How does birth control affect menopause symptoms. When should women stop using contraception during perimenopause. What are the best birth control options for perimenopausal women. How can you tell if you’ve reached menopause while on birth control. What are the pros and cons of using hormonal contraceptives during perimenopause.

Understanding Perimenopause and the Need for Contraception

Perimenopause, the transitional phase before menopause, can be a confusing time for many women, especially when it comes to birth control. The key question is: do you still need contraception during this period? The answer is a resounding yes. Until your doctor confirms it’s safe to stop, you should continue using birth control to prevent unwanted pregnancies.

Why Contraception Remains Important During Perimenopause

During perimenopause, your body undergoes significant hormonal changes, but you can still become pregnant. Irregular periods, a common feature of perimenopause, make it challenging to predict ovulation, increasing the risk of unintended pregnancy. Therefore, it’s crucial to maintain effective contraception throughout this phase.

Birth Control Options for Perimenopausal Women

Perimenopausal women have various contraceptive options available to them, both hormonal and non-hormonal. These include:

• Birth control pills
• Hormonal injections
• Skin patches
• Vaginal rings
• IUDs (Intrauterine Devices)
• Sterilization (for either men or women, non-reversible)
• Barrier methods (condoms, diaphragms, sponges)

It’s important to note that the rhythm method, also known as natural family planning, is not recommended during perimenopause due to irregular menstrual cycles.

Advantages of Hormonal Birth Control During Perimenopause

Hormonal birth control methods offer several benefits for perimenopausal women beyond contraception:

• Maintaining bone strength
• Treating acne, which may worsen during perimenopause
• Reducing the risk of ovarian and uterine cancer
• Alleviating hot flashes
• Easing menstrual pain and heavy bleeding
• Regulating menstrual cycles

Potential Risks and Considerations

While hormonal birth control is generally safe for perimenopausal women, there are some potential risks to consider, especially for women over 55. These include an increased risk of blood clots, heart attacks, strokes, and breast cancer. Women who smoke or have certain medical conditions may need to avoid hormonal contraceptives.

Detecting Menopause While on Birth Control

Identifying the onset of menopause can be challenging when using hormonal birth control. These methods can mask common menopausal symptoms such as irregular periods, hot flashes, and night sweats. Women taking combination pills may continue to experience regular bleeding, making it difficult to determine if they’ve reached menopause.

How can you tell if you’ve reached menopause while on birth control?

There’s no definitive test to determine if you’ve gone through menopause while on birth control. The most reliable indicator is the absence of menstruation for a specific period:

• For women over 50: No period for more than 1 year
• For women under 50: No period for more than 2 years

However, hormonal birth control can make this determination challenging by inducing regular bleeding patterns.

When to Stop Birth Control During the Menopausal Transition

The decision to stop birth control should be made in consultation with your healthcare provider. However, there are some general guidelines:

• Women should typically stop using combined pills at age 50
• After 50, consider switching to progestogen-only pills or non-hormonal methods
• Women over 55 can usually discontinue hormonal methods due to very low pregnancy risk
• For safety, continue birth control until you’ve had no periods for a full year

Does birth control delay menopause?

A common misconception is that birth control pills can delay menopause. According to Dr. Sherry Ross, an award-winning OBGYN, this is not the case. Birth control does not affect the timing of menopause; it simply masks the symptoms.

Birth Control and Sexual Health in Menopause

While pregnancy prevention may no longer be a concern for menopausal women, sexual health remains important. Dr. Ross emphasizes that sexually active menopausal women should still use protection against sexually transmitted infections (STIs).

Should menopausal women use condoms?

Yes, menopausal women who are sexually active, especially those dating or with new partners, should use condoms to protect against STIs. While pregnancy risk is eliminated, the risk of contracting STIs remains.

Hormonal Birth Control and Menopausal Symptoms

Hormonal birth control can have a significant impact on menopausal symptoms. Many women find that these methods help alleviate some of the discomforts associated with the menopausal transition.

How does hormonal birth control affect menopausal symptoms?

Hormonal contraceptives can help manage several menopausal symptoms:

• Reducing hot flashes and night sweats
• Stabilizing mood swings
• Improving vaginal dryness
• Maintaining bone density
• Regulating menstrual cycles

However, it’s important to note that these benefits come with potential risks, especially for older women or those with certain health conditions.

Making Informed Decisions About Birth Control During the Menopausal Transition

Navigating birth control options during perimenopause and menopause requires careful consideration and consultation with healthcare providers. Every woman’s experience is unique, and what works for one may not be suitable for another.

What factors should women consider when choosing birth control during perimenopause?

When selecting a birth control method during perimenopause, consider the following factors:

• Age and overall health status
• Personal medical history and risk factors
• Severity of menopausal symptoms
• Desire for additional health benefits (e.g., bone health, cancer risk reduction)
• Convenience and personal preferences
• Potential side effects and risks

Discussing these factors with your healthcare provider can help you make an informed decision about the most appropriate contraceptive method for your individual needs.

The Role of Non-Hormonal Birth Control Methods in Perimenopause

While hormonal methods offer numerous benefits, some women may prefer or require non-hormonal contraception during perimenopause. These methods can be effective alternatives for those who cannot or choose not to use hormonal contraceptives.

What are the best non-hormonal birth control options for perimenopausal women?

Several non-hormonal contraceptive methods are suitable for perimenopausal women:

• Copper IUD: Offers long-term, hormone-free contraception
• Barrier methods: Condoms, diaphragms, and cervical caps
• Sterilization: A permanent option for women or their partners
• Spermicides: Can be used alone or in combination with barrier methods

These methods provide effective contraception without altering hormone levels, which may be preferable for some women during the menopausal transition.

Monitoring Health During Perimenopause and While Using Birth Control

Regular health check-ups are crucial during perimenopause, especially for women using hormonal birth control. These check-ups allow healthcare providers to monitor for any potential side effects or health risks associated with contraceptive use in older women.

What health screenings are important for perimenopausal women on birth control?

Perimenopausal women using birth control should undergo regular health screenings, including:

• Blood pressure checks
• Breast examinations and mammograms
• Pap smears and HPV tests
• Bone density scans
• Cholesterol and blood sugar tests
• Thyroid function tests

These screenings help ensure that the chosen birth control method remains safe and appropriate as women transition through perimenopause.

Addressing Common Concerns About Birth Control and Menopause

Many women have questions and concerns about using birth control during the menopausal transition. Addressing these concerns can help women make informed decisions about their reproductive health.

Can birth control mask the signs of menopause?

Yes, hormonal birth control can mask some signs of menopause. It may:

• Regulate menstrual cycles, making it difficult to detect natural changes in period frequency
• Alleviate hot flashes and night sweats, common menopausal symptoms
• Maintain consistent hormone levels, potentially delaying the appearance of other menopausal symptoms

This masking effect can make it challenging for women to determine if they’ve reached menopause while on hormonal contraceptives.

Is it safe to continue birth control after age 50?

The safety of birth control after age 50 depends on individual health factors. While many women can safely use certain forms of contraception into their 50s, others may need to switch methods or discontinue use. Factors to consider include:

• Personal and family medical history
• Presence of risk factors for cardiovascular disease or cancer
• Smoking status
• Overall health and fitness level

It’s essential to consult with a healthcare provider to determine the most appropriate contraceptive approach for women over 50.

Transitioning Off Birth Control During Menopause

Deciding when and how to stop using birth control as menopause approaches is an important consideration for many women. This transition should be managed carefully to ensure continued protection against unintended pregnancy while adapting to natural hormonal changes.

How should women transition off birth control during menopause?

The process of transitioning off birth control during menopause typically involves:

1. Consulting with a healthcare provider to discuss timing and options
2. Gradually reducing hormonal contraceptive use, if applicable
3. Switching to non-hormonal methods for a transition period
4. Monitoring for signs of natural menopause, such as changes in menstrual patterns
5. Continuing some form of contraception until menopause is confirmed (typically after 12 months without a period)

This gradual approach allows for a smooth transition while maintaining protection against unintended pregnancy.

What symptoms might women experience when stopping birth control?

When discontinuing hormonal birth control, women may experience various symptoms as their bodies adjust to natural hormone levels. These can include:

• Changes in menstrual flow or regularity
• Increased premenstrual syndrome (PMS) symptoms
• Mood swings or irritability
• Acne or other skin changes
• Breast tenderness
• Emergence or intensification of menopausal symptoms like hot flashes

These symptoms are usually temporary and subside as the body adjusts to its natural hormone cycle.

The Importance of Continued Sexual Health Care After Menopause

While the need for contraception diminishes after menopause, sexual health remains an important aspect of overall well-being. Women should continue to prioritize their sexual health even after reaching menopause.

What sexual health considerations are important for postmenopausal women?

