Can menopause be confirmed before stopping contraception?

Question

Hello doctor,

I am 52 years old and still have a Mirena IUD (Levonorgestrel-releasing intrauterine system). I have not had proper periods for a long time, so I am confused about whether I have reached menopause or if it is because of the IUD. Can someone at 52 confirm that menopause has occurred before stopping contraception safely?

My gynecologist said blood tests can help but also mentioned that the results may not be accurate because of my IUD. Now I am very confused and do not know what to trust.

I am scared to stop using contraception. What if it is too early and I end up pregnant at this age?
But I also do not want to keep hormones in my body if I no longer need them. Is there any reliable way to confirm menopause, or is it always based on clinical judgment?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

I understand why you feel confused. This is a very common and frustrating situation for women in their early 50s who have a Mirena IUD (Levonorgestrel-releasing intrauterine device), because the device itself can make it difficult to know whether their periods have stopped because of menopause or because of the IUD.

Your concern about an unintended pregnancy is valid because, even though fertility decreases significantly with age, pregnancy can still occur until menopause is confirmed.

The Mirena IUD (Levonorgestrel-releasing intrauterine device) releases a small amount of hormone into the uterus and commonly causes very light periods or no bleeding at all. Because of this, your bleeding pattern cannot reliably tell you whether menopause has occurred.

Blood tests, such as follicle-stimulating hormone (FSH), can sometimes help, but they are not always easy to interpret while using hormonal contraception because the hormones can affect your natural cycle and hormone levels.

There is not always one perfect test that gives an immediate answer. For many women using hormonal contraception, doctors use a combination of factors, including age, the type of contraception, medical history, and sometimes hormone testing.

Many guidelines suggest that women using hormonal contraception continue using contraception until a certain age range when natural menopause becomes very likely, but the exact approach depends on your contraception type and your personal health situation.

Your gynecologist can help decide whether you need to keep the Mirena (Levonorgestrel-releasing intrauterine device), replace it, remove it, or switch to another method while your menopause status is being clarified.

At 52, it is also worth discussing why you still have the Mirena (Levonorgestrel-releasing intrauterine device) and how long it has been in place, because recommendations depend on the insertion date and whether it is being used only for contraception or also for reasons such as heavy bleeding or protection of the uterine lining while taking estrogen therapy.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.