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DMPA over 50 — DFSRH MCQ

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HardProgestogen-only contraceptionDMPA over 50DFSRH

A 51-year-old has used DMPA for 8 years and requests another injection. She is amenorrhoeic and has vasomotor symptoms. What is the best approach?

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Correct answer: A — Review DMPA and discuss switching contraceptive method

The best answer is “Review DMPA and discuss switching contraceptive method”. FSRH advises people over 50 using DMPA to consider an alternative because of age-related bone and cardiovascular considerations. Amenorrhoea on DMPA cannot diagnose menopause, so contraception should not simply stop. If, after individualised counselling, she chooses to continue, the benefits and risks should be reviewed regularly rather than applying an automatic age cut-off.

Reference: CoSRH/FSRH, Contraception for Women Aged Over 40 Years (amended May 2025): https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-guideline-contraception-for-women-aged-over-40-years.pdf