Postmenopausal women should focus on several aspects of sexual health:

• Protection against sexually transmitted infections (STIs)
• Management of vaginal dryness and discomfort
• Maintaining pelvic floor health
• Addressing changes in libido
• Regular gynecological check-ups and screenings
• Open communication with healthcare providers about sexual concerns

By addressing these aspects, women can maintain a healthy and satisfying sex life well into their postmenopausal years.

Embracing the Menopausal Transition: Beyond Birth Control

While managing contraception is an important aspect of the menopausal transition, it’s also a time for women to focus on overall health and well-being. This period offers an opportunity to reassess and prioritize various aspects of physical and emotional health.

How can women optimize their health during the menopausal transition?

To promote overall health during the menopausal transition, women should consider:

• Adopting a balanced, nutrient-rich diet
• Engaging in regular physical activity, including weight-bearing exercises
• Prioritizing stress management and mental health
• Maintaining social connections and support systems
• Exploring hormone replacement therapy options, if appropriate
• Staying informed about menopause and its effects on health
• Regular health screenings and check-ups

By taking a holistic approach to health during this transition, women can navigate menopause with confidence and vitality.

What role does lifestyle play in managing menopausal symptoms?

Lifestyle factors can significantly impact the experience of menopause. Positive lifestyle choices can help alleviate symptoms and promote overall well-being:

• Maintaining a healthy weight to reduce the severity of hot flashes
• Limiting caffeine and alcohol intake to improve sleep quality
• Practicing relaxation techniques to manage stress and mood swings
• Staying hydrated to combat dry skin and vaginal dryness
• Quitting smoking to reduce the risk of early menopause and associated health issues
• Engaging in regular exercise to boost mood and maintain bone health

By incorporating these lifestyle modifications, women can often manage menopausal symptoms more effectively and improve their overall quality of life during this transition.

How to Tell if You’ve Reached Menopause on Birth Control

When you’re in perimenopause, or the time before your body shifts into menopause, you may be unsure if you still need to use birth control to avoid pregnancy. If you’re worried about pregnancy, you shouldn’t stop birth control until your doctor has told you it’s safe to do so.

Birth Control Choices for Women in Perimenopause

There are many birth control choices to choose from if you’re near menopause. You can use hormonal or nonhormonal options:

• Birth control pills
• Hormonal injection
• Skin patch
• Vaginal ring
• IUDs
• Sterilization for either men or women, which isn’t reversible
• Barrier methods such as condoms, diaphragms, or sponges

The rhythm method, also called natural family planning, is not as effective as other birth control methods if you’re in perimenopause. This is when you track your menstrual pattern to know when you’re most likely to get pregnant. When you’re in perimenopause, you’ll have irregular periods that make it hard to track your menstrual cycle. If you can’t tell when your next period will come, the rhythm method won’t help you avoid pregnancy.

Pros and Cons of Birth Control Around Menopause

Hormonal birth control can help you in many ways when you’re in perimenopause:

• Helps maintain bone strength
• Treats acne, which may get worse when you’re in menopause
• Lowers your chances of ovarian and uterine cancer
• Lessens hot flashes
• Eases period pain and bleeding
• Makes your periods more regular

Hormonal birth control is usually safe for women in perimenopause. But there are some downsides to be aware of when you choose to go on birth control over the age of 55. It may cause you to have a higher risk of blood clots, heart attacks, strokes, and breast cancer. Hormonal methods may not be safe options for you if you smoke or if your doctor has diagnosed you with:

Menopause When You’re on Birth Control

There’s no test to tell if you’ve gone through menopause yet or not. The best way to tell is through your period.

You’ve most likely gone through menopause if you’re over 50 years old and haven’t had a period in more than 1 year, or if you’re under 50 years old and haven’t had a period in more than 2 years. But you may not be able to tell if you’ve reached menopause if you’re still on birth control.

Hormonal birth control may hide some of the symptoms of menopause, such as an abnormal period, hot flashes, or night sweats. If you take combination pills (pills that have estrogen and progestin), even after menopause, you may continue to bleed similarly to how you would on your period. This can make it hard to tell if you’ve gone through menopause and whether you’re still able to get pregnant.

When to Stop Your Birth Control

In most cases, you should stop the combined pill when you’re at the age of 50. Women in this age group may have other health issues that could make it dangerous to use. Talk to your doctor to see if it’s safe for you to use it if you’re 50 or older.

If you don’t want to be on the combined pill anymore but still want protection against pregnancy, you can use a progestogen-only pill or other forms of birth control, like condoms. If you’re over the age of 55, you can probably stop hormonal methods since your chances of pregnancy are very low. But to be safe, don’t stop any type of birth control until you haven’t had a period for a full year.

Do Birth Control Pills Delay Menopause? Dr. Sherry Ross explains

Does using birth control delay menopause? Does it increase the risk of breast cancer or heart disease in menopausal or perimenopausal women? After many years on the Pill, how will I know it’s safe to go off it?

Birth control and menopause: what do we need to know?

For answers to our birth-control-and-menopause questions, we turned to Dr. Sherry Ross, award-winning OBGYN and author of the book >She-ology, a look into women’s health beyond the doctor’s office.

Dr. Sherry Ross

For those in perimenopause, should we stop taking the Pill?

“First,” Dr. Sherry told us, “be sure you understand this: until you’ve had no periods for a year, you can still get pregnant.

“Part of the confusion is around definitions: The true definition of ‘menopause’ is when you don’t have a period for one full year, but many women suffer from disruptive symptoms for a few years leading up to full cessation of periods—that’s called ‘perimenopause.’ As I said, until you are officially in menopause—meaning no periods for a full year—you can potentially get pregnant, so be sure to use some form of contraception. If you are single and dating while in menopause, you may not have to worry about getting pregnant, but you do have to protect yourself against sexually transmitted infections, so make sure your partner wears a condom.”

So, re: birth control, keep on keeping on until one year with no periods, and re: condoms, always always always outside of committed, monogamous relationships. Check.

Do birth control pills or using a hormonal IUD help with perimenopause?

“ Oral contraceptives and an IUD like Mirenacan mask some of the symptoms of perimenopause and menopause,” Dr. Sherry told us. “That’s one of the benefits. Women on the Pill may have fewer, less-intense hot flashes, more ‘normal’ periods when other women are all over the menstrual map, and they might have more modulated emotional swings, which can be a huge benefit in their personal and professional lives. That’s why many doctors—myself included—prescribe low-estrogen birth control pills women having a rough menopause and don’t smoke or to make the transition into menopause easier.”

Does birth control delay menopause?

Short answer: No. Here’s why:

“Menopause is a time when your ovaries stop producing estrogen and your female hormone reserves are depleted. Known factors that can affect what age you enter menopause include your genetic predisposition, knowing when your mom went through the change, chromosomal abnormalities such as Turner Syndrome, very thin or obese women, long smoking history, needing chemotherapy or radiation therapy, those with autoimmune diseases and epilepsy.

“It’s clear that short- and long-term stress, such as extreme weight loss and weight gain, can offset your hormones, causing irregular periods. The extent this type of significant stress has on your endocrine system, causing hormone adrenal depletion and possibly affecting menopause, is not as clear.

“There is an association between extreme and long-standing exercising causing weight loss which can offset your hormones and cause early menopause. Excessive exercising creates a hormonal imbalance, causing irregular ovulations. It’s less likely short-term exercising mixed in with months of not exercising could cause a cascade of events leading to an early hormonal depletion.

“So there are some things that can bring on early menopause, but being on the birth control pill does not affect when you begin menopause. The Pill can mask the symptoms of menopause and, as I said, many women depend on it to help ease the transition into menopause.”

If we’ve been taking oral contraceptives for 20+ years, how will we know if perimenopause has started?

“The best way to know if you are in menopause while taking the birth control pill is to check your hormonal levels at the end of the pill-free week. Some women may even notice hot flashes during the pill-free/placebo week since they are not taking estrogen that’s normally in the active pills. Your doctor can conduct a simple blood menopause test that determines if your follicle-stimulating hormone level (FSH) has reached menopausal levels.”

If you need a trusted opinion, determine if medication is right for you, and possible prescription support. Book an appointment with one our Gennev menopause-certified gynecologist doctors here.

Are there health risks to continuing to take the Pill?

Says Dr. Sherry: “As long as you’re not a smoker over the age of 35, and you don’t have any contraindications of being on the Pill (high blood pressure, a history of blood clots, liver disease, breast or uterine cancer, strokes or migraine headaches), there are no health risks to taking the Pill during the first couple of years of menopause. The birth control pill stabilizes your hormones and keeps you physically and mentally balanced. ”

And, according to Dr. Sherry, there’s even more good news.

Wait. There’s good news? About menopause?

“There’s evidence that taking birth control pills reduces the risk the risk of ovarian and uterine cancers. It may also help with rheumatoid arthritis.”

OK, that’s all terrific, but there have to be drawbacks.

What are the risks?

