Features of contraception after 40 years
The age of a woman over 40 is considered the prime of sexuality. It is during this period that she begins to appreciate sexual relationships in all their glory. And right now, an unwanted pregnancy can become an extremely unpleasant surprise for a couple.
The choice of contraception after 40 should be taken seriously. By this age, almost every woman already has from one to several chronic diseases, more often pathologies of the cardiovascular system. The method of contraception should not aggravate health problems.
Also, already at this age, women may be haunted by symptoms of approaching menopause:
- increased sweating;
- hot flashes;
- increased heart rate;
- decreased libido;
- dryness of the genitals.
The hormonal substances included in contraceptive medications help cope with all these symptoms.
Best method of contraception
Sexual intercourse with an unfamiliar partner can threaten a woman, in addition to unwanted pregnancy, with other unpleasant things.
For example, she may become infected with sexually transmitted infections. That is why the best means of protection in this case is a condom, since only it guarantees almost one hundred percent protection both from pregnancy and from sexually transmitted diseases. The advantage of condoms for casual sexual intercourse is that they were originally developed specifically as a method of contraception for such cases. If once men said that their sensations were dulled by condoms, then, thanks to modern materials, such complaints can be considered practically unfounded. Low price and widespread availability make condoms the number one choice.
What contraceptives are suitable for women over 40 years of age?
Let's take a closer look at each contraceptive method.
Combined oral contraceptives
The main principle of action is inhibition of ovulation processes, which prevents possible conception.
The most common COCs for use in women over 40 years of age:
- Trisiston;
- Marvelon;
- Triquilar;
- Silest and others.
The selection of hormonal contraceptives should be carried out only by a gynecologist. Before use, it is necessary to assess the presence or absence of a number of contraindications in a woman.
Mini-pill
These include hormonal drugs that do not contain an estrogen component. The mini-pills contain gestagens that have minimal negative effects on the female body.
Such drugs are acceptable for use in women with cardiovascular diseases, as well as those who have bad habits.
The most common pills for women over 40 years of age: Charozetta, Microlut, Exluton.
Condoms
One of the most popular methods of contraception, therefore it is often used in women after 40 years. The advantages of using condoms include the fact that they also protect partners from infectious diseases.
However, condoms may not be very comfortable to use. The disadvantages are a decrease in sensitivity, the appearance of discomfort if the size of the product is incorrectly selected. If used incorrectly, condoms can break and slip off.
How to protect yourself?
Today, the choice of such drugs is huge - they differ in the content of active ingredients.
In order for the contraceptive effect to be reliable, like a Swiss watch, and to avoid any other unpleasant consequences, it is best to select the type of pills, dosage, start time, and duration of the course not independently, but together with a gynecologist. Moreover, the doctor should not just advise, but also ask to take tests for hormones and blood clotting (COCs affect the blood coagulation system), and do an ultrasound examination of the pelvic organs.
Properly selected combined oral contraceptives can not only provide reliable protection against pregnancy, but also relieve pain during premenstrual syndrome and improve skin condition.
And if the drug is chosen incorrectly, it can:
- increase body weight
- mood worsens
- sudden bleeding from the vagina
All these consequences may be temporary side effects, but if they do not go away for more than a month, you should stop taking the drug. Without it, the body must return to normal. And the doctor will help you choose a more suitable means of contraception.
Combined
Oral contraceptives are called because the active ingredients in them are different combinations of sex hormones - most often progestogens (progestins) and estrogens.
In a “mature” (ready for reproduction) female body, these hormones are produced primarily in the ovaries. For tablets, such substances are synthesized in the laboratory, which is why you can often hear the phrase “synthetic hormones” in relation to COCs. There is nothing dangerous in this syntheticity and artificiality - this is not “chemistry”, but just a way to produce the drug on an industrial scale.
Progestogens
- in everyday life they are called “motherhood hormones” - they are more actively secreted during real pregnancy, when the egg meets the sperm and begins to turn into an embryo and fetus. So, if you increase the level of progestogens in the body with the help of pills and essentially deceive the body by simulating pregnancy, the female reproductive system will think that one egg is already in action (pregnancy has started), and will slow down the maturation of a new active egg. Thus, the possibility of conception will be blocked.
Estrogens
in tablets are needed in order to maintain hormonal balance in the body - since with an artificial increase in progestogens, estrogen production decreases.
Which means are not suitable?
If we talk about a relatively healthy woman, then there are no restrictions in choosing a method of contraception.
However, hormonal contraception after 40 years may be prohibited for women:
- smokers;
- with pathology of the heart and blood vessels - hypertension, atherosclerosis, angina pectoris, history of heart attacks and strokes;
- with a predisposition to blood clots in the past, or if close relatives have had thrombosis;
- with varicose veins of the lower extremities, pelvis, esophagus.
COCs are contraindicated for such women; methods that do not involve the use of hormones should be chosen for them.
