Both vasectomy and female sterilisation are popular in older couples. However, since many reversible methods such as the IUS and implants are as effective as sterilisation, often with added benefits for period related problems, sterilisation needs to considered carefully. SEE EXTRA INFO
Copper intrauterine device
Modern copper intrauterine devices (IUDs)or ‘coils’ offer highly effective reversible contraception. If inserted after your 40th birthday, an IUD can remain in place until a couple of years after the menopause. The main disadvantages of this method is increased menstrual blood loss and period pains so its use is not recommended if you already have heavy or painful periods
With declining fertility, barrier methods can be highly effective. Condoms remain the most popular barrier method and are widely available without prescription. Polyurethane condoms are available and are particularly suited to those with latex allergy.
Diaphragms are popular with many couples and new female barrier methods are now available over the counter.
A small, one size, disposable vaginal sponge is available over the counter. It is impregnated with a gel containing a combination of three different spermicides. In addition to the effects of the spermicides, the sponge forms a physical barrier over the cervix and absorbs sperm.
In women over age 50, a spermicide is sufficient on its own since fertility is so low and can help with vaginal lubrication.
Coitus interruptus or the ‘withdrawal’ method is not a reliable contraceptive at any age and you should consider other more effective methods.
Although fertility awareness such as measuring changes in you temperature, checking your cervical secretions, and calculating your ‘safe period’ can be very effective for motivated women with regular menstrual periods, these methods become less reliable in perimenopause.
Both of the methods used for emergency contraception in younger women, i.e. hormonal contraception or the copper IUD, can safely be used by perimenopausal women.
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