Said Dr. Sherry: “As I said, hormonal birth control is not for women who smoke, particularly if they’re 35 or older. Birth control pills may increase your risk of strokes and blood clots, and that risk is exponentially higher for smokers over 35. Yet another reason to quit!”

We completely agree. Anything else?

“Studies are still being conducted into hormonal birth control and breast cancer. But unless a woman has a history of breast cancer or other factors that make her high risk, she should feel comfortable taking low-dose birth control pills to control perimenopausal or menopausal symptoms,” Dr. Sherry told us.

“The best first step is to have a frank and open discussion with your menopause doctor. And don’t be embarrassed or shy—I can tell you from personal experience that almost nothing shocks a doc! Menopause is a normal, natural process and part of life, though women may experience it differently. Your doctor is here to help you understand what’s happening and alleviate symptoms that are interfering with your quality of life. There are solutions. You can feel better. And that’s the best news of all.”

Sheryl A. Ross, M.D., “Dr. Sherry,” is an award-winning OBGYN, author, entrepreneur and women’s health expert. The Hollywood Reporter named her as one of the best doctors in Los Angeles, Castle Connolly named her as a Top Doctor in the specialty of Obstetrics & Gynecology, and she was selected as a 2017 Southern California Super Doctor. Dr. Sherry continues the conversation of women’s health and wellness in her monthly newsletters and on DrSherry. com.  

Dr. Sherry Ross blogs for Huffington Post, Maria Shriver, Greatist, SheKnows, HelloFlo, Today Showt, All Things Menopause, and Gurl, and we are thrilled to welcome her to the Gennev community!

We can help you get your questions answered about menopause

• Meet with a Gennev board-certified gynecologist who is a menopause specialist – they are used to having frank and open discussions about menopasue, and can offer a trusted opinion, determine if medication is right for you, and provide prescription support.  
• Partner with a Menopause Health Coach for understanding the actionable lifestyle changes that may help manage your symptoms, and the support you need to help you start feeling better.
• Try Vitality – our #1 daily multi-vitamin supplement is packed with nutrients that support your whole body including mood, energy, stress response, immune health, joint pain, and inflammation. 96% of women report having more energy after just 2-weeks with Vitality.

 

The information on the Gennev site is never meant to replace the care of a qualified medical professional.  Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev’s telemedicine doctors before beginning any new treatment or therapy.

Night sweats, weight gain — coping with perimenopause | UCI Health

Exercise can help the symptoms of perimenopause. It improves your mood, enhances your memory, boosts your libido and supports your bone strength.

The time leading up to menopause can be a frustrating phase of life for many women. Whether it’s interrupted sleep from night sweats, random hot flashes, wild mood swings, stubborn weight gain, or all of the above, it can seem as if your hormones devised a special brand of torture.

Menopause vs perimenopause

First, let’s define some terms:

• Menopause by definition is when a woman has not had a period for 12 months.
• Perimenopause is when physiological changes occur that begin the transition to menopause (i.e., symptoms associated with menopause).

Symptoms of perimenopause 

Any combination of these symptoms may occur due to the fluctuation and decline of estrogen and progesterone levels:

• Hot flashes
• Night sweats
• Irregular periods
• Mood swings/mood changes
• Vaginal dryness
• Vaginal pain
• Vaginal pain during sex
• Urinary tract infections (UTIs)
• Heart palpitations
• Weight gain, especially around the stomach
• Poor concentration or brain fog

I’ve seen patients in perimenopause, the time leading up to menopause, in their 40s all the way through to their 60s. The average age for menopause is in the early 50s. Menopause before age 40 is considered premature; usually an autoimmune response is linked to these cases.

Remember that this is a natural part of the aging process; menopause isn’t a disease to be “cured.” It’s important not to get caught up in comparisons. Every woman’s experience is different. Some women battle symptoms during perimenopause. Others breeze through perimenopause only to confront symptoms when they enter menopause.

How to relieve the symptoms of menopause

Regular exercise

Exercise has numerous benefits. Not only does it improve your mood, enhance your memory, boost your libido and support your bone strength, it also can help you sleep, provided you don’t exercise too close to bedtime. Try to get outside so you can get some vitamin D naturally from the sun.

Sleep aids

If you don’t have good sleep, it’s almost impossible to treat anything else or have the energy to make helpful lifestyle changes. Over-the-counter medications or melatonin are not habit-forming and can be helpful. Be cautious with prescription sleep aids as those can be addictive; discuss the risks with your doctor.

Vitamins

To support bone health, make sure you are getting enough calcium and vitamin D even before you begin perimenopause. Our bone density naturally declines after our 30s. 

Lubricants

For women experiencing vaginal dryness or pain during sex, over-the-counter water-based lubricants can help. They may also help reduce the incidence of UTIs. For severe cases, prescription vaginal estrogen creams may help.

Medications

Women suffering from intense hot flashes and night sweats are often surprised that selective serotonin reuptake inhibitors (SSRI) antidepressants may help. In addition to easing the physical symptoms, they also may improve the mental symptoms. Other drugs used off-label that may ease symptoms include a high blood pressure drug and a neuropathy drug.

Birth control pills

Besides doing their obvious duty of preventing pregnancy when used correctly, the hormones in birth control pills help even out irregular periods and may balance mood swings, too. Even if you don’t use birth control pills, have a birth control plan in place because it is still possible to get pregnant during perimenopause.

Hormone replacement therapy (HRT)

Hormone replacement therapy (HRT), replacing the declining estrogen and/or progesterone, is usually a last resort because studies have shown that HRT can increase a woman’s risk of breast cancer, heart attack, blood clots and stroke. Make sure you discuss the risks and benefits of HRT with your doctor.

Supplements

Many of my patients have reported relief from symptoms with supplements. These can include soy, black cohash, evening primrose oil and wild yam. Discuss these with your doctor.

Perimenopause and menopause mimickers

Some of the perimenopause and menopause symptoms, such as heart palpitations, weight gain and brain fog, may look like other conditions. Make sure your doctor does a full screening to rule out:

With a little patience and support from your doctor, you too can make it successfully through the perimenopause and menopause gamut.

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Contraception for the Mature Woman | The Menopause

At what age will I stop being fertile?

The time of menopause varies tremendously between women. Before your periods stop altogether, it is likely that your periods will become irregular and unpredictable. Although you are less likely to produce an egg (ovulate) every month, your ovaries will still be producing some eggs and, for this reason, it is important that you consider using contraception. So, although there is a natural decline in your fertility after the age of about 37 years, effective contraception is still required to prevent an unplanned pregnancy. Most women will no longer be fertile by the age of 55 years. However, a few women will still be having periods at this age and may need contraception. The average age at which women get to their menopause in the UK is 51 years.

When can contraception be safely stopped?

If you are using contraception that does not contain hormones, you will be able to stop using contraception one year after your periods stop if you are aged over 50 years. If you are aged under 50 years, you should use contraception until two years after your periods stop.

However, if you are using hormone-based contraception then your periods (withdrawal bleeds) are not a reliable way of knowing if you are fertile or not. Some women who take hormone-based contraceptives will have irregular or no periods but they will still be fertile if they stop using their contraceptive. The ages for stopping the different hormone-based contraceptives are detailed below.

Clinical Editor’s comments (September 2017)
Dr Hayley Willacy recommends the Faculty of Sexual and Reproductive Health’s latest guidelines on Contraception for women aged over 40 years – see ‘Further Reading and References’, below. The guideline updates information relating to when women no longer require contraception. Progestogen-only pills, progestogen-only implants, levonorgestrel intrauterine systems and copper intrauterine devices can safely be used until the age of 55 and may confer non-contraceptive benefits such as reduced menstrual pain and bleeding and endometrial protection. During perimenopause, isolated serum estradiol, FSH and luteinising hormone levels can be misleading and should not be used as the basis for advice about stopping contraception; ovulation may still occur with a risk of pregnancy.

What are the different methods of contraception available?

Your choice of contraception when you are over the age of 40 years may be influenced by:

• How effective it is.
• Possible risks and side-effects.
• Your natural decline in fertility.
• Personal preference.
• If you have a medical condition that needs to be considered.

Many women over the age of 40 will have just the same options available to them as younger women, but may have different priorities. Read the overview of all options in contraception methods. The following information lists the options, linking to individual leaflets, and commenting on any aspects specific to women between the age of 40 and the menopause.

Hormones, pills, patches and rings

See the separate leaflet called Contraceptive Hormone Pills, Patches and Rings.

Combined pill

The combined oral contraceptive (COC) pill is often just called “the pill”.

There are some specific advantages to the COC pill for more mature women. Taking the COC pill may improve period problems such as heavier or irregular periods which may occur as you approach your menopause. They may also help with any menopausal symptoms that you may have. There is also some evidence that taking the COC pill when you are aged over 40 years may increase the density of your bones. This means your bones are stronger and may be less likely to fracture when you have gone through the menopause. The COC pill can safely be taken by women over the age of 40 years with no other medical problems.

