Bhathena R K, Guillebaud J
Department of Obstetrics and Gynaecology, Petit Parsee General and Masina Hospitals, Bombay, India.
Climacteric. 2006 Aug;9(4):264-76. doi: 10.1080/13697130600857904.
Although fertility declines with advancing age as the woman approaches the menopause, some risk of pregnancy persists, and effective contraception needs to be offered to avoid an unintended pregnancy. An older woman may have menstrual dysfunction or climacteric symptoms and these factors would need consideration when making the choice of contraception. Low-estrogen dose combined oral contraceptives may be prescribed to healthy non-smoking women up to about 50 years of age. The progestogen-only pill may be an appropriate option in an older woman with declining fertility. The copper intrauterine device is an optimal method for parous women free of pre-existing menstrual problems. The levonorgestrel-releasing intrauterine system is considered the contraceptive method of choice for perimenopausal women with menstrual dysfunction. The woman should be provided with individualized advice so that she has a choice between the newer, effective, largely safe, reversible methods and sterilization.
随着女性接近更年期，生育能力会随着年龄增长而下降，但仍存在一定的怀孕风险，因此需要提供有效的避孕措施以避免意外怀孕。老年女性可能存在月经功能紊乱或更年期症状，在选择避孕方法时需要考虑这些因素。低雌激素剂量的复方口服避孕药可开给健康的非吸烟女性，年龄上限约为50岁。对于生育能力下降的老年女性，仅含孕激素的避孕药可能是一个合适的选择。铜宫内节育器是没有既往月经问题的经产妇的最佳避孕方法。左炔诺孕酮宫内缓释系统被认为是有月经功能紊乱的围绝经期女性的首选避孕方法。应向女性提供个性化建议，以便她能在更新、有效、基本安全、可逆的避孕方法和绝育之间做出选择。
