Hostname: page-component-848d4c4894-x24gv Total loading time: 0 Render date: 2024-05-12T08:24:51.431Z Has data issue: false hasContentIssue false

Appropriate contraception for middle-aged women

Published online by Cambridge University Press:  27 September 2011

Robert B. Greenblatt
Affiliation:
Medical College of Georgia, Augusta, Georgia, USA
Camran Nezhat
Affiliation:
Medical College of Georgia, Augusta, Georgia, USA
Virginia P. McNamara
Affiliation:
Medical College of Georgia, Augusta, Georgia, USA

Extract

The United States Food and Drug Administration and the International Planned Parenthood Federation recommend that women over the age of 40 should utilize forms of contraception other than the pill. This decision was reached as a result of the 1975 clinical papers by Mann and his associates (Mann et al., 1975; Mann & Inman, 1975) and the epidemiological reports of the Royal College of General Practitioners (1977), Mann, Inman & Thorogood (1976) and Vessey, McPherson & Johnson (1977). Several authoritative bodies believed it prudent to suggest that the age limit for oral contraceptive use be lowered to 35, and even to 30 years (Anon, 1977; Planned Parenthood memorandum, 1977). The investigations of Inman & Vessey (1968) point to a precarious rise in mortality figures for women over age 35 on oral contraceptives.

Type
III. Fertility control in middle age
Copyright
Copyright © Cambridge University Press 1979

