BEIJING, April 7 (Xinhuanet)-- Women of 40 years old or older can choose pill, IUD, or nonsurgical method of tube-tying for their birth control, said a study in the New England Journal of Medicine Monday.

    Both the pill and IUD methods are safer than they used to be, according to the study led by Dr. Andrew Kaunitz, a gynecologist at University of Florida.

    Traditionally, women at this age are the least likely to use birth control. They have the highest rates of abortion, along with adolescents.

    This variety of methods has long been needed, because 40- and 50-somethings are a complex group, said Kaunitz and other experts.

    The risk of dangerous blood clots rises sharply at age 40 for women who take birth control pills containing estrogens. It is even greater for overweight women, who also are more likely to have high blood pressure and diabetes, said Kaunitz.

    But the dosage of estrogen in current birth control pills has been dramatically reduced. The pill is now considered a safe alternative for lean, healthy, older women, Kaunitz and other experts said.

    Middle-aged women who are obese, smoke, have migraines, high blood pressure or certain other risk factors should be steered toward IUDs or progestin-only treatments like "mini-pills," they said.

    The nonsurgical type of tubal ligation (tube-tying) has been approved by the U.S. government since 2002. Instead of cutting through the abdomen to cut and tie the fallopian tubes, a doctor works through the cervix, using a thin tube to thread small devices into each fallopian tube. These cause scarring, which in about three months plugs the tubes, stopping eggs from the ovaries from reaching the uterus.

    (Agencies)