Can You Get Pregnant After Menopause?
Some people may ask “Can you get pregnant after menopause?" Well, when I was in my early 40s, I was keen to have one last baby. I was aware that my biological clock was ticking loudly, so I did an internet search to find out how likely it was that I could get pregnant if the process of menopause had started.
I wondered if starting hormone replacement therapy (HRT) might boost my chances of getting pregnant. My reasoning was if dropping estrogen hindered ovulation maybe replacing the hormones would boost my fertility.
Surely other people have searched for the answer to this question for completely the opposite reason. For many women, not having to worry about preventing an unwanted pregnancy is quite a relief.
You’d think the answer would be quite straightforward, but sadly it isn’t. However, understanding what menopause actually is, what the process is and what happens to our bodies during it can help to make things clearer.
What Is Menopause?
There is often confusion about what exactly menopause is. Many women have an idea that it involves the end of menstruation and maybe some hot flashes. Maybe because menopause is a stage of life many still don’t talk openly about younger women often don’t know what to expect or when to expect it.
In fact, the first period of this stage is called perimenopause with “peri" meaning “around or surrounding".
Perimenopause
Perimenopause can start as early as your mid-30s but is more common in the your 40s and is triggered by changing levels of the female hormone estrogen.
The first noticeable sign that estrogen levels are rising and falling erratically is usually a change in menstruation. Periods may become erratic. They may become longer or shorter and you may find you have a heavier or lighter flow.
Other symptoms such as the infamous hot flashes, mood swings, sleep issues, skin and vaginal dryness may also start appearing.
Menopause is defined as the period following 12 months without any menstruation.
Testing for Menopause
Surely it would be easiest to take a test to see if you are in perimenopause or full menopause. Well, a doctor can perform a blood test to measure the levels of follicle-stimulating hormone (FSH). A raised FSH level of 30 mIU/mL or more along with an absence of menstrual periods would be considered fairly conclusive evidence of menopause. This can be trickier during perimenopause when birth control pills, wildly varying hormone levels and irregular periods make diagnosis less reliable.
You can also buy home test kits online and from the drugstore which also measure FSH in urine. They work like home pregnancy tests in that you pee on the end of the stick and wait for a result.
Both positive and negative results from home tests should not be taken as 100% accurate. Results can be affected if you don’t use first-morning urine, if you’re taking some medications and if you have drunk quite a lot of liquid before taking the test.
Can I get Pregnant During Perimenopause?
Uneven estrogen levels during perimenopause means that you may not ovulate (when your ovaries release an egg ready for fertilization) every month. With no egg there can be no pregnancy. However, during this rather unpredictable period, your body may release an egg and you may still be able to get pregnant.
Estrogen, progesterone and other hormones required to maintain fertility can fluctuate during perimenopause. Women are born with a finite number of eggs in their ovaries and that egg quality tends to decrease as they age, so it can be harder to get pregnant and maintain a pregnancy.
One in four healthy women in their 20ss and 30s will get pregnant each month. When women get to their 40s, only 1 in 10 will get pregnant each menstrual period.
Despite these figures demonstrating that older women are less likely to become pregnant, it is still possible, and anyone wishing to avoid a “menopause baby" should use some form of birth control until at least 12 months have passed with no menstruation.
If you are hoping to get pregnant it becomes even more important to track your menstrual periods; as they become erratic it would be harder to work out your fertile period.
Be warned that ovulation tests can become unreliable as menopause can cause them to show false positives.
Will HRT Boost Fertility?
Turns out my amateur science was not entirely incorrect. Infertility can be caused by relatively minor imbalances in hormone levels and replacing the natural hormones with tablets or patches can correct that imbalance.
So yes, there is some evidence to show that in rare cases HRT can cause the body to release a few more eggs. If pregnancy does occur while taking HRT, it’s important to see an OBGYN as soon as possible to discuss when to stop taking HRT to let the natural hormones from the developing placenta take over.
Can I Get Pregnant During Menopause?
The simple answer to this is “no."
Once menstruation has ceased, no eggs are being released and it would not be possible to get pregnant. Women in new or casual relationships should still consider using condoms as they can protect against sexually transmitted conditions.
It’s very important to remember that bleeding which occurs, even slight spotting, after a full 12 months without menstruation should be investigated as a matter of urgency by a doctor.
In all probability the bleeding will be caused by a minor issue or random hormone surge, but it can be indicative of potentially serious or even fatal conditions and should always be checked out. It’s happened to me twice since I entered full menopause and both times a quick ultrasound examination ruled out anything sinister.