Contraception in menopause

[Randomchat]

I'm overwhelmed with hormones and medication and want to stop something.

I've been on hormonal contraception most of my adult life so I've never had reliable periods. For that reason the gp tells me contraception is suggested until age 55. We've also been using condoms for a while because of vaginal dryness.

I'm taking oestrogen gel (horribly allergic to 2 different brands of patch), progestogen pills and a progestogen only contraceptive (have an odd shaped uterus so don't get on with coils). Unrelated, but I've also started medication for glaucoma recently.

I'm considering stopping the hormonal contraceptive and just using condoms. I spoke to the practice nurse today who said that the chances of getting pregnant at 51 are really small but not zero. Properly using condoms massively reduces the risk. So the risk would be tiny.

I want to stop taking it because I'm slightly overwhelmed with the amount of medicines I'm taking. Also the amount of hormones I'm adding to my body for one reason or another. If it's not entirely necessary I'd like to cut it out.

But I've been on hormonal contraception pretty much forever and I feel a bit terrified about stopping, like I'm bound to get pregnant aged 51 the very first time we have sex. Even though we would still use condoms.

I'm also not sure how I would know I was pregnant since I don't have periods. I didn't have many early symptoms when I was pregnant. Should I take a test every month for peace of mind?

I don't know why I've got a bit fixated on this tiny pill. I would actually love to just stop interfering with my hormones altogether and just be however my body is meant to be, but I don't think it would be pretty, based on how I was feeling before starting HRT. So do I stop this one part of my hormone regime? Or will it not make much difference and I should just keep taking it and stop thinking about it so much?

Please talk some sense into me. Thank you

What does the doctor recommend? It seems if you’ve always been on the pill it might throw your system a bit of a curveball to just stop?

What does it mean, do you have all the eggs stored up because you never ovulated or what? (sorry I’m very non-medical but intrigued!)

I’ve never been on the pill and condoms have worked fine for the last 20 years for us, so please don’t worry about getting pregnant if you are using them. I’m the opposite, I couldn’t not use the barrier now I’m used to it, just the pill would scare me!

@JinglingSpringbells Fair enough. My husband knew at 45 that if were I to die or we divorced, to consider the possibility of having children with another woman in the future would be inherently selfish - it's not something he would ever want. I massively respect him for that viewpoint, even if it goes against "the grain" as it were.
Hence booking in for the snip shortly after his only bio child was born (our daughter).
It's been so liberating! Would recommend!

Hi from Belgium! Our healthcare is different from yours but the human body works the same whatever side of the Channel we are, right!

i had the same problem/questions as you have now.

I had been on oral contraception "all my life" and always have known I'm very fertile.

When I stopped taking my pill there was a baby 9 months later, simple as that.
At 53 I went to my GP and explained I'd had enough.
He told me - and this is important @OP : as long as you're on oral contraception a bloodtest will show "not fertile".

So he ordered me to stopp my pill and come back in 3 months.

I did, and he sent my bloodsample to the lab.

it showed that at 53 I still had the fertility of a 35 y.o. woman.

So I asked for a coil...'...and he said no.

It appears that here in Belgium coils are not placed in women over 50.
I was perfectly allowed to become pregnant at 53+, but not to have a coil placed.

So I stuck with the oral contraception.

Only when I was 58 Mother,Nature decided to give it a rest and gave up on my fertility.
I'm 68 now and haven't taken any hormones at all since 10 years now.

I really think you should take that fertility test after a few months with no hormones at all.
Wishing you the best ❤️‍🩹

When I came off the pill aged 52/3, we used spermicide gel and condoms. I had to do a pregnancy test at the family planning clinic before they'd issue the gel.

Stop the pill! condoms are very effective and realistically your chances of conceiving even if you were actively trying are very low.

Ask your partner to get neutered!

If you have spent your whole adult life taking responsibility for having pregnancy risk free sex, then asking him to have a teeny tiny operation (can be done without anaesthetic on a dining room table theoretically) and is less invasive than having coils fitted or an actual pregnancy!

You should advise him that in three months you are ending contraception and he has time to organise his procedure, or you are pulling the plug on bedtime fun!

I think the main risk of stopping your progesterone only pill is more unscheduled bleeding. Talk to a GP re the whole regime to see if there's anything that can be swapped / combined / stopped.

