I am 49 years old, and I am definitely having symptoms of perimenopause. I am only having periods a few times a year now. Do I really still need to use birth control at this point? It seems silly.
—Anonymous
I am 46 years old. I definitely feel the absurdity of continuing to use contraception. My getting pregnant now seems like a story that would belong on the front page of a tabloid magazine at the grocery store checkout.
However, studies suggest that women continue to ovulate — albeit less frequently — through perimenopause. One study showed that women ovulated in 25% of cycles longer than six months (cycles longer than six months are a sign of late perimenopause). If a woman has a uterus and fallopian tubes, ovulates, and has vaginal intercourse around ovulation, she can become pregnant.
Egg quality does decline as we age. For those of us in our middle and late 40s, this means any given egg is less likely to result in a pregnancy, but those that do result in pregnancy are more likely to end in miscarriage. Miscarriage is physically and emotionally taxing. Recurrent miscarriages more so.
Long story short, if you do not want to be pregnant and you are having vaginal intercourse, you should continue to use contraception until you are officially in menopause.
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