Contraceptive Management and Menopause

by Bethany King WHNP

Contraception management is a large and very important topic for discussion and can only be briefly covered in the following paragraphs. Contraceptive options, both hormonal and non-hormonal, are used by approximately 60% of all reproductive age women. Most often, women use contraception to prevent pregnancy or to have healthier pregnancies by delaying childbearing until ready. It can also be used to help time and space births and achieve one’s desired family size. However, the term “contraceptive management” is misleading as hormonal options for contraception are also commonly used to treat very heavy menstrual periods, painful menstrual periods, and pelvic pain. In this regard, contraceptive management is often used to treat women who may not be sexually active or desiring fertility.

Contraceptive methods include the pill, flexible rod implants (i.e. Nexplanon), injections, hormone and non-hormonal intrauterine devices (IUD), patches, vaginal diaphragms, and condoms. With consistent and correct use, unintended pregnancies can be dramatically decreased by about 99.98%. Current medications, health diseases, as well as weight can adversely affect the efficacy of contraceptive options and it is important to discuss this in detail with your health care provider. It is also important to understand that contraceptive options do not prevent sexually transmitted illness such a gonorrhea, chlamydia, HIV, herpes, syphilis, hepatitis, and human papilloma virus (HPV). If you are concerned about possible exposure or symptoms, testing is recommended.

As mentioned above, hormonal contraceptive methods can also provide a number of gynecologic health benefits such as treatment for excessive menstrual bleeding, menstrual pain, menstrual cycle irregularity, menopause symptoms during perimenopause, acne, and excessive hair growth. Treatments are highly individualized. Appropriate contraception counseling with your provider is extremely important when considering hormonal or non-hormonal methods for contraceptive or non-contraceptive purposes.

As women age beyond reproductive years, it is the natural progression to be faced with changes associated with perimenopause and menopause. The average age of menopause is between the ages of 45-55 y/o, with a median age of 51 y/o. Menopause is defined by the lack of a menstrual period for 1 year. Symptoms of menopause or “perimenopause” can begin up to 10 years prior to menopause! Menopause is associated with a decreased production in ovarian estrogen and other hormones which is often accompanied with vasomotor symptoms such as hot flashes, night sweats as well as symptoms of mood irritability, mental fogginess, vulvovaginal atrophy, vaginal dryness or painful intercourse. As you can imagine, all of these symptoms can interfere with quality of life and vitality as we age! A detailed medical history and a trusting provider-patient relationship can help women transition better into menopause. Both hormonal and non-hormonal treatment options are available. Hormonal options include low dose oral tablets, topical creams and gels, lozenges, hormonal pellets, and vaginal estrogen or DHEA. Based on the patient’s symptoms and needs, bioidentical hormone therapy may be a preferred option. If a woman has not undergone a hysterectomy, it is imperative that estrogen therapy be combined with low dose progesterone for uterine protection. Non-hormonal options include mood stabilizing medications such as SSRIs, SNRIs; non-pharmacologic and over the counter options; and cognitive-behavioral therapies. Just like contraceptive management, menopause symptom management is highly individualized and counseling with your provider is recommended.

If you would like more information or want to discuss an individualized treatment plan with our providers, call McDowell Mountain Gynecology for an appointment today! 480.483.9011

Bethany King WHNP and our providers are excited to take care of your Women’s Health needs!

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