To just stop taking the pill and assume I am now infertile ?

[Goodskin46]

I am 46 for the last 4 years have been back on the pill as the coil started causing problems in my 40's. I haven't taken it now for 3 weeks, no bleeding, negative pregnacy test. Last period was probrably April. Googling chance of conception is very low (less than 1%). WIBU to just not start it again, assuming I am now infertile. Then if no period for a year see GP for HRT ?. I have no menopause symptoms.

Given you've ruled out most other forms of contraception, perhaps you should consider tracking your ovulation using tests and/or basal body temperature to identify your fertile window and avoid sex. This will further reduce the risk of conception

As a science teacher, whilst I massively agree we should all be as educated and informed as possible, there's very little point teaching this at school. Firstly, because teaching something at school that you won't need for the next 30-40 years mean you're very unlikely to remember it and secondly, because medicine (and especially "women's" medicine) is advancing so quickly now in terms of new research and new medications, that anything we teach in school would be completely out of date by the time it becomes relevant to those students. If anything, it'd make things worse to tell them something that (by the time they apply that knowledge in real life) is no longer true. If we had infinite time, then learning about menopause so students understand what others are going through but schools should prioritise what will directly impact students themselves over tangential experiences.

My great grandmother thought she was in menopause. Turns out she was 6 months pregnant with her 10th baby. She was 50 years old.

What about the copper coil? No hormones, so you will continue to ovulate and menstruate until you actually are in the menopause. Once you've confirmed you are, you can have it removed.

It was the copper coil previously.

Would people really go through this to avoid an extremely unlikely pregnancy in their mid to late 40's ? Wow. I think I will talk to my GP (easier said than done) which tbh I should have done to start with. I do wonder how many women are out there at my age not bothering with contraception and not having very late surprise babies. Clearly nobody on this site.

Ask your partner to have a vasectomy

Probably not because there are multiple easier forms of contraception but you've ruled them all out.
I certainly wouldn't want to risk an unexpected pregnancy in my late 40s. Mainly because I wouldn't want to start again with kids at that age (personal choice, I know some women do), partially because on top of potentially having another kid, I'd be looking at a higher chance of a disabled child which is likely to be more work. And also, I've been through miscarriage, I don't want to go through that again if I can avoid it (eg by my husband having a vasectomy, using condoms or my taking a pill)

We discussed vasectomy in 2018 and decided the risks were unaceptable. It make even less sense now.

I'd go straight to a mirena coil. As then all you do is add in patches for hrt.

You could still be fertile and may have a period coming.

Also, you could start hrt now if you felt like you had some symptoms. At 45 you're assumed to be in peri and can get without a test.

Don't risk it as someone I know this age accidentally became pregnant and had a lateish miscarriage, but it was one of those growths rather than a baby.

I don't mind taking the pill, I was just idling wondering if it was still really necessary. Obviously if avoiding pregnancy is paramount then you would. I am going to talk to my GP, as I say I started 4 years ago, I thought it would only be for a shortish time (5 years maybe). The idea of a another 7 years from now isn't appealing. I am not prepared to use condoms with my husband of 20 years (many reasons not least enviromental concerns).

Mirena coil may be different.

A few on hrt take the progesterone only pill alongside the hrt.

The risks to vasectomy were unacceptable?! There's more risk to your health by taking long term hormonal contraception. So your health is worth less than your DHs? Jesus christ woman.
If you really don't want a child he either gets the snip and sucks it up or you abstain from sex. Or you could get your tubes tied, but recovery is longer than a vasectomy and chances of complications are higher, which is why women on this site suggest men get the snip.

Oh don't be ridiculous. If you have a bad reaction to the pill, ypu just stop it Even DVT which I assume you refer to are easily treated. When we looked at it up to 10% of men have chronic testicular pain after vasectomy (figures vary but around 2-7% was frequently quoted) that sounds horrible and would destroy your quality of life.

Yeah, unless you get a blood clot which enters your lung and kills you but hey, that's nothing compared to a bit of testicular pain eh?

I'm not sure what you're hoping to get out of this thread, OP.

People have said that you can't assume you are infertile and need to use contraception if you don't want to risk an unplanned pregnancy.

We've listed pretty much all the forms of contraception available and you've poured hot water on all of them.

So you're left with risking an unplanned pregnancy or not having sex.

Your choice, OP. You're a grown woman, you know what the options are. Pick one.

How many fatal pulmonary eboli secondary to the COCP with no other risk factors do you think there are each year ?

Compared to the millions of women who take it ? I don't know but I am guessing less than 1:10,000. It is not a significant risk.

Risk of VTE is very low especially if no other risk factors.

Neither is the risk of testicular pain significant but you seem more concerned with that.

What about a diaphragm? In your scenario could be a good option if you want contraceptive but not hormonal:

www.nhs.uk/conditions/contraception/contraceptive-diaphragm-or-cap/

The overwhelming majority of women are infertile by 46 even if they are still having periods. Just because your friend, mother, aunt, cousin had a baby at 48 (or 46 or 50 or whatever) doesn’t contradict that fact. We know of people who smoked all their lives and still lived to 90 - doesn’t mean that cigarettes don’t cause cancer and early death.

The chances of conception are very low. The chances of miscarriage following a conception (in the unlikely event of conception occurring) are extremely high - and in these cases it is likely that the miscarriage happens so early that the woman doesn’t even know that conception occurred, and therefore emotional trauma from such a miscarriage is unlikely.

You have to weigh the balance between risks. Hormonal contraception is very safe, but not without risks, and can cause side effects that many women find unpleasant. The risk of pregnancy is very low, but also not zero. The (physical) risks of an abortion are likely to be lower than the risks of hormonal contraception. (Emotional risks are personal to each individual.)

Are the unpleasant side effects worth enduring to ensure against such a low risk of conception and pregnancy beyond 6 weeks? Not for many women.

Most human activities and decisions involve risks. Giving up birth control at the age of 46 while still being sexually active can be a perfectly rational decision.

This what I thought, but clearly IABU. DM had completed her menopause by 49, I have had irregular bleeding since 42 so thought the risk might well be pretty low.

I am not sure that a misscarriage would upset me too much- it is very common, probrably the most frequent outcome of pregnamcy at my age. Quite happy to accept my child bearing days are over.

But still a fact

Not wanting to use condoms for environmental reasons sounds reasonable until you think of all the medical waste that you would generate through a pregnancy, a miscarriage, an abortion or through having a child! When I had my baby there were two huge hazardous waste bags filled up in the delivery room + more before and after for various minor procedures related to an induction and post partum checks and bleeding.
The diaphram sounds like it could be a good option though in your situation. Even the pull out method would be significantly better than just assuming you’re not fertile and having sex as normal.