If you're in your late 30s or 40s and noticing changes in your cycle, you might be wondering: Can you get pregnant during perimenopause? The short answer? Yes, you absolutely can. While fertility declines as you approach menopause, ovulation can still be unpredictable, making pregnancy possible and in fact sometimes when you least expect it.
What Is Perimenopause?
Perimenopause is the transitional phase leading up to menopause, when the body’s reproductive hormones fluctuate. This period can last anywhere from a few years to over a decade, typically starting in the late 30s or early 40s. During this time, estrogen and progesterone levels shift, leading to irregular cycles, heavier or lighter periods, mood swings, and other symptoms. Despite these changes, ovulation can still occur—even if your cycle isn’t as regular as it once was.
How Likely Is Pregnancy During Perimenopause?
While fertility does decline with age, perimenopausal pregnancies happen more often than you might think. According to ACOG (the American College of Obstetricians and Gynecologists), women in their 40s have a lower chance of conception per cycle than younger women, but pregnancy is still possible until menopause officially occurs (defined as 12 consecutive months without a period).
One challenge is that ovulation becomes less predictable. Some months you may ovulate, others you may not, and sometimes you might release multiple eggs. This unpredictability means that relying on cycle tracking alone as birth control can be risky if you’re not planning for a pregnancy.
Signs of Pregnancy vs. Perimenopause Symptoms
One reason perimenopausal pregnancy can be surprising is that many early pregnancy symptoms—fatigue, missed periods, mood changes, and nausea, overlap with perimenopausal symptoms. This makes it easy to mistake pregnancy for just another hormonal shift. If there’s any possibility of pregnancy and your period is irregular, taking a test can help provide clarity.
If you’re hoping to get pregnant, talking with a doctor or fertility specialist can help you navigate options. Some women choose assisted reproductive technologies like IVF, while others focus on optimizing natural fertility through lifestyle and diet.
The Bottom Line
So, can you get pregnant during perimenopause? The short answer is yes! While fertility declines, ovulation is still possible, meaning contraception is necessary if you’re not planning for pregnancy. If you’re trying to conceive, tracking ovulation and working with a healthcare provider can improve your chances. Either way, understanding your body’s changes is key to making informed reproductive health decisions.
Needed supplements are designed for whatever lifestage you are in, from optimizing your fertility, giving and your baby what you need to thrive during pregnancy or supporting your body through perimenopause.
