Women in their 40s often ask, "Will it hurt my health if I keep taking birth control pills?"-while women past menopause ask, "Am I at risk because I used to take the Pill?" Here's what you need to know... and what not to worry about.

  • Pregnancy. Women in their 40s may assume that they're too old to get pregnant-yet the unintended pregnancy rate in this age group rivals that of teens.

Current users: For many midlife women, low-dose birth control pills provide safe contraception, make periods lighter and more regular, and minimize mood swings.

Caution: The Pill is not appropriate if you are at high risk for cardiovascular problems (see below)...have a history of breast cancer...or are a smoker over age 35.

  • Cardiovascular problems. For most women, the Pill raises the risk for heart attack, stroke and blood clots only slightly-but significantly increases risk in women already at elevated risk due to smoking, high blood pressure or diabetes.

New finding: The Pill may raise stroke risk in migraine patients.

Current users: If you have cardiovascular risk factors, ask your doctor about pills that contain only progestin (synthetic progesterone hormone). These are less likely than combined estrogen-progestin pills to boost risk.

Past users: Don't worry about past use. Cardiovascular risk drops within weeks after you stop taking the Pill.

  • Benign tumors. Oral contraceptives are linked to liver adenomas, noncancerous growths that carry a small risk for bleeding or becoming malignant.

Current users: If you develop pain or a lump in the upper abdomen, alert your doctor-you may need to stop using the Pill. Rarely, surgery is required.

Past users: Adenomas usually shrink soon after you go off the Pill.

  • Breast cancer. Studies are contradictory. Some suggest that long-term Pill use can raise risk slightly.

Current users: Pregnancy diminishes breast cells' sensitivity to hormonal effects. If you've never been pregnant and have taken the Pill for close to a decade or longer, ask your doctor about using non-hormonal contraception.

Past users: Be extra conscientious about mammograms and breast exams if you took the Pill in the 1960s or 1970s (when doses were higher) or before your first pregnancy...were never pregnant...or stopped taking the Pill less than a decade ago.

  • Ovarian cancer. Ovulation itself contributes to ovarian cancer risk. The Pill halts ovulation, reducing risk.

Current users: For every five years on the Pill, risk falls by 20%.

Past users: Protective effects persist for many years after you go off the Pill. Your long-term risk for uterine cancer and possibly colon cancer also is lower, perhaps because progestin decreases cell growth in these organs.

What Most Doctors Don't Tell Women About Fibroids

Most women who consulted gynecologists about fibroids (noncancerous and sometimes painful uterine growths) were offered surgery to remove the fibroids or uterus. Only 18% of patients were told of minimally invasive uterine fibroid embolization-done by interventional radiologists using X-ray guidance-in which tiny bead-like particles are injected into small blood vessels to block fibroids' blood supply, shrinking growths and easing symptoms.

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