Publisher Summary This chapter discusses currently available contraceptive options with the intent that they will be used for women over the age of 35 years. Combination oral contraceptives (COCs), containing both an estrogen and a progestin should be considered for those individuals over 35 years of age who do not smoke. The use of oral contraceptives in women who smoke cigarettes and are over the age of 35 is not recommended because of the reported increase in cardiovascular disease. The incidence is reported to be 400 cases per 100,000 women who smoke and are over the age of 35. The use of COCs in women with controlled hypertension or diabetes mellitus should be individualized. These medical conditions are felt to represent relative contraindications to the use of COCs. The contraceptive products that are available for young women are also available for women over the age of 35. However, the physician or health care provider should be aware of the fact that women over the age of 35 still have a pregnancy potential and take into consideration the woman's medical history, physical findings, and past contraceptive utilization before recommending or prescribing any of the contraceptive options.