General Gynecology

Contraception & Menopause

Contraception and menopause are two central parts of general gynecology. Both are about choice: when to avoid pregnancy, when to try for it and how to protect your quality of life as hormones change over time.

In Lisbon, Dra. Joana Faria offers consultations focused on contraception and menopause in Portuguese, English, French, and Spanish. The aim is to help you understand your options, balance benefits and risks and choose a plan that fits your body and your priorities.

You will also find dedicated pages about contraception and menopause that provide more detail on each topic.

What it is

This section of care brings together two main areas:

  • Contraception counseling choosing a safe and effective method to avoid unintended pregnancy and, when relevant, to treat other symptoms such as heavy periods or acne.
  • Perimenopause and menopause care supporting women through the years before and after the last period, managing symptoms and protecting long term health.

Typical reasons to book a consultation in this area include:

  • Starting contraception for the first time.
  • Changing method because of side effects, new health conditions or a change in your relationship or plans.
  • Clarifying whether you are already in perimenopause or menopause.
  • Hot flushes, night sweats, sleep problems, mood changes or vaginal dryness.
  • Questions about hormone therapy, its risks and its benefits.

Main symptoms and when to worry

Many symptoms related to contraception or menopause are uncomfortable but not dangerous. A structured consultation helps distinguish what is expected from what needs further investigation.

You should consider booking an appointment if you notice:

  • Irregular bleeding, spotting between periods or bleeding after sex while using contraception.
  • New headaches, visual symptoms, chest pain or leg swelling that appear after starting a hormonal method.
  • Cycles that become very irregular in your forties or fifties.
  • Hot flushes, sleep disturbance, low libido or vaginal dryness that affect your daily life or relationships.
  • Bleeding after 12 months with no periods.

These signs are common and most of the time they have benign explanations, but they should be discussed with a doctor. In particular, bleeding after menopause always deserves an evaluation.

If you have sudden chest pain, shortness of breath, signs of stroke or a very swollen and painful leg, you should seek emergency care immediately and inform the team which medicines or hormones you are taking.

Diagnosis: exams and what to expect

Most of the work in contraception and menopause consultations is done through careful listening and discussion. Additional exams are requested only when they change management.

During a typical visit you can expect:

  • Clinical history
    Conversation about your cycle, pregnancies, previous contraception, medical conditions, family history of thrombosis or cancer, lifestyle and what you hope to achieve from the consultation.
  • Physical examination
    Measurement of blood pressure and weight, and when indicated a gynecologic examination to assess the pelvis and vaginal tissue.
  • Pelvic ultrasound when relevant
    Used especially if you also have heavy bleeding, pelvic pain or known uterine or ovarian disease.
  • Laboratory tests in selected cases
    Blood tests may be requested, for example to check lipids, glucose or other hormones. In many women, menopause is diagnosed mainly based on age and symptoms, without the need for repeated blood tests.

At the end of the consultation, Dra. Joana Faria summarises the key points and discusses which contraceptive methods or menopause treatments are suitable for you, explaining why some options may be less appropriate in your case.

Treatment options and follow up

There is no single best method of contraception or single best way to live through menopause. The right choice depends on your medical history, values and plans for the future.

Possible options that may be discussed include:

  • Long acting reversible contraception such as intrauterine devices or implants, for women who want very effective contraception without a daily pill.
  • Combined hormonal methods like pills, patches or rings, which may improve cycle control and specific symptoms in selected women.
  • Progestogen only methods for women who cannot or prefer not to use oestrogen.
  • Barrier methods and fertility awareness methods, sometimes combined, for women who prefer non hormonal options.
  • Treatment of menopausal symptoms which may include lifestyle advice, local vaginal treatments, non hormonal medicines or hormone therapy when appropriate.

Follow up is important to check how you feel with the chosen plan, to monitor possible side effects and to adjust the strategy as your life circumstances change. Many women change contraception several times or reconsider menopause treatment as their needs evolve, and this is normal.

How Dra. Joana Faria approaches contraception and menopause in practice

Dra. Joana Faria believes that decisions about contraception and menopause should be based on shared information, not pressure. Her role is to explain the real benefits and risks of each option in clear language, so that you can choose with confidence.

In daily practice she:

  • Starts by asking what matters most to you, such as effectiveness, natural cycles, control of symptoms or avoiding certain side effects.
  • Uses up to date scientific evidence to explain which methods are safe in your situation and which should be avoided.
  • Speaks openly about common fears related to hormones and about the difference between myths and proven information.
  • Adapts plans over time as your health, relationships and life projects change.
  • Provides written or digital summaries when a complex plan is agreed, so that you can review it calmly at home.

For many women, this approach transforms contraception and menopause from a source of confusion into an area where they feel supported and in control.

FAQ

Frequently Asked Questions


How do I choose the best contraceptive method for me?

The best method is the one that fits your medical history, your lifestyle and your preferences. Together with your doctor you will review your health, family history, smoking status and other medicines. Then you will discuss what matters most to you, such as effectiveness, bleeding pattern, possible side effects and ease of use. In many cases several methods are suitable and the choice is made through shared decision making.

Does contraception affect my future fertility?

Most reversible contraceptive methods do not have a negative effect on long term fertility. When you stop them, your natural cycle usually returns over the following weeks or months. Some methods can temporarily change bleeding patterns, which may make it harder to read your cycle, but they do not usually cause permanent infertility. Your doctor can explain what to expect when you stop a specific method.

When can I stop using contraception around menopause?

Many women still ovulate and can become pregnant during perimenopause, even if cycles are irregular. The right time to stop contraception depends on your age, the method you use and whether you have already had 12 months with no periods. Some methods also influence how menstruation appears, which can make the situation less clear. In consultation, your doctor can review your case and suggest a safe time to stop or switch methods.

Are hormonal contraceptives safe in the long term?

For muitas women, hormonal contraceptives are safe and offer benefits beyond pregnancy prevention, such as cycle regulation or reduced menstrual pain. However, they are not suitable for everyone. Factors like age, smoking, migraine with aura, history of thrombosis or certain cancers can change the balance of benefits and risks. This is why a personalised evaluation with a gynecologist is essential before starting or continuing hormonal contraception.

How long do menopause symptoms usually last?

There is no single answer. For some women, symptoms like hot flushes or sleep disturbance last a few months. For others they can continue for several years with varying intensity. Vaginal dryness and discomfort with intercourse often persist if they are not treated. The goal of consultation is not to ignore symptoms until they pass, but to assess how much they affect your daily life and to discuss safe options to improve comfort and long term health.

What are the main risks and benefits of hormone therapy for menopause?

Hormone therapy can reduce hot flushes, night sweats, vaginal dryness and some mood and sleep problems, and may help protect bone density. At the same time, it can increase certain risks, such as blood clots or specific types of cancer, depending on the type of hormones, the dose, the duration of use and your personal history. This balance is not the same for every woman. A detailed consultation is the best way to decide whether hormone therapy is appropriate for you and, if so, in which form and for how long.

Schedule

Book your consultation


In person

XClinic

Av. Eng. Duarte Pacheco, nº26 - Piso intermédio 1070-110 Lisboa (in front of Amoreiras Shopping)

Online

Video consultation

On zoom

photo gallery of Dra Joana Faria operating and performing lectures