However, for some women, the COC pill may have more risks as they get older. You should not take it if you are aged over 35 years and a smoker. You should not take it if you are aged over 35 years and have migraine. You also should not take it if you have a history of stroke or heart disease, or if you are very overweight. Women who have complications from diabetes (including problems with eyes, blood vessels or kidneys) should not take the COC pill. These are just a few of the conditions which make it unsafe to take the COC pill. Your doctor or healthcare professional will go through your medical history with you to decide if it is safe for you personally. If you have no medical problems or risk factors for medical problems, the COC pill can be taken until the age of 50 years.

You should stop taking the COC pill and use another form of contraception when you reach the age of 50 years.

Progestogen-only pill

The progestogen-only pill (POP) is sometimes called “the mini-pill”. It is commonly taken if the COC pill is not suitable – for example, breastfeeding women, smokers over the age of 35 years and some women with migraine.

The POP is safe if you have previously had a stroke or a heart attack, or if you have developed a clot in the past. There is no increased risk of developing breast cancer if you take the POP. However, women who have had breast cancer cannot usually take a POP.

The POP can be continued until you reach the age of 55 years, after which time you will probably no longer need to use contraception. Blood tests can be done if you are not sure if you have gone through your menopause.

Contraceptive patch

The contraceptive patch (Evra®) can safely be used by women over the age of 40 years with no other medical problems. However, you should not use it if you are aged over 35 years and a smoker, or are aged over 40 years and have cardiovascular disease, or a history of a stroke or migraine. You should stop using the patch and use another form of contraception when you reach the age of 50 years.

Contraceptive vaginal ring

The contraceptive vaginal ring has similar risks to the patch and COC pill. As with the patch and COC pill, you should not use it if you are aged over 35 years and a smoker, or are aged over 40 years and have cardiovascular disease, or a history of a stroke or migraine. You should stop using the contraceptive ring and use another form of contraception when you reach the age of 50.

Barrier methods

See the separate leaflet called Contraception Barrier Methods.

These include male condoms, the female condom, and diaphragms and caps. These are all suitable and safe for women between the age of 40 and menopause. However, they are less effective than other methods of contraception, so if it would be a disaster to become pregnant, you may wish to consider alternative choices. If you do use these methods, make sure you use them correctly. If you forget, or if you use a condom and it splits, for example, then consider emergency contraception.

Natural methods

Natural methods of contraception involve being able to predict your fertile time – effective if done correctly. It requires commitment and regular checking of fertility indicators such as body temperature and cervical secretions. This is less likely to be an effective method around the time of menopause if your periods have become irregular and unpredictable.

Long-acting reversible contraceptives

See the separate leaflet called Long-acting Reversible Contraceptives (LARCs).

Contraceptive injection

Long-term use of the progestogen-only injection can be associated with a reduction in the strength (density) of your bones. However, this returns to normal after stopping using the injection. Bones become thinner after the menopause, so this may be a factor for you and your healthcare professional to consider when choosing your contraception.

The contraceptive injection is usually stopped when you reach the age of 50 years and another method of contraception should then be used.

Contraceptive implants

The contraceptive implant (Nexplanon®) can be continued until you reach the age of 55 years, after which time you will no longer need to use contraception. If you think you have had your menopause before this, some blood tests may help to confirm this. If you have become menopausal then the implant can be removed one year after if you are over 50 years, and two years after if not.

The implant has not been shown to increase your chances of having a blood clot (thrombosis) or to cause bone thinning. It may be a good option for women who might avoid other forms of contraception which do have these risks.

Intrauterine contraceptive device

The intrauterine contraceptive device (IUCD) lasts for up to ten years, so may be a good option when you have completed your family. If you have an IUCD inserted when you are aged 40 years or over, this can remain in place until you have gone through the menopause and no longer require contraception. That is, for one year after your periods stop if you are aged over 50 years, or two years after your periods stop if you are aged under 50 years. So in some cases when it is fitted after the age of 40, it can last for more than ten years.

Intrauterine system

The hormone-releasing intrauterine device called an intrauterine system (IUS) can be continued until you reach the age of 55 years, after which time you will probably no longer need to use contraception. If you have an IUS put in at the age of 45 years or older, you may be able to keep it longer than the usual five years before removing it.

The IUS can also be used as a part of hormone replacement therapy (HRT) in some women. This may be particularly useful around the start of the menopause.

Sterilisation – a permanent method of contraception

See the separate leaflet called Sterilisation for more information.

You and your partner may have decided that you would like a more permanent method of contraception. Sterilisation involves an operation. It is more than 99% effective; however, even sterilisation can fail. Options include:

Can I still use emergency contraception?

Emergency contraception can be used at any time if you had sex without using contraception. Also, it can be used if you had sex but there was a mistake with contraception. For example, a split condom or if you missed taking your usual contraceptive pills. Options include pills or an IUCD and are suitable for most women between the age of 40 and the menopause.

Can hormone replacement therapy be used for contraception?

As hormone replacement therapy (HRT) contains very low levels of hormones, it does not work as a contraceptive. Unless you went through the menopause (had no period for one year if aged over 50 years or for two years if aged under 50 years) before you started HRT, you should use contraception until you are aged 55 years.

If you are taking HRT but still need contraception then you can take the POP or have an IUCD or IUS inserted. Alternatively, many women choose to use barrier methods of contraception. As above, the IUS can be used as part of your HRT (you still need the oestrogen, but the IUS provides the progestogen part) so is a good option if you need contraception and HRT.

What You Need to Know About Menopause

Medically Reviewed by Barbara Dehn

At 47, Louisa, a community college adjunct professor, has been struggling with perimenopause symptoms including an erratic menstrual cycle, cramping without bleeding, leg pains and severely sensitive breasts.

“I had to protect them, even in the shower,” Louisa said, referring to her breast pain. Though she had already been taking a low-dose contraception pill for birth control, her doctor upped her pill’s hormone dosage as a first attempt to combat her perimenopause symptoms. When she spoke to HealthyWomen, Louisa had been on her new regimen for a couple of weeks and said her breast and leg pains haven’t come back since she upped her dose.

Healthcare providers are increasingly turning to the birth control pill as a treatment for perimenopause symptoms. Women who don’t smoke or experience migraine with aura can safely take the pill into their early 50s, explained Barbara Dehn, a North American Menopause Society (NAMS)-certified nurse practitioner and a member of HealthyWomen’s Women’s Health Advisory Council.

“[The pill] smooths out that perimenopause transition with its wild, roller coaster swings in hormone levels,” Dehn, author of “The Hot Guide to a Cool, Sexy Menopause,” explained.

Low risk

The pill’s new role in combating perimenopause symptoms is one of the recent evolutions in menopause knowledge and treatment that Dehn is excited about. For too long, Dehn said, women have been forced to make decisions based on fear, not facts, when it comes to menopause and hormone therapy (HT).

Much of the fear stemmed from a study released in 2002 that suggested HT increased the risk of breast cancer and heart attacks in women. However, in the years since the study’s release, it’s become increasingly clear it led to numerous misconceptions about hormones, and it’s now believed that using HT to ease perimenopause/menopause symptoms is low risk for women who are within the first 10 years of their final period and younger than 60.

“A lot of research has been coming out, dispelling that fear and ushering in a new era of thinking about hormones in a much more holistic way,” Dehn said. “Using hormone treatment for some women is much more beneficial than risky. If they start using hormones early, when their body is starting to show the symptoms of depletion, they have enormous health benefits in the short and long term.”

Dehn said HT is the most effective way to reduce hot flashes and night sweats, improve sleep, and reduce brain fog. It also helps with vaginal dryness, genitourinary symptoms and maintaining bone mass.

Additionally, for women who start HT within the first 10 years from their final period, there seems to be a reduced risk of cardiovascular disease. These short-term benefits improve overall quality of life in the long term. (Women over 60 who’ve exceeded 10 years from their last period, however, face an increased risk of breast cancer and stroke with HT.)

A study published in the August Journal of The North American Menopause Society also found that younger women who used estrogen-only therapy following ovary removal (oophorectomy) saw a 32% reduction in all-cause mortality over long-term follow-up.

“It is super important, especially for women who’ve had a surgical menopause or induced menopause to think about using hormones because it may help them live longer,” Dehn said.

While induced menopause can be triggered by drug or radiation therapies that damage the ovaries, the most common cause of surgical and induced menopause is the removal of the ovaries, which is frequently combined with a hysterectomy. (A hysterectomy that only removes the uterus does not cause menopause.) Unlike with natural menopause, those who undergo ovary removal begin menopause abruptly on the day of the surgery.

Easing symptoms

There are several different options that can alleviate symptoms of perimenopause and menopause. Dehn is a proponent of bioidentical hormones, which are chemically identical to those your body produces. They include estrogen and progesterone (FDA-approved, well-studied medications available by prescription).

