Best contraceptive pill

[hopsalong]

If I have symptoms of perimenopause but still need contraception and am still having regular cycles (I'm 45), what would the best birth control pill be? I haven't taken the combined pill since my late 20s. Am I too old? The progesterone-only pill never suited me when younger (acne, depression, got pregnant once) but should I give it another try? I could have a Mirena coil fitted, but would that reliably get rid of my natural cycle? I am dealing with a variety of conditions exacerbated by very high perimenopausal oestrogen at ovulation. Would like to cut out ovulation altogether, but not sure how best to do that!

I had my first ever Mirena fitted in September aged 58 to try and stop my bleeding and so far, I think it’s working - still early days.
The meno consultant wanted me to have it, saying it’s the best method to protect my womb (endometrium), partic as my older sister died of endometrial cancer 2 years ago. With high oestrogen, don’t you have to be very careful with the lining of your womb?
GP tried to put me off, saying she didn’t think they would be able to fit it. Another GP was less resistant, had a go and fitted it easily.

Can't help re cutting out ovulation or the high oestrogen stuff.

However regarding contraceptive pills. You can take the combined pill up to 50 provided you've no contraindications.

The pdf linked from this page has all the guidelines etc for women over 40. www.fsrh.org/Public/Documents/fsrh-guidance-contraception-for-women-aged-over-40-years-2017.aspx

Tables 2 and 3 contain the stuff that tells you that a combined pill is allowed.

For progesterone only contraceptive pills it's worth being aware that there are different drugs in them. I was really really unwell with the one containing desogestrel (like ill enough I was checked for bowel cancer type issues and coeliac disease). The pop pill containing levenogestrel (same progesterone that's in most combined pills) doesn't make me ill.

GPs usually prescribe the desogestrel because it has a 12 hour window in which to take it and thus less risk of pregnancy as you've more time to take it if you forget. The levenogestrel one has 3 hour window.

Thank you both. @Wid I've had the Mirena coil before but (and perhaps I should get over myself) it made me look 4 months pregnant. I am a thin person who normally has a flat stomach and I felt awful!

@macdui I've only tried the standard POP (several times) and felt appalling on it, so this might be worth trying. I'll go and speak to the GP. I'd also wondered about some of the newer pills that seem to be promoted to older women, e.g. Qlaira.