June 20, 2025, 1:37 pm | Read time: 5 minutes

Contraception and Age: Two topics closely intertwined yet rarely discussed with the same ease. It’s like fashion: What fits at 20 might pinch at 40—and by 50, comfort suddenly becomes key. We spoke with Dr. Heidi Gößlinghoff, who reveals which contraceptive methods are suitable for different ages. A little spoiler: The answer isn’t always a clear “That one!” but often “It depends…”

Teenagers to Early 20s: “The Pill is Simply Uncomplicated”

When you’re young, you often don’t think about thrombosis—but about freedom, security, and maybe even clear skin. And that’s where the pill comes into play. “The pill is uncomplicated,” says Dr. Gößlinghoff. “Especially for young women with acne, oily skin, or irregular periods, it often has cosmetic benefits.” It’s also a blessing for painful menstrual periods.

And: Contraception with the pill is generally safe—a factor that also reassures mothers. “I would prefer my daughter to use a safe contraceptive rather than become unintentionally pregnant,” the doctor says openly. But beware: The pill is not a candy—those who smoke or have a family history should seek good advice.

Mid-20s to Late 30s: Everything is Possible—But with Caution

At this age, everything is allowed—as long as you know what you’re getting into. The pill is often still a classic here, but not for everyone. “With increasing age, it becomes more complicated with estrogen-containing products, especially if other risk factors like smoking or being overweight are present,” says Dr. Gößlinghoff.

Those who want hormone-free contraception will find good alternatives in the copper IUD, diaphragm, or condoms—with the small catch: You must be consistent. “If you miss ovulation, it can become critical,” warns the doctor. “Then you’re not entirely on the safe side, literally.”

Also interesting: Experience with Copper IUD: “I Definitely Don’t Want to Go Back to the Pill!”

From 35: Hormones? Yes and No!

From the mid-30s, the rule is: If you smoke, you should say goodbye to estrogen-containing pills. “In the past, textbooks said: No more pills for women over 35 who smoke,” says Dr. Gößlinghoff—and adds: “But at 35, you’re not beyond the pale.”

Many women switch to progestin-only products at this stage of life. By the way, the mini-pill today no longer requires precise alarm clock timing. “It now comes with a 12-hour intake window—so it’s practical for everyday life!” Those who want to stay hormone-free are well served with the copper IUD & Co.—provided they tolerate it.

From 40: Time for New Options

The older you get, the more difficult hormonal contraception becomes—especially when estrogens are involved. The risks increase, such as for thrombosis. But no need to panic! “Progestin-containing methods like the hormonal IUD or an implant are a good alternative,” says Gößlinghoff. The downside: The period often stops completely—which can be unsettling for some women.

However, there are advantages: “If women suffer from migraines during the pill break, a progestin product can help with the constant hormone levels—without these hormonal roller coasters.”

From Mid-50s: Please Without Estrogens

“I actually had a patient who was still taking an estrogen-containing pill in her mid-50s,” says Dr. Gößlinghoff. “I said: If your general practitioner is okay with it, fine—but I will inform you about the thrombosis risk.”

By this age, you should definitely consider alternatives—such as progestin products or mechanical methods like the copper IUD, diaphragm, or cervical cap.

What to Do When a Desire for Children is in Sight?

If a honeymoon or long-awaited trip to Bali is coming up, but a baby should wait, Dr. Gößlinghoff recommends short-term methods. “Then better hormone-free—condoms, diaphragm—the main thing is not to disrupt the cycle.”

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Health, Lifestyle & Co.—These Should Be Considered

Those who smoke, are significantly overweight, or suffer from conditions like endometriosis should discuss the appropriate method particularly carefully with their doctor. “For endometriosis, I recommend pure progestin products—estrogens would only feed the lesions,” says Dr. Gößlinghoff.

And if you are on long-term blood-thinning medication, it might be sensible to use a hormonal method without a monthly period.

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Contraception is (Also) a Matter of Type

Whether hormonal or mechanical, short-term or long-term, with or without a period: The selection is vast—and depends on age, lifestyle, and personal comfort zone.

Or as Dr. Gößlinghoff sums it up: “There is no standard model. It’s like shoes—what pinches, isn’t worn.” And yes: The topic of contraception by age may be complex—but with a bit of information and honest advice, the right solution is usually closer than you think.