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Contraception in the perimenopause and menopause

If not on HRT or hormonal contraception, the rules are:

If under the age of 50, can stop contraception 2 years after the last period.

If over the age of 50, can stop contraception 1 year after the last period.

It is important to remember that HRT is not a contraceptive.

Many women will move on to HRT without knowing what is happening with their periods as they are using hormonal contraception. FSH levels can be measured if on progestogen-only methods but not when on the combined pill or HRT.

If a women is over 50 and wants to start HRT, but is not sure whether she still needs contraception, she can have her FSH level checked before starting HRT. If this is over 30, she then only needs to use contraception for one more year.

Without an FSH level, women will need to continue with contraception until the age of 55. The Mirena works well in this scenario, acting as the progestogen part of HRT, contraception and also reducing heavy periods for many women.

Remember condoms are still important at this age if not with a long-term partner.