Are You Still On Birth Control? When Is The Last Time You Changed It?

Here's why you may be using the wrong kind.

Published August 07, 2023

Eden Weingart

In the past decade you’ve probably changed your shampoo brand, your eye shadow, your moisturizer and your haircut. So, why haven’t you thought twice about birth control?

As our bodies age — especially past 40 — we’re more likely to have irregular bleeding, uterine lesions, vaginal dryness and other health issues (fun!). Birth control may help with all of those. (Remember when you took it as a teen to handle your pimples? It’s similar to that — but now for even more serious concerns.)

And don’t even think about stopping birth control just because you’re getting closer to menopause.

“I have several patients who have stopped taking birth control because they may have been in perimenopause and had irregular cycles, so they assumed they were going through menopause and couldn’t get pregnant,” says Aldene Zeno, M.D., a California ob-gyn and a fellow of the American College of Obstetricians and Gynecologists. “A woman having menstrual cycles is still fertile, even though the chances of pregnancy may be lower compared with what they were when she was in her 20s or 30s.”

About 75 percent of pregnancies in women over 40 are unplanned, according to the Mayo Clinic. That’s because women over 40 still have a 5 percent chance of getting pregnant per menstrual cycle (versus a 25 percent chance when they’re in their 20s). And when they’re in their 40s, pregnancy can be very difficult, as the risk of complications, for the woman and for the baby, increases. There’s a higher chance of chromosomal abnormality, high blood pressure, gestational diabetes, preterm labor and more, notes Deborah Charfoos, M.D., an ob-gyn from Troy, Michigan.

We spoke with gynecologists to get your age 40-plus birth control questions answered.

How do women’s bodies change as they age, making the birth control they used in earlier years not as suitable past 40?

As women get older, they are more at risk for blood clots and stroke from birth control complications, says Sophia Yen, M.D., cofounder and CEO of Pandia Health, a women-founded, women-led birth control delivery service. That’s why any birth control containing estrogen should be avoided, as it will lead to a higher risk for blood clots.

What birth control is recommended for women 40-plus?

Paragard IUD

Since women in their 40s and 50s tend to be busy with work and family, and most aren’t interested in having more children, Charfoos prefers a long-acting contraception such as a Paragard IUD, which can stay in place for up to 10 years. After this copper, hormone-free IUD is inserted into the uterus, some women have complained about heavier, longer periods, according to the Mayo Clinic. While the insertion can be painful for some, the Mayo Clinic suggests taking an ibuprofen one to two hours beforehand, which can help reduce cramping.

Implant

But an IUD isn’t the only option. Yen typically recommends the implant for women 40-plus. It’s a tiny rod, inserted into the upper arm, that releases hormones and can be left in place for up to three years — so, like the IUD, it has long-term effectiveness. Although the implant releases progestin daily, you shouldn’t feel anything once it’s inserted. About 25 percent of women experience headaches with the implant; if you’re susceptible to headaches, you may want to choose a different form of birth control.

Vaginal ring

Yen also likes to recommend the vaginal ring (though she prefers the IUD or the implant for older women, since the ring contains estrogen, which can contribute to blood clots). The vaginal ring — the two types are known by their brand names, the NuvaRing and the Annovera — is inserted into the vagina and releases hormones. The NuvaRing can stay inside your vagina for three weeks; then you wait a week before replacing it with a new one. Or you can use it for up to five weeks if you want to skip your period, but consult with your health care provider first. It’s safe to have sex with the NuvaRing inside, and it shouldn’t bother your partner. The Annovera ring also stays inside for three weeks before you take it out for a week. Then you put the same ring back in. It will need replacing after 13 cycles, or just over a year. The vaginal ring contains estrogen and progestin, and this stops you from ovulating. Side effects include headaches, spotting and increased discharge. The good thing about the vaginal ring, however, is that if you’re having any issues with it, you can simply remove it yourself.

When is it safe for women to stop using birth control if they don’t want to get pregnant?

Women may stop using birth control to prevent pregnancy after they’ve completed menopause. But the only way to clinically diagnose this is the absence of periods for 12 months, Zeno says. Many women will have other symptoms, including lighter or less-frequent periods, hair loss, hair thinning, hot flashes, night sweats, mood changes or more. Can’t tell if you’re going through menopause because you’re on birth control?

“One way to check if someone has gone through menopause while on birth control is to check their hormone levels through a blood test,” Zeno notes.

The average age of menopause is 51 or 52 in the United States, and most women will hit menopause between 45 and 56, Charfoos says. After this point, you can no longer get pregnant.

Are you still taking birth control? What do you use? Let us know in the comments below.

Danielle Braff is a Chicago-based writer who knows how to find the heart (and humor) in everyday life. When she’s not reporting or crafting smart, relatable stories, she’s juggling life with her husband, two daughters, two cats, and one very lucky dog. A devoted traveler, lifelong reader, and unapologetic ice-cream enthusiast, Danielle brings curiosity, empathy, and joy to everything she writes. Discover more of her work at www.Daniellebraff.com.