Contraception during the perimenopause

Reliable contraception should be used until menopause is confirmed either by cessation of menses for 2 years prior to age 50, for 1 year after age 50, or by two elevated follicle-stimulating hormone (FSH) values ≥20-30 IU/l while off hormonal methods for at least 2 weeks. Sterility cannot be assumed until at least age 60 because spontaneous pregnancies have been reported in women up to age 59.