The birth control pill over 35: what you need to know

Today is Women's Health Day and May 28 is International Menstruation Day. We are giving extra thought to your health as a woman. A good time to also take a closer look at your contraceptive use, especially if you are over 35 years old. Have you been using the birth control pill for years? If so, it's important to know that your risk of certain side effects changes as you get older.

.

Risks change as you get older

The combined pill increases the risk of thrombosis. That means a blood clot can form in a blood vessel. Without using hormonal birth control, the thrombosis risk already increases slightly with age. But with a combined pill, that risk actually triples.
Maybe you've been using the same pill since you were a teenager and keep renewing your prescription. Still, it's wise to consciously reexamine whether the pill is still the best choice for you around age 35.

Why is the combined pill a greater risk?

The combined pill contains two hormones: an estrogen (usually ethinylestradiol) and a progestogen (for example, levonorgestrel, desogestrel, gestodene or drospirenone). The estrogen increases the risk of thrombosis.
The type of progestogen helps determine how much extra risk you run. There are several generations of combination pills:

Second generation: with ethinylestradiol + levonorgestrel, for example. This combination has a lower risk of thrombosis.
Third generation: with, for example, ethinylestradiol + desogestrel or ethinylestradiol + gestodene. These present a higher risk.
Fourth generation: with ethinylestradiol + drospirenone, for example. Again, the risk is higher than with second-generation pills.

In young women without other risk factors, this increased risk is often still considered acceptable. But after age 35, your natural thrombosis risk increases. Using the combined pill then increases this risk even more.

What alternatives are there?

There are many safe alternatives to contraception that do not increase thrombosis risk, such as:

A copper-containing IUD, such as a copper-containing intrauterine system (e.g., T-shaped IUD with copper).
A hormone IUD containing only levonorgestrel (for example, a levonorgestrel intrauterine system).
An implantable rod containing etonogestrel.
The mini-pill (progestogen pill), for example, with only desogestrel.
A combination pill with a lower dose of estrogen (lower than 30 micrograms of ethinylestradiol, but still some thrombus risk).

Discuss with us or your doctor which form of contraception is best for you. You can also find more information at Thuisarts.nl and Anticonception.

.

Please note when smoking

Do you smoke and are over 35 years old? Then use of the combined pill is strongly discouraged. Smoking together with the pill significantly increases the risk of cardiovascular disease. In that case, switching to another form of birth control is even more important.

Good to know

Your risk of thrombosis increases with age, even without using hormonal contraception.
The combined pill that risk significantly.
After age 35, it is wise to revisit your contraception.
Safe alternatives are available without increased thrombus risk.