Contraception carelessly shunned by women over 40 leading to more abortions

Although the menopause typically hits women at about the age of 50, a good number of women experience this ‘change of life’ in their 30s or 40s, where their ovaries no longer produce eggs, monthly periods are no more and it is very unlikely the woman will become pregnant.

Therefore, this could be behind an increasing number of women in their 40s undergoing abortions, as their attitude towards contraception and fertility becomes more lax in comparison to women in their 20s.

According to abortion provider The British Pregnancy Advisory Service (BPAS), over four in ten women over the age of 40 who undergo an abortion have carelessly not been using any contraception. Despite being younger and viewed as potentially more immature, less than one in three women in the 20 to 24-year-old age bracket found to not be using contraception then went for an abortion.
In 2002 there was 6,531 abortions carried out for women aged between 40 and 44, but by 2012 this had soared to 7,737.

BPAS say a large number of women are under the impression that by their 40s, it is so difficult to fall pregnant that they can avoid using any contraception altogether. This is inexplicable and quite absurd when considering the wide variety of options out there for women in the present day, such as Dianette, Marvelon, Yasmin, Zoely, or the Levonelle 1500 morning after pill – an emergency contraception pill that can be taken within 12 hours of unprotected sex and no later than 72 hours after.

In addition, experts also say that as women are commonly warned about a lower chance of motherhood in their 30s due to declining fertility, this message has been taken to extremes and now means women older than this are simply foregoing safe sex in the assumptions they will not become pregnant.

Prof Neil McClure, Professor of Obstetrics and Gynaecology at Queen’s University Belfast, says: “Women should not rely on their increasing age as a method of contraception.”

BPAS are responsible for conducting the majority of abortions in Britain paid for by the NHS, with more abortions seen for women aged over 35 than for females under the age of 18.

Ann Furedi, bias Chief Executive said: “Over the past few years we have seen much scaremongering about older women’s fertility. From ‘career women’ leaving it too late to older women ‘banking on IVF’ to conceive, these stories lead many women to dramatically underestimate their own fertility later in life.

“At bpas we see more women over 35 with unplanned pregnancy than we do women under 18. We know from speaking to women that stories and campaigns suggesting it’s hard to get pregnant after 35 – even if well intentioned – are having a real impact on women’s perception of their own fertility, and therefore their use of contraception. Women deserve accurate, impartial information to make their own choices about family planning in their 30s. Fertility does decline as you get older, but the drop is not as great as we are sometimes led to believe. For women who don’t want to fall pregnant the message is simple: use contraception until you have passed your menopause.”

Prof McClure added: “The message needs to be that fertility is lower in older women when compared with younger women, that fertility does decline after the age of 35 but women over the age of 35 are still fertile and need to use contraception right up to the menopause if they do not want to conceive.”
Data from the Office of National Statistics show that since 1990 there has been more than a double rise in the conception rate for the over-40s, jumping from 6.6 to 14.0 conceptions for every thousand women. The number of over-40s becoming pregnant increased from 12,032 in 1990 to nearly 29,000 by 2011, whilst conception rates in women aged 35 to 39 almost doubled in the same time frame.

Schools should provide free morning after pills and condoms, says NICE

New guidance published by the National Institute for Health and Care Excellence (NICE) has called for schools to offer free morning after pills and condoms to teenage girls to reduce teenage pregnancy rates. NICE even recommended those under the legal age of consent should be provided with contraception.

The guidance aims for more accessible emergency contraception for under-25s; not just contraceptive pills and condoms but also the IUD (intrauterine device, or coil).

The new plans will involve qualified nurses, including school nurses, and pharmacists being able to offer free-of-charge emergency contraceptive pills in accordance with patient group directions (PGDs).

Under PGDs, health workers are able to give medicine directly to the patient without a prescription being required.

Emergency contraceptive pills include Levonelle 1500, which if taken within 72 hours (3 days) of sexual intercourse, will usually prevent pregnancy. Levonelle 1500 can be taken following unprotected sex or if a condom has accidentally come off or split and is available right now from Medical Specialists™ Pharmacy for just £22.50.

