The long-acting methods of hormonal contraception (Norplant and Depo-Provera) deserve consideration in those situations where combination estrogen-progestin is unacceptable because of health problems (where estrogen is contraindicated), or where oral contraception has already proved to be unsuccessful. Older women, as they approach the menopause, may be any more comfortable with the irregular bleeding or amenorrhea associated with these methods. However, the irregular bleeding patterns associated with these methods can cause any more concern in some women regarding possible pathology. Hormone treatment can be initiated if menopausal symptoms develop or when annual measurement of the FSH level (beginning at age 50) indicates a rise above 30 IU/L.