She has patients who worry about taking hormones for menopause symptoms because they’re afraid that they’re unnatural. “As providers, one myth we hear is that hormones aren’t natural. We have to clarify this: Hormones are natural; you have them circulating in your body right now.”

Estrogen therapy can also improve vaginal health by reducing the risk of bacterial infections and alleviating vaginal dryness, which can make even wiping painful. Today, Dehn noted, there are a variety of treatment options available.

“There’s a general lack of information regarding what women need to thrive both during the menopausal transition and afterwards,” Dehn said.

Brain fog

Aside from a better understanding of HT, Dehn said there’s now research that helps
providers understand why brain fog happens.

“It comes from
sleep fragmentation,” Dehn said. This happens when the body transitions from deep, restorative sleep to lighter sleep multiple times at night without coming fully awake. “Women may be in bed thinking they’re sleeping for eight hours but wake up exhausted and can’t function.”

Dehn spoke of a patient, who was considering retirement at 48 because she simply couldn’t remember things. Dehn discovered her patient was in premature menopause and put her on the birth control pill. “A few months later, she told me ‘you gave me my life back,'” Dehn said. “Sleep fragmentation is real. It affects memory and causes brain fog.”

As treatments for menopause continue to evolve, it’s important for women to talk with their healthcare provider about their symptoms and concerns. Dehn recommends finding a
NAMS-certified practitioner — be it a doctor or a nurse practitioner.

“Remember, women may live another 30-50 years after menopause, which is why choices we make early on in menopause have lasting impacts,” Dehn said. For anyone experiencing perimenopause or menopause symptoms, Dehn advised, “If you’re having a lot of symptoms, don’t delay.”

*Louisa asked us not to use her last name to protect her privacy.

Resources:

The North American Menopause Society

Menopause and Contraception – HealthyWomen

This article has been archived. We will no longer be updating it. For our most up-to-date information, please visit our birth control information here.

Q:

I am 47 years old and take oral contraceptives. My gynecologist says I can take them until age 50, but then I should stop so I can see where I am with menopause. I do not smoke and am in good health. Is it safe to keep taking oral contraceptives?

A:

Good for you for taking steps to prevent an unwanted pregnancy! I see too many women your age who think they’re “too old” to get pregnant and just give up on birth control. But until you have gone 12 consecutive months without a period (the true definition of menopause), you could still become pregnant.

There’s no age limit on any contraceptive option. Having said that, however, it’s clear that some options are more appropriate than others based on a woman’s individual circumstances and health profile.

For instance, you don’t mention if you’re married, in a monogamous relationship or dating, or how sexually active you are. All are issues you should discuss with your health care professional when determining contraceptive options. For instance, if you’re having sex infrequently, you might want to consider a barrier method, such as a condom or diaphragm.

The most common birth control method used by perimenopausal women is sterilization, either tubal ligation, i.e., “having your tubes tied,” or hysterectomy. Either is a pretty drastic option, however, since both involve surgery. Plus, research shows that other options can be just as effective when used appropriately.

If you’re experiencing the heavy menstrual bleeding common to perimenopausal women, talk to your health care provider about the levonorgestrel IUD, which not only provides effective birth control, but may also help with the heavy bleeding. And, of course, another good option is the one you’re already using—oral contraceptives. The combination estrogen-progesterone pill Natazia is the first birth control pill specifically approved by the FDA to treat heavy menstrual bleeding not caused by a condition of the uterus.

Decades ago — in the 1970s—women over 35 were told to stop taking oral contraceptives because of the potential risk of heart disease. Since then, however, we’ve learned that risk exists primarily for women who smoke, making birth control pills a good option for nonsmoking premenopausal women of any age. Plus, given the drop in the amount of estrogen used in oral contraceptives in recent years, the risks of other health conditions, including blood clots, stroke and heart disease, have also dropped.

In fact, long-term use of birth control pills has numerous health benefits, including reducing the risk of ovarian cancer, probably by preventing ovulation. Studies also suggest that birth control pills reduce the risk of endometrial cancer, colorectal cancer, pelvic inflammatory disease, fibroids and even endometriosis, as well as helping alleviate some of the heavy bleeding related to fibroids and endometriosis.

One of the main reasons perimenopausal women choose oral contraceptives as their contraception of choice is to help reduce the heavy bleeding and irregular periods often a part of this time of life. There’s also some evidence they can help maintain bone density and reduce the risk of osteoporosis, as well as reduce the incidence of hot flashes, both of which concern perimenopausal women. An added bonus—they can help clear up middle-aged acne.

So, to summarize, it’s fine to continue taking birth control pills up to age 50 or even 51 (keep in mind that the average age of menopause in this country is 51) as long as you don’t have any risk factors for heart disease or other potential complications, including smoking, obesity, diabetes, high cholesterol, high blood sugar or migraines.

One reason your doctor suggested you stop taking birth control pills when you turn 50 is so you’ll know if you’ve reached menopause. If you continue taking them as directed—with a week’s break between active pills—you’ll continue to menstruate and won’t know.

Although the decision is between you and your doctor, you may want to consider at least taking a break for a few months and using a non-hormonal contraception to see if your periods continue, or if you have reached menopause and no longer need contraception.

Birth Control and Perimenopause – Nurx

If you’re of a certain age and experiencing irregular periods, hot flashes, and insomnia there’s a good chance you’ve entered perimenopause, the time leading up to menopause. How long perimenopause lasts, and how severe symptoms like sleepless, sweaty nights are, varies by person.

For women who take birth control pills, however, the signs of perimenopause might not be so obvious. This is because the hormones in birth control can mask perimenopause symptoms.

After all, as long as periods continue, even sporadically, pregnancy is still possible. Contraception is important for these women. But is birth control necessary and safe during perimenopause?

Knowing the Symptoms of Perimenopause

Before answering that question, first it’s important to define perimenopause. Marked by a reduction in estrogen and progesterone, perimenopause is the transitional time before menopause. It’s not until a woman has been without a menstrual cycle for one year that she has officially entered menopause.

On average, perimenopause lasts four years, and the average woman enters menopause at age 51. However, these ranges can vary widely. Perimenopause can begin during a woman’s early 40s or even sooner.

One of the most important steps in navigating the changes perimenopause brings is to know the common symptoms, which include:

• Insomnia or other sleep problems

Taking Birth Control Pills During Perimenopause

The most common birth control pills contain a combination of synthetic estrogen and progesterone, the hormones responsible for a woman’s menstrual cycle. At the onset of perimenopause, estrogen and progesterone levels decline, usually bringing on the symptoms mentioned above.

However, since combination birth control pills release estrogen and progesterone into the body, women who take them may not have perimenopause symptoms. Some women still experience them, but to a lesser degree, and others may notice the signs only when they take the inactive pills.

Determining if You Are in Perimenopause

Unlike pregnancy, there is no test you can take to definitively tell you if have reached perimenopause. If you observe perimenopausal symptoms while taking the placebo pills in your birth control pack, this is often a good indicator that your body is in perimenopause.

Some women who are using birth control choose to stop taking the pills because they want to let the body’s natural hormones take over, possibly giving them a more conclusive answer. If symptoms persist, you are likely in perimenopause. If, after halting the birth control, the symptoms disappear, they could have been side effects of the medication, meaning you are not in perimenopause.

It may take anywhere from four weeks to several months for the body and its hormones to regulate after you have ceased taking birth control. There is also a possibility that you have already reached menopause, and menstruation might not be present at all.

Continuing Birth Control Pills to Manage Perimenopause Symptoms

Taking birth control during perimenopause has several benefits. Doing so keeps hormone levels consistent, reducing the fluctuations that produce perimenopause symptoms, many of which can significantly and negatively impact women’s lives. 

The obvious benefit is contraception, and it is necessary for many women experiencing perimenopause. In fact, in the United States, women in their 40s have the second highest rate of unintended pregnancy (teens have the highest). In addition, birth control pills can protect perimenopausal women from ovarian and uterine cancers, while also helping to prevent bone loss that can lead to osteoporosis.

In general, birth control is safe for nonsmoking women who are older than 35, as most perimenopausal women are, and who do not have a history of any of the following:

• Estrogen-dependent cancer

Choosing the Right Birth Control During Perimenopause

If perimenopause causes a natural reduction in estrogen and progesterone levels, how do you know which birth control medication is best for your body?

Most of the time, perimenopausal women will benefit from a combination birth control method, meaning one containing both estrogen and progesterone. Combination pills are the most common. The other type of birth control is the progestin-only pill, sometimes called the mini pill. This is not usually recommended for perimenopausal women because it does not replace the body’s naturally declining estrogen.

Narrowing down the choices, many health experts recommend low-dose birth control pills for women in perimenopause. The reduced amount of estrogen, specifically 20 micrograms or less, is considered safer for women as they approach menopause. Companies like Nurx provides access to several low-dose combination birth control options. They all have 20 micrograms of Ethinyl estradiol, which is the synthetic version of estrogen. The exceptions are Lo Loestrin FE and Nuva Ring, containing 10 and 15 micrograms, respectively.