Alternatively, women can take ellaOne within 120 hours (5 days) and an IUD may be inserted up to five days following unprotected sex.

The guidance called for young women to be ‘encouraged to consider and choose a suitable form of contraception for their future needs’.

NICE also say that in accordance with best practice guidance, health professionals that are providing emergency contraception should understand they are able to give it to under-16s even without the knowledge or consent of the child’s parent(s).

“Health professionals, including pharmacists, who are unwilling (or unable) to provide emergency contraception should give young women details of other local services where they can be seen urgently”, the guidance states.

Professor Mike Kelly, director of the centre for public health at NICE, said: “It is really important that sexual health services offering information and advice can be found in places where young people have access to them. Evidence clearly shows that the availability of contraception reduces the rate of unwanted pregnancies. Local planners and providers of services must make sure that what they offer is right for their area.”

He added: “Young people often find contraceptive services and advice difficult to locate. This can be for a number of reasons. They may not know where services are, who provides them or when they are open. They can also be wrongly worried that information they give may not be treated confidentially. For that reason, this guidance focuses on ensuring they receive culturally sensitive, confidential, non-judgmental and empathic advice and support tailored to their individual needs.”

Last month saw the Office for National Statistics release figures showing UK pregnancy rates amongst under-18s is at its lowest since 1969 at 27.9% per 1,000 women aged 15 to 17.

It seems things are improving steadily with the number of pregnancies within under-18s dropping to 27,834 in 2012 from 31,051 in 2011, a decrease of around 10%. Meanwhile, 5,432 under-16s became pregnant in 2012, compared with 5,991 in 2011, a decrease of 9.3%.

The astonishing wonders of the female contraceptive pill Yasmin

With so many versions of the contraceptive pill currently available, it may be a little confusing and even daunting for many women when trying to decide exactly which is the right choice for them.
Many people may not be aware, but ‘The pill’ first came to prominence 56 years ago (1956) in Puerto Rico and in the present day there are approximately 3.5 million women in the UK alone who choose this as a contraception method.

Contraceptive pills are chosen often in conjunction with the male still wearing a condom as normal in what could be regarded as a ‘belts and braces’ safety precaution. More and more women could turn to contraceptive pills for their incredibly high rate of pregnancy prevention.

Another persuasive factor could also be the fact that only two months ago, the Implanon contraceptive implants hit headlines for all the wrong reasons when it was revealed that the small biodegradable rod had become lost within the body of hundreds of women after doctors are struggling to locate them, leaving the woman infertile.

Long term patients with Medical Specialists Pharmacy may already be aware that we have provided oral contraceptive treatment for women for a number of years now, in the form of the wonder drug Dianette. For those unfamiliar with Dianette, it is a pill taken by women for everyday for 21 days of their menstrual cycle, followed by a 7 day break when no pills are taken at all (also known as ‘cyclic treatment’). During this break, women are still protected against unwanted pregnancies. In the 7 day rest period, hormone levels in the blood begin to decrease and women will experience a withdrawal bleed that is just like a normal period. Regardless of bleeding, the next pack of 21 tablets is begun after the week is up.

However, there are now more options than ever for women in regards to contraception. One such option is another contraceptive pill, named ‘Yasmin’. Taken by thousands of women across the UK and even millions more worldwide, it has recently been introduced by Medical Specialists along with Marvelon and the Morning after pill, Levonelle 1500.

A Yasmin tablet contains two active ingredients; ethinylestradiol and drospirenone. These are synthetic forms of the naturally occurring female sex hormones, oestrogen and progesterone. The drospirenone within Yasmin works as a diuretic, meaning it helps to flush the body of excess fluid and reduce the symptoms of bloating which stem from this problem that arises when a woman is pre-menstrual. One tablet is taken every day for 21 days and you then have a seven day break from pill-taking, exactly the same as Dianette.

