Contraception in women over the age of 40

Women over the age of 40 years have a unique set of factors to consider when discussing contraception. Though there is a natural decline in fertility with increasing age, contraception is still necessary to prevent pregnancy until menopause. In women over 40, there are different risks related to pregnancy, background health concerns, and evolving risks and benefits of each contraceptive method to consider. Therefore, it is important to be knowledgeable on how to assess the needs and priorities of the patient at this time in a woman’s life. This article seeks to summarise the different methods of contraception, their appropriateness, when they should be reassessed or stopped, and how they intersect with symptoms of the perimenopause and hormone replacement therapy.