Glasier A, Gebbie A
Family Planning and Well Woman Services, Dean Terrace Centre, Edinburgh, UK.
Baillieres Clin Obstet Gynaecol. 1996 Apr;10(1):121-38. doi: 10.1016/s0950-3552(96)80066-6.
Contraception presents particular problems for women over the age of 40. Although fertility is declining and the risk of pregnancy may be small, the consequences of an unplanned pregnancy may be socially devastating and medically ill-advised. Menstrual dysfunction and psychosexual difficulties increase with age and may exacerbate the side-effects of some methods of contraception. The long-term risks of combined hormonal contraception, particularly cardiovascular disease, become more pertinent to women whose natural risk of disease increases with age. Patterns of sexual activity and contraceptive use change with age. The advantages and disadvantages of currently available methods of contraception are difficult to quantify, and the choice of method is very much a matter for individual concern. The increasing prevalence of HRT may complicate matters for some women who are unsure for how long to continue using contraception. Contraceptives of the future may be designed to improve the reproductive health of all women, particularly those approaching the menopause.
避孕对于40岁以上的女性来说存在特殊问题。尽管生育能力在下降，怀孕风险可能较小，但意外怀孕的后果在社会层面可能具有毁灭性，从医学角度来看也不明智。月经功能紊乱和性心理问题会随着年龄增长而增加，并且可能会加重某些避孕方法的副作用。复方激素避孕的长期风险，尤其是心血管疾病，对于那些随着年龄增长自然患病风险增加的女性来说更为相关。性活动模式和避孕方法的使用会随着年龄而变化。目前可用的避孕方法的优缺点难以量化，方法的选择很大程度上是个人需要考虑的问题。激素替代疗法（HRT）的日益普及可能会给一些不确定要继续避孕多久的女性带来困扰。未来的避孕药可能会被设计用来改善所有女性的生殖健康，尤其是那些接近更年期的女性。
