What are the risks of hormonal contraceptive use in middle-aged women?

      We enthusiastically read Ruan and Mueck review of oral contraceptive use in middle-aged women [
      • Ruan X.
      • Mueck A.O.
      Oral contraception for women of middle age.
      ]. They describe in detail some of the issues faced by middle-aged women and review the potential benefits associated with oral hormonal contraceptive (HC) use. They also incorporate an interesting section on age as a risk factor. This is undoubtedly the point that we believe has been the most poorly investigated in the literature and deserves a more thorough review. Herein, we raise a specific question: are there different or greater risks associated with the use of HC in middle-aged women?
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        • Ruan X.
        • Mueck A.O.
        Oral contraception for women of middle age.
        Maturitas. 2015; 82: 266-270
        • Mendoza N.
        • Sanchez-Borrego R.
        Classical and newly recognised non-contraceptive benefits of combined hormonal contraceptive use in women over 40.
        Maturitas. 2014; 78: 45-50