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Birth Control After 35: What Are Your Options?

Kristin Hall

Reviewed by Kristin Hall, FNP

Written by Nicholas Gibson

Published 08/31/2020

Updated 09/01/2020

As you enter your 30s and 40s, it’s normal for your body to start to change. With this change can come new health risks, including certain risks associated with hormonal methods of birth control such as the pill, the patch and the ring.

For most women, it’s safe to continue using the birth control pill as you go into the second half of your 30s. However, there are a few things you should be aware of, as well as several health risks that you need to know about if you smoke or have certain health conditions.

Below, we’ve explained everything you need to know about your birth control options after you reach the age of thirty-five. We’ve also looked at the relationship between your method of birth control and your general reproductive health during your thirties.

The birth control pill, patch and other common methods of hormonal birth control have a variety of benefits. If you're not sure which is right for you, we have guides on that such as Ortho Evra vs. Xulane.

The biggest of these is their ability to lower your risk of becoming pregnant. Used perfectly, most birth control pills are up to 99 percent effective (and 91 percent effective with normal use) as a form of contraception. But preventing pregnancy isn’t the only benefit of hormonal birth control. 

Certain birth control pills can also:

  • Treat and prevent acne, including inflamed and cystic acne, by controlling your body’s production of acne-contributing hormones.

  • Make managing your period easier by giving you a consistent and predictable 28 day menstrual cycle, shortening your period and reducing menstrual cramps.

  • Reduce your risk of developing certain diseases, such as ovarian cysts and ovarian cancer.

  • Treat the symptoms of some conditions, such as endometriosis and polycystic ovary syndrome (PCOS). 

In addition to reducing your risk of pregnancy, these are all good reasons to continue using birth control as you get older.

Hormonal methods of birth control such as the pill and the patch are safe for most women aged 35 and up. In fact, most healthy women can safely continue using the birth control pill until they reach menopause. 

However, some health risks associated with hormonal birth control become more of a risk after 35, especially if you’re a smoker or have a history of certain health conditions. 

If you’ve been using the birth control pill for more than a decade — which is quite likely once you enter your mid 30s — it’s also important to be aware of the potential effects that long term use of hormonal contraceptives could have on your health. 

We’ve covered these below, including the specific conditions that can become more common in your 30s and 40s. 

Hormonal Birth Control and Breast Cancer

First, while the relationship between birth control and breast cancer isn’t totally known, long term use of hormonal birth control such as the pill is associated with a slight increase in your total risk of developing breast cancer. 

However, the increase in breast cancer risk from the pill is very, very small. Rates of breast cancer are very low in women under the age of 40, meaning there’s no need to panic if you’ve used the pill or other hormonal birth control for a long time. 

It’s worth noting that many of the studies used to correlate the relationship between the pill and breast cancer involved women who used older, first-generation birth control pills, which typically contained a larger dose of hormones than modern pills. 

It’s also worth noting that the pill actually reduces your risk of developing other cancers, such as ovarian and endometrial cancer. 

If you have a family history of breast cancer, it’s important to inform your healthcare provider about this when you discuss birth control options. 

Depending on your risk, your healthcare provider may suggest switching to a progestin-only birth control pill, or mini-pill, which is less associated with breast cancer. 

Hormonal Birth Control and Blood Clots/Stroke

The birth control pill does not cause blood clots. 

However, it is associated with an increased risk of blood clots. Data from the National Blood Clot Alliance indicates that certain birth control pills can increase your risk of developing a blood clot by about three to four times.

As we covered in our guide to birth control side effects, blood clots from the birth control pill are extremely rare. Research indicates that only one in every 1,000 women per year who take birth control pills will develop a clot.

This means that your risk of experiencing a blood clot while using the pill is very small. 

However, it’s important to be aware of any health risks that could increase your risk of blood clots or other cardiovascular side effects from the pill as you enter the second half of your thirties.

Although the risk is low in your 30s, blood clots, heart attacks and other serious cardiovascular issues become significantly more common with age. 

If you have high blood pressure or a family history of heart disease, it’s important to inform your healthcare provider when you discuss birth control. 

