Over 50
twelve months without a period, if you are over 50
Can I get Pregnant During Perimenopause?
Yes, you can get pregnant during perimenopause. Until you have gone a full twelve months without a period, your ovaries can still release an egg, and irregular cycles, long gaps and lighter bleeding do not mean they've stopped. The odds are lower than they were at 35, sometimes much lower, but women in their mid-40s still conceive.
When to stop contraceptionPregnancy or perimenopause?
Medically reviewed by Dr. Ashley Alexis, ND,
Updated
When you can stop contraception.
Over 5012 months
twelve months without a period, if you are over 50Under 5024 months
twenty-four months without a period, if you are under 50Hormone therapy for menopause symptoms is not contraception; it doesn't stop ovulation.
Six things worth knowing.
- Pregnancy remains possible until you have gone twelve consecutive months without a period, which is the definition of menopause.
- The odds are lower than they were at 35, sometimes much lower, but women in their mid-40s still conceive.
- The early signs overlap: a missed period, tender breasts, fatigue, nausea, mood changes and bloating all occur in both. The only way to tell is a pregnancy test.
- The usual advice is to continue contraception until you have had no period for twelve months if you are over 50, or for twenty-four months if you are under 50.
- Hormone therapy for menopause symptoms is not contraception; it doesn't stop ovulation.
- If your period is late and there is any chance of pregnancy, take a test, then call.
Why pregnancy is still possible
Perimenopause is the transition before menopause.
Over several years, ovulation becomes erratic: some cycles release an egg, some don't, and the hormone signals that drive them swing widely.
The rising follicle-stimulating hormone (FSH) of perimenopause can occasionally recruit more than one follicle, and in some cycles a second egg is released late in the cycle (clinicians call this a luteal out-of-phase, or LOOP, event).
That is part of why the rate of fraternal twins rises modestly with maternal age.
It does not mean fertility overall goes up; it means the timing becomes unpredictable.
What are the chances of getting pregnant during perimenopause?
Low, and falling with every year.
The number of eggs declines steeply through the 40s, the proportion that are chromosomally normal declines with them, and more cycles pass without ovulation at all.
The chance of conceiving in any given month in the mid-40s is a small fraction of what it was at 30, and the chance of a pregnancy continuing is lower too.
"Low" is not "zero". A woman having periods even a few times a year can ovulate without warning, and the longest gap between periods is not a safe window; it is simply the gap before the next egg.
Is it pregnancy or perimenopause?
The early signs overlap.
A missed or late periodSore breastsNauseaFatigueMood swingsBloatingHot flushes
A missed or late period, sore breasts, nausea, fatigue, mood swings, bloating, and even hot flushes can all be early pregnancy or perimenopause.
The only reliable way to tell is a pregnancy test; home tests are accurate from the day a period is due.
A good rule for the perimenopausal years: any time a period is unexpectedly late and you have had sex without reliable contraception, test before you assume it's menopause.
When can you stop contraception?
The standard guidance is to keep using contraception until:
Under 50
twenty-four months without a period, if you are under 50
Hormone therapy for menopause symptoms is not contraception; it doesn't stop ovulation.
Some contraceptive options, such as a hormonal IUD or, for suitable women, combined hormonal contraception, can also smooth out heavy bleeding and other perimenopausal symptoms. Your clinician will weigh your age, blood pressure, clot risk and symptoms.
Pregnancy after 40: what to know
If you do become pregnant in your 40s, planned or not, it is worth knowing that the risks of miscarriage, chromosomal conditions, gestational diabetes and high blood pressure in pregnancy are higher than at younger ages.
Many women in their 40s have healthy pregnancies; the difference is that early prenatal care and screening matter more.
See a provider as soon as you know.
If you're trying to get pregnant during perimenopause
When to see someone
For what to expect from the transition itself, read our guide to perimenopause and when menopause starts.
Questions, answered plainly.
Can you get pregnant during perimenopause?
Yes. As long as you are still having periods, even irregular ones months apart, you can ovulate and you can conceive. Pregnancy remains possible until you have gone twelve consecutive months without a period, which is the definition of menopause.
What are the chances of getting pregnant during perimenopause?
Low, but not zero. Fertility falls sharply through the 40s as the number and quality of eggs decline and more cycles pass without ovulation. Unplanned pregnancies still occur in the mid-40s.
Is it pregnancy or perimenopause?
The early signs overlap: a missed period, tender breasts, fatigue, nausea, mood changes and bloating all occur in both. The only way to tell is a pregnancy test. In perimenopause, take one whenever a period is unexpectedly late before assuming it's menopause.
When can I stop using contraception?
The usual advice is to continue until you have had no period for twelve months if you are over 50, or for twenty-four months if you are under 50. Hormone therapy for menopause symptoms is not contraception. Your clinician can advise on options that suit perimenopause, some of which also help with symptoms.
Can you get pregnant after menopause?
Not naturally. Once you have gone twelve months without a period, the ovaries have stopped releasing eggs. Pregnancy after that point is possible only with donor eggs through IVF.
Questions about contraception or fertility in perimenopause.
A video visit with a clinician who treats perimenopause and menopause, in 33 states.