Smoking and protection. 5 questions to a gynecologist
Smoking is harmful. Especially for the heart and blood vessels. Scientists have found that women who smoke have a 5-fold increased risk of heart attack and a 2-fold increased risk of stroke. And this threat becomes even more real when taking certain contraceptives.
Birth control pills and smoking
I am 37 years old. For the last three years I have been taking estrogen-containing contraceptives. I'm happy with everything. But the gynecologist, having learned that I started smoking, persuades me to either “quit” cigarettes or give up pills. The question is, why?
Your gynecologist is right. It is better, of course, to quit smoking, because smoking is a proven risk factor for cardiovascular diseases and cancer. Not to mention aesthetic problems - gray skin, yellow teeth, tobacco smell from the mouth... Plus, smoking increases the risk of heavy menstrual bleeding. If you are unable to part with a cigarette, consider a suitable method of contraception.
Estrogen-containing drugs themselves are generally safe for health. But the situation changes if a woman is over 35 years old and smokes. In this case, her likelihood of developing blood clots increases, which can lead to atherosclerosis, heart attack and stroke.
Contraception after 35 years
My friends have been “smoking” since their youth. And at the same time they take birth control pills. Nothing bad happens to them! Moreover, they did not prescribe the pills for themselves, but bought them on the advice of a doctor. So many doctors can't be wrong, can they?
What can I say - we need to look for more competent gynecologists. For some reason, many doctors do not consider smoking a contraindication for taking estrogen-containing hormonal drugs. And they either turn a blind eye to the patients’ bad habits, or are not at all interested in whether they smoke. Meanwhile, according to the WHO document, if a woman is over 35 years old and smokes more than 15 cigarettes a day, combined methods of contraception containing estrogen are absolutely contraindicated for her! These include oral contraceptives, patches, injections and vaginal rings.
It turns out that the only means of contraception for women who smoke is a condom?
Not necessary. For women 35+ who smoke, progestin-only oral contraceptives (mini-pills) are suitable. They need to be taken at the same time every day. If you are at least 3 hours late, you may need to use additional protective equipment, such as a condom.
Another method of contraception is an intrauterine device, including a hormonal one. True, some women are wary of spirals. They are afraid of heavy menstrual bleeding, inflammation, loss or ingrowth of the helix. Their fears are only partly justified. For example, metal IUDs do pose additional risks for the development of iron deficiency anemia due to heavy menstrual bleeding.
New generation intrauterine systems, hormonal, are also prescribed to relieve heavy discharge during menstrual periods. They do not cause headaches, increase blood pressure, have virtually no effect on libido and can be used during breastfeeding. The only thing is that in the first months after installation there is sometimes spotting. But you shouldn’t be afraid of this - the body simply “adapts” to the spiral.
I heard that there are some implants with hormones. What are they and are they suitable for smokers?
Hormone implants are another product from the “contraception without worries” series. They provide protection against unwanted pregnancy for up to 3 years and are suitable for women who smoke.
The implants are inserted under the skin of the inner surface of the shoulder (if you are right-handed, then in the left hand; if you are left-handed, then in the right). Initially, there may be side effects: weight gain, headaches and breast tenderness. However, they usually disappear later.
How can you understand that the gynecologist is qualified and has prescribed contraception not for show, but according to all the rules?
You reason correctly - a doctor and only a doctor should select hormonal implants, intrauterine systems, and oral contraceptives! You cannot buy them on the advice of a friend or pharmacist at a pharmacy. A qualified specialist will definitely clarify your age and the number of pregnancies (childbirth, miscarriages, abortions), ask questions about the regularity, pain and duration of menstruation, the abundance of discharge, and ask about the presence of chronic diseases, lifestyle and bad habits. This will allow you to choose the protection method that suits you.
How to choose a method
First of all, you need to see a gynecologist. The specialist will conduct a full examination and interview the woman for the presence of chronic pathologies and bad habits. After this, the doctor can refer the patient for additional examinations: mammography, ultrasound of the pelvic organs, ECG and consultations with related specialists.
It is important to answer all the doctor’s questions honestly, because the choice of contraceptive method will depend on this.
Properly selected means of protection against unwanted pregnancy will not harm your health and can even facilitate the transition to the natural stage of menopause.
How to protect yourself for women after 35 years of age
There are many methods of contraception, some of which are more reliable than others. Most often, women turn to a gynecologist with a request to install an intrauterine device or select hormonal drugs in tablets.
At the same time, every woman has her own recommendations and prohibitions, including those who are over 35 years old.
Women of Balzac age have to pay special attention to their health and avoid unwanted pregnancy. At the same time, the means used by young gynecologist patients are unacceptable to them.
To take hormonal pills or not after 35 years
At this age, you can expect unpleasant surprises from taking oral contraceptives. Often, mature women complain that these medications cause them severe headaches, abdominal pain, changes in weight and libido.
But this is not the worst that can be expected from these drugs. In mature women, especially smokers, this combination of hormones can cause thrombosis of the veins in the legs, heart attack or stroke.
