The question that Anna has is not unusual. Even after 40 years, if the woman is healthy, the advantages provided by taking the combined pill usually outweigh the risks. In any case, a medical opinion is still necessary. Some studies have shown that in premenopausal women aged 40 years and older, hormonal contraceptives have not shown any significant effects on bone mass, while they seem to preserve it during the period of time that is closer to the end of menstruation (perimenopause).
The gynecologist can evaluate the cardiovascular risk and the possible impact on the metabolism of the individual woman on a case by case basis, taking into account that as the protective umbrella of estrogen decreases, this risk in women increases, eventually reaching the same levels as a man. You can always use a progestin-only contraceptive.
