The menstrual cycle
The monthly loss of the lining of the womb (the endometrium) is known as your period and is accompanied by bleeding if you are not pregnant. Menstruation is the conclusion of a number of hormone interactions in your menstrual cycle. At the start of your cycle, estrogen hormone makes the lining of your womb thicken in preparation for the possibility of fertilization. In the middle of your cycle, ovulation (the release of an egg) is accompanied by an increase in the release of progesterone hormone that causes the cells of the womb lining to swell and thicken with fluid. These changes enable a fertilised egg to implant in the womb.
If fertilization does not take place, the production of estrogen and progesterone from the ovaries starts to fall, and the womb lining is shed around 14 days after the start of ovulation. Womb contractions force the womb lining to be expelled into the vagina during your period. The menstrual cycle, which is counted from the first bleeding day to the last day before your next period, lasts on average 28 days, and the average length of bleeding is 5 days.
The aim of a long-acting reversible contraceptive (LARC) is to prevent fertilization. Other sections of this website provide detailed information on how each long-acting contraceptive works.
The menopause, which is sometimes referred to as the 'change of life', is a time in your life that is marked by the gradual cessation of menstruation, i.e. when you stop having periods. This doesn’t happen suddenly but you’ll notice that your periods become less frequent, the odd period is missed and finally they stop altogether. If you haven’t had a period for one year then you have reached the menopause.
Do women still need contraception if they have menopausal symptoms?
During the time leading up to the menopause (the perimenopause) the hormonal and biological changes that are associated with the menopause begin. As a result of these hormonal changes, many women experience both physical and emotional symptoms, such as hot flushes, night sweats and irritability.
The menopause is also when you stop producing eggs as a result of falling levels of the female sex hormone estradiol, which regulates your periods.
As it is possible to get pregnant after the menopause, you should carry on using contraception for 2 years after your last period if you are under 50 and for one year if you are over 50.