Therefore, it is better to forget this method of preventing unwanted pregnancy.
Pros and cons of the intrauterine device
When advising how to protect women after 35 years of age, gynecologists most often opt for the IUD. This method is very reliable, has no strong side effects, and the female body quickly gets used to it.
However, for a certain percentage of women, the IUD causes a lot of inconvenience and problems and is generally poorly tolerated. In this case, we can only advise one thing - buy condoms and always use them during intimacy.
There is also a type of female contraceptive called a diaphragm, which is easily installed and removed and is not felt at all when in contact with a man.
Is it worth using the calendar method?
The method, in which a woman monitors her basal temperature, thick mucus production on the day of ovulation and calculates safe days, can also be used by a 35-year-old woman.
However, you need to know that any stress, overwork, illness or even drinking alcohol can shift the “safe days”: according to statistics, 8 out of 10 pregnancies in women of this age are unwanted.
Advantages of the barrier method
As you know, a condom provides an almost one hundred percent guarantee that pregnancy will not occur. Unlike all of the above methods of contraception, it does not interfere with a woman’s well-being and protects against diseases and infections transmitted through sexual intercourse.
Therefore, women over 35 should give preference to this option, as the most reliable and safe.
What else can you do to protect yourself?
Often, couples use the method of interrupting sexual intercourse. This method turns out to be especially popular when for some reason there is no condom at hand. However, this type of contraception is the most ineffective, and it does not protect a woman from any diseases at all.
Keep in mind that in order to get pregnant, even the lubricant that is released from a man’s penis during intercourse is enough. This lubricant usually contains sperm. An additional risk factor is the fact that the partner needs to control himself at the most crucial moment; not all men are capable of this. If you don't know this person well, you can't be sure of your safety.
Vaginal douching can help if only done in the very first minutes after intercourse has been completed. In the future, the effectiveness of the method tends to zero.
The so-called “safe days” method does not work because it is almost impossible to accurately calculate the time of ovulation. If everything was simple with safe days, then there would simply not be so many healthy couples trying to conceive a child for a long time.
Discussing contraception with your partner
Some women find that discussing contraception with a partner can be awkward. But if you don’t know this person well, then you definitely cannot be sure of his health and ability to control himself. Think that in this situation, first of all, it is you who are at risk, since he definitely will not be able to get pregnant.
Emergency contraceptives taken after sex, which some women flippantly rely on, are such a serious hormonal stressor that they can affect your women's health and your ability to have children in the future.
If your partner is not willing to care about your health and safety, then the best thing to do is to avoid having sex with him.
How to reduce your chance of developing an STD in other ways
One of the methods for preventing the occurrence of sexually transmitted infections is preliminary preparation. Before having sex with a new partner, it is recommended to take care of your safety in advance (even if you are not planning a long-term relationship). To do this you need:
- Undergo a preliminary examination for the presence of sexually transmitted infections in both partners. For this purpose, you need to visit a dermatovenerologist: the doctor will write you a referral for testing for all possible diseases that are transmitted through sexual contact. To do this, you need to donate blood, a vaginal smear for women and a urethral smear for men. The doctor will be able to detect some of the infections during the initial examination and, if necessary, prescribe treatment. If both partners are healthy, you can have an active sex life.
- Have a conversation about safe sex with your significant other. It is necessary to agree in advance on the use of a particular method of contraception to prevent STDs and unwanted pregnancy. If your partner reacts negatively to such a conversation and does not want to use any method of contraception, you should refuse sexual contact with him.
- Be sure to familiarize yourself with the main external signs of the development of STDs in men and women. To do this, it is better to use trusted medical sites, encyclopedias or information brochures. The presence of rashes, bumps, unpleasant odor and pathological discharge in a partner is a good reason to refuse sexual contact and ask him to undergo examination at a skin and venous dispensary.
- Explore the issue of vaccination. Currently, only vaccines have been developed against hepatitis B and human papillomavirus (HPV). Vaccination is carried out exclusively in the absence of these diseases in the vaccination office of any clinic. The hepatitis B vaccine is free, while the HPV vaccine requires a fee.
- Ensure the cleanliness and proper handling of sex toys. Many of them are made of synthetic material with pores, in which particles of secretions containing pathogenic microorganisms can remain. Toys made of latex, rubber and polyurethane must be washed with soap and water and then wiped with an antiseptic solution. Glass toys should be boiled for 10 minutes, after which they should also be treated with an antiseptic. It is recommended to store such items in a specially designated place, which is reliably protected from moisture and dust.
One of my friends told me that in her homeland of Azerbaijan, a man and a woman cannot get married until all tests for sexually transmitted infections have been passed. This allows you to avoid the development of many serious complications and preserve reproductive function, as well as give birth to a healthy child. Many of my fellow doctors believe that this technique is extremely effective and reduces the risk of developing sexually transmitted infections.
