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Are you in your mid to late forties and experiencing symptoms of the perimenopause? Unless you would like to get pregnant, it's not time to say goodbye to contraceptives quite yet. Which are the best ones, and when can you finally stop using them?

Age is the Number One cause of infertility, as any woman who is trying to conceive in her late thirties or early forties knows. While plenty of women in their forties, and some in their fifties and sixties, now get pregnant and have healthy babies with the help of fertility treatment, getting pregnant naturally is another story entirely.

Did you know that women between the ages of 45 and 49 have a two to three percent chance of conceiving spontaneously, while that chance drops to less than one percent once a woman reaches 50?

These figures are frustrating if you are hoping to get pregnant naturally. If you are done having kids, they may seem like a great reason to ditch birth control altogether — the odds of getting pregnant are really quite small, after all!

But think twice. If you are over 40 and want to avoid pregnancy, you should remember that those few-percent odds are quite a bit larger than zero.

What are the most suitable birth control options for women who are approaching the menopause, then? Leaning towards more permanent contraceptive options such as tubal ligation, tubal ligation implants, contraceptive pills or plain old condoms?  

Perimenopause Symptoms

A woman has officially entered the menopause when she has not has a menstrual period for 12 months

— and for the average woman, this happens at age 51. When a woman enters the menopause, her ovaries stop producing mature follicles, her menstruation comes to a halt, and her hormonal cocktail changes. The menopause is a step-by-step process that actually takes years, and the transitional period is what we call the perimenopause. 

Women usually start noticing perimenopause symptoms at some point in their forties, but some women start noticing signs that they are transitioning much earlier.

The average length of the perimenopause is four years, but it can take as little as a few months or as much as a decade, too. 

So, how do you know when you are transitioning? Not menstruating as frequently as before is one important tell-tale sign that you are perimenopausal. Hot flashes, tender breasts, vaginal dryness, general fatigue, and mood swings are other signs you should watch out for. 

Can you quit using birth control once you are sure you are perimenopausal, then? No! Not unless you are totally OK with the idea of adding a baby to your family. While it is unlikely that you will get pregnant, a significant minority of women does indeed conceive spontaneously during the perimenopause. Women who wish to avoid pregnancy can quit using contraceptives only once their periods have been absent for a full 12 months. Or in other words, until they have reached the menopause. 

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