If you’re a non-smoker with no history of high blood pressure, blood clots, deep vein thrombosis, diabetes, breast cancer or other health conditions, it’s normally completely safe for you to keep using the birth control after you reach the age of thirty-five.

To be safe, it’s a good idea to use your 35th birthday as an opportunity to touch base with your healthcare provider and discuss your use of birth control. 

Depending on your health history, your healthcare provider will either give you the all clear to continue using the pill, patch or other form of birth control as normal. 

Alternatively, if you have a risk factor for a certain disease or condition, your healthcare provider  might recommend an alternative form of birth control.

If you smoke, using the birth control pill after you reach the age of 35 can significantly increase your risk of experiencing a stroke or heart attack.

This risk is particularly high if you use a form of birth control that contains estrogen, such as the combination birth control pill. If you smoke, it’s important for you to discuss your use of the birth control pill with your healthcare provider  to make sure you’re safe.

Depending on your needs and health history, your healthcare provider  might recommend an alternative form of birth control that’s less likely to cause cardiovascular issues. 

Worried about the health risks of smoking while you use birth control? Our guide to birth control and smoking goes into more detail on how smoking can affect your health as a user of hormonal birth control, as well as what you can do to manage these risks. 

Even if you’re a non-smoker, it may not be safe to continue using your current birth control pill after the age of 35 if you have an existing health condition.

If you have a history of high blood pressure or other cardiovascular issues, it’s important to talk to your healthcare provider  about the risks of continuing to use birth control. 

To reduce your risk of stroke or blood clotting, your healthcare provider may recommend a progestin-only pill or non-hormonal birth control. 

Other health conditions that can affect the safety of birth control after 35 include diabetes, liver disease and migraine headaches. 

If any of these conditions are relevant to you, make sure to discuss them with your healthcare provider  to find out which contraceptive options are safe for you.

birth control pills

access to birth control shouldn’t feel like an obstacle course.

If you’ve recently given birth and want to start using birth control again, it’s important to talk to your healthcare provider  about your options. 

This is because some forms of birth control, particularly those that contain estrogen, can affect your ability to produce milk. 

Depending on your needs and health history, your healthcare provider  may recommend a progestin-only pill, which is less likely to affect your milk supply, or a non-hormonal form of contraception. 

If you’re planning to start a family but haven’t yet taken action, it’s important to understand how aging and birth control could affect your fertility as you enter the second half of your 30s. 

While there isn’t a perfect age to get pregnant, it’s common for your fertility to gradually decline in your 30s, particularly after you reach the age of 35. 

For example, according to the American Society for Reproductive Medicine, at age 30, a healthy and fertile 30-year-old woman attempting to get pregnant has an approximately 20 percent chance of success every menstrual cycle. 

By age 40, this chance declines to less than five percent per menstrual cycle, making it harder to successfully become pregnant. The risk of miscarriage, genetic disorders and other potential issues also begins to rise as you reach your mid-to-late thirties. 

If you’re planning to start a family, your healthcare provider  might recommend a form of birth control that lets you quickly restore your fertility if needed. 

Certain options, such as the birth control pill, patch or ring, all allow you to quickly return to ovulation in the event that you want to become pregnant.

Longer-term forms of hormonal birth control, such as the Depo-Provera® injection or the implant, can affect your fertility for a longer period of time and make it more difficult to become pregnant in the near future. 

birth control pills

access to birth control shouldn’t feel like an obstacle course.

If you’re a healthy non-smoker with no history of heart issues, high blood pressure, diabetes or migraines, it’s generally safe to continue using hormonal birth control after thirty-five. 

However, like anything else related to your health, it’s best to discuss your continued use of the pill, patch or other hormonal birth control with your healthcare provider. They’ll be able to provide an expert’s opinion on your best birth control options for the future. 

If you’re a smoker or someone with a history of cardiovascular health issues, diabetes or other health conditions, talk to your healthcare provider about your use of hormonal birth control. Your healthcare provider may prescribe a safer, lower-dose or non-hormonal form of birth control with fewer health risks. 

For more information about birth control side effects and safety, read our guide to the common and uncommon side effects of the pill.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kristin Hall, FNP

Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership. 

She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH

Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare. 

Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.

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