As with all medications, each drug has side effects. In general, side effects of birth control include breakthrough bleeding, nausea, breast tenderness, headaches, weight gain, mood swings, decreased libido, and vaginal discharge changes.

 

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This blog pro­vides infor­ma­tion about telemed­i­cine, health and related sub­jects. The blog content and any linked materials herein are not intended to be, and should not be con­strued as a substitute for, med­ical or healthcare advice, diagnosis or treatment. Any reader or per­son with a med­ical con­cern should con­sult with an appropriately-licensed physi­cian or other healthcare provider. This blog is provided purely for informational purposes. The views expressed herein are not sponsored by and do not represent the opinions of Nurx™.

90,000

Clinical Trial Advanced Hepatocellular Carcinoma: Durvalumab, Hypofractionated Radiation Therapy, Tremelimumab – Clinical Trials Registry

Acceptability

Criteria:

Inclusion criteria: – Histologically diagnosed HCC with progression during or after the previous PD- (L) 1 checkpoint inhibitory immunotherapy (e.g. nivolumab and / or pembrolizumab or atezolizumab; durvalumab excluded) with the last dose of PD- (L) 1 inhibitor less than 4 weeks but within 6 weeks months prior to enrollment – At least 1 response criterion for solid tumors (RECIST) Tumor measurable 1. 1 present that did not receive radiation therapy or other topical therapy prior to enrollment – Clinical indications for radiation therapy anywhere (e.g. painful primary or metastatic tumor, risk of local complications such as impending biliary or vascular obstruction) – Child-Pugh A or B7 – Eastern Cooperative Oncology Group (ECOG) 0 or 1 – Appropriate antiviral therapy for hepatitis B virus (HBV) as required by the institution.deoxyribonucleic acid (DNA) polymerase chain reaction (PCR) treatment standard HBV <2000 IU / ml - Hemoglobin> = 9.0 g / dL – Absolute neutrophil count> = 1500 / microliter (μl) – Platelet count> = 75000 / μL – Serum Bilirubin = <1.5 times the institution's upper normal range. This does not apply to patients with confirmed Gilbert's syndrome (persistent or recurrent hyperbilirubinemia that is predominantly unconjugated in the absence of hemolysis or liver pathology), who will be allowed only after consultation with their doctor - Aspartate aminotransferase (AST) = <2. 5 x upper limit of normal if liver metastases are present, in which case they may be = <5 x upper limit of normal (ULN) - International normalized ratio (INR) <1.5 - Creatinine clearance> 40 ml / min according to Cockcroft Gault formula – No contraindications to immunotherapy immune checkpoint inhibitors – No contraindications to RT – Life expectancy> = 12 weeks – Body weight> 30 kg (66.1 lb) – Evidence of postmenopausal status or negative pregnancy test in urine or serum of a premenopausal patient.Women will be considered postmenopausal if they have amenorrhea within 12 months without an alternative medical cause. Age requirements apply: – Women younger than 50 years of age are considered postmenopausal if they have amenorrhea for 12 months or more after stopping exogenous hormone treatment and have luteinizing hormone and follicle-stimulating hormone levels in the postmenopausal range for an institution or undergoing surgery sterilization (bilateral oophorectomy or hysterectomy) – Women over 50 years of age will be considered postmenopausal if they have amenorrhea for 12 months or more after stopping all exogenous hormonal treatments, had radiation-induced menopause with last menstrual period> 1 year ago, had chemotherapy-induced menopause with last menstruation> 1 year ago or underwent surgical sterilization (bilateral oophorectomy, bilateral salpingectomy, or hysterectomy) – Women of childbearing age and men should agree to use adequate contraception from screening until total participation in the study and at least 6 months after taking the combination durvalumab + tremelimumab and 3 months after the last dose of durvalumab – The patient is willing and able to adhere to the protocol throughout the study. including treatment and scheduled visits and examinations, including upward follow-up – The ability to provide signed informed consent, which includes compliance with the requirements and restrictions listed on the Informed Consent Form (ICF) and in this protocol. Written informed consent and any authorization required locally (such as the United States [US] Health Insurance Portability and Accountability Act) obtained from the patient / legal representative prior to any procedure related to the protocol, including screening assessments Exclusion criterion: – Prior radiation therapy to tumor sites requiring radiation therapy, which may compromise the safety of additional procedures – Preliminary radiation therapy of more than 30% of the bone marrow or a large field within 4 weeks of the first study treatment – Pretreatment with a CTLA-4 or PD-L1 inhibitor – Transplant history allogeneic organs – On prior immunotherapy with a PD-1 inhibitor: – There should be no immunity-related side effects with National Cancer. NCI’s version of the Institute’s Common Criteria for Adverse Events (CTCAE) (v.) 5 points> = 3 for any prior immunotherapy or toxicity that resulted in permanent withdrawal of previous immunotherapy – All AEs during prior immunotherapy should resolve to grade = < 1 or allowed to baseline prior to screening for this study, except for patients with grade <2 endocrine AEs who are eligible for enrollment if they are stable on appropriate replacement therapy and are asymptomatic - Should not have required the use of additional immunosuppressive agents other than corticosteroids for treatment AEs, there has been no recurrence of AEs score> = 3 AE if previously retested and currently do not require maintenance doses> 10 mg prednisone or its equivalent per day – Major surgery, liver-targeted therapy, or any other cancer therapy (for example, chemotherapy, immunotherapy apia, endocrine therapy, targeted therapy, biological therapy, tumor embolization, monoclonal antibodies) less than 4 weeks before enrollment – Any other unsolved NCI CTCAE toxicity grade> = 2 from previous anticancer therapy excluding alopecia, vitiligo and laboratory parameters, defined in the Inclusion Criteria – Patients with a neuropathy grade> = 2 will be assessed on a case-by-case basis. after consultation with the investigating physician – Patients with irreversible toxicity that cannot reasonably be expected to exacerbate treatment with durvalumab or tremelimumab may only be initiated after consultation with the investigating physician – Concurrent participation in another interventional clinical trial, except during the observation period of this study – Participation in another interventional clinical study of investigational product within the last 4 weeks, excluding the follow-up period of that study – Active or previously documented autoimmune or inflammatory diseases (including inflammatory bowel disease [eg, colitis or Crohn’s disease], diverticulitis [with the exception of diverticulosis] , systemic lupus erythematosus, sarcoidosis syndrome, or Wegener’s syndrome [granulomatosis with polyangiitis, Graves disease, rheumatoid arthritis, hypophysitis, uveitis, etc.]). The following are exceptions to this criterion: – Patients with vitiligo or alopecia – Patients with hypothyroidism (for example, after Hashimoto’s syndrome) are stable to hormone replacement – Any chronic skin disease that does not require systemic therapy. – Patients with celiac disease controlled only by diet – Patients without active disease in the past 5 years may be included, but only after consultation with a medical researcher – Uncontrolled intercurrent disease, including, but not limited to, current or active infection, symptomatic congestive heart failure , uncontrolled hypertension, unstable angina, cardiac arrhythmia, interstitial lung disease, severe chronic gastrointestinal illness associated with diarrhea or mental illness / adherence social situations significantly increase the risk of AE or impairment of the patient’s ability to give written informed consent – History of other primary malignant neoplasm, other than: – Malignant neoplasm that is being treated for the purpose of treatment and without known active disease> = 2 years before the first dose of the investigational product ( PI) and with low potential risk of recurrence – Adequately treated non-melanoma skin cancer or malignant lentigo with no evidence of disease – Adequately treated carcinoma in situ without evidence of disease – History of leptomeningeal carcinomatosis – History of active primary immunodeficiency – Active infection, including tuberculosis (clinical assessment including clinical history, physical examination and radiographic findings, and testing for tuberculosis (TB) according to local practice) – Known human immunodeficiency virus (HIV) infection – Current or previous use of immunosuppressive drugs within 14 days prior to the first dose of durvalumab / tremelimumab Exceptions to this criterion: – Intranasal, inhalation, local steroids or local steroid injections (eg, joint injection) – Systemic corticosteroids in physiological doses not exceeding 10 mg / day. prednisone or its analogue – Steroids as a premedication for hypersensitivity reactions (eg, tomography [CT] premedication) – Receive a live attenuated vaccine within 30 days before the first dose of IP. Patients, if included in the study, should not receive live vaccine at the time of PI and until 30 days after the last dose of IP – Female patients who are pregnant or breastfeeding, or male or female patients of reproductive potential who do not want to use effective control fertility from screening throughout the study period and at least 6 months after taking the durvalumab + tremelimumab combination and 3 months after the last dose of durvalumab – Known allergy or hypersensitivity to IP, any of the study drugs, or any of the study drugs.drug excipients – Pre-randomization or treatment in previous clinical practice with durvalumab and / or tremelimumab study regardless of treatment group assignment – Participation in the planning and / or conduct of the study (applicable to AstraZeneca staff and / or staff at the study site) – Any condition that , according to the researcher, makes the object unfit for participation in the test.

