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How can I tell if my 54 year old patient on Depo-Provera, is menopausal? #1038

I have a 54 year old patient on Depo-Provera. How can I determine when she is menopausal and past the need for contraception?

Good, useful information

Carolyn Norris, ARNP, Allen Women's Health, Waterloo, IA

FSH levels can rise in the late reproductive years or in her pre-menopausal years when a woman can become pregnant so an elevated serum FSH level is definitely NOT clear evidence that a woman is menopausal.


            At age 54, I would recommend using Depo-Provera until age 55 and then stop.  Pregnancy is very, very unlikely over the age of 55 without fertility drugs.  (It is very unlikely even with fertility drugs).  The very oldest woman to become pregnant spontaneously and carry a pregnancy to term was 57 years and 120 days when fertilization occurred.  After stopping Depo, if she has no period for a year you have your answer, she is menopausal.


            In any case, encourage your patient to take calcium supplementation, vitamin D supplementation, and to get regular weight bearing exercise.  Also encourage her to quit smoking if she does smoke. 


            Some women choose to use condoms until they have gone one year without a period.


            At what age can a woman stop contraception without fear of pregnancy?  According to Dr. Sarah Bergha at Emory, a 50 year old woman who uses no contraceptive has a 1 in 100,000 chance of becoming pregnant.  At age 44 women who have unprotected intercourse have a chance of only 1 in 10,000 of becoming pregnant. 


Reply on 11-10-2005:

Our patient has continued to use Depo.


Please read the following question from our website:

How does one diagnose menopause in a woman on Depo-Provera? #618/6  Click here



Key Words:  Depo-Provera, menopause, contraception


Posted 11-19-2005, Updated 6-25-2006, Updated 2-12-8-2008




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Robert A. Hatcher MD, MPH
Emeritus Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA

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