There are many myths around perimenopause and pregnancy, but it is, in fact, possible to get pregnant.
\nPerimenopause, by definition, means that your menstrual cycle becomes irregular in the lead-up to menopause, which is when your periods stop completely for at least a continuous period of 12 months.
\nDuring perimenopause, ovulation still occurs, usually in a more unpredictable pattern than before, which means there is still a chance of pregnancy.
\nSome healthcare providers say people might ovulate multiple times in a short period of time; this is because of hormonal fluctuations.
For many, perimenopause usually begins around the mid-40s, although onset can vary widely, and there is still a lack of global studies to give a more inclusive outlook.
\nPerimenopause is not defined by a concrete age, timeframe, or symptoms. It varies between people; some do not experience symptoms at all. For some people, ovulation may still occur, usually in an unpredictable pattern than before.
The difference between perimenopause and menopause can get confusing.
\nPerimenopause literally means “around menopause.” It is when you are starting to reach the end of your menstruating years, and for some, during this time, periods can become irregular.
\nThe length of this phase varies from person to person; it can last anywhere from 2–8 years, and in some rare cases it can last as long as 10 years.
Menopause is when you are not having a period for 12 months, and you’re not using hormonal contraception so that no withdrawal bleed could be confused with a period.
\nSadly, like a lot of sexual and reproductive health topics, there is a huge lack of research on perimenopause and menopause.
It is only recently that more people are talking about perimenopause and menopause openly and the symptoms they have experienced.
\nThat’s partly because of negative stigma and patriarchal society that likes to dismiss people who are perimenopausal or menopausal, commonly using negative phrases like “past their reproductive years.”
This is simply not true. A person’s worth should never be defined by their reproductive organs and how they function.
\nGenerally, irregular ovulation and age both reduce fertility by decreasing the frequency of available eggs and lowering egg quality. But this is not a set rule for everyone.
\nThose who are born with ovaries have a fixed number of eggs (roughly 1 to 2 million). However, over time these eggs naturally decrease, dropping to around 25,000 by age 37 and about 1,000 by menopause. But again, these figures are on average and not the same for everyone.
\nFor some, perimenopause symptoms can present very similarly to pregnancy symptoms.
\nIt is also important to remember that not everyone has symptoms of perimenopause.
Perimenopause symptoms might include:
\nChanges to your menstrual cycle such as flow, number of days between periods
\nMany of these symptoms are similar to common pregnancy symptoms.
\nBut there are some pregnancy symptoms that you might experience that you typically don’t experience in perimenopause.
\nThese might include:
\nIf your periods are irregular, it can be difficult to know exactly when your last missed period was and when to take a test.
\nIf this is the case, keep in mind pregnancy can be detected 10 to 14 days after having unprotected sex using a home test.
Follow the instructions on the test kit carefully to get the most accurate reading.
\nIf the test is positive, it may indicate pregnancy. If it’s negative but your period is still late, try testing again in a few days to be sure.
When thinking about contraception during perimenopause, there are a few things you might want to consider or discuss with a healthcare professional.
\nThis can include whether you are taking HRT or other medications, and any health conditions you might have.
\nSome contraceptive methods can help with reducing perimenopause symptoms.
\nThe estrogen in some methods can help with hot flashes and other menopausal symptoms, and it can help improve bone density, which declines during perimenopause.
\nIf you are not sure what HRT is, it is a medical treatment that restores declining levels of estrogen, progesterone, and sometimes testosterone during perimenopause and menopause.
\nIf you are considering HRT (hormone replacement therapy), it is useful to know that it is not compatible with all contraceptive methods.
\nHormonal contraception includes progesterone and oestrogen (combined method), or progesterone only.
\nSome of the combined options are the combined pill, vaginal ring, and the patch.
\nHowever, these three methods cannot be used at the same time as HRT, as the hormone levels in these methods are much higher.
\nBut they can act as a replacement for HRT, as they can help with symptoms.
It is not advised to use the three combined methods listed above after the age of 50 or if you have certain health conditions because there can be a higher risk of blood clots.
\nProgestogen-only methods can be used safely with HRT. These include the injection, the implant, the progestogen-only pill, and the hormonal coil (LNG-IUD).
\nUnlike the combined methods, they don’t contain oestrogen.
If you choose nonhormonal options of contraception, there is less to consider, as these methods won’t interfere with your hormone levels. Therefore, they won’t cause any hormonal side effects.
\nThe downside is that nonhormonal methods cannot help with menopause and perimenopause symptoms.
\nNonhormonal options include condoms, the copper coil, caps, and diaphragms.
\nWith nonhormonal options, it also means you will be able to tell when you enter perimenopause and then menopause.
\nWith combined hormonal options and progesterone-only methods, this can be less clear sometimes, because you could continue to get a withdrawal bleed that looks like a period, which can make it hard to know when you’ve reached menopause.
\nWhatever you choose, the decision should be based on what makes you feel comfortable, safe, and empowered.
\nThis is a decision that can vary depending on your situation and preferences.
\nIf you have not had a period for 12 consecutive months, and you are not taking any hormonal contraception, you have likely entered menopause.
\nWhen you are in menopause, the chance of natural pregnancy is extremely low, as your body has stopped producing the hormones related to fertilizing an egg.
\nOther health advice says that after the age of 55, it is very rare that someone can get pregnant.
\nThe short answer is no. HRT does not prevent pregnancy.
\nHRT contains estrogen and progesterone, but the doses of these hormones are meant to relieve menopause symptoms, not to stop ovulation the way birth control does.
\nIf you are still in perimenopause, ovulation can still happen.
\nIf you don’t want to get pregnant and you have had unprotected sex, you can see if emergency contraception is available to take in your country.
\nIf you prefer to wait and take a pregnancy test and it is positive, you can discuss the options available to you with a free, confidential abortion counseling and emotional support service, safe2choose.
\nThe medically trained abortion counselors help provide unbiased guidance to people around the world to make the decision that is best for them depending on their situation.
\nFinding a contraceptive method that fits your needs can take time and feel like a challenging process.
\nTo make life easier, you can use Find My Method’s chatbot or head to the FMM page and see the comparison between all the methods and what is available in your country.
\nSOURCES
\nhttps://www.nhs.uk/conditions/menopause-and-perimenopause/what-are-menopause-and-perimenopause/
\nhttps://www.uhhospitals.org/blog/articles/2025/08/can-you-get-pregnant-during-perimenopause
\nhttps://www.britishfertilitysociety.org.uk/fei/at-what-age-does-fertility-begin-to-decrease/
\nhttps://www.clearblue.com/menopause/myths-and-facts-about-perimenopause
\nhttps://pmc.ncbi.nlm.nih.gov/articles/PMC11224163/
\nhttps://safe2choose.org/blog/am-i-pregnant-when-to-test-what-to-expect
\nhttps://www.london-gynaecology.com/menopause-when-to-stop-contraception/
\nhttps://www.medicalnewstoday.com/articles/can-you-get-pregnant-on-hrt
\nhttps://safe2choose.org/abortion-counseling
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