Women. Wisdom. Wellness. May 16, 2017 Show 
See a Premier Physician Network provider near you. As you head toward “the big change,” keep in mind that diaper changes aren’t quite out of the picture just yet. You can still get pregnant during perimenopause defined as the years leading up to your final period. This “menopausal transition” brings unpredictable ovulation cycles as estrogen and progesterone hormone levels go up and down. During these years of yo-yoing hormone levels, your ovaries continue to release eggs for fertilization. Translation: You can still become pregnant. Premier Health Ob/Gyn physician J. Scott Bembry, MD, says he’s seen a handful of patients in his own practice who’ve become unintentionally pregnant in their late 40s. Who Can Still Get Pregnant?The bottom line is if you haven’t reached menopause – defined as 12 straight months without a period – you can still get pregnant. Dr. Bembry acknowledges that some women develop a false sense of security when they go off birth control and go for years without becoming pregnant. Similarly, women with a history of infertility might assume they can’t get pregnant in their 40s. The same goes for women with premature ovarian failure. While these patients may look like they’re menopausal, they can still ovulate and become pregnant. How to Tell If You’re Pregnant or PerimenopausalMany pregnant women have no symptoms other than a missed period, which could be confused with perimenopause. If you’re in perimenopause and are having irregular periods, pregnancy should be considered, Dr. Bembry explains, especially if you’re not using contraception. He advises pregnancy tests on women up to age 52 or even 60 if menopause has not been confirmed and no form of contraception has been used. This is especially important for patients with abdominal symptoms, which could be a sign of a life-threatening tubal pregnancy. Denying or ignoring possible pregnancy can delay medical care, which could be risky. Both the risk of miscarriage and having a baby with a chromosomal abnormality increase with age. “Pregnancy can be so far out of patients’ minds that they seek care further along than you’d normally see,” he says. The bottom line is if you haven’t reached menopause – defined as 12 straight months without a period – you can still get pregnant. How to Protect Against Unplanned PregnancyTo prevent a baby bump on your road to menopause, use an effective, safe and appropriate method of birth control until your menopause is confirmed. Natural family planning (the rhythm method) is not recommended for perimenopausal women because irregular periods make predicting ovulation difficult. Many contraception options exist. Dr. Bembry says vasectomy is the most effective form of birth control, as long as post-procedure care is followed, but admits a lot of men “just don’t go there.” When considering birth control options, talk to your physician. She can discuss risks, effectiveness rates, perimenopausal symptom relief and even which methods can protect against certain cancers.
See a Premier Physician Network provider near you. Source: North American Menopause Society; National Institute on Aging; J. Scott Bembry, MD, Premier Health Specialists
Small Steps: Talk About It. If your spirits have taken a dive during menopause, talk to your women friends or consult with a counselor. How do I know if it’s menopause or pregnancy? Can I get pregnant at 50 years old? Or is it too late? These are just some of the questions women find themselves asking about fertility as they progress into the early years of menopause and their period is ‘late’ for the first time in years. Women are waiting longer now than ever before to start their families so it’s important to address these questions head-on. We looked into the research to help provide helpful insights into what menopause means for women who might still be thinking about having children – or not. Perimenopause is defined as the years leading up to menopause, which formally occurs one full year after your last period. During this time, women may experience all the trademark symptoms usually associated with menopause like night sweats, hot flashes, and mood swings. These symptoms make it seem like you can’t get pregnant anymore, but that’s not entirely true. As long as you still have your period—no matter how irregular—you can still get pregnant. 14 Surprising Facts Every Woman Should Know About Perimenopause Because you can still get pregnant during perimenopause, it’s important to continue using contraception if you don’t want to get pregnant. There are hormone changes happening during perimenopause that can result in multiple eggs being released at the same time.1 This can not only make it more likely to get pregnant but to have twins as well! 1 Even if you have a tried and true contraceptive method, perimenopause is a good time to check-in with your doctor. Some contraceptive methods can exacerbate symptoms, while others may help alleviate them. Either way, it’s worth re-evaluating your options during this new stage of life. Perimenopause symptoms can last up to ten years for some women, and many of them are similar to pregnancy symptoms. It’s important to listen