Health Update: Fertile forties

How does a woman in her late forties know whether she is still fertile? Unfortunately, it can be determined only retrospectively - when there has been a clear 12 months since her last period.

Women are commonly advised to continue contraception for 12 months after the last period if they are over 50, and for two years if younger. This rule of thumb can be complicated if a woman is using an oral contraceptive or is taking hormone replacement therapy, both of which can obscure many common menopausal signs.

But many women like to know when they can stop using contraception with no risk of becoming pregnant. While the risk is low in those over 45, relatively few women would welcome a pregnancy when they were, say, 49.

The Drug and Therapeutic Bulletin, published by the Consumers' Association, says that women who want to know for certain could ask for a measurement of their follicle- stimulating hormone level. Women with raised levels are unlikely to conceive; it would be safe for them to use the contraceptive sponge until the menopause is confirmed.