Contraception for the older woman: an update

Abstract

Although fertility declines with advancing age as the woman approaches the menopause, some risk of pregnancy persists, and effective contraception needs to be offered to avoid an unintended pregnancy. An older woman may have menstrual dysfunction or climacteric symptoms and these factors would need consideration when making the choice of contraception. Low-estrogen dose combined oral contraceptives may be prescribed to healthy non-smoking women up to about 50 years of age. The progestogen-only pill may be an appropriate option in an older woman with declining fertility. The copper intrauterine device is an optimal method for parous women free of pre-existing menstrual problems. The levonorgestrel-releasing intrauterine system is considered the contraceptive method of choice for perimenopausal women with menstrual dysfunction. The woman should be provided with individualized advice so that she has a choice between the newer, effective, largely safe, reversible methods and sterilization.

Antinociceptive Effects of Docosahexaenoic Acid against Various Pain Stimuli in Mice

“…In a human study, it is known that n-3 PUFAs alter the plasma levels of opioid peptides. 13) Moreover, other reports suggest that n-3 PUFAs could compete with arachidonic acid, 14) leading to reduction in the inflammatory eicosanoids. These findings indicate that n-3 PUFAs might exert antinociceptive effects via an endogenous opioidergic system or anti-inflammatory system.…”

Intrauterine contraception: an update

“…The copper IUD and the LNG-IUS are more cost-effective than the combined oral contraceptive pill and injectable contraceptives (NICE 2005). When a prospective user with normal menstrual cycles opts for intrauterine contraception, high-load banded copper devices, rather than the LNG-IUS, may be preferred, as they are equally effective, last longer and provide highly cost-effective contraception (Dennis and Hampton 2002;Bhathena and Guillebaud 2006). The LNG-IUS is ideal for women with menorrhagia or dysmenorrhoea.…”

“…The differences in the effectiveness of the various devices may be less obvious in women over 40 years with declining fertility (Bhathena and Guillebaud 2006).…”

The Reproductive Health Priorities, Concerns, and Needs of Women in Midlife: A Feminist Poststructuralist Qualitative Analysis

“…Hesitancy to use hormonal contraception is not unique to women in midlife (Frost et al, 2012; Gomez & Wapman, 2017; Oakley et al, 2018), but may become more common with age. Conversely, the lower efficacy of many nonhormonal methods may be less consequential for women in midlife due to declines in fertility and fecundity (Bhathena & Guillebaud, 2006).…”