1. The risk of pregnancy persists
Caution. At this stage it is recommended to take measures to avoid unwanted pregnancies.
Although perimenopause occurs in a significant decrease in the fertility of women, the risk of pregnancy persists.

The possibility of pregnancy is 10% approximately 40 to 44 years and 2-3% in women aged 45 to 49 years. Even after 50 years the risk of pregnancy in perimenopause is less than zero.

The wisest course is to use some method of contraception until 12 months after the last natural menstruation.

In a recent survey across the country, it was found that over 50% of women between 40 and 50 do not use any contraceptive method and 80% is because they believe they no longer get pregnant at this age.

Because of this lack of information, pregnancy at this stage of life are often not scheduled, so are rarely desired.

There is a mixture of feelings, from fear of social rejection and / or family by becoming pregnant at this age, to the concern of a complicated pregnancy or a baby with some type of malformation.

And it is true that complications of pregnancy and delivery increase with age, as well as birth defects in the fetus.

2. And perimenopause birth control
Counseling. The choice of a contraceptive method should be supervised by a physician.

Natural Contraceptives
Due to frequent irregularities of menstruation in perimenopause, natural methods, which are based on the probable date of ovulation, the method of periodic abstinence, that of Ogino, or basal temperature are of little use, for be very inefficient and cumbersome.

Barrier Contraceptives
The methods that pose a barrier to the passage of sperm, such as diaphragms, spermicidal creams or condoms, may be safe (effectively about 98%) for women in perimenopause.

Condoms also provide an advantage to women without a stable partner, which is protection against diseases transmitted by sexual routes, especially to AIDS.

The IUD in women approaching menopause is a practical, effective, reversible, and can be easily inserted where they had children. Although the IUD can increase the amount of menstrual flow and sometimes enhance existing complaint among these women, the risks associated with IUDs are practically negligible.

Irreversible method of sterilization
In perimenopause sterilization methods such as tubal ligation in women and vasectomy in men can be very adequate measures of family planning during this time. However, it depends on the proximity of menopause and women’s preference.

It is obvious that perform a tubal ligation, a woman of 50 years, which probably lacks a short time in order to be withdrawn definitively rule would in principle be misplaced.

It would be different if women had 42, and that theoretically would be missing nearly a decade to reach menopause, and during that time would always present the risk of pregnancy.

Furthermore, we must remember that this method is irreversible and could only be done if the woman was very sure of not wanting to conceive more children.

Today tubal ligation is performed through an instrument called a laparoscope. It is a small surgical procedure that has very few complications, requires the patient’s hospitalization and recovery is very rapid, and there is hardly a discreet scar in the navel area.

Hormonal contraceptives
More than 30 years since the publication of scientific work which has suggested the use of oral hormonal contraceptives (AHO) for women over 35 years increased the risk of thromboembolic disorders (thrombophlebitis, for example).

As a result, neither doctors nor women prescribed wanted to take them. But we must not forget that these studies were performed with the old pills, which had a very high dose of hormones.

Also, do not take into account what kind of women are given, ie whether they were smokers, if they had high blood pressure, or had some other risk factor.

Pills today pills called “new generation” containing much smaller amounts of hormones and their formulations are quite different. By oral hormonal contraceptives (the pill), mainly those of low doses of estrogen are considered an excellent method of contraception in perimenopause, and are now the most frequently chosen by physicians and by women.

Besides offering nearly 100% certainty in preventing pregnancy, is helpful in correcting the hormonal imbalance between estrogen and progestin present in the perimenopause.

Also help regulate menstrual cycles, prevention of breast abnormalities, reduce uterine cancer and ovarian cancer, and in some way, decrease bone loss, thus contributing to the prevention of osteoporosis.

Oral contraceptives are made with synthetic estrogen, unlike those used in the treatment of climacteric disturbances, which are natural. So while the latter prevents cardiovascular disease, those can cause an increased risk of cardiovascular and thromboembolic disease, when used by women with a history of these diseases or smokers over 40 years.

Furthermore, this risk is multiplied when there are both metabolic disease, hypertension, or liver cancer.

… In short, women should expect from the health professional, to tell you the advantages and disadvantages of each métodoy together to choose the most effective and most suited to the characteristics of the couple.

3. The morning after pill
The morning after pill, rather than a contraceptive method should be interpreted as an occasional or emergency measure interceptive, since its objective is to prevent the implantation of the fertilized egg.

Therefore, this procedure should be reserved for those occasions when the relationship occurs in the period of ovulation in the absence of a contraceptive method, or for example, when a condom breaks.

It has been marketed in Spanish pharmacies postcoital contraception pill. This drug, sold by prescription, it takes high doses of progestin (levonorgestrel) and creates a very unfavorable uterine condition, preventing a fertilized egg continues its development.

Should be initiated as soon as possible, no later than 72 hours after intercourse, if it was done in the fertile period of the cycle (midcycle, around ovulation).

Not to be confused with RU-486, a medical abortion because it acts at a more advanced embryonic chain. ie pregnancy interrupted at the onset of embryonic development.

Today, as most common regimen, is used to take two tablets once a half-dose hormonal contraceptive (50 mcg ethinyl estradiol) followed within 12 hours of two tablets.

The percentage of efficiency of this method is around 98 to 99.8%. It is possible and should not cause concern for nausea, vomiting, or breast tenderness, because these symptoms are secondary to high dose of estrogen intake.