A SELECTION OF METHODS OF CONTRACEPTION

Combined oral contraceptive pill ('the pill')

'The pill' is a highly effective method of contraception at all ages and is used by 8% of women over the age of 40. It may have special advantages for older women by helping heavy or painful periods or preventing ovarian cysts. It contains a combination of the two hormones, estrogen and progestogen which are given in a high enough dose to suppress ovarian function, preventing egg release. Women may continue with 'the pill' up to the age of 50 years provided they are fit, slim, non-smokers and have no risk factors for heart disease or stroke but in women who smoke, it should be stopped at the age of 35. 'The pill' must be prescribed by a doctor and the woman will need to have her blood pressure checked regularly. 'The pill' will not suit some women. It may be associated with a very slightly increased risk of breast cancer and should not be prescribed for women with migraine. Using 'the pill' in the long term protects a woman against both cancer of the ovary and of the lining of the womb(endometrium); a reduction of at least 50% in the risk of ovarian and endometrial cancer with combined pill use has been suggested, and this reduced risk continues for 15 years after stopping.

.

The progestogen-only pill ('mini-pill')

The 'mini pill' is very suitable for older women with no upper age limit for use. It is thought to be used by 7% of women aged over 40 who are using contraception. As it does not contain estrogen, it can be used by women who are unsuitable for the standard combined contraceptive pill. Therefore, women with problems such as high blood pressure, migraines or who have had a previous thrombosis can use the 'mini pill'. Most ‘mini pills’ may however cause quite erratic periods or cause periods to stop altogether. The ‘mini pill’ contains progestogen only and it’s main contraceptive effect is by causing a thickening of the mucus at the neck of the womb, thereby making it difficult for sperm to travel into the womb. Recently, a ‘mini pill’ has become available which, as well as thickening the mucus, suppresses ovulation in about 97% of women. This is particularly helpful in women who are beginning to have irregular periods since many women on this preparation will not have periods at all. The progestogen only pill must be prescribed by a doctor but can be continued for as long as a woman requires contraception.

 

Page last updated: 4 July 2007