Know Your Birth Control Options

In Your 40s and 50s

What’s on your mind

Since you’re perimenopausal, your big question is probably “Do I even need birth control?” Short answer: yes. “More than 50 percent of pregnancies over age 40 are unplanned,” says Streicher.

Methods to consider

Any Hormonal Contraceptive

They not only prevent pregnancy but also help regulate your menstrual cycle, which can become unpredictable as your body’s own estrogen production slows down, says Migliaccio. Some doctors prefer low-estrogen pills, progesterone-only pills, or the non-estrogen Mirena for perimenopausal women.

Sterilization

If you’re certain you’re done with child-bearing, hysteroscopic sterilization might be for you. One common procedure, called Essure, involves your doctor placing two tiny coils inside your fallopian tubes with the help of a camera inserted through the cervix. “Your body’s tissue grows around the coils in about three months, closing off your tubes,” says Basinski. The procedure takes about 10 minutes and requires no anesthesia (you may get a Valium to relax you and a shot of lidocaine to numb your cervix). After three months, you’ll need a hysterosalpingogram, an X-ray in which dye is flushed through the fallopian tubes to confirm that they are blocked.

Cost: $3,000 to $4,500; may be covered by insurance.