A review of the current science of contraception and women 40 and older was published recently in the New England Journal of Medicine. The author, University of Florida gynecologist Dr. Andrew Kaunitz, noted that the risk of dangerous blood clots rises sharply at age 40 for women who take birth control pills containing estrogen.The risk is even greater for overweight women, who also are more likely to have high blood pressure and diabetes.
But the dosage of estrogen in current birth control pills has been dramatically reduced. The pill is now considered a safe alternative for lean, healthy, older women Kaunitz and other experts said.
"It may not be well known that the current low-dose formulations are a reasonable option for healthy women in their 40s," said Dr. JoAnn Manson, a Harvard endocrinologist who wrote a book on menopausal hormone therapy.
The pill may be preferable for some women, because it can help control irregular menstrual bleeding and hot flashes and has been shown to reduce hip fractures and ovarian cancer, wrote Kaunitz. He has received fees or grants from several companies that make oral contraceptives.
But middle-aged women who are obese, smoke, have migraines, high blood pressure or certain other risk factors should be steered toward IUDs or progestin-only treatments like "mini-pills," experts said.
I hope that more studies explore this issue. The fact that taking the new "low estrogen" pill is touted to not only act as a contraceptive but also reduce hot flashes and menopausal symptoms is a red flag that despite the low doses of estrogen, this is still a form of HRT. Also, note that the lead researcher Kaunitz has been paid by oral contraceptives companies. Another red flag.
For the holistic point of view on perimenpausal women's contraceptive choices, here is a well-researched article from Women to Women: Women:http://www.womentowomen.com/menopause/bcpperimenopause.aspx#arebcpssafe
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