Floor:

All

Minimum age:

18 years old

Maximum age:

No data

Healthy volunteers:

No

Divine Gift of healing and help.

Who controls the birth rate in our country? Why is the climax rejuvenated? And why without Viagra, nowhere ?! Friends, most often we talk with you on topical topics. On topics that are painful for you. Topics that are troubling and require explanation. You and I have already become sufficiently prepared or “advanced” to understand that any symptom in the human body first appears on the subtle plane, and then speaks eloquently on the physical body. We have discussed these causes and effects many times.We talked a lot about a healthy lifestyle, thoughts and thoughts. They discussed generic problems that doctors call “genetic predispositions.” So, and this time, I would like to discuss such an important topic for many of you as reproductive function in men and women, hormonal dysfunctions and premature deviations in this area, which have become more frequent lately. So, we all know that menopause and erectile dysfunction have become “younger” in our country. Moreover, female and male infertility has gone beyond the realm of possibility.The queue for IVF now takes a year. What is it? Ecology? Stress? I do not think so. A human being, adapting to almost any conditions! And during the Great Patriotic War, they became pregnant and gave birth! Yes, we, in general, (in Russia) for the first 70 years there is no war! And coups? What about defaults? And repression (under Stalinism?) Is something that was already in our memory, but did not affect the birth rate and the general hormonal background of the population! And the birth rate in the post-war years surpassed all expectations, despite all the stress and hunger experienced not long before. Now the situation is completely different. Hormonal disorders in the field of reproductive function are becoming a real scourge of our time and our country. In women, this manifests itself as 1) inability to conceive; 2) failures or perversion of the menstrual cycle; 3) complete absence of the menstrual cycle 4) the onset of early menopause (35-40 years old is already common) 5) neuroses and depression In men, this manifests itself as 1) erectile dysfunction 2) a small number of active sperm; 3) hormonal changes due to disturbances in the endocrine system (manifested as weak libido, obesity, life and sexual passivity) 4) neuroses and depression. To blame everything on GMOs, bad ecology and stress is stupid! And we understand that. Simply, the mind is somehow trying to explain this picture. Here, explain to me! WHY, instead of fixing a person’s life, he is stuffed on TV with advertisements for antidepressants ??? Where has it been seen that Persen has become for us, like an ordinary Percil, that Viagra analogues have become as familiar as Komet and so on! And, after all, this is TELEVISION! Why do they want us, in general, to “calm down” and, in some places, “cheer up”? I believe that everyone knows everything perfectly: the Ministry of Health, analysts and politicians! They know that the people are freaking out, the men are “not worth it”, and the women (almost all) are on certain drugs from 30-40 years old! And now, let’s figure it out, WHO benefits from the early decay of the nation, such a huge demand for drugs (some already LIVE “on wheels”) The pharmaceutical industry, once! Two latent enemies of our people! Pharmacologists – to buy more! “Enemies” – so that they die out faster and liberate the territory. But, here, on which side of our state border these enemies are – a big question ……. So, friends, with completely primitive reasoning, we came to the conclusion that a planned impact from these two sides, after all, GOES! But how ? Looking at the impact on my clients, I see that the cleaner they become, the stronger the impact on them is from Friday to Sunday (overall impact on the country, especially Moscow and Moscow region). What is it? Does this impact include not only physical and psychological control, but also birth control? In general, I have established that this GENERAL effect can be removed, or at least mitigated and brought to a relative norm.As before, I am of the opinion that it is not the symptomatology that needs to be removed, but the common cause. My research in this area made it possible to obtain fairly consistent results. To protect my client from negative influences, both private and global, this is my credo. In confirmation of my practice, the aurochamber of the newest generation has now entered, during the diagnosis of which, the elements of influence are clearly visible BEFORE my sessions and, the purification of all plans AFTER. Of course, no one has canceled traditional medicine – it is vital! But, nevertheless, the inherently existing negative interventions in the subtle plans of a person play a decisive role in the occurrence of physical pathology.Therefore, the union of traditional and non-traditional medicine is the Union of the FUTURE! So long awaited by me. Always YOUR Mage-Healer Maxim Nikitin (Mage Cyprian) Russia http://egregord-dobra.rf/ +7 (901) 559-82-25 (Skylink-Moscow) Skype: mn5598225 5598225 @ gmail. com © Copyright: Magician-Healer Maxim Nikitin, 2015 Certificate of publication No. 215012400864

what is it, how to find out the volume and what can change

Uterine volume is measured using imaging tests requested by the gynecologist, in which a volume of 50 to 90 cm3 is considered normal for adult women.However, the volume of the uterus can vary depending on the woman’s age, hormonal stimulation and gestational age, in which case an increase in uterine volume can be seen due to the presence of a developing fetus.

Although most causes of changes in the uterus are considered normal, if signs and symptoms such as difficulty in conception, miscarriage, irregular menstruation or heavy discharge, pain and discomfort when urinating or during intercourse, and severe cramps are observed, it is important to consult a gynecologist to find out the reason symptoms and thus can prescribe the most appropriate treatment.

How to find out the volume of the uterus

The volume of the uterus is assessed by the gynecologist using imaging tests, such as mainly transvaginal and abdominal ultrasound. Thus, during the examination, the doctor can check the length, width and thickness of the uterus and then calculate its volume.

These tests are usually done routinely and are given at least once a year, but they can also be ordered when a woman has signs and symptoms of changes. It is important to pay attention to the examination requested by the gynecologist, because, for example, in the case of an ultrasound of the abdominal cavity, it is necessary to fast for 6 to 8 hours and also leave the bladder full. Learn how an abdominal ultrasound is performed.

Things to change

A change in the size of the uterus is often considered normal, so treatment is not necessary. However, if accompanying signs or symptoms appear, it is important that the doctor refer to the results of other gynecological and blood tests, in addition to imaging tests, in order to determine the cause of the change in the size of the uterus and thus the most appropriate treatment.

Some of the situations in which a change in the volume of the uterus can be observed:

1.Pregnancy

As pregnancy progresses, there is often an increase in the volume of the uterus because the baby needs more space to develop properly. Also, if a woman has had two or more pregnancies, it is also normal for the uterus to expand.

2. Woman’s age

As a woman develops, the uterus increases in size simultaneously with the development and maturation of other genital organs, which in this case is considered a natural process in the body. Thus, the normal value of the volume of the uterus can vary depending on the person’s age, be lower in children and increase over time.

3. Hormonal stimulation.

Hormonal stimulation is usually performed by women who find it difficult to become pregnant because hormones can stimulate ovulation and guarantee uterine conditions that favor embryo implantation, which can affect uterine volume.

4. Menopause

Menopause is a natural process in the body, during which a decrease in the volume of the uterus is usually observed.In this case, in order to confirm that the decrease in volume is indeed associated with menopause, the gynecologist indicates the measurement of hormones that confirm the period in which the woman is. Check out some of the tests that confirm menopause.

5. Infant uterus

Infant uterus, also known as hypoplastic uterus or hypotrophic hypogonadism, is a congenital disorder in which a woman’s uterus does not develop and remains the same volume and size as in childhood. Understand what it is and how to identify the baby’s uterus.

6. Gynecological changes

The presence of fibroids, fibroids, endometriosis or tumors in the uterus can also cause changes in the volume of the uterus, and there can also be signs and symptoms such as bleeding, back pain and discomfort during intercourse, for example, and must be examined by a doctor so that the most appropriate treatment can be initiated.

CBD FOR MENOPAUSE: CAN IT HELP HELP WITH THE SYMPTOMS? – MENOPAUSE

Cannabidiol (CBD) is a chemical derived from the cannabis plant.CBD oil can help with some of the symptoms of menopause.

CBD is one of over 100 cannabinoids in the cannabis plant. Unlike the better-known cannabinoid, tetrahydrocannabinol (THC), CBD is not euphoric.

CBD is psychoactive, which means it can affect a person’s mood, but is not harmful.

Like any natural transition period, menopause can cause unpleasant changes, including hot flashes, sleep disturbances, and mood swings. Researchers have studied a variety of herbal and natural remedies for these symptoms with mixed results.

There has been a lot of interest in the possible benefits of CBD lately, and some research suggests it can relieve certain menopausal symptoms.

However, the Food and Drug Administration (FDA) has not approved this use of CBD. So far, the only approved uses are for the treatment of two rare forms of epilepsy, with approval issued in June 2018.

Although CBD has become a popular alternative treatment and some people may find it effective for menopausal symptoms, there is currently no scientific evidence to support this use.

How CBD Oil May Affect Menopause?

