Contents x
    When to stop contraception
    • 08 Dec 2023
    • 1 Minute to read
    • Print
    • PDF
    Contents

    When to stop contraception

    • Updated on 08 Dec 2023
    • 1 Minute to read
    • Print
    • PDF
    Article summary

    The table below was created by the FSRH and is a helpful guide.

    Contraceptive methodAge 40 -50 yearsAge >50 years
    Non-hormonalStop contraception after 2 years of amenorrheaStop contraception after 1 year of amenorrhea
    Combined hormonal contraceptionCan be continuedStop at age 50 years and switch to a non-hormonal method or IMP/POP/LNG-IUD, then follow appropriate advice
    Progestogen only injectableCan be continued Women aged 50 years and over should be counselled regarding switching to alternative methods, then follow appropriate advice
    Progestogen only implant (IMP)
    Progestogen only pill (POP)
    Levonorgestrel intrauterine system (LNG-IUD)    		Can be continued to age 50 years and beyondStop at age 55 years when natural loss of fertility can be assumed for most women.
    • If a woman >50 years with amenorrhea wishes to stop before age 55 years, FSH levels can be checked. 
    • If FSH levels greater or equal to 30 IU/L the IMP/POP/LNG-IUD can be discontinued after 1 more year.
    • If FSH level is in the premenopausal range, then the method should be continued and FSH levels checked again 1 year later. 

    A 52mg LNG-IUD can remain in situ if inserted at aged 45 years or after until the age of 55 years if being used for contraception.

    WOMEN NOT USING HORMONE TREATMENTS:

    • A woman who is not taking any hormone treatments is potentially fertile for 2 years after her last menstrual period if she is <50 years, and for 1 year if she is >50 years.

    WOMEN USING HORMONE TREATMENTS:

    • Most women using hormonal contraception will have altered bleeding patterns, and as a result, it can be difficult to give accurate advice regarding underlying menopausal status.
    • In women over 50 years who are amenorrheic, and using a progestogen only methods (including DMPA), FSH levels can be used to advise about stopping contraception.
    • FSH levels should not be checked in women taking the COC or HRT, however, because these treatments suppress estradiol and gonadotrophin levels.
    • In general, all women can stop contraception at 55 years when natural sterility can be assumed.
    NOTE:
    • The FSRH suggests restricting measurement of serum FSH for advice about stopping contraception to women over 50 years using progestogen only contraception who are amenorrheic.
    References and Further Information:
    Was this article helpful?
    What's Next