Birth control or contraception is important for adults of all ages. However, choosing the right method of birth control is just as important for people over the age of 40.

As women get older, their contraceptive needs and options may evolve, particularly for those over 40. Factors such as family planning, health concerns, and personal preferences come into play when choosing the right birth control method.

Fortunately, various options are available to suit different lifestyles and health considerations.

In this article, we explore the range of birth control options for women over 40, addressing both nonsurgical and surgical methods, as well as estrogen-free alternatives or permanent and emergency contraception.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Different forms of birth control, also known as contraception, may come with various benefits and risks.

As the body changes, individuals in their 40s have several birth control options to consider. The choice depends on individual health, reproductive goals, and lifestyle factors, and includes:

Individuals may consider changing their method of birth control as they reach their 40s, as perimenopause is likely to begin around this time.

Learn more about different birth control options.

Nonsurgical contraception refers to a range of birth control methods that often include taking hormones to prevent pregnancy. In addition to condoms, nonsurgical contraception includes:

  • Birth control pills: Also known as “the pill,” around 14% of females ages 15–49 years take oral contraceptive pills in the United States. Doctors may recommend low dose formulations for women over 40 to minimize potential risks associated with estrogen. These pills regulate menstrual cycles and offer reliable contraception when taken consistently.
  • Contraceptive patch: The contraceptive patch delivers hormones through the skin. A person may wear it on the lower abdomen, buttocks, or upper body. It provides a convenient alternative for women who prefer not to take daily pills. According to Planned Parenthood, it is 99% effective, with perfect use.
  • Vaginal ring: Doctors insert this flexible, hormonal ring into the vagina, and it releases estrogen and progestin. The vaginal ring is left in place for 3 weeks and removed for 1 week to allow for menstruation.

Surgical contraception offers long-term or permanent birth control through various surgical procedures.

  • Hysterectomy: In some cases, women may opt for a hysterectomy, the surgical removal of the uterus, as a form of contraception. However, doctors typically recommend this procedure for medical reasons rather than solely for birth control.
  • Tubal ligation: Commonly known as “getting your tubes tied,” tubal ligation is a surgical procedure where a doctor blocks or cuts the fallopian tubes to prevent eggs from reaching the uterus. While doctors consider it a permanent form of contraception, it is important to note that reversal procedures are possible but may not always be successful.

For women who can’t or prefer not to use estrogen-based contraceptives due to health concerns such as high blood pressure, migraine with aura, or a history of blood clots, estrogen-free options are available.

  • Progestin-only pills (mini-pills): These pills contain only progestin and are suitable for women who are sensitive to estrogen or at risk of estrogen-related side effects. It may also help with painful or heavy periods and endometriosis.
  • Intrauterine devices (IUDs): Hormonal IUDs such as the levonorgestrel-releasing device provide long-term contraception without containing estrogen. A healthcare professional inserts them into the uterus, and they can remain effective for several years.
  • Other IUDs: Other IUDs include nonhormonal IUD, which is a copped-based birth control.

Permanent contraception refers to nonreversible birth control as a permanent and final decision to prevent future pregnancy.

  • Tubal occlusion: Also known as tubal sterilization, this minimally invasive procedure involves blocking or sealing the fallopian tubes to prevent pregnancy permanently. Methods of tubal occlusion include using tubal clips, vasectomy, or electrocoagulation.

In certain situations where an individual does not use regular contraception, or in the case that it fails, emergency contraception can provide a backup option to prevent pregnancy.

  1. Emergency contraceptive pills (ECPs): Also known as the “morning-after pill,” ECPs contain hormones that can prevent pregnancy if taken up to 72 hours after sex without contraception. It is 95% effective during the first 24 hours, falling to 58% by 72 hours. It prevents ovulation, fertilization, or implantation of an embryo.
  2. Copper intrauterine device (Cu-IUD): The Cu-IUD is an emergency contraceptive that is effective if inserted within 5 days after sex without contraception. It prevents pregnancy by inhibiting sperm movement and fertilization.

Choosing the right birth control method is a personal decision that should take into account individual health, lifestyle, and reproductive goals.

For women over 40, there are numerous contraceptive options available, including nonsurgical methods such as pills, patches, and rings, as well as surgical options like tubal ligation.

Estrogen-free alternatives and permanent contraception provide additional choices for women with specific health considerations or those seeking long-term solutions. Emergency contraception offers a backup plan in case of contraceptive failure or unprotected intercourse.

Consulting with a healthcare professional can help women navigate their options and make informed decisions about birth control in their 40s.