*Content reviewed by HotPause Health Medical Advisor & Board-Certified OB/GYN Dr. Beverly Joyce

Can You Get Pregnant After Menopause?

Menopause marks a significant transition in a woman’s life, bringing with it many questions and changes—one of the most common being about fertility. Can you get pregnant during perimenopause? Can you get pregnant after menopause? These are crucial questions for many women navigating this new phase. In this article, we’ll explore the possibilities and realities of pregnancy during the menopause transition and after menopause, and what options might be available.

Understanding The Stages of Menopause 

Perimenopause
Perimenopause is the transitional period leading up to menopause, typically starting in a woman’s late 30s or 40s and lasting several years. The average length of perimenopause is four years, but can range from a few months to ten years. During this time, estrogen and progesterone levels begin to fluctuate, leading to symptoms like irregular periods, hot flashes, and mood swings. Despite these hormonal changes, ovulation can still occur sporadically, meaning pregnancy is still possible, though less likely than before.

Menopause
Menopause is a single day of your life. It’s the day that marks the 12 consecutive months without a menstrual period, usually occurring between ages 45 and 55. The average age of menopause is 51. At this stage, the ovaries have significantly reduced their production of estrogen and progesterone, and ovulation ceases.

Postmenopause
Postmenopause refers to the years following menopause. Hormone levels stabilize at low levels, and menstrual periods no longer occur. Natural pregnancy is considered biologically impossible during this phase due to the absence of ovulation.

Can You Get Pregnant During Perimenopause?

Yes, it is possible to get pregnant during perimenopause. Although fertility declines with age, and menstrual cycles become irregular, ovulation can still happen occasionally. If you’re not planning to become pregnant during this time, it’s important to continue using contraception until you have reached menopause (12 months without a period). Once you’ve reached the age of 40, your chances of getting pregnant naturally is about 5% each menstrual cycle. It is estimated that for women 40–44 years of age, 48% of pregnancies are unintended. [1]

Factors Affecting Fertility During Perimenopause

• Hormonal Fluctuations: Irregular hormone levels can make ovulation unpredictable.
• Decreased Egg Quality: Eggs released during perimenopause may be of lower quality, reducing the chances of fertilization and increasing the chances of chromosomal anomalies and miscarriage.
• Lifestyle and Health: Smoking, stress, and overall health can further diminish fertility.

Can You Get Pregnant Once You’re In Menopause?

Once you’ve gone a full year without a menstrual period, your ovaries have stopped releasing eggs, and hormone levels have changed sufficiently to prevent natural conception. Remember, menopause is the single day that marks 12 consecutive months without a period. 

Therefore, once you’re in menopause (post-menopause), natural pregnancy is not possible because the ovaries no longer release eggs. However, advances in assisted reproductive technology (ART) have made it possible for women to become pregnant after menopause using fertility treatments like in vitro fertilization (IVF).

IVF After Menopause

• Donor Eggs: Since postmenopausal women no longer produce viable eggs, IVF typically involves the use of donor eggs from a younger woman.
• Hormone Therapy: Hormone treatments are used to prepare the uterine lining to receive and support the implanted embryo.
• Success Rates and Considerations: Success rates can vary, and the process may involve significant physical, emotional, and financial commitments.

Conclusion

While natural pregnancy is not possible after menopause, and becomes increasingly unlikely during perimenopause, assisted reproductive technologies offer options for those wishing to conceive later in life. It’s important to weigh the potential risks and benefits and to have thorough discussions with healthcare providers.

If you’re experiencing menopausal symptoms and are concerned about pregnancy—either wanting to prevent it or explore the possibility of conceiving—consult your doctor. They can provide personalized advice based on your health history and reproductive goals.

References

1. Johnson-Mallard, V., Kostas-Polston, E.A., Woods, N.F. et al. Unintended pregnancy: a framework for prevention and options for midlife women in the US. womens midlife health 3, 8 (2017). https://doi.org/10.1186/s40695-017-0027-5