question and answer
September 2002
ANNE DE SILVA, MD, of North York, ON, inquires, "What contraceptive do you recommend for perimenopausal women, aged 48-52 years, who are otherwise healthy?"
Contraception is still an important consideration in perimenopausal women -- next to girls under the age of 15, this group of women has the highest number of unintended pregnancies. In single women (or those with the potential for multiple partners), condoms remain the best choice for contraception, as the risk of sexually transmitted disease can't be overlooked. Oral contraceptive pills are safe to use in this age group, and offer extra benefits, such as good cycle control, lower blood flow, protection from ovarian and endometrial cancer, an increase in bone mineral density, as well as a significant improvement in quality of life. A levonorgestrel-containing intrauterine device (Mirena), recently approved in Canada, is also an excellent alternative for contraception, providing not only the best method of reversible contraception, but also a significant decrease in menstrual flow. Finally, let's not forget about sterilization. FW
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