As we age, there are tons of shifts within our body — ones we can and can’t feel. The shifts that come with perimenopause are both. Perimenopause, or the years leading up to menopause (the year after our last period), is when our bodies produce less estrogen. Our menstrual cycles can come increasingly irregular during perimenopause which can lead to both physical and emotional symptoms.
In this turbulent time, we’re likely focused on how to deal with those symptoms and try to expect the unexpected when it comes to our periods. But what about pregnancy?
With all these hormonal changes and varied cycles, can you get pregnant during perimenopause? The short answer is yes — here’s how, and what to do whether you’re trying to family plan during perimenopause or avoid conception.
What is perimenopause?
Perimenopause means “about” or “around” menopause. Menopause is the 12 months after a person has had their last period — which means perimenopause is the transitional phase right before you get that last period.
During perimenopause, your ovaries gradually produce less estrogen. Estrogen’s job in your ovaries is to regulate the menstrual cycle and support fertility through the growth of the egg follicle. When the amount of estrogen in your ovaries decreases, it can lead to irregular cycles, with periods becoming shorter, longer, lighter, or heavier than usual. As your body adapts to changing hormone levels, you may also experience a range of physical and emotional symptoms.
Perimenopause typically happens anywhere from two to ten years before menopause and starts in your mid-40s. However, the exact timing, length, and symptoms you experience during menopause is heavily unique and dependent on things like your genetics, lifestyle, and health.
How can you get pregnant during perimenopause?
So, can you get pregnant during perimenopause? Yes — it’s not as common, but it’s still possible.
How is this possible? Even though perimenopause often comes with irregular cycles, you’re still ovulating.
Ovulation is a precondition for getting pregnant. It occurs when the egg is released from the ovary into the fallopian tube. Once in the fallopian tube, the egg waits for a sperm cell to fertilize it. If it’s fertilized, the egg implants into the uterus and begins the early stage of pregnancy.
You can get pregnant during perimenopause because your body is still releasing eggs into the fallopian tube. This means that if you’re having sex around ovulation, there’s still a chance you can get pregnant.
How common is pregnancy during perimenopause?
Even though the answer to “can you get pregnant during perimenopause?” is a resounding “yes,” pregnancy during menopause isn’t as likely as pregnancy before perimenopause. This is because as we age, our chances of pregnancy decrease.
According to the American Pregnancy Association, the main reason our chances of pregnancy decrease as we get older is because we ovulate less frequently. We have fewer eggs, meaning that we might not release an egg each cycle. When there’s no egg, there’s nothing to fertilize, and no ability to get pregnant.
Our eggs also age with us – and when eggs age, they’re more likely to be chromosomally abnormal. It can be harder or impossible to fertilize these eggs, and not all of these eggs can grow into a healthy fetus.
So, what are the actual chances of pregnancy during perimenopause? It depends on your age, but if you’re 40 or older, you have about a 5% chance of getting pregnant every cycle. (This compares to about 25% when you’re in your 20s and 30s.) The American College of Obstetricians and Gynecologists says getting pregnant naturally after 45 is highly unlikely.
Trying to conceive (or not to conceive) during perimenopause
Whether you felt excited or disappointed that the answer to “can you get pregnant during perimenopause?” was “yes,” you have options.
If you’re trying to get pregnant during perimenopause...
While the likelihood of getting pregnant during perimenopause is lower, that doesn’t mean it’s not possible. Here are a few ways to aid your fertility journey if you’re trying to conceive.
Prioritize your health
Focusing on multiple aspects of your health can help boost your fertility. Be sure to maintain a healthy lifestyle with a nutrient-rich diet, regular physical activity, low stress, and adequate sleep. This overall well-being can help improve your hormonal imbalance and prevent things that can negatively affect pregnancy, like high stress, high blood pressure, being over or underweight, and malnutrition.
Your emotional health is especially important during this journey, too. Be sure you have a strong support system and take time to process what you’re feeling. You’re not alone in this journey.
Track your ovulation
Irregular cycles are a common aspect of perimenopause, which means it’s harder to understand exactly when you’re ovulating. Yet tracking your ovulation is key to identifying your fertile window — so you know exactly when to time intercourse to increase your chances of pregnancy.
Instead of relying on a standard 28-day cycle to try and predict when you’re ovulating, the Oova kit tracks your specific hormone levels to understand your cycle and confirm you’ve ovulated. It’s the only testing device that shows you when you ovulate (by tracking luteinizing hormone) and if you ovulate (by tracking progesterone), and it is completely customized to you and your specific hormone levels.
Seek professional guidance
Consulting a fertility specialist or reproductive endocrinologist can help you understand your fertility status and options. They may test your ovarian reserve, hormone levels, genetics, and other factors that can influence conception.
Professionals can also help you explore assisted reproductive technologies like in vitro fertilization (IVF) and intrauterine insemination (IUI). These approaches can increase your chances of pregnancy by circumventing age-related fertility obstacles like egg quantity and quality. For example, assisted reproductive technologies utilize hormonal stimulation to encourage the ovaries to produce multiple eggs in a single cycle. These eggs are then retrieved and fertilized in a controlled laboratory environment, increasing the chances of obtaining viable embryos for implantation.
If you’re not trying to get pregnant during perimenopause...
If you’re concerned or disappointed that you can get pregnant during perimenopause, there are still options for preventing pregnancy. You can still use any birth control method, including hormonal oral contraceptives, non-oral hormonal contraceptives (like the vaginal ring), IUDs, or barrier methods (like condoms).
Hormonal oral contraceptives in particular can be beneficial for women going through perimenopause, according to the North American Menopause Society. This type of birth control can lead to more regular menstrual cycles, reduced bleeding, reduced cramps, reduced hot flashes, and improvements in acne. However, because of the increase in regular cycles and reduced symptoms, it can be harder to know when menopause is coming.
Can you get pregnant during perimenopause? The bottom line
While it’s not as likely, you can get pregnant during perimenopause. This is because you’re still ovulating, which means you’re still releasing eggs that can be fertilized and lead to pregnancy. The chances of getting pregnant after 40 — which is when most people start perimenopause — are about 5% each cycle. If you are trying to get pregnant during perimenopause, arming yourself with knowledge, making informed decisions, using resources to help you learn about your cycle, and seeking professional guidance can help you on your fertility journey.
- American College of Obstetricians and Gynecologists (ACOG). (2023). Having a Baby After Age 35: How Aging Affects Fertility and Pregnancy.
- American Pregnancy Association. (n.d.). Trying to conceive after age 35.
- The North American Menopause Society. (2010). Contraception: You Need It Longer Than You May Think.
- WebMD. (2023). Pregnant at 40: What to Expect
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