I have perimenopausal symptoms and am in my mid-40s, so I think I am entering menopause. Do I need to continue using birth control? Can you get pregnant after menopause? What about once perimenopause starts?
—Anonymous
As long as you are ovulating, you can get pregnant. I have a handful of patients who have gotten pregnant on their own after age 45, though this is not common. The chances of getting pregnant do decrease as women progress toward menopause. This is because the eggs that the ovaries are ovulating toward the end of the reproductive years are of lower quality than the eggs that were ovulated in a woman’s 20s or 30s.
Add to that that as you move through perimenopause, you have fewer cycles during which you ovulate. It is estimated that women who have gone more than six months without a period are ovulating before about 25% of the periods they do have. So there are just fewer opportunities to get pregnant. The same study estimates that about 40% of last menstrual cycles are ovulatory cycles.
How likely is it that a woman in her 40s gets pregnant without fertility treatments? In epidemiological studies of women conceiving naturally, the median age at last pregnancy is 40 to 41. But that means that half of last pregnancies are after age 41. All this means is that it is possible to become pregnant during perimenopause, and if you do not want to be pregnant, you should use an effective form of contraception.
Once you have had your last menstrual period and are in menopause, you will no longer ovulate, so you can no longer become pregnant on your own. It is possible with the aid of a reproductive endocrinologist and a donor egg or donor embryo to become pregnant via IVF after menopause.
Community Guidelines
Log in