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Original ArticleOpen Access
Contraception in Perimenopause
Taneepanichskul S 
,
Dusitsin N
,
Dusitsin N Women in their forties are still potentially fertile, and pregnancy in this age group is attended
with increased maternal mortality, spontaneous abortion, fetal anomalies and perinatal mortality.
Contraception for women in this age group has special risks and benefits; both should be balanced to
choose between the different options available. Recent epidemiological and clinical pharmacology
studies have indicated the safety of extending the use of combined oral contraceptives (COCs) beyond
the age of 35 years and up to menopause. Women who have reasons for avoiding COCs can use
progestogen-only contraceptives like pills, depot injectables and implants. Implant combines high
efficacy and long-term effect. Both copper-releasing and levonorgestrel-releasing intrauterine contra-
ceptive device (LNG-IUD) combine the advantages of high efficacy and long-term effect. The reduced
fecundity above the age of forty can allow extending the use beyond the accepted term, and up to one
or two years beyond the menopause without the need for replacement. The levonorgestrel IUD has
the advantage of reducing the amount of menstrual bleeding. The condom has the added benefit of
protection against sexual transmitted diseases (STDs). Male or female sterilization is an excellent
contraceptive option, provided that this approach is culturally acceptable and available at reasonable
cost and low risk.
Key word
: Contraception, Perimenopause
TANEEPANICHSKUL
with increased maternal mortality, spontaneous abortion, fetal anomalies and perinatal mortality.
Contraception for women in this age group has special risks and benefits; both should be balanced to
choose between the different options available. Recent epidemiological and clinical pharmacology
studies have indicated the safety of extending the use of combined oral contraceptives (COCs) beyond
the age of 35 years and up to menopause. Women who have reasons for avoiding COCs can use
progestogen-only contraceptives like pills, depot injectables and implants. Implant combines high
efficacy and long-term effect. Both copper-releasing and levonorgestrel-releasing intrauterine contra-
ceptive device (LNG-IUD) combine the advantages of high efficacy and long-term effect. The reduced
fecundity above the age of forty can allow extending the use beyond the accepted term, and up to one
or two years beyond the menopause without the need for replacement. The levonorgestrel IUD has
the advantage of reducing the amount of menstrual bleeding. The condom has the added benefit of
protection against sexual transmitted diseases (STDs). Male or female sterilization is an excellent
contraceptive option, provided that this approach is culturally acceptable and available at reasonable
cost and low risk.
Key word
: Contraception, Perimenopause
TANEEPANICHSKUL
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