they’ll be glad to leave their periods in the past, it’s not quite as straightforward as that. Your periods don’t usually just grind to a halt overnight, and one of the perimenopausal symptoms many women notice is erratic periods.

This can be a particular issue for women who have always had regular-as-clockwork cycles, as they may start to notice their periods are lasting longer, are heavier or lighter, are more or less frequent – when it comes to perimenopause and periods, there are no hard and fast rules. 

Can I still get pregnant in perimenopause?

Even if your periods are all over the place, you can still get pregnant while you’re in perimenopause, so unless you are trying for a baby it’s very important to continue using contraception until your periods have stopped completely.

Women’s Health Concern say that ‘contraception should be continued for at least one year after your last period if the periods stop after the age of 50, and for two years if your periods stop before the age of 50. This is because sometimes periods may restart even after several months with no bleeding.’

Rather startlingly, more than 20 women over the age of 50 in the UK have a termination every year. We often associate unintended pregnancy with a younger age group, but this really does happen to older women too. Of course, some people choose to become pregnant a little later in life and will welcome a longer fertility, but if you’ve completed your family or chosen not to have children, it really is something you still need to consider.

I’m on HRT, can I still get pregnant?

In short, yes. HRT is not a contraceptive. But women on HRT can sometimes find it hard to know when they’ve reached menopause, as they may still get artificial bleeds (like women get on the pill). If you want to find out if you’ve reached menopause, you could try stopping HRT for a month and then having a blood test to find out if you’re in the postmenopausal range.

If you are, then you will need to still use contraception for another year if you don’t want to become pregnant. If you’re not, then repeat the same exercise a year later.

The same also applies if you have a hormonal coil such as the Mirena coil fitted or are taking a birth control pill, as it can be difficult to know if you’re still getting natural periods. Although blood tests are not reliable if you are using combined hormonal methods.

Of course, contraception is not just used to prevent pregnancy but also to guard against sexually transmitted infections, so you will need to consider contraception for this reason regardless of where you are on your menopause journey.

Menopause can symbolise a new era of a woman’s life and in many ways can be liberating. Just a little careful planning can help make sure you’re not caught off guard.


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