Menopause usually marks the end of your childbearing years, but it’s important to remember that pregnancy can still happen during perimenopause. Contraception during this time requires careful consideration. Read on for all the facts on menopause and pregnancy.
Find what you need quickly
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Can you get pregnant during menopause?
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Can you get pregnant if you don’t have periods?
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How likely is pregnancy during perimenopause and menopause?
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How can you tell if you are pregnant during menopause?
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Can you have a successful pregnancy during perimenopause?
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Can you get pregnant on HT?
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HT and pregnancy
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When should you see your healthcare provider?
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Final word
Can you get pregnant during menopause?
Although it’s unlikely, you can get pregnant during perimenopause. You may have symptoms such as hot flashes, night sweats, and mood swings, but your body also still has periods and will still be releasing eggs – ovulating – so pregnancy is a possibility.
If your final period was more than 12 months ago, you have potentially passed into menopause, meaning that you are postmenopausal. When you are postmenopausal, your body no longer releases eggs and you can’t get pregnant naturally. Occasionally, even though you have met the definition of menopause, it is possible to still ovulate.
You must speak to your healthcare provider before you stop taking 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 healthcare provider 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 significant limitations and you will need to use previously frozen or donor eggs, which means eggs from another person. Serious pregnancy complications also become more frequent.
Seek advice from a qualified specialist as early as possible if you think you might want to try and have a baby during or after menopause. They can give you advice about the available options.
Can you get pregnant if you don’t have periods?
The short answer is yes.
During your reproductive years, most people’s ovaries release an egg each month. If the egg isn’t fertilized, your uterus lining breaks down a couple of weeks later resulting in menstrual bleeding.
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 perimenopause and menopause?
Although possible, pregnancy is very unlikely for a number of reasons:
- Less frequent ovulation
- Falling egg quality, which is a normal part of aging
- Increased chances of genetic defects in the embryo leading to miscarriage
- Other health issues becoming more common with age
The chance of pregnancy generally decreases as you progress on your menopause journey, whatever your age. This means that you are more likely to get pregnant if you are experiencing your first menopause symptoms than if you had your final period a few months ago.
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, breast tenderness, 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 have regular periods, or your menopause symptoms could be confused with signs of pregnancy!
You might want to make sure you are not pregnant if you notice any changes to your bleeding pattern, abdominal pain, swelling of your stomach, or pregnancy symptoms. See your healthcare provider urgently if you have any severe pain or heavy bleeding.
If in doubt, take a home pregnancy test or speak to your healthcare provider for more advice. Home pregnancy tests work just as well during menopause as they do at any other time.
Can you have a successful pregnancy during perimenopause?
You can 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 such as high blood pressure and diabetes, pre-eclampsia, genetic defects in the baby, and risks during birth, like heavy bleeding, increased risk of c-section, 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, visit Planned Parenthood for extra support and resources.
Can you get pregnant on HT?
Yes, you can get pregnant while taking HT. HT contains the same hormones as many contraceptives but not in high enough doses to effectively protect against pregnancy. HT is not a contraceptive!
Until you have not had a menstrual period for two years you still need an effective form of contraception to prevent pregnancy. Most forms of contraceptive can be considered at this time and can be used alongside HT.
If you want to combine both HT and contraception in one medication, you have a few options. A hormonal IUD such as Mirena, for example, is an effective contraceptive that can be used for HT as it supplies progesterone to protect the uterus lining.
The combined oral contraceptive pill is also used to treat menopause symptoms in certain people as it contains both estrogen and progesterone.
Be aware that your bleeding pattern can be affected by your HT. 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.
HT and pregnancy
You must stop HT during pregnancy. This is because pregnancy and some types of HT can increase your risk of developing certain conditions, including blood clots. It is also to minimize any impact that the hormones could have on the developing baby. But don’t worry – being on HT at the time you conceive is not thought to be a problem.
If you find yourself pregnant while taking HT, speak to your healthcare provider as soon as possible.
When should you see your healthcare provider?
See your healthcare provider 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 HT
- Your menopause symptoms are troubling you
See your healthcare provider urgently if you have:
- Any heavy bleeding
- New or severe abdominal pain
- 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 diaper changes in your future, it’s important to speak to your healthcare provider to ensure that you are receiving the care you need.
Find out more about menopause on our blog or in our symptoms library.
- Ameratunga, D., Weston, G., Osianlis, T., Catt, J., & Vollenhoven, B 2009, In vitro fertilisation (IVF) with donor eggs in post-menopausal women: are there differences in pregnancy outcomes in women with premature ovarian failure (POF) compared with women with physiological age-related menopause? Journal of assisted reproduction and genetics, vol 26, no. 9-10, pp. 511–514
- Stella, Menopause and contraception
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