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Perimenopause stopping contraception — DFSRH MCQ

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ModerateContraception in special circumstancesPerimenopause stopping contraceptionDFSRH

A 48-year-old woman using condoms asks when she can stop contraception. She has not had a period for 9 months, has vasomotor symptoms, and is not using hormonal contraception. What would you advise this patient?

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Correct answer: B — Continue until 24 months after the last menstrual period

The best answer is “Continue until 24 months after the last menstrual period”. For someone under 50 who is using non-hormonal contraception, contraception should continue until 2 years after the last menstrual period. Vasomotor symptoms and 9 months of amenorrhoea do not yet meet that rule. A single FSH measurement is not a routine stopping test in this situation, and starting CHC at age 48 requires its own eligibility assessment.

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