You want vaginal oestrogen (you can use this at the same time as systemic HRT) whether or not you're doing sexual stuff with a partner. It treats vaginal and vulval dryness and is good for recurrent UTI. Separately you want a non-hormonal vaginal moisturiser (for routine use every 1-3 days) and lubes suitable for your activities (water based with condoms etc)

What about a diaphragm? I don’t get on with hormonal contraception and hated the copper coil, so I use a Caya diaphragm. It’s not as effective as a contraceptive, but the risk is already small and you use condoms anyway. It comes with a gel that you put in it and round the edges too, presumably similar to spermicide.

Maybe not ideal if you have vaginal dryness though, but thought I’d offer up another suggestion.

Hi, Hope you get to read this. It sounds a little like your confusion (brain fog) might be to do with menopause. I know it is expensive but could you make an appointment to see Louise Newson? She, or one of her practitioners will sort you out and they are so clued up with this sort of thing. At the very least check her web site. You may find some answers to your questions as she posts a lot about all our queries. I went to her years ago and the NHS will prescribe for you after she works out the right plan. GPs in general will just keep feeding out various drugs and then it gets confusing as to what does what. What you need is a one stop simplification from someone who knows women. Good luck and this is worth it as it will set you up for life.

I’m 53 and use the mini pill

I know everyone on here has a collective heart attack but I stopped contraception at 50. I still have periods age 53. The chance of pregnancy is vanishingly thin and if you do get pregnant, the chances of carrying to term are even slimmer. If you use condoms, you’ll be fine. None of my friends post 50 stayed on the pill nor did they do anything else.

I know OP can’t take the CCP, but for others, if your individual risks are low, and there is good reason why it would suit you, a private gynaecologist in the UK can indeed prescribe the combined contraceptive pill for you until 55. My gynaecologist in Harley Street does this for me. The NHS does not generally prescribe until 55 because its guidelines are based on generalised risks and outcomes, not individual needs. I have no menopause symptoms whatsoever, have not had a period since I was 25, and intend to sail through to the other side and only take HRT once the messy, to me (childfree) utterly unnecessary, reproductive shenanigans have stopped.

HRT isn't necessarily for after periods have stopped, it's to relieve the symptoms of peri or full meno. The former of which you will probably still be having periods.

I'm 58, been on HRT five years, still have periods!

Cut off for combined definitely seems to be 50. I’m 49 and still on it but told it’s my last year. I take it for PCOS management a I’ve no risk factors. Younger GPs wanted me off it before 40 and get very nervous when I got for reviews so I always see a particular GP who is older and takes everything into consideration.

Her plan for 50 is to put me onto high dose of HRT and then to wean me off it slowly. I’m worried about plunging into menopause as she has told me the combined pill will prevent any symptoms at the moment. I already get massive menstrual migraines when I take a breaks due to oestrogen withdrawal so o just back to back. I tried the POP pill but it made my PCOS symptoms worse.

Yes. I don’t want to have periods. I take the CCP back to back without breaks. I haven’t had periods, period pains, or any related hormonal up and downs since I was in my 20s. Why would I want to start now when my friends in their 50s are complaining of “flooding”?! I’m not trying to persuade anyone this is for them, but it definitely is for me, and the whole “NHS says no” mantra pisses me off.

If it turns out I’m still having periods when I’m 55, I’ll cross that bridge then. My mother was through menopause at 51, so odds are I’ll be fine by then.

I am 48, in full peri (periods totally haywire) but a scan this week showed I am still very fertile 🤦‍♀️
Perhaps I’ve missed it, but why can’t your DH have a vasectomy? Mine had his years ago, no issues. And no more hormonal contraceptives for me!

I stopped using anything at 50. 😲 Periods stopped at 52 years

12 hours.

Yeah, well, everyone is different, I've never stopped having periods, even with a Merina coil.

Never had "flooding" though. It's not a given this will happen.

I don't know how you think you're going to know when your periods have stopped if you don't have periods anyway 🤷🏻‍♀️

Yeah, but only for a day or so. It never stops it for good, you have to use it consistently a few days a week.

I think condoms are better than oral contraceptives, but my personal experience might be unusual.

I stopped taking anything at 49 (was on combined pill) to see if my periods had naturally stopped. We used condoms. 51 in September and no periods in over a year and a half. I'm on combined HRT now.

Also no endometriosis symptoms since I was 39/40. Neither the combined pill nor combined HRT seem to have kicked it off again, fortunately.

Peri menopause is probably the most fertile you’ll have been for years, as your body throws everything into ‘one last chance’.
I have a progesterone coil fitted as part of my HRT, but it’s also a contraceptive. Two birds, one stone 😁 EDIT The dose is tiny as it’s delivered right where it needs to be.
Topical estrogen twice a week (I’d recommend the tablets rather than the cream, as it’s less messy/greasy) will stop the dryness.

Yeah?