Ask The Doctor: Birth Control... Health Article

Joan Bengtson, M.D., is assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and a member of the Department of Obstetrics, Gynecology & Reproduction at Brigham and Women's Hospital.

Question:

I am 49 years old and want to go off the pill. What can I expect physically? What are chances of getting pregnant at my age?

Answer:

Perimenopause is a transition time during which the production of estrogen and release of eggs by the ovaries gradually decreases. Many women experience symptoms as a result of the changing hormone environment. Typical symptoms include hot flashes, mood swings, and sleep disruption. Perimenopausal symptoms can be masked in women who use birth control pills because the pills contain estrogen.

Many women will transition from birth control pills to hormone replacement therapy during perimenopause in order to limit their exposure to hormones. The amount of estrogen needed to treat symptoms is less than that needed to prevent pregnancy. Continuing to use an alternative form of birth control during the transition is prudent.

Fertility rates decrease with increasing age, and by the late 40s are quite low. However, a fertility rate is simply a statistic, and women can still become pregnant during this time. For women not wanting to become pregnant, contraception should be used right up until menopause.