During perimenopause from your early 40s until menopause the birth control methods you used in the past may not be appropriate.

Examples: if you have high blood pressure or a history of breast cancer, smoke or are obese, your doctor may recommend against hormone-based contraception and natural family planning is less reliable now that menstruation is irregular. Ask your doctor about the risks and benefits of the following options (all prices are approximate). If you're looking for…

  • Convenience—try an intrauterine device (IUD), a small t-shaped plastic device. A doctor inserts it into the uterus...then you simply place a finger inside your vagina monthly to feel for a string indicating that the IUD is still in place. The Mirena IUD contains a progestin hormone, can be left in for five years and often makes periods lighter. A nonhormonal IUD with copper, called ParaGard, lasts 10 years but may make periods heavier.

Cost: $400 to $500.

Alternative: Implanon is a matchstick-size plastic rod with a progestin that a doctor inserts under the skin of your arm. It works for three years. Periods often become irregular.

Cost: $600 to $700.

  • No monthly periods—try a continuous-use estrogen/progestin oral contraceptive, such as Lybrel or Seasonique.

Bonus: no menstrual migraines or cramps.

Cost: $50 to $70 a month.

  • PMS relief-try Yaz. This oral contraceptive, which combines a very low dose of estrogen with the progestin drospirenone, may alleviate premenstrual depression and irritability.

Bonus: lighter periods.

Cost: $50 to $70 a month.

  • More comfortable sex—try NuvaRing, a low-dose estrogen/progestin vaginal ring that increases vaginal lubrication and often decreases menstrual flow). You insert it yourself every four weeks.

Cost: $40 to $70 a month.

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