All women that nevertheless call for contraception and do not need to get pregnant should always be supplied

When are contraception no further recommended?

Suggestions relating to preventing contraception are summarised in dining table 2.

Ladies who commonly using a hormone approach to contraception are advised to continue using contraception after their LMP for: 1

In which time of menopause is confusing because of usage of contraception or HRT, women can keep using contraception until get older 55 and stop (natural conception at the years are rare in the event a woman continues to bring monthly period bleeding). 1 If a woman wants to continue using an approach of contraception for non-contraceptive factors after years 55 or menopausal, this might be assessed on an individual factor. 1 Intrauterine contraception shouldn’t be kept in situ indefinitely as it could being a focus of disease, 1 or confuse the clinical photo if the woman after presents with post-menopausal bleeding.

The guide encourages experts to evaluate and heal girls according to their unique ailments and requirements versus their own serum hormonal markers. 1 For example, a woman aged 53, amenorrhoeic with a 52 milligrams LNG-IUS put 3 years in the past for contraception and HMB can keep the product and have they removed after years 55; there’s absolutely no indication for hormone assessment. However, if needed, one FSH degree >30 IU/L in a woman over 50 is enough to confirm ovarian insufficiency and contraception may be ceased one year after. Progestogen-only ways of contraception do not avoid the menopausal rise in FSH stages. 1 FSH levels are usually repressed in women utilizing CHC or HRT and they are perhaps not for that reason scientifically helpful. 1


Quit contraception after a couple of years of amenorrhoea

End contraception after 1 year of amenorrhoea.

Blended hormone contraception

Is continued

Visit era 50 and switch to a non-hormonal method or IMP/POP/LNG-IUS, then heed suitable suggestions.

Progestogen-only injectable

May be continuing

Girls a‰?50 must counselled relating to using solution means, subsequently heed appropriate information.

Progestogen-only implant (IMP)

Progestogen-only product (POP)

Levonorgestrel intrauterine system (LNG-IUS)

Is generally proceeded to ageing 50 and beyond

Take a look at years 55 when natural losing fertility can be assumed for the majority females:

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

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

Reproduced with authorization

Contraception and HRT

Sequential HRT isn’t a fruitful type contraception because does not easily reduce ovulation. 1 ladies who try not to want to get pregnant should incorporate contraception alongside HRT. Dining table 3 summarises the contraceptive possibilities which you can use along with HRT.

Hormonal replacing treatments may trigger cyclical bleeding in postmenopausal lady although it does perhaps not restore fertility. Ladies who tend to be post-menopausal don’t need to start contraception when using HRT, regardless of if hemorrhaging resumes. 1

Levonorgestrel intrauterine program (LNG-IUS)

Protected to make use of as contraception alongside oestrogen of choice.

Mirena is certified for endometrial cover when along with oestrogen. Truly currently the sole LNG-IUS authorized for this function.

It may be used-up to five years for endometrial safety and requirements become changed on a regular basis when utilized for this objective, regardless of get older at installation.

Progestogen-only injectable

Protected to use as contraception alongside sequential HRT but think about switch to lower-dose progestogen-only strategy.

Really more likely efficient for endometrial safeguards with oestrogen as part of HRT but should not be advised as unlicensed with this indicator.

Progestogen-only enhancement (IMP)

Secured to make use of as contraception alongside sequential HRT.

Should not be advised presently for endometrial shelter included in HRT as no proof to guide efficacy.

Progestogen-only capsule (POP)

Safe to make use of as contraception alongside sequential HRT.

Cannot be advised presently for endometrial cover as an element of HRT as no proof to aid effectiveness.

Combined hormone contraception (CHC)

Don’t use in combination with HRT.

May be used in qualified women

Girls should always be advised to switch to a progestogen-only way of contraception at get older 50; discover above for option selection as they relate genuinely to HRT.

LNG-IUS= l evonorgestrel intrauterine system; HRT=hormone replacement therapies; IMP=progestogen-only implant; POP= p rogestogen-only supplement; CHC=combined hormonal contraception

Reproduced with approval


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