When was contraception no more necessary?

Advice with regards to preventing contraception are summarised in dining table 2.

Ladies who are not utilizing a hormone method of contraception are encouraged hoe gebruik je lumen to continue using contraception after their own LMP for: 1

• 1 year if they are elderly over 50 years
• 24 months if they’re aged under 50 years.

In which time of menopause was unclear as a result of utilization of contraception or HRT, lady can keep using contraception until age 55 after which end (spontaneous conception as of this age is unusual regardless if a female will continue to posses monthly period bleeding). 1 If a female would like to keep using a technique of contraception for non-contraceptive grounds after age 55 or menopause, this can be reviewed on someone factor. 1 Intrauterine contraception should not be kept in situ indefinitely as it could come to be a focus of issues, 1 or mistake the medical photo when the woman later presents with post-menopausal bleeding.

The guideline motivates enthusiasts to evaluate and address female based on her disorders and requirements instead their particular serum hormone indicators. 1 like, a woman aged 53, amenorrhoeic with a 52 milligrams LNG-IUS put 36 months in the past for contraception and HMB can keep the unit and also they eliminated after era 55; there is absolutely no sign for hormonal tests. However, if needed, an individual FSH degree >30 IU/L in a woman over 50 is sufficient to ensure ovarian insufficiency and contraception is stopped 1 year later. Progestogen-only ways of contraception cannot stop the menopausal rise in FSH degree. 1 FSH amount usually are repressed in females making use of CHC or HRT and are not thus clinically useful. 1

Non-hormonal

Stop contraception after 2 years of amenorrhoea

Stop contraception after 1 year of amenorrhoea.

Blended hormone contraception

May be carried on

Stop at get older 50 and switch to a non-hormonal system or IMP/POP/LNG-IUS, next adhere suitable pointers.

Progestogen-only injectable

Is proceeded

Females a‰?50 is counselled concerning switching to alternate methods, next adhere appropriate pointers.

Progestogen-only enhancement (IMP)

Progestogen-only tablet (POP)

Levonorgestrel intrauterine program (LNG-IUS)

Could be continuing to ageing 50 and beyond

Stop at get older 55 whenever natural reduced fertility can be presumed for almost all female:

A Mirena LNG-IUS inserted a‰?45 can stay in situ until era 55 if used for contraception or heavy menstrual bleeding.

IMP=progestogen-only implant; POP=progestogen-only capsule; LNG-IUS=levonorgestrel intrauterine system; FSH=follicle-stimulating hormonal; IU=international device

Recreated with authorization

Contraception and HRT

Sequential HRT is certainly not a successful type contraception because doesn’t easily control ovulation. 1 women that don’t want to become pregnant should make use of contraception alongside HRT. Table 3 summarises the contraceptive alternatives which can be used together with HRT.

Hormonal replacing treatment may cause cyclical bleeding in postmenopausal women although it does maybe not restore fertility. Women that is post-menopausal do not need to commence contraception when making use of HRT, though bleeding resumes. 1

Levonorgestrel intrauterine system (LNG-IUS)

Protected to make use of as contraception alongside oestrogen preference.

Mirena is actually trained for endometrial safeguards whenever combined with oestrogen. It is the only LNG-IUS recommended for this specific purpose.

It may be used-up to five years for endometrial defense and needs to-be changed frequently when useful this factor, no matter what get older at insertion.

Progestogen-only injectable

Safe to make use of as contraception alongside sequential HRT but consider change to lower-dose progestogen-only process.

Always likely to be efficient for endometrial safety with oestrogen within HRT but are not suggested as unlicensed because of this indication.

Progestogen-only implant (IMP)

Secure to use as contraception alongside sequential HRT.

Is not recommended currently for endometrial cover as an element of HRT as no evidence to support effectiveness.

Progestogen-only product (POP)

Secure to make use of as contraception alongside sequential HRT.

Can’t be ideal at the present time for endometrial safeguards as part of HRT as no proof to compliment effectiveness.

Matched hormone contraception (CHC)

Don’t use in conjunction with HRT.

Can be used in qualified women

Ladies should-be advised to switch to a progestogen-only approach to contraception at get older 50; read above for solution alternatives because they relate solely to HRT.

LNG-IUS= l evonorgestrel intrauterine program; HRT=hormone replacement treatment; IMP=progestogen-only implant; POP= p rogestogen-only product; CHC=combined hormone contraception

Reproduced with approval