From the Guidelines
Birth control does not delay menopause, and women should continue contraceptive use until menopause or age 50-55 years, as recommended by the American College of Obstetricians and Gynecologists and the North American Menopause Society 1.
Key Points to Consider
- Hormonal contraceptives can mask the symptoms of menopause by providing external hormones that regulate menstrual cycles, but they do not change when natural menopause occurs 1.
- Menopause is defined as the permanent cessation of menstruation due to the loss of ovarian follicular activity, typically occurring between ages 45-55 1.
- While using hormonal contraceptives, women may continue to have withdrawal bleeds that mimic periods, making it difficult to identify when natural menopause has occurred 1.
- If a woman is over 50 and using hormonal contraception, her healthcare provider might recommend transitioning to non-hormonal methods or performing hormone tests to check her menopausal status 1.
Important Considerations for Contraceptive Use in Women of Advanced Reproductive Age
- Pregnancies among women of advanced reproductive age are at higher risk for maternal complications, such as hemorrhage, venous thromboembolism, and death, and fetal complications, such as spontaneous abortion, stillbirth, and congenital anomalies 1.
- Risks associated with continuing contraception, in particular risks for acute cardiovascular events (venous thromboembolism, myocardial infarction, or stroke) or breast cancer, also are important to consider 1.
- The U.S. MEC states that on the basis of age alone, women aged >45 years can use POPs, implants, the LNG-IUD, or the Cu-IUD, and women aged >45 years generally can use combined hormonal contraceptives and DMPA, but chronic conditions or other risk factors may render use of hormonal contraceptive methods unsafe 1.
From the Research
Delay in Menopause due to Birth Control
- There is no direct evidence to suggest that birth control causes a delay in menopause 2, 3, 4, 5, 6.
- However, hormonal contraceptives can affect menstrual cycles and fertility, which may impact the timing of menopause 2, 4.
- The use of hormonal contraceptives in perimenopausal women can help manage symptoms and prevent unintended pregnancy, but the optimal contraceptive regimen for these women is unclear 4.
- The American College of Obstetricians and Gynecologists recommends that women with coexisting medical conditions use contraception based on their individual risk factors and medical history 5.
- Hormonal contraceptives have been shown to have various benefits and risks, including improving medical conditions associated with hormonal changes and increasing the risk of venous thrombosis 3, 6.
- The decision to use birth control should be based on individual patient needs and preferences, taking into account their medical history, risk factors, and personal values 3, 4, 5, 6.