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The question

At what age is it reasonable for a woman to think that she's no longer at risk of becoming pregnant? I'm in my mid-40s and am thinking it's about time to stop using my birth control pills. Is it safe now or should I wait?

The answer

In general, your child-bearing years usually end approximately 10 years before the onset of menopause. This is the time in a woman's life when hormonal changes cause her periods to stop and the body is no longer able to get pregnant. The age of menopause varies from woman to woman, but the average age in Canada is 51, according to the society of obstetricians and gynecologists of Canada .

It is only reasonable for a woman to think she is no longer at any risk of becoming pregnant when she reaches menopause. While the risk of pregnancy decreases significantly after 40 (when cycles become irregular and ovulation is unpredictable), there is still a chance of getting pregnant until menopause is reached.

Another thing you may want to consider is that the potential consequences of an unplanned pregnancy for a woman in her 40s carries risk for both the mother and baby. Birth defects, pregnancy complications and miscarriage are more common for women who get pregnant later in life .

Considering the potential risks, it is best to use some form of contraception unless you have officially entered menopause. If you're not comfortable with your birth control pills, consider other options non-hormonal methods, such as condoms or the intrauterine device (IUD).

The benefits of the Pill, in addition to contraception, is that it can help decrease some of the symptoms of transitioning into menopause such as heavy periods and PMS. However, there are some safety considerations to consider at your age. If you are over 35, smoke and take the combined hormonal birth control pill (contain both estrogen and progesterone), there is a higher risk of blood clots that can be potentially life-threatening.

If this is a concern or you would like to review your risks and other methods for contraception, check in with your health-care provider to discuss the safest options for you.

Send family doctor Sheila Wijayasinghe your questions at doctor@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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