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adamopoulos, D.A., Loraine, J.A., & Dove, G.A., (1971) Endocrinological studies in women approaching the menopause. J. Obstet. Gynaec. Br. Commonw. 78, 62.CrossRefGoogle ScholarPubMed
Ambrus, J.L., Courey, N.G., Browne, B.J., Mink, I.B., Moore, R.H., & Ambrus, C.M., (1977) Progestational agents and blood coagulation. VIII. Effect of low-dose, alternate day, estrogenprogestin combinations on blood coagulation factors in man, with a special note on the effect of freezing of blood samples. Am. J. Obstet. Gynec. 128, 161.CrossRefGoogle ScholarPubMed
Anderson, B., Connell, E., Kaplan, H.S., Kemeny, N., Notman, M., Perlmutter, J., Shainess, N., & Tyson, M.C., (1977) The reason for contraception. In: The Menopause Book, p. 24. Edited by Rose, L.. Hawthorn, New York.Google Scholar
Anon (1977) Editorial. Lancet, ii, 747.Google Scholar
Asch, R.G., Greenblatt, R.B., & Mahesh, V.B., (1978) Pure crystalline estradiol pellet implantation for contraception. Int. J. Fert. 23, 100.Google ScholarPubMed
Berger, G.S., (1977) Oral contraceptives and myocardial infarction. N.C. med. J. 38, 323.Google ScholarPubMed
Chez, R.A., Jaffe, R.B., Kase, N.G., & Plunkett, E.R., (1976) The sexually active premenopausal woman. Dialogues in Oral Contraception, 1, No. 6.Google Scholar
Costoff, A., (1974) An ultrastructural study of ovarian changes in the menopause. In: The Menopausal Syndrome, p. 12. Edited by Greenblatt, R. B., Mahesh, V. B. & McDonough, P. G.. Medcom Press, New York.Google Scholar
Davies, J.A., (1976) Workshop Report: Estrogens and clotting factors. In: Consensus on Menopause Research, p. 55. Edited by van Keep, P. A., Greenblatt, R. B. & Albeaux-Fernet, N.. MTP, Lancaster.Google Scholar
Drill, V.A., (1972) Oral contraceptives and thromboembolic disease. J. Am. med. Ass. 219, 583.CrossRefGoogle ScholarPubMed
Elkeles, R., Hampton, J., & Mitchell, J., (1968) Effect of oestrogens on human platelet behaviour. Lancet, ii, 315.CrossRefGoogle Scholar
Ellinas, S.P., (1977) Experience with medroxyprogesterone acetate as an injectable contraceptive. Int. J. Gynaec. Obstet. 14, 145.CrossRefGoogle Scholar
Emperaire, J.C., & Greenblatt, R.B., (1969) L'Implantation de pellets d'oestradiol dans la contraception. Gynec. Prat. 5, 327.Google Scholar
Gambrell, R.D. Jr. (1978) The prevention of endometrial cancer in postmenopausal women with progestogens. Maturitas, 1, 107.CrossRefGoogle ScholarPubMed
Gambrell, R.D. Jr, Castaneda, T.A., & Ricci, C.A., (1978) Management of postmenopausal bleeding to prevent endometrial cancer. Maturitas, 1, 99.CrossRefGoogle ScholarPubMed
Geller, S., (1978) La Pilule, 20 Ans Apres. Mediprint, Marseille.Google Scholar
Goldzieher, J.W., & Dozier, T.S., (1975) Oral contraceptives and thromboembolism: a reassessment. Am. J. Obstet. Gynec. 123, 878.CrossRefGoogle ScholarPubMed
Gordon, G.S., & Greenberg, B.G., (1976) Exogenous estrogen and endometrial cancer. Postgrad. Med. 59, 66.CrossRefGoogle Scholar
Greenblatt, R.B., (1952) Dysmenorrhea. In: Office Endocrinology, p. 200. Thomas, Springfield, III.Google Scholar
Greenblatt, R.B., Asch, R.G., Mahesh, V.B., & Bryner, J.R., (1977) Implantation of pure crystalline pellets of estradiol for conception control. Am. J. Obstet. Gynec. 127, 520.CrossRefGoogle ScholarPubMed
Greenblatt, R.B., Hammond, D.O., & Clark, S.L., (1954) Membranous dysmenorrhea: studies in etiology and treatment. Am. J. Obstet. Gynec. 68, 835.CrossRefGoogle ScholarPubMed
Greenblatt, R.B., & Stoddard, L.D., (1978) Estrogen-cancer controversy. J. Am. geriat. Soc. 11, 1.CrossRefGoogle Scholar
Hammond, C.B., Jelovsek, F.R., Lee, K.L., Creasman, W.T., & Parker, R.T., (1979) Effects of long-term estrogen replacement therapy. I. Metabolic. Am. J. Obstet. Gynec. (In Press.)CrossRefGoogle Scholar
Hunter, S.J.D., Akande, E.O., Corr, P., & Stallworthy, J., (1973) The clinical and endocrinological effects of estradiol implants at the time of hysterectomy and bilateral salpingooophorectomy. J. Obstet. Gynaec. Br. Commonw. 80, 827.CrossRefGoogle Scholar
Inman, W.H.W., & Vessey, M.P., (1968) Investigation of deaths from pulmonary, coronary and cerebral thrombosis and embolism in women of childbearing age. Br. med. J. 2, 193.CrossRefGoogle Scholar
Inman, W.H.W., Vessey, M.P., Westerholm, B., & Engelung, A., (1970) Thromboembolic disease and the steroid content of oral contraceptives. A report of the Committee on Safety of Drugs. Br. med. J. 2, 203.CrossRefGoogle Scholar
Jain, A.K., (1976) Cigarette smoking, use of oral contraceptives and myocardial infarction. Am. J. Obstet. Gynec. 126, 301.CrossRefGoogle ScholarPubMed
Kaufman, S.A., (1969) Fertility and conception after age forty. Obstet. Gynec. N.Y. 3, 288.Google Scholar
Larsson-Cohn, U., (1976) Lipids and estrogens. In: Consensus on Menopause Research, p. 51. Edited by van Keep, P. A., Greenblatt, R. B. & Albeaux-Fernet, M.. MTP, Lancaster.CrossRefGoogle Scholar
Lebech, P.E., & Borggard, B., (1974) Serum tipid and antithTombin-III changes effected by synthetic and natural estrogen therapy. In: The Menopausal Syndrome, p. 68. Edited by Greenblatt, R. B., Mahesh, V. B. & McDonough, P. G.. Medcom Press, New York.Google Scholar
Mack, T.N., Pike, M.C., Henderson, B.E., Pfeffer, R.I., Gerkins, V.R., Arthur, M., & Brown, S.E., (1976) Estrogens and endometrial cancer in a retirement community. N. Engl. J. Med. 294, 1262.CrossRefGoogle Scholar
Mann, J.I., & Inman, W.H.W., (1975) Oral contraceptives and death from myocardial infarction. Br. med. J. 2, 245.CrossRefGoogle ScholarPubMed
Mann, J.I., Inman, W.H.W., & Thorogood, M., (1976) Oral contraceptive use in older women and fatal myocardial infarction. Br. med. J. 2, 445.CrossRefGoogle ScholarPubMed
Mann, J.I., Vessey, M.P., Thorogood, M., & Doll, R., (1975) Myocardial infarction in young women with special reference to oral contraceptive practice. Br. med. J. 2, 241.CrossRefGoogle ScholarPubMed
Martinez-Manautou, J., Ramos, R.A., & Giner, J., (1974) The premenopausal woman: her fear of pregnancy and choice of contraception. In: The Menopausal Syndrome, p. 162. Edited by Greenblatt, R. B., Mahesh, V. B. & McDonough, P. G.. Medcom Press, New York.Google Scholar
Mauvais-Jarvis, P., (1978) La contraception, apres 40 ans. Gaz. med. Fr. 85, 3091.Google Scholar
McDaniel, E.B., & Pardthaisong, T., (1971) Return of menstruation and fertility in Thai women after contraceptive injections. J. biosoc. Sci. 3, 209.CrossRefGoogle ScholarPubMed
Netter, A., & Lambert, A., (1975) Etude hormonal preliminaire de la premenopause, In: La Menopause, p. 28. Edited by Bernard, I., Kollenc, M. & Audebert, A.. Imprimerie E. Drouillard, Bordeaux.Google Scholar
Notelovrtz, M., (1977) Coagulation, oestrogen, and the menopause. In: Clinics in Obstetrics and Gynaecology, Vol. 4, p. 107. Edited by Greenblatt, R. B. & Studd, J. W. W., Saunders, London.Google Scholar
Notelovitz, M., (1978) Clotting factors and oestrogen replacement therapy. In: Female and Male Climacteric, p. 103. Edited by van Keep, P. A. & Greenblatt, R. B.. MTP. Lancaster.Google Scholar
Philips, J.M., (1977) Complications in laparoscopy. Int. J. Gynaec. Obstet. 15, 157.CrossRefGoogle Scholar
Punnonen, R., & Rauramo, L., (1976) The effect of castration and oral estrogen therapy on serum lipids. In: Consensus on Menopause Research, p. 132. Edited by van Keep, P. A., Greenblatt, R. B. & Albeaux-Fernet, M.. MTP, Lancaster.CrossRefGoogle Scholar
Royal College of General Practitioners (1977) Oral contraceptive study: mortality among oral contraceptive users. Lancet, ii, 727.Google Scholar
Sherman, B.M., West, J.H., & Korenman, S.H., (1976) The menopausal transition: analysis of LH, FSH, estradiol, and progesterone concentrations during menstrual cycles of older women. J. clin. Endocr. Metab. 42, 629.CrossRefGoogle ScholarPubMed
Smith, D.C., Prentice, R., Thompson, D.J., & Herrmann, W.L., (1975) Association of exogenous estrogen and endometrial carcinoma. N. Engl. J. Med. 293, 1164.CrossRefGoogle ScholarPubMed
Sturtevant, F.M., (1977) Comments on epidemiological studies relating myocardial infarction and oral contraceptives. In: Pharmacology of Steroid Contraceptive Drugs, p. 297. Edited by Garattina, S. & Berendes, H. W.. Raven Press, New York.Google Scholar
Thom, M., Dubiel, M., Kakkar, V.B., & Studd, J.W.W., (1978) The effect of different regimens of oestrogens on the clotting and fibrinolytic system of postmenopausal women. Front. Horm. Res. 5, 192.CrossRefGoogle Scholar
Tietze, C., & Lewit, S., (1970) Evaluation of uterine devices. Ninth progress report of the cooperative statistical program. Stud. Fam. Plann. 55, 1.CrossRefGoogle Scholar
Tietze, C., & Lewit, S., (1977) Mortality and fertility control. Int. J. Gynaec. Obstet. 15, 100.CrossRefGoogle ScholarPubMed
Vessey, M.P., McPherson, K., & Johnson, B., (1977) Mortality among women participating in the Oxford/Family Planning Association contraceptive study. Lancet, ii, 731.CrossRefGoogle Scholar
Ziel, H.K., & Finkle, W.D. (1975) Increased risk of endometrial carcinoma among users of conjugated estrogens. N. Eng. J. Med. 293, 1167.CrossRefGoogle ScholarPubMed