Thankfully old-fashioned images of a woman’s biological clock ticking down the minutes until she reaches menopause are a thing of the past. Yet, even with a more nuanced understanding of a woman’s reproductive years, there are still common misconceptions about fertility—especially when it comes to going through perimenopause.
Perimenopause signals the transitional period before menopause and is accompanied by some pretty significant hormonal shifts. As a quick biology 101 reminder, ovulation—the release of an egg from the ovary—is determined by several key hormones, primarily estrogen and progesterone.
During perimenopause, the delicate hormonal balance that regulates ovulation begins to change. Estrogen levels start to decline, sometimes erratically, impacting ovulation and the menstrual cycle, which can make it harder to become pregnant.
So can you get pregnant during perimenopause? The answer is a resounding yes, but recognizing these changes and seeking expert help when needed can make all the difference.
When does perimenopause occur?
They say that 40 is the new 30. That may be true when it comes to age, but not necessarily when it comes to fertility. “Most women begin experiencing symptoms of perimenopause in their late 40s or early 50s, but perimenopause can also occur in the mid to late 30s or early 40s for some,” Banafsheh Kashani, MD, double board-certified OB-GYN and reproductive endocrinology and infertility specialist explains.
Symptoms of perimenopause
How do you know if you’re in perimenopause? Get up close and personal with your menstrual cycle, says Dr. Kashani. “Some women may report a change in the length of time between cycles, a change in menstrual flow, or even a lack of period some months.” The better you know your cycle, the easier it is to detect changes.
Dr. Kashani shares you may also notice the following:
- Hot flashes
- Mood swings
- Vaginal dryness as estrogen levels drop
Estrogen keeps your vaginal tissues lubricated and elastic. As levels decline, so does moisture, leading to discomfort during intercourse.
Can you get pregnant during perimenopause? Yes, but it may feel different than in your 20s
As menstrual cycles start to change, ovulation becomes harder to predict. “There may be some months that women also don’t ovulate and therefore reduce the chances of being able to conceive.” In other words, there’s less opportunity for egg and sperm to meet.
Women may also find it harder to get in the right headspace for intimacy. “Some women going through perimenopause may have a reduced libido, and this can decrease their desire for intercourse, which can affect their chances of conceiving,” says Dr. Kashani. Estrogen keeps you feeling frisky, so as it drops, so can your sex drive. Add on less vaginal lubrication, and suddenly it feels more difficult—or even painful—to get in the mood.
Perimenopause can impact fertility, but you can take steps to increase your chances
The most important piece to keep in mind is that while you can still get pregnant during perimenopause, it signals a time of declining fertility simply because there are fewer viable eggs left. “Women going through perimenopause have a limited number of oocytes and time is of the essence if you are trying to achieve a pregnancy using your own eggs,” says Dr. Kashani.
As a result, she suggests working with a fertility specialist sooner rather than later to maximize your chances of pregnancy.
But you can take some other steps to be proactive about getting pregnant during perimenopause, starting with making sex more comfortable. Dr. Kashani suggests using a lubricant specially designed for people trying to conceive such as Pre-Seed Fertility lubricant if vaginal dryness keeps you from having sex.
Since the number of eggs left starts to dwindle during perimenopause, health habits that support ovarian health are more important than ever. “The goal is to help optimize oocyte quality,” Dr. Kashani shares. This can include antioxidant supplements, quitting smoking and minimizing alcohol intake.
“Make sure you are exercising and eating a healthy well-balanced diet,” she adds. Research suggests that a diet rich in whole grains, vegetables, and healthy fats 1Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstet Gynecol. 2007;110(5):1050-1058. doi:10.1097/01.AOG.0000287293.25465.e1 can all support fertility.
Not every woman is the same, so Dr. Kashani encourages checking in with your OB-GYN. “Perimenopause symptoms may look different for everyone, so it’s important to stay in tune with your body and see your provider if you have concerns or questions.”
Banafsheh Kashani, MD, is a double board-certified OB-GYN and reproductive endocrinology and infertility specialist focused on providing her patients with the most personalized, compassionate approach to fertility services and treatments. She has been practicing infertility since 2014.
Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstet Gynecol. 2007;110(5):1050-1058. doi:10.1097/01.AOG.0000287293.25465.e1
- 1Chavarro JE, Rich-Edwards JW, Rosner BA, Willett WC. Diet and lifestyle in the prevention of ovulatory disorder infertility. Obstet Gynecol. 2007;110(5):1050-1058. doi:10.1097/01.AOG.0000287293.25465.e1