In addition to battling the problems of water retention, Yasmin can also help to maintain or even lose weight and just like Dianette, has been shown to be incredibly effective at easing skin conditions such as acne.

Don’t take our word for it though, this is what Dr Diana Mansour, head of fertility services for Newcastle Primary Care Trust, had to say about Yasmin: “It is not unusual for women to come back to us and say that Yasmin is the best contraceptive option they’ve had so far. Some of the other contraceptive pills they’ve been on have made them feel awful. Women have not only put on weight but have felt moody, too. If you ask women why they give up taking the pill, it is usually the side-effects, or perceived side-effects, and one of those is weight gain.”

In fact, trials conducted in June 2000 pitted Yasmin against Microgynon 30; another main contraceptive pill used by women in the UK. Both contraceptives were found to improve acne symptoms. However, it was discovered that women taking Yasmin actually lost between 1lb 10oz and 3lb 10oz over the course of a year. In comparison, women taking Microgynon 30 managed to put on 1lb 8oz.

One delighted user of Yasmin is 28-year-old Kathy Hart, a marketing director based in Kent. At aged 17, Kathy began to take the low dose contraceptive pill Mercilon. Initially happy, she began to gain weight with Mercilon. Kathy says: “But after ten years I started to gain weight and at that point the low dosage pill was no longer deemed suitable. I started to get intermittent bleeding between periods, tender breasts, awful headaches and a real feeling of bloatedness – something I’d never experienced before. I was about to get married at the time, so was under a lot of personal stress. The condition of my skin deteriorated and I started getting lots of spots, which left me feeling very depressed. It felt like a nightmare vicious circle. When you’re getting married, you’re desperate to look like a princess – but my body seemed be refusing to cooperate. At one point I thought I would not be able to fit into my wedding dress because I was so bloated all of the time. Eventually, I decided I’d had enough and went to see a family planning adviser. After listing all my problems, she mentioned the new contraceptive pill, Yasmin. I was told Yasmin would help my skin look better, that my hair would be less oily and more glossy, and, most importantly, that it would help stop the bloating. Although it wasn’t available on prescription at the time, I was told I could take it on a trial basis. I didn’t even hesitate. The combined package of benefits was exactly what I needed. I jumped at the chance. For the first month of taking it, I actually felt quite nauseous and the pills didn’t seem to agree with me at all. But my family planning adviser said that the nausea was completely normal. I’d been taking a different contraceptive pill – and therefore a different drug – for nearly ten years, so there was bound to be an adjustment period. After the first month, the improvement was fantastic. I stopped getting the “spotting” between periods, and over the next few months my skin cleared completely. It helped me regain all the confidence I’d lost. Now, 13 months on, I’m 100 per cent happy with Yasmin and I recommend it to all my friends. The base level benefits – such as not getting pregnant and the cycle control – work exactly as they should. But above and beyond that is the fact that Yasmin controls the bloatedness and all the other awful things I was experiencing on my previous contraceptive pill.”
If Kathy’s story wasn’t enough, just listen to what Dr Mansour had to say in her praise of Yasmin, where 90% of the 60 women taking Yasmin prescribed by Newcastle Primary Care Trust, were still on the treatment after three months. Dr Mansour comments: “That’s a much higher rate than with the standard pill we prescribe, Microgynon 30, when only 78 per cent of patients are still taking it after three months. Basically, if you’re using a pill that actually has a health benefit, then you’re much more likely to stick with it and the women we’ve prescribed Yasmin to, are far happier using it than previous contraceptive pills they’ve been on.”

So, there you have it. We hope women now feel a little more clued up about the wide range of contraceptive pills that are available, and the added benefits that some of them have besides their primary purpose. For further information though, feel free to visit the Women’s Health section of the Medical Specialists website where we offer female contraceptives such as Yasmin, Marvelon, Dianette and Levonelle 1500 (Morning after pill), as well as medications for other conditions such as female hair loss and sexual health.