Did you know that women can take the Pill right through their lives until reaching menopause, provided that they have no medical problems such as high blood pressure or diabetes? I also recommend intra-uterine devices. These can be inserted painlessly if the woman has been pregnant at least once.

Recently, women who have complained of excessive menstrual blood or period pain have been prescribed with what I call an intra-uterine birth control system, which is a combination of the Pill and an IUD and has been highly rated by those who've adopted it. Either way, they'll need to see a gynecologist to get them. And if a woman wants to go really out on a limb regarding birth control, there is always sterilization as a last resort to protect herself.

So, how do you know when you no longer need to use birth control?

The answer to that question lies in deciding correctly whether menstruation has ceased or not. A Japan Society of Obstetrics and Gynecology glossary defines menopause as being the state where a woman has passed her period of sexual maturity, her ovulation cycle has ended and menstruation ceased forever. However, it's really hard to determine at that time whether menstruation has actually ended, so the only sure way to know is if there has not been a period for at least 12 months or estrogen withdrawal bleeding cannot be recognized even after a dose of progestational hormones.

Incidentally, the most common age for a Japanese woman to reach menopause is 50 years, six months, but the normal period is usually any age from 45 to 56. As long as a sexually active woman does not meet the conditions for having gone through menopause, birth control is something she should always keep on her mind, regardless of the amount of sex she's having.

Personally, I don't blindly condemn abortion. There's not a woman with an unwanted pregnancy who wanted to get that way and no woman undergoes an abortion for fun. But until there is a 100 percent effective method of birth control, pregnancy is something that can happen in an instant to any sexually active woman. Sometimes that pregnancy can be unintended, and there are occasions where pregnancy can place such enormous burdens on a woman's body that termination is the only option available. Nobody can criticize in such cases.

Even so, Japanese women unfortunately have a repeat abortion rate of 23.6 percent. While any experience is good experience, it's hard to feel that way when it comes to people who repeatedly make the same mistakes when it comes to birth control. What really should happen is that doctors or nursing staff involved in abortions send patients away with good advice about birth control so that they never need their help again. What tends to happen, though, is that the abortion patient leaves a clinic with the message that they're always welcome to return if something unexpected pops up again in the future. That "something unexpected popping up" usually means another unwanted pregnancy, and cases like that are infuriating for me.

Having said that, I would like women who undergo abortions to take matters into their own hands and ask medical staff if they can provide her with a surefire birth control method to prevent future unwanted pregnancies. Rather than be passive and wait for somebody else to prod them into action, I'd like women to be firm with expressing their own will. (By Dr. Kunio Kitamura, special to the Mainichi)Slow Life, Slow Sex: Pregnancy in middle age far from inconceivable.

Did you know that women can take the Pill right through their lives until reaching menopause, provided that they have no medical problems such as high blood pressure or diabetes? I also recommend intra-uterine devices. These can be inserted painlessly if the woman has been pregnant at least once.

Recently, women who have complained of excessive menstrual blood or period pain have been prescribed with what I call an intra-uterine birth control system, which is a combination of the Pill and an IUD and has been highly rated by those who've adopted it. Either way, they'll need to see a gynecologist to get them. And if a woman wants to go really out on a limb regarding birth control, there is always sterilization as a last resort to protect herself.

So, how do you know when you no longer need to use birth control?

The answer to that question lies in deciding correctly whether menstruation has ceased or not. A Japan Society of Obstetrics and Gynecology glossary defines menopause as being the state where a woman has passed her period of sexual maturity, her ovulation cycle has ended and menstruation ceased forever. However, it's really hard to determine at that time whether menstruation has actually ended, so the only sure way to know is if there has not been a period for at least 12 months or estrogen withdrawal bleeding cannot be recognized even after a dose of progestational hormones.

Incidentally, the most common age for a Japanese woman to reach menopause is 50 years, six months, but the normal period is usually any age from 45 to 56. As long as a sexually active woman does not meet the conditions for having gone through menopause, birth control is something she should always keep on her mind, regardless of the amount of sex she's having.

Personally, I don't blindly condemn abortion. There's not a woman with an unwanted pregnancy who wanted to get that way and no woman undergoes an abortion for fun. But until there is a 100 percent effective method of birth control, pregnancy is something that can happen in an instant to any sexually active woman. Sometimes that pregnancy can be unintended, and there are occasions where pregnancy can place such enormous burdens on a woman's body that termination is the only option available. Nobody can criticize in such cases.

Even so, Japanese women unfortunately have a repeat abortion rate of 23.6 percent. While any experience is good experience, it's hard to feel that way when it comes to people who repeatedly make the same mistakes when it comes to birth control. What really should happen is that doctors or nursing staff involved in abortions send patients away with good advice about birth control so that they never need their help again. What tends to happen, though, is that the abortion patient leaves a clinic with the message that they're always welcome to return if something unexpected pops up again in the future. That "something unexpected popping up" usually means another unwanted pregnancy, and cases like that are infuriating for me.

Having said that, I would like women who undergo abortions to take matters into their own hands and ask medical staff if they can provide her with a surefire birth control method to prevent future unwanted pregnancies. Rather than be passive and wait for somebody else to prod them into action, I'd like women to be firm with expressing their own will. (By Dr. Kunio Kitamura, special to the Mainichi)