Bateson Deborah, McNamee Kathleen
MBBS, MSc, MA, is Senior Medical Coordinator, Family Planning New South Wales.
Aust Fam Physician. 2017 Jun;46(6):372-377.
Women who are perimenopausal are at risk of unintended pregnancy despite relatively low fertility at this stage. Contraceptive choice can be limited by increased comorbidities, but the UK Medical Eligibility Criteria (UKMEC) system provides a framework for safe prescribing.
This article provides evidence-based guidance on contraceptive options, and information to support decision-making about stopping contraception at menopause.
Contraceptive choice is determined by several factors, including medical eligibility, side effects and risks, non-contraceptive benefits, cost and personal preference. Long-acting reversible contraceptives (LARCs) are an effective, acceptable and safe choice for many women. For women aged ≥50 years who are using a non-hormonal method, contraception is recommended until after 12 months of amenorrhoea, or 24 months if they are aged 50 years; serial follicle-stimulating hormone (FSH) levels can guide method cessation given amenorrhoea is not a reliable indicator of menopause in this context.
围绝经期女性尽管在此阶段生育能力相对较低，但仍有意外怀孕的风险。合并症增加可能会限制避孕方法的选择，但英国医学适用性标准（UKMEC）系统提供了一个安全开药的框架。
本文提供关于避孕选择的循证指南，以及支持绝经时停止避孕决策的信息。
避孕方法的选择取决于多个因素，包括医学适用性、副作用和风险、非避孕益处、成本和个人偏好。长效可逆避孕方法（LARCs）对许多女性来说是一种有效、可接受且安全的选择。对于年龄≥50岁且使用非激素方法的女性，建议避孕至闭经12个月后，50岁女性则为24个月；鉴于在此情况下闭经并非绝经的可靠指标，连续的促卵泡生成素（FSH）水平可指导停止使用避孕方法。
