Menopause usually happens around the ages of 45 to 55 when ovaries stop producing eggs, and less oestrogen (a female hormone) is made in your body. This triggers menopausal symptoms.
But can you become pregnant during menopause? How do you test to find out – and what are the risks involved in becoming pregnant later in life?
Can you get pregnant during menopause?
Yes, even if you’re not having periods. Fertility naturally declines with age, meaning you’re less likely to become pregnant the older you get. Even so, until you’re sure that you’ve gone through menopause, it’s very important to continue to use birth control if you’re sexually active and don’t want to get pregnant.
If you’re under 50 years old, reliable contraception should be used until you haven’t had any periods for 2 years. If you’re over 50 years old, you should use contraception until it’s been at least 12 months since your last period. Generally, 55 is thought to be the cut-off age for needing contraception, even if you’re still having periods. After this time, you will become menopausal and you won’t be able to get pregnant.
Unintended pregnancies can still happen in the perimenopause even though fertility decreases and menopausal symptoms such as vaginal dryness and mood changes can affect how often you have sex.
After the age of 40, a higher proportion of pregnancies are unplanned. Pregnancies that do occur are at a higher risk of complications, including miscarriage or chromosomal abnormalities, which is when your child is born with a genetic condition such as Down’s syndrome.
Using contraception during menopause
Using hormonal contraception does not affect when you start the perimenopause or how long it may last, but it can hide some of the signs and symptoms because it can affect your hormone levels.
The combined contraceptive pill, patch and contraceptive vaginal ring can be taken if you are over the age of 40 years as long as you have no medical problems, are a healthy weight and you don’t smoke. Your doctor can work out which is the best type for you as some are safer than others.
However, you should switch to another form of contraception when you reach 50. The progesterone-only pill (the ‘mini-pill’) can be continued until you reach the age of 55 after which you will probably no longer need to use contraception.
Again, you should change to another form of contraception when you reach the age of 50.
The Mirena coil can be used during menopause to help manage the effects of one common symptom, which is heavy periods. If the coil is inserted at age 45 or over it can be used as contraception up to the age of 55 and also as part of hormone replacement therapy (HRT).
Other options can include the contraceptive implant which can be used until menopause. There are also non-hormonal options that won't affect your menopause symptoms including a copper intrauterine device (copper coil) and condoms.
When to take a pregnancy test during menopause
Many symptoms of menopause are similar to those of pregnancy. If you get pregnant, you won’t have a period, but you may experience some light spotting that could be mistaken for a period.
You could experience other symptoms like mood swings, problems sleeping, fatigue and headaches, which can also happen in the perimenopause and menopause. When you are pregnant you may also feel sick or vomit (especially in the morning), pee more often and have tender breasts. And in perimenopause and menopause it’s also common to report bladder changes (incontinence and peeing more at night).
If you’re sexually active and experience any of these symptoms, it’s important to do a pregnancy test. This can be done at home or by your doctor.
Home pregnancy tests are available from the pharmacy and measure the levels of the pregnancy hormone human chorionic gonadotropin (hCG) in your pee. It’s present in higher levels if you’re pregnant. A positive test result is almost certainly correct. Negative test results can be less reliable.
What are the risks of late pregnancy?
Becoming pregnant after the age of 35 is classified as a 'later in life' pregnancy because it carries certain risks. These include:
- pregnancy-related high blood pressure (gestational hypertension) and diabetes (gestational diabetes)
- ectopic pregnancy – a life-threatening condition that occurs when the embryo attaches itself outside the uterus
- an increased likelihood of needing a caesarean section (surgical delivery)
- delivery complications, such as excessive bleeding
- a long labour
- genetic conditions in the baby such as Down’s syndrome
When to see a doctor about pregnancy during menopause
If you’re sexually active and you’re still having periods (even irregularly) and believe you may be pregnant, take a home pregnancy test and discuss the result with your doctor.
If you’re over the age of 35 and you’ve had no luck getting pregnant for more than 6 months, you should also talk to your doctor in case you need to investigate a possible fertility problem.
Your health questions answered
Can you do IVF during perimenopause?Answered by: Dr Roger Henderson
If you’re having difficulty becoming pregnant and you think you may be in the perimenopause, speak to your doctor. They’ll be able to discuss how to improve your chances of having a baby. If appropriate, they may be able to refer you to a specialist for consideration of fertility treatments like IVF.
If you’re not eligible for fertility treatment through your healthcare system, you could consider treatment through a private clinic, but you would need to pay for this service.
- menopause occurs around the ages of 45 and 55 when your ovaries stop producing eggs and make less oestrogen
- until that time, you can still become pregnant if you are sexually active
- this means that until after menopause, you should always use contraception if you want to avoid becoming pregnant
- becoming pregnant later in life carries more risks than being pregnant at a younger age
- if you think you may be pregnant during the perimenopause, always do a pregnancy test