As you enter the menopausal stage of your life, you might be wondering if you can still get pregnant. It’s a good question, since the answer will affect family planning and birth control decisions.
It’s important to understand this transitional time of life. Even if you’re having hot flashes and irregular periods, it doesn’t mean you can’t get pregnant. It does mean you’re probably a lot less fertile than you once were, though.
You haven’t officially reached menopause until you’ve gone a whole year without a period. Once you’re postmenopausal, your hormone levels have changed enough that your ovaries won’t release any more eggs. You can no longer get pregnant naturally.
Continue reading to learn more about the stages of menopause, fertility, and when in vitro fertilization (IVF) may be an option.
The word “menopause” is often used to describe the time of life following your first symptoms, but there’s more to it than that. Menopause doesn’t happen overnight.
During your reproductive years, you produce estrogen, progesterone, luteinizing hormone (LH), and follicle stimulating hormone (FSH). In the middle of your monthly cycle, LH, FSH, and estrogen work together, prompting your ovaries to release a mature egg during ovulation.
Ovulation can’t occur unless your hormone levels are within the optimal range. If the egg is fertilized, LH stimulates progesterone production to maintain the pregnancy.
Perimenopause is a time of transition — the “change of life.” Your ovaries are starting to produce less estrogen and progesterone. LH and FSH levels are starting to rise as your ovaries are becoming less responsive to them.
As your hormone levels fluctuate, you may start noticing symptoms such as hot flashes and night sweats. Your periods are getting irregular in length and frequency. Your ovaries may release an egg some months, but not others.
Although your fertility is declining, you can still conceive. If you don’t want to get pregnant, you need to use birth control throughout perimenopause. This phase can last for several years.
During perimenopause, your periods may seem to have stopped, but then they start up again. That can happen many times, which can trick you into thinking you’ve reached menopause even though you haven’t.
If it’s been an entire year since your last period, you’ve reached menopause. For most women, this occurs somewhere between the ages of 40 and 55, with an average age of 51.
Once you’ve reached menopause, your LH and FSH levels remain high and your estrogen and progesterone levels remain low. You no longer ovulate and you cannot conceive a child.
Once you’re postmenopausal, your hormone levels will never again be in the suitable range for ovulation and pregnancy. Birth control is no longer necessary.
IVF after menopause has been successfully demonstrated.
Postmenopausal eggs are no longer viable, but there are still two ways you can take advantage of IVF. You can use eggs you had frozen earlier in life, or you can use fresh or frozen donor eggs.
You will also need hormone therapy to prepare your body for implantation and to carry a baby to term.
When compared with premenopausal women, postmenopausal women are more likely to experience both minor and major complications of pregnancy after IVF.
Depending on your overall state of health, IVF after menopause may not be an option for you. It’s worth consulting with a fertility expert who has worked with postmenopausal women.
The short answer is no, but researchers are working on it.
One avenue of study is treatment using a woman’s own platelet-rich plasma (autologous PRP). PRP contains growth factors, hormones, and cytokines.
Early efforts to restore activity in the ovaries of perimenopausal women indicate that ovarian activity restoration is possible, but only temporarily. Research is still in the early stages. Clinical trials are underway.
In a small study of postmenopausal women, 11 of 27 who were treated with PRP regained a menstrual cycle within three months. Researchers were able to retrieve mature eggs from two women. IVF was successful in one woman.
Much additional research on larger groups of women is needed.
Health risks in pregnancy increase with age. After age 35, the risks of certain problems rise in comparison to younger women. These include:
- Multiple pregnancy, especially if you have IVF. Multiple pregnancies can result in early birth, low birth weight, and difficult delivery.
- Gestational diabetes, which can cause health problems for both mom and baby.
- High blood pressure, which requires careful monitoring and possibly medication to ward off complications.
- Placenta previa, which may require bed rest, medications, or cesarean delivery.
- Miscarriage or stillbirth.
- Cesarean birth.
- Premature or low birth weight.
The older you are, the more likely it is that you have a preexisting health condition that could complicate pregnancy and delivery.
After menopause, you may be able to carry a baby to term through hormone therapies and IVF. But it’s not simple, nor is it risk-free. If you’re considering IVF, you’ll need expert fertility counseling and careful medical monitoring.
Other than IVF, though, if it’s been a year since your last period, you can consider yourself beyond your childbearing years.