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Dr. Julie Gould, St. Luke's Hospital

Can women use birth control pills after 40?

Women commonly ask me, "At what age do I need to stop using birth control pills?" Although the answer varies for each woman based on her circumstances, a woman can conceivably use birth control pills through menopause.

The average age a woman experiences menopause (the stopping of menstrual cycles when the ovaries stop releasing eggs and produce much less estrogen and progesterone) is 51. Some healthcare providers will extend the use of birth control pills a few years past this age and then attempt to discontinue the pill altogether or reduce hormones in a step-down fashion.

As a woman begins to experience symptoms related to perimenopause (the beginning phase of menopause when she is still having periods but experiencing symptoms such as menstrual changes, hot flashes and vaginal dryness), she is often surprised when given the option of a low dose birth control pill. It is an easy method to reduce perimenopausal symptoms while providing many other health benefits. Marking 50 years this year since its approval for use in 1960, the birth control pill has been proven to decrease the risk of certain cancers, including endometrial (uterine) cancer by 50 percent, and it's been proven to provide a protective effect against ovarian and colon cancer. Birth control pills also may reduce bone fracture risk in perimenopausal women and possibly reduce acne and facial hair growth. With very low dose birth control pills, some women may even stop having periods altogether.

A physician or healthcare provider will usually start or continue a woman on the lowest dose pill possible to control her symptoms. If menstrual cycles are not controlled or other side effects occur, a different dose or brand of medication may be prescribed.

There is no known maximum number of years that someone can be on birth control pills. Each woman should review her own risks and benefits with her doctor. Birth control pills are not a safe option for some women, even before their 40s. Women who smoke and are over the age of 35, have a history of blood clotting disorders, have migraines with aura or have active liver disease should not use birth control pills.

Dr. Julie Gould is a board-certified OB/GYN at St. Luke's Hospital. Call 314-205-6788 or visit her Meet the Doctor page.

This article was published in the St. Louis Post-Dispatch on December 2, 2010.