Can You Get Pregnant During Perimenopause?

The simple answer: yes, you can still get pregnant during perimenopause. But fertility is far from simple. The hormonal shifts happening in your body make ovulation less frequent, reduce your total egg count, and make pregnancy less likely than in your premenopausal years.

As perimenopause arrives, typically in the late 30s and early 40s, you will begin to feel the early symptoms like mood swings, irregular periods, even hot flushes and night sweats. It's essential to understand what these hormonal changes mean for your fertility. Whether you're hoping for a baby or just need to know how on top of your birth control to be, you deserve the facts.

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01

Fertility During Perimenopause

During perimenopause, the ovaries produce fewer eggs, but ovulation can still occur. Estrogen levels fluctuate, and even though fertility decreases, getting pregnant is not entirely out of the question. According to the North American Menopause Society, many women underestimate their chances of getting pregnant during this phase(1). While fertility declines, pregnancy is possible as long as you're still ovulating.

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02

Chances of Getting Pregnant Naturally

The chances of getting pregnant naturally during perimenopause depend on several factors, including hormone levels, regularity of your menstrual cycle, and the availability of a viable egg. Follicle-stimulating hormone (FSH) plays a critical role in this process. While the body produces estrogen and FSH, they regulate the menstrual cycle, keeping the possibility of getting pregnant open(2).

Most women experience a decline in natural fertility, but conception can still occur naturally, especially in the early perimenopause stage when menstrual periods are still somewhat regular. However, the chances of getting pregnant decrease as perimenopause lasts for a few months or even years, with ovulation becoming less frequent over time(3).

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Pregnancy vs. Perimenopause Symptoms

One challenge for women in perimenopause is that pregnancy symptoms and perimenopause symptoms can overlap. Missed periods, breast tenderness, and weight gain are common signs of both pregnancy and perimenopause. A blood test is often necessary to determine whether you're pregnant or experiencing typical symptoms of perimenopause(4).

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04

Unplanned Pregnancy Risks

Because the menstrual cycle becomes irregular, many women assume they cannot get pregnant naturally during perimenopause. However, unplanned pregnancies can still happen if you're not using birth control(5). For women who want to avoid pregnancy, continuing birth control during perimenopause is important. Healthcare professionals recommend continuing birth control until you've officially reached menopause (12 consecutive months without a menstrual period)(1).

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Ensuring a Healthy Pregnancy During Perimenopause

A healthy pregnancy during perimenopause is completely achievable. Healthcare professionals recommend managing lifestyle factors like a healthy diet and regular check-ups to monitor conditions such as high blood pressure and other health concerns(6).

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06

Fertility Treatments and Reproductive Medicine

If natural conception is not possible, many turn to fertility treatments like in vitro fertilisation or assisted reproductive technology. Fertility treatments can increase the likelihood of a successful pregnancy for those trying to conceive during perimenopause. Reproductive medicine offers a range of options, including donor eggs, for women struggling to conceive naturally(7).

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07

Conclusion: Navigating Fertility in Perimenopause

While getting pregnant during perimenopause is more challenging, it is still possible, especially in the early stages. Understanding your body's hormonal changes and working with a healthcare professional can help you navigate this complex phase. Whether you’re looking to avoid an unplanned pregnancy or trying to have a healthy pregnancy, managing your reproductive health during perimenopause is essential.