Women over the age of 40 urged to take contraception

Women over the age of 40 are less likely to present for smear tests and are also more likely to consider that they do not need contraception, the Dublin Well Woman Centre has said in its annual report.

The trend in relation to smear tests has been described as "worrying", according to the centre's chief executive Alison Begas.

She also warned that many women over 40 who are still sexually active should not stop taking contraception. There were 223 births last year to women over 45 in the State.

“We would see a lot of women coming up to menopause. Even in the year before they officially stop having their periods or the year or two afterwards, they should carry on taking contraception,” she said.

Ms Begas said they had come across women who were surprised to become pregnant in their forties. “They thought it definitely shouldn’t happen to them,” she said. “We have women coming in seeing our pregnancy counsellors saying ‘my God, I didn’t think I would be in this position’. At that stage they are not thinking of being mothers to young babies.

“If their periods stop before they are 50, they should carry on taking contraception for two years. That is the standard practice.”

The Dublin Well Woman Centre medical director Dr Shirley McQuade said there was a “ worrying trend” of women not reporting over the age of 40 for cervical tests.

The average age for the diagnosis of cervical cancer is 44 and the average age of death is 55.

“There are minor changes that can progress to major changes over 10 years. If the minor changes can be detected, it makes it easier to treat,” she said.

In the 18 to 29 age group, almost 80 per cent of women are presenting for a smear test. That figure drops to below 70 per cent for women over the age of 40 and for women over the age of 60 it is less than half.

Dr McQuade said this was an international trend and down to a number of factors.

“ A lot of women are generally fit and healthy. They are not going to the doctor and they have stopped taking contraception. Some of them see themselves as too busy. Their priority isn’t their health. They look after everyone else except themselves,” she said.

“ Keeping up to date with regular smear tests is by far the most effective way to for women aged 25 - 60 to protect themselves from this preventable disease.”

The annual report found that Chlamydia continues to be a concern for patients, with over four thousand tests taken in 2013, with 4.6 per cent testing positive for the infection.

In addition, 881 long-acting reversible contraceptive devices (LARCs) were fitted by the Well Woman Centre in 2013, compared to 914 in 2012.

The Dublin Well Woman Centre welcomed the enactment of the Protection of Life During Pregnancy Act, 2013, yet expressed concern over some elements of the legislation.

However, Ms Begas described the legislation as “long overdue”. She accused the Government of presenting legislation which “ fails to deliver a compassionate response to women dealing with a fatal foetal abnormality.

“Learning that a much-wanted baby has a fatal foetal condition is not the fault of the woman, but the lack of compassion in the State’s response to those women clearly places it at fault.”

The Well Woman Centre provides a wide range of primary health care services, family planning, counselling and sexual health services to women and men. The organisation employs nearly 50 doctors, nurses, counsellors and administration staff at three locations in Dublin - Liffey Street, Pembroke Road and Coolock.