Advanced contraception

Janine Berdelmann studied social sciences and completed her traineeship in the editorial team. She is the author of numerous science news and advice topics on .

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"I'm done with the pill, I've swallowed it for too long" - a sentence that gynecologist Dr. Christian Albrig hears this or similar frequently from women during menopause. Unfortunately, it does not work entirely without contraception: women can also become pregnant in mid-life.

Infertile only after menopause

Career boost, long journeys, new partners - women in midlife often start all over again. The shock is all the greater when suddenly the answer is: “You are pregnant!” Even though the patient in question may already be in the menopause.

A pregnancy can only be ruled out with certainty after the last bleeding, the menopause. When this takes place is very different: It can be in your mid-40s or only in your late 50s. Since the cycle becomes more and more irregular during menopause, it is difficult to say what the final use for tampons and sanitary towels was. "After twelve months without bleeding, however, the matter is pretty clear," says Albrig in an interview with A test by the gynecologist then provides final certainty.

The pill - yes or no?

The right contraception remains an issue. Beyond the age of 40, various risk factors play a role in the selection: the age of the woman, her cigarette consumption or diseases such as high blood pressure or diabetes, which increase the risk of cardiovascular disease. The pill acts like an additional amplifier: it encourages blood clots to form, which can cause a stroke or even a heart attack.

One possibility would be to at least switch to the mini pill. This contains fewer hormones and is therefore less risky. "If the woman is healthy, the normal dose pill is not a problem either," explains the practicing gynecologist. This also applies to the contraceptive stick and ring.

Point victory for the spiral

Albrig himself, however, favors other methods: "The best contraceptive for women during menopause is the IUD." There are basically two different variants: the copper and the hormone IUD. The copper IUD has the advantage that it does not contain any hormones at all - and is therefore free from cardiovascular risks. However, some women do not get along well with this method because it can cause heavy bleeding and severe menstrual pain.

With a hormone coil, menstrual periods often dry up to a large extent - which many women really appreciate. It causes the uterine lining to develop less abundantly. "And where there is nothing, nothing more needs to be flushed out," says the gynecologist. In contrast to the copper IUD, this variant is not free of hormones, but, unlike pill & Co., it only works directly on site, in the uterus. “The pill, on the other hand, has a systemic effect - including in the right earlobe and left big toe,” explains Albrig. The consequence. The hormones are also buzzing around where they are not needed - and where they only cause harm. Another advantage of the IUD: "In contrast to the pill, you can't forget it".

Alternatively, there is of course the option of sterilization. “However, men are also in demand here,” says the gynecologist. Because with them, the procedure is far less complicated and cheaper. The following applies to both sexes: The decision is almost always final for women, and often for men, because reoperations have only a limited chance of success.

Late pregnancy possible

However, pregnancy is not bad news for all mature women. Some are happy after the first shock, others have even hoped to get pregnant again. "With close care, a late pregnancy can be completely problem-free," explains Albrig. However, the risk of genetic defects in children of older mothers increases dramatically. "The risk of chromosomal defects, for example, is then between 1 in 10 and 1 in 20 - and that is extremely high," says the gynecologist.

Not to forget: the older the mother, the older the child's father is usually too. His sperm are past their prime as well. Studies show that children with older fathers suffer from mental disorders more often, among other things.

But here, too, nature often takes care of things itself. Albrig knows: "If a limp sperm meets a weak egg, the probability of fertilization is not particularly great anyway."

Tags:  nourishment digital health Menstruation