Like most people with uteruses, I’ve spent the majority of my adult life taking birth control to prevent pregnancy. So you better believe I've wondered, more than once, at what age should you stop taking birth control. The idea of no longer having to worry about taking this pill or having that shot or just no longer having to think about any type of birth control method is, you know, nice. But since I've been on some form of birth control for such an extended period of time, it's also important to know when, and how, to stop taking birth control.
According to the American College of Obstetricians and Gynecologists (ACOG), most people can continue taking birth control safely until they reach menopause, with a few caveats. In this day and age, there is a contraceptive method that works for almost everyone, no matter what their age and medical history. In fact, a review of research published in the Canadian Medical Association Journal found that the risks of not using birth control — namely, an unplanned pregnancy — outweigh potential risks of using birth control for women over 35, which include bone loss and blood clots for people without underlying health conditions.
Still, it's super important to talk through your health history and habits with your doctor, to not only find a birth control method that's right for you, but to discuss any changes in birth control and how that might impact your health.
To find out more about how to safely and effectively continue to prevent pregnancy as you get older, Romper spoke with Dr. Huma Farid, MD, an OB-GYN at Harvard Medical School and Beth Israel Deaconess Medical Center in Boston, Massachusetts. According to Farid, the right contraceptive method for you depends on your medical history — especially if you have other risk factors — as well as your preferences and your past experiences with birth control.
"In women who are over 35 years old who smoke, I recommend avoiding any contraceptive option that contains estrogen (such as the pill, the patch, or the ring) as that increase their risk of blood clot and stroke," Farid says. "For women who are healthy, nonsmokers, are not overweight, and have been on estrogen-containing birth control for years without any issues, they can continue their birth control until menopause."
Estrogen isn't necessarily something we all have to worry about, Farid explains. However, some people should definitely not take the pill or use another birth control method containing estrogen, especially if they're past the age of 35. "Women who smoke, have elevated blood pressure, have migraines with aura, have had breast cancer or uterine cancer, or have a history of blood clots should not be on estrogen containing birth control," she says.
For people who want to continue or start a hormonal option, but for whom estrogen is not a good fit, the review published in the Canadian Medical Association found that progestin-only options like the hormonal IUD and contraceptive shot had few risks, and can come with the added benefit of lighter periods and the reduced risk of endometrial and ovarian cancers.
Farid agrees that these methods may be the best choice for someone who can't take combination pills. "Women who use progestin-only methods (such as the progestin-only pill, IUD, implant, or shot), and have not had any adverse reactions when using them, can generally continue to use those methods until menopause," she says. There are a few exceptions, though, including those with a history of breast cancer.
For patients who can't or don't want to use hormonal options, ACOG notes that copper IUDs remain one the most effective forms of birth control, with only a 0.8 percent failure rate and can be used for up to 10 years. Per the same site, the biggest complaints from patients using the copper IUD are related to heavy bleeding and pain during menstruation. However, a Canadian Medical Association review found that using a non-hormonal IUD can actually decrease your risk for endometrial cancer.
When making recommendations for birth control for people of any age, Farid generally starts with the the most effective. "I would recommend a long acting reversible contraceptive method such as the IUD, the shot, or the arm implant," she says. "These methods are easy to use and extremely effective at preventing pregnancy."