‘I’ll cut my throat if I get pregnant’ is a frequent statement by women attending the menopause clinics. With all these variations in your hormones and ovulation, how can you be sure you won’t get pregnant? Your doctor also is concerned to provide efficient contraception for you. People expect to enjoy sex at any age, and nothing spoils that enjoyment so much as fear of an unwanted pregnancy. In addition, there is the increased danger of foetal abnormality and maternal mortality in the older woman.
When can you ignore contraception? After fifty pregnancy is rare, even if you are still having periods. In the United States only one in 24 000 live births are from mothers over the age of fifty.6 In the United Kingdom, there are even fewer.7 A woman over fifty is as likely to become pregnant as she is to be struck down by lightning. Statistically, therefore, contraception at this age is unnecessary.
Could the pill be continued instead of hormone replacement therapy?
The doses are much higher than are necessary to control postmenopausal symptoms, and with increased knowledge of side effects with doses of the present oral contraceptive pills, it is unwise to use this for replacement therapy.
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