Contraceptive options for women over age 40 are similar to those for a younger woman. Types of contraception include:

Barrier Contraception

• Spermicide – spermicide is a jelly or cream that is toxic to sperm. It is placed into the vagina before each episode of intercourse. The effectiveness rate is 74% to 94%.
• Condoms – condoms are devices, often made of latex, that are placed over the penis to provide a barrier between the penis and the vagina. This form of birth control is the only method that also provides protection from sexually transmitted diseases. The effectiveness rate is 86% to 97%.
• Diaphragm – A diaphragm is a round rubber shield that is inserted into the vagina and placed against the cervix. This device is used in conjunction with spermicide. It may be inserted up to 2 hours prior to intercourse and must be left in place for at least 6 hours after intercourse. The effectiveness rate is 80% to 94%.

Barrier methods of contraception are useful for women of all ages, and are as effective for women in their 40s as they are for younger women.

Intrauterine Device

An intrauterine device (IUD) is an extremely effective form of contraception. IUDs are inserted into the uterus by a physician. These devices release a small amount of copper or progesterone that cause an inflammatory response within the uterine cavity. This inflammatory response provides the contraceptive benefit. The effectiveness rate is 98% to 99.9%. This form of birth control is a good choice for someone in a monogamous relationship, and is often a good choice for older women.

Methods

• Oral Contraceptive Pills – Oral contraceptive pills are a common form of contraception. Oral contraceptives are well tolerated in older women (over age 35) unless they smoke or have high blood pressure. These factors increase the risk of cardiovascular complications. The effectiveness rate of birth control pills is 97% to 99.9%. There has been no evidence in the literature that contradicts oral contraceptives in general in older women, nor is there associated increased risk of breast cancer. Oral contraceptive use is safe all the way to menopause.
• DepoProvera – DepoProvera is injected progesterone. Injections are administered every 3 months. Effectiveness rate is 99.7%. The greatest complaint from users of DepoProvera is irregular bleeding.
• Norplant – Norplant is time-released progesterone that is implanted in the form of 6 capsules under the arm. Norplant is effective for approximately 5 years. Effectiveness rate is 99.9%. The most common complaint with this form of contraception is irregular bleeding.

All the hormonal forms of birth control have been shown to be safe for a healthy woman in her 40s. Discuss with your physician which of the above options is best for you.

Thomas G. Stovall, M.D.

Dr. Stovall is a Clinical Professor of Obstetrics and Gynecology at the University of Tennessee Health Science Center in Memphis, Tennessee and Partner of Women’s Health Specialists, Inc.

For more information about birth control options for specific age groups, read our next posts for women in their 20s and 30s.