Can You Get Pregnant In Menopause Or Perimenopause? - Stella
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9 mins

Can you get pregnant during menopause?

byDr. Lucy Wilkinson

Menopause usually marks the end of your childbearing years, but it’s important to remember that pregnancy can still happen during perimenopause. Contraception requires careful consideration. Whether you would love to conceive or want to avoid getting pregnant, read on for all the facts on menopause and pregnancy.

Can you get pregnant during menopause?

Although it’s unlikely, you can get pregnant during perimenopause. You probably still have periods at this time but may also notice symptoms such as hot flushes, night sweats and mood swings. Your body will still be releasing eggs – ovulating – and pregnancy is a possibility. 

If your final period was over 12 months ago, you have potentially passed menopause (meaning that you are postmenopausal). When you are postmenopausal, your body no longer releases eggs and you can’t get pregnant naturally. Even so, you must speak to your doctor before ditching your contraception. 

This is because it can be difficult to tell whether you have truly had your final period. Medical conditions, medications and other factors can sometimes make your periods come less often, if at all. Your doctor may recommend blood tests or continuing contraception for a while longer to be safe.

IVF is possible throughout perimenopause and after menopause in some circumstances. But there are limitations and many find they need to use previously frozen or donor eggs. Complications also become more frequent. 

If you’re hoping to have a baby during or after menopause, seek advice from a qualified specialist as early as possible. They can give you advice about the available options.

Can you get pregnant if you don’t have periods?

Yes. For pregnancy to happen, your body needs to release an egg cell from your ovary. This then travels down your fallopian tube towards your womb. The egg may become fertilised if it bumps into sperm and implant into the womb lining, where it continues to develop.

During your reproductive years, most people’s ovaries release an egg each month. If your egg isn’t fertilised, your womb lining breaks down a couple of weeks later to give you a monthly period.

But the relationship between ovulation and periods isn’t always straightforward. Some may release an egg without this being followed by a period. Others may experience periods but without ovulation, known as an anovulatory cycle. 

This is especially true during perimenopause, when periods become increasingly erratic and infrequent due to hormonal changes. The same goes for ovulation, making it really tricky to predict fertility based on periods alone.

The bottom line is that if your body releases an egg and you’re sexually active, you can get pregnant – whether or not this is usually followed by a period!

How likely is pregnancy during menopause?

Although possible, pregnancy is pretty unlikely for a number of reasons:

  • Less frequent ovulation
  • Falling egg quality, which is a normal part of ageing
  • Increased chance of miscarriage
  • Other health issues becoming more common with age

The chance of pregnancy generally decreases as you progress on your menopause journey. This means that you are more likely to get pregnant if you are in your early forties and experiencing your first menopause symptoms than if you’re into your fifties and had your final period a few months ago.

Studies have found that between ages 40 and 44, 10-20% of those having regular unprotected sex will get pregnant after one year. In the 45 to 49 age range – when most are well into perimenopause – the pregnancy rate is closer to 12%. 

How can you tell if you are pregnant during menopause?

If you normally have regular periods, it’s worth taking a home pregnancy test if you notice:

  • That your period is late
  • Any typical pregnancy symptoms, including nausea, tiredness and abdominal bloating among others

It can be more difficult to pick up early signs of pregnancy if you are going through menopause. You may not not have regular periods, or your menopause symptoms could be confused with signs of pregnancy! 

You might want to consider pregnancy if you notice any changes to your bleeding pattern, abdominal pain, swelling of your tummy or pregnancy symptoms. See a doctor urgently if you have any severe pain or heavy bleeding.

If in doubt, take a home pregnancy test or speak to your doctor for more advice. Home pregnancy tests work just as well during menopause as they do at any other time.

It can be more difficult to pick up early signs of pregnancy if you are going through menopause.”

Can you have a successful pregnancy during perimenopause?

You can absolutely have a healthy pregnancy during perimenopause, but it’s important to ensure that you are supported with the appropriate medical care due to the increased risk of complications.

Complications can include problems during pregnancy, such as high blood pressure and diabetes, and risks during the birth, like haemorrhage and abnormal positioning of the placenta. Ectopic pregnancy and miscarriage are also more common as you age.

If you have been affected by miscarriage or stillbirth, contact The Miscarriage Association or Sands for extra support.

Can you get pregnant on HRT?

Yes, you can get pregnant while taking HRT. HRT contains the same hormones as many contraceptives but a higher dose is needed for them to effectively protect against pregnancy. HRT is not a contraceptive!

This means you need an effective form of contraception to prevent pregnancy. Most forms of contraceptive can be considered at this time and can be used alongside HRT.

If you want to combine both HRT and contraception in one medication, you have a few options. The Mirena coil, for example, is an effective contraceptive that can be used for HRT as it supplies progesterone to protect the womb lining.

The combined oral contraceptive pill is also used to treat menopause symptoms in certain people as it contains both oestrogen and progesterone.

Be aware that your bleeding pattern can be affected by your HRT. You shouldn’t ignore pregnancy symptoms even if you’re having a regular period-like bleed, as this bleeding could just be a result of the medication. 

HRT and pregnancy

Doctors will generally advise stopping HRT during pregnancy. This is because pregnancy and some types of HRT can increase your risk of developing certain conditions, including blood clots. It is also to minimise any impact that the hormones could have on the developing baby. But don’t worry – being on HRT at the time you conceive is not thought to be a problem.

Many find that their menopause symptoms improve during pregnancy, thanks to the placenta producing many different hormones to support the growing baby – including high levels of oestrogen. But it’s not always simple! Pregnancy symptoms can also be troublesome for some, and many report finding pregnancies tougher with age.

If you find yourself pregnant while taking HRT, speak to your doctor as soon as possible.

When should you see a doctor?

See a doctor if:

  • You become pregnant in perimenopause
  • You experience new symptoms or signs of pregnancy with a negative pregnancy test
  • You would like advice about fertility or IVF
  • You have any unusual bleeding – including irregular bleeding, bleeding after sex or a change to your usual pattern
  • You need to discuss contraception or HRT
  • Your menopause symptoms are troubling you

See a doctor urgently if you have:

  • Any heavy bleeding
  • New or severe abdominal pain
  • Pain in the tip of your shoulder, because this can rarely be a sign of ectopic pregnancy
  • Dizziness or faintness
  • Any other serious or worrying symptoms

Final word

Although it’s rare, menopause and pregnancy can happen at the same time. Whether you are hoping for a new addition to the family or don’t see any nappy changes in your future, it’s important to speak to your doctor to ensure that you are receiving the care you need.

Find out more about menopause on our blog or in our symptoms library.

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