The years approaching menopause are the most confusing time for contraception. Cycles become longer and less predictable, and many women conclude that pregnancy is no longer possible. That assumption accounts for a meaningful number of unplanned pregnancies in women over forty.
In reality ovulation during this period does not stop — it becomes unpredictable. Some months there is no ovulation at all; others are entirely normal. While any bleeding pattern remains, pregnancy remains possible. General guidance is that women under fifty continue contraception until they have had no periods for two years, and women over fifty until one year has passed.
A point often missed is that some methods do two jobs at once at this stage of life. A hormonal intrauterine device provides contraception and reduces the heavy bleeding that is common in the years before menopause, and in some cases forms part of a hormone therapy regimen. Choosing a method is therefore worth considering alongside whatever other symptoms you are dealing with, rather than as a contraception question in isolation.
At the same time, the risk profile of some methods changes with age and health factors. The combined hormonal pill may not be suitable for women who smoke, have high blood pressure, or have migraine with aura, and doctors usually suggest alternatives in those situations. Reviewing a method you have used for years without reassessment is worth doing once you reach your forties.
See a doctor to review your contraception from your forties onwards or when your cycle starts to change, to discuss when you can stop, and sooner if you have spotting between periods, bleeding after sex, or unusually heavy periods.