Puberty, menstruation, pregnancy, perimenopause and menopause. These are the various stages in a woman’s biological cycle. One leads to the other, while pregnancy can happen at any time during a woman’s years of fertility.
The chances of getting pregnant come down as the woman crosses 35 years. By her 40s, the perimenopause is likely to begin and is followed by menopause, which is usually the end of the reproductive phase.
But could you get pregnant during the perimenopausal or menopausal stage? In this MomJunction post, we tell you about menopause, the possibility of getting pregnant during this phase, and the risks involved.
How Does Menopause Occur?
Menopause is the physical change that marks the end of menstruation. The process of menopause is slow and begins months or years before the menstruation phase ends. The process has three stages (1):
- Perimenopause: It is characterized by an irregular menstrual cycle and could begin around eight to ten years before menopause. It can start in the 40s or even in the 30s in some women. In this phase, the production of estrogen and progesterone, which are responsible for releasing eggs from the ovaries, gradually comes down. In the last one to two years, there is a sharp drop in estrogen. During this phase, you are likely to have irregular periods, night sweats, hot flashes, forgetfulness, mood swings, stiff joints, weight gain, and a drop in sex drive (2).
- Menopause: This is the stage where a woman did not have her menstrual periods for at least a year. It usually occurs in between 45 and 50 years. During this time, the ovaries stop releasing eggs, and it is the end of the reproductive stage. Therefore, the woman cannot ovulate or conceive (3).
- Postmenopause: In this stage after menopause, the menopausal symptoms ease. However, the decrease in the estrogen level makes women vulnerable to health problems such as osteoporosis, heart diseases, and obesity. Medications and lifestyle changes might lower the risk of these conditions (4).
This is the time when your reproductive cycle turns erratic, misses the rhythm and ultimately stops. What if you want to get pregnant under such circumstances?
Can You Get Pregnant During Perimenopause?
It is possible to become pregnant until you reach the menopausal stage, but it may be difficult. During the perimenopausal stage, though your periods are irregular, you are still ovulating and the ovaries release the mature eggs (3).
How Does Pregnancy Occur During Perimenopause?
Despite the irregular periods, ovulation occurs in the perimenopausal stage. Therefore, there is a chance for the release of a healthy egg, which gets fertilized with the release of the sperm, and you conceive.
Signs such as breast tenderness and white vaginal discharge could help you know you are ovulating. Unprotected sexual intercourse 3-4 days before ovulation and on the day of ovulation could increase the chances of getting pregnant.
Is Pregnancy Possible During Menopause?
Once you enter menopause, you no longer ovulate and cannot conceive naturally. Women enter the menopausal stage at various ages. It usually happens anytime between 40 and 55 years.
How Do You Know If You Are Still Fertile?
It is difficult to know about your fertility as the menstrual cycle turns irregular during perimenopause. You may or may not ovulate, and also the levels of estrogen, progesterone, and other hormones fluctuate while the egg quality could deteriorate. All these factors cause a decrease in fertility, but we cannot exactly predict the probability of natural conception.
Chances Of Getting Pregnant During Perimenopause And Postmenopause
If you hope to become pregnant during perimenopause, and you have not conceived even after six months of trying, you should consult a doctor. The below measures can increase your chances of getting pregnant:
- Intercourse during ovulation: Observe the signs of ovulation such as breast tenderness, abdominal bloating, increased sex drive, slight cramping, and white discharge. Ovulation time is the most fertile time in the menstrual cycle.
- Diet and exercise: Have a balanced diet and exercise to stay fit and healthy. These will improve the chances of conception.
- In vitro fertilization (IVF): Getting an IVF treatment during perimenopause or menopause could help. In this case, you may have to use the eggs that were frozen in the past or donor eggs. You might also need hormone therapy to prepare your body for implantation and pregnancy. However, this might not be the case for all women (5).
With lifestyle changes and medical help, you might get pregnant during the perimenopausal stage. But is it safe for you and the baby?
What Are The Risks Of Pregnancy During Perimenopause And Menopause?
- IVF treatment could result in multiple fetuses. This is likely to cause preterm labor, low birth weight in babies and delivery complications.
- High blood pressure could lead to preeclampsia.
- Gestational diabetes.
- Placenta previa, in which the placenta lies low in the womb and causes problems during childbirth.
- Placental abruption in which the placenta is detached from the womb, causing fetal growth problems, stillbirth, and premature birth.
- Stillbirth or miscarriage.
- Premature or low birth weight.
- Ectopic pregnancy, where the egg is implanted outside the womb.
- Increased chances of birth defects.
The older you get, the higher are the chances of complications in pregnancy and delivery. Therefore, if you have decided against having children at this age, you might want to know about the use of contraception.
Do You Still Need Contraception During Perimenopause And Menopause?
Although you are less likely to get pregnant during the perimenopausal and menopausal stages, it is advisable to use contraceptives. There is a possibility to ovulate, even if the periods are irregular. Contraceptives, such as condoms, not only prevent unplanned pregnancy but also help you avoid sexually transmitted infections (10).
Can Menopause Be Reversed?
Research done on eight perimenopausal women has shown that temporary restoration of ovarian activity is possible. The women were injected platelet-rich plasma (PRP) into ovaries. After one to three months, all participants resumed regular periods, and the doctor could retrieve mature eggs for fertilization (7).
Another research has found that melatonin restored the menstrual cycle in women who were in either the perimenopausal or menopausal stage. Melatonin is known to play a role in producing reproductive hormones (8).
However, these studies are limited and may not be universal.
If you want to have children during menopause, consider adopting a child. This will satiate your parental instincts while promising a better life to the little one. However, if you have a strong desire to have biological children after menopause, talk to your doctor about the possibilities you have and the risks involved.
Do you think it is possible to conceive during the menopausal age? Let us know in the comment section below.
2. Perimenopause: Rocky road to menopause; Harvard Health Publishing; Harvard Medical School
3. Menopause; US Department of Health and Human Services (2019)
4. Postmenopause; Northwell Health
5. In vitro fertilization (IVF); Center for Women’s Health; Oregon Health & Science University
6. Pantos K et al.; Ovarian rejuvenation and folliculogenesis reactivation in peri-menopausal women after autologous platelet-rich plasma treatment; New York Fertility Institute
7. Brittany J Harrison et al.; Advanced maternal age: Ethical and medical considerations for assisted reproductive technology; Int J Womens Health (2017)
8. Baldwin MK and Jensen JT; Contraception during the perimenopause; Maturitas (2013)
9. Bellipanni G et al.; Effects of melatonin in perimenopausal and menopausal women: A randomized and placebo controlled study; Exp Gerontol (2001)
10. Tower C; Pregnancy in peri- and postmenopausal women: Challenges in management; Menopause Int (2009)