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Abstract

Contraception in perimenopausal women

In the Perimenopause, the time immediately prior to and the first year after the menopause, the reproduction is continuously.Ovulation may occur without warning and effective contraception is still necessary if pregnancy is not desired.There is no contraceptive method that is contraindicated merely by age.Therefore various contraceptive options may be offered to perimenopausal women, including oral contraceptives with low dosage of ethinylestradiol, transdermal patches, vaginal ring,progestins - pills, injectables, implants, the intrauterine system with levonorgestrel, natural estrogen (estradiol) in combination with a progestin, intrauterine devices, barrier methods and tubal ligations.However,women should receive accurate individualized advice about the risks and benefits of each contraceptive method. Oral hormonal contraceptives are a safe option for healthy non-smokers without contraindications with normal blood pressure and with healthy problems, and up to one or two years beyond the menopause. The use of low dose oral contraceptives has many benefits. For women with cardiovascular risk factors and smokers progestin only methods (pills, injectables, implants), intrauterine system (IUS) with Levonorgestrel, intrauterine devices (IUD), barrier methods or sterilization are the better choice. For smokers are all estrogen-progestincombinations contraindicated because the important risks factor for cardiovascular disease. CME Prakt Fortbild Gynakol Geburtsmed Gynakol Endokrinol 2009; 5(1): 2-12

Keywords
Perimenopause, contraception, oral contraceptives, vaginal ring, intrauterine system

Gunther Göretzlehner
Parkstr. 11, Rostock
Reviewer: Hans-Joachim Ahrendt,Magdeburg
und Sören von Otte, Kiel

Göretzlehner G. Kontrazeption ... Gynakol Geburtsmed Gynakol Endokrinol 2009; 5(1): 2-12 publiziert 31.03.09 www.akademos.de/gyn ©akademos Wissenschaftsverlag 2009 ISSN 1614-8533