Women over 35 years old are typically less fertile than their younger counterparts, and their cycles can start to become irregular. This makes it hard for women to predict when ovulation occurs and often results in unplanned pregnancies. It’s important to continue some form of birth control until you’ve been period-free for a whole year. There are some risks that are more common in older women than in the under-35 women.  The greatest risk to women over 39 using hormonal contraception is venous thromboembolism or blood clots. The risk is approximately 4 times higher than for adolescents and is almost 8 times higher in obese women over 39. In these higher risk women, progestin-only pills containing levonorgestrel or norgestimate or an IUD are much safer options.You should also avoid birth control pills if you smoke, have hypertension, are diabetic, or have migraine headaches with auras. The pills can put you at risk for heart attacks and stroke. One rumored risk that turned out to be unsubstantiated was the idea that oral contraceptives increase your risk for breast cancer. In fact, several studies have shown no increased risk for women using combination pills or progestin only pills. Birth control pills have also been shown to reduce the risk of ovarian, endometrial and colorectal cancers to varying degrees.The Depo-Provera shot has been linked to bone loss and breast cancer in women, so is not recommended for women over 39 who are typically starting to lose their protective hormones.  Birth control pill use, on the other hand, has been shown to reduce the risk of hip fracture among postmenopausal women by 25% by increasing bone mineral density.Hormonal contraception may also ease hot flushes and other menopausal symptoms. The pills have low doses of hormones and are often an effective way of preventing pregnancy and controlling the occasional hot flush with one prescription.At what age should hormonal contraception be discontinued? The age at which you no longer need birth control will be different for every woman. An elevated FSH can be one sign of menopause, but that level can be artificially depressed by birth control pill use. Having no periods for one year would be a sign you no longer need birth control. Birth control pills are usually safe in healthy women up to 50 years old. Ask your doctor to be sure before you stop birth control.