Image Credit: ronstik / Getty Images

The endocannabinoid system is a collection of cellular receptors called cannabinoid receptors in the brain and other organs and tissues throughout the body.

This system plays an important role in menopause, and cannabis and CBD influence how it works. In theory, this means cannabis and CBD could influence the effects of menopause on the body.

Cannabinoid receptors are involved in:

• mood regulation
• functioning of the immune system
• pain
• sleep
• memory capacity
• fertility and reproduction
• temperature regulation

the system can lead to various diseases.By interfering with the function of the endocannabinoid system, chemicals like CBD can help treat these conditions.

Cannabinoid receptors are present throughout the female reproductive system, and menopause appears to disrupt the endocannabinoid system. For these reasons, it is possible that CBD oil can reduce some of the symptoms of menopause.

For more information and resources on CBD and CBD products, visit our dedicated center.

What symptoms of menopause can be treated?

No studies have directly investigated the effects of CBD on menopausal people. This means that researchers are not sure if it works or is a safe option.

However, various studies have tested the effect of CBD on certain symptoms in other groups of people.

For example, a 2020 review concluded that CBD may help relieve chronic pain, improve sleep, and reduce inflammation. However, they observed these effects in people with special health problems, not in people with menopause.

There is no evidence that CBD oil can relieve all symptoms of menopause, but it can help with:

Mood changes

The risk of depression and anxiety is higher during menopause, and this may be due to hormone changes, other symptoms of menopause, or and both.

Animal studies, including a 2014 review of relevant studies in mice, showed that CBD can reduce the effects of depression and anxiety.

However, as the authors of the 2020 review warn, very limited human research has been done.

They note that there are only a few case studies in which individuals with a history of depression reported improvements after taking CBD.

They also point to text that is part of an FDA-approved CBD package called Epidiolex, which lists depression and suicidal ideation as possible side effects.

Learn more about CBD and depression here.

Sleep Disorders

Many people report having difficulty sleeping during menopause, and this problem can significantly affect daily life.

According to the aforementioned 2020 review, endocannabinoids play a role in the sleep-wake cycle. This suggests that CBD may interfere with sleep.

Researchers highlight some limited studies of CBD and sleep in humans. The results indicate that higher doses of CBD may have a sedative effect.

It is therefore possible that CBD oil may help treat menopause-related sleep disorders, but conclusive evidence is lacking.

Learn more about CBD and sleep here.

Loss of bone density

People begin to lose bone mass after menopause. Osteoporosis affects one in four women aged 65 and over.

Low bone density can increase the risk of fractures, so treatment is essential.

An animal study in 2008 showed that CBD interacts with the cannabinoid receptor, which may play a role in bone density loss.Hence, CBD can reduce the rate of bone density loss that can occur during menopause.

However, this has not been demonstrated in humans – no studies have shown that CBD improves the loss of bone density associated with menopause.

Legality

Hemp and hemp-derived products with less than 0.3% THC are legal under the Agriculture Act 2018.

However, the legal status of CBD and other cannabinoids varies from state to state.If a person in the US is thinking of trying CBD, they can check their local laws here.

Safety and risks

People generally tolerate CBD well, although it can cause side effects such as diarrhea, nausea, and drowsiness.

CBD can also have negative effects when mixed with certain medications and supplements, especially those that can interact with grapefruit.

In addition, it can affect the metabolism or breakdown of drugs in the body.

People can buy CBD products without a prescription. However, these products are not FDA approved – they are not regulated by the FDA in the same way as medicines.

This means that it is impossible to know if a product is safe. Many OTC products without this type of regulation do not contain the ingredients listed on their labels. For these reasons, it is especially important to do a little research and find a quality product.

Other strategies and treatments

An active lifestyle, good sleep hygiene and finding ways to reduce stress can help relieve symptoms of menopause, says the FDA.

Meanwhile, hormone replacement therapy can help relieve symptoms such as hot flashes, vaginal dryness, and mood changes.

Anyone who may be depressed or anxious may find it helpful to speak with a doctor or mental health professional for support.

Many people turn to natural remedies for menopause symptoms, including:

• black cohosh
• red clover
• soy

While some believe these remedies bring relief, they are not FDA approved for menopause. and studies of their effectiveness have led to mixed conclusions.

Summary

There is currently very little reliable evidence that CBD oil can help relieve menopausal symptoms.

Researchers are just beginning to understand how the endocannabinoid system works and what role it can play in various aspects of health.

Testing theories about the role of CBD in menopause will require further research. Only then will the medical community be able to determine if CBD oil has menopause-related benefits.

Is CBD Legal? Hemp-derived CBD products with less than 0.3% THC are federal legal but illegal under some state laws. On the other hand, cannabis-derived CBD products are illegal at the federal level, but legal under the laws of some states. Check your local laws, especially when traveling. Also, keep in mind that the Food and Drug Administration (FDA) has not approved OTC CBD products, which may be inaccurately labeled. .

LESS KEY BRAIN AREA FOR WOMEN TAKING THE PILL.

– BIRTH CONTROL – CONTRACEPTION

At the base of the brain is a small but important area that acts as a control center for the nervous and hormonal systems. The study found that among women, this rate is significantly lower among those who take birth control pills.

New research reveals an intriguing link between birth control pills and the size of a brain region key to hormone control.

The Food and Drug Administration (FDA) first approved birth control pills for use in the United States in 1960. Today in the United States, 12.6% of women aged 15 to 49 are taking these pills.

This oral contraceptive, simply known as the “pill,” is one of the most popular birth control drugs, but people also use it to treat a wide range of conditions, including irregular menstruation, acne, polycystic ovary syndrome, endometriosis, and seizures….

Essentially, pills were introduced as a means of preventing pregnancy through hormonal control.

Manufacturers originally developed it to stop ovulation using the hormone progesterone, but it has evolved into many different types since then. These include various combinations, doses, and hormone schedules depending on the desired outcome. People can also use pills to skip or stop menstruation altogether.

But what does this use of the power of hormones mean for the body’s natural hormone system?

Prior to the present study, which the researchers presented at the 2019 Annual Meeting of the Radiological Society of North America, there was very little research into the effects of birth control pills on the hypothalamus.

This small area of ​​the brain, located above the pituitary gland at the base of the organ, plays a vital role in hormone production and helps control a number of bodily functions, including sleep cycles, mood, libido, appetite, body temperature, and heart. bid.

The researchers who presented the study admitted that prior to their work, there were no reports of the effect of birth control pills on the structure of the human hypothalamus.

“There is a lack of research into the effects of oral contraceptives on this small but important part of the living human brain,” says Michael Lipton, Ph. D., professor of radiology at the Gruss Magnetic Resonance Research Center in Alberta.Einstein College of Medicine and Medical Director of MRI Services at Montefiore Medical Center, both in New York, NY.

This may be due to the fact that until now there was no known method for quantitative analysis of MRI studies of the hypothalamus.

Lipton explained to Medical News Today that the team’s previous work also inspired them to investigate these effects. “We’ve reported some pretty interesting findings about the risk of traumatic brain injury based on gender,” he said.“In particular, women seem to live worse than men. Other studies have shown that the female sex hormone progesterone is neuroprotective. ”

“Since [oral contraceptive pills] are widely used, we wanted to study the effects of [oral contraceptives] on healthy women in order to understand their potential role in our results regarding gender disagreement. The discovery we are reporting here is one of the results of this study. ”

A sharp difference in the size of the hypothalamus

“I didn’t expect to see such a clear and lasting effect,” Lipton said.The researcher also notes: “We found a dramatic difference in the size of brain structures between women who took oral contraceptives and those who did not.”

For the study, scientists recruited 50 healthy women, 21 of whom were taking birth control pills.

The team performed an MRI scan using radiology to obtain images of organs to look at the brains of each of the 50 women. They then used a proven methodology to measure the volume of the hypothalamus.

“We tested methods for assessing the volume of the hypothalamus and for the first time confirmed that current use of oral contraceptives is associated with less volume of the hypothalamus,” says Lipton.

Researchers found that women who took birth control pills had significantly lower hypothalamic volume than those who did not use oral contraceptives.

Hypothalamic volume and anger

Although the study found that there was no discernible association between hypothalamic volume and cognitive or thinking ability in women, preliminary results suggest there is a link between lower hypothalamic volume and decreased anger.

“These results are broadly consistent with previous studies [of oral contraceptive pills] that support [impact] on mood regulation. Our discovery may reflect a manifestation of the mechanism underlying these effects, or simply not be relevant. “It’s too early to tell,” Lipton said.

“This initial study shows a strong link and should motivate further research on the effects of oral contraceptives on brain structure and their potential effects on brain function,” Lipton concludes.

With regard to future work plans, Lipton said: “For my group, the most important and immediate goal is to include the role of [oral contraceptive pills] in our current research and further explore the role of normal sex hormone cycles associated with the menstrual cycle. cycle, and the role of androgens (testosterone) in men and women. ”

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