Should You Change Your Birth Control Pill at 40? Expert Advice

Birth control pills

Dear Dr.
Lin,
I am 40 years old and have 2 children.
I have been taking "Diane-35" for 6 years already.
Does it need to be changed?
1.
Is the dosage of "Diane-35" too high for a 40-year-old woman? Does it also have the function of adjusting facial skin?
2.
Should I take a break after long-term use? For example, a three-month break after three years?
3.
Would switching to "Mercilon 28" (Organon Oss Holland) be more appropriate? Will there be any differences in my body condition?
Please help clarify these questions.
Thank you!
16/03/2004

Huang, 40~49 year old female. Ask Date: 2004/03/16

Dr. Lin Zhaopei reply Obstetrics and Gynecology

1.
Diane oral contraceptive contains 2 mg of cyproterone acetate and 0.05 mg of ethinyl estradiol.
The former can suppress the body's male hormones, leading to improvements in acne and sebaceous gland secretion, while also inhibiting ovulation, thus achieving contraceptive effects.

2.
Some women who take this medication long-term may develop melasma, especially exacerbated with sun exposure.
If this condition occurs, a direct switch to another medication can be made without the need to pause for three months.
3.
Mercilon contains 0.15 mg of desogestrel and 0.02 mg of ethinyl estradiol, classified as a low-dose contraceptive, which has a lower risk of vascular complications and may also be considered for use.

Reply Date: 2004/03/16

More Info

When considering whether to change your birth control pill at the age of 40, there are several factors to take into account, especially given your history of using Diane-35 for six years. Diane-35 is a combined oral contraceptive pill that contains both estrogen and progestin, and it is often prescribed for its benefits in regulating menstrual cycles and treating conditions like acne. However, as women age, particularly around the age of 40, the risk factors associated with hormonal contraceptives can change.

1. Dosage and Suitability: At 40, the dosage of Diane-35 may still be appropriate for you, but it is essential to evaluate your individual health profile. The estrogen component can increase the risk of blood clots, especially in women who smoke, are overweight, or have a family history of thromboembolic events. It’s crucial to discuss your current health status with your healthcare provider to determine if the dosage is still suitable or if a lower-dose pill might be more appropriate.

2. Skin Benefits: Diane-35 does have properties that can help improve skin conditions, such as acne, due to its anti-androgenic effects. If you have noticed improvements in your skin while on this pill, it’s worth discussing with your doctor whether these benefits can be maintained with an alternative contraceptive method.

3. Breaks from Hormonal Contraceptives: Long-term use of hormonal contraceptives does not typically require a mandatory break, but some healthcare providers recommend a "pill-free" interval to assess natural menstrual cycle patterns and overall reproductive health. A common suggestion is to take a break for a few months every few years, but this should be personalized based on your health and family planning goals.

4. Switching to Mercilon 28: Mercilon is another combined oral contraceptive that contains a different formulation of estrogen and progestin. It may be considered a suitable alternative, especially if you are looking for a lower dose of estrogen. However, switching to a different pill can lead to different side effects or benefits, so it’s essential to monitor how your body responds to any new medication.

5. Health Monitoring: As you transition into your 40s, regular health check-ups become increasingly important. Conditions such as hypertension, diabetes, and other chronic illnesses can influence the choice of contraceptive methods. Your doctor may recommend regular screenings for these conditions, especially if you have risk factors.

6. Non-Hormonal Alternatives: If you are concerned about the risks associated with hormonal contraceptives, you might want to explore non-hormonal options such as copper IUDs, barrier methods, or fertility awareness methods. These can be effective and may alleviate concerns about hormonal side effects.

In conclusion, it is advisable to have a thorough discussion with your healthcare provider about your current contraceptive method, any side effects you may be experiencing, and your overall health as you approach 40. They can help you weigh the benefits and risks of continuing Diane-35 versus switching to another method like Mercilon 28 or exploring non-hormonal options. Regular monitoring and open communication with your healthcare provider will ensure that you make the best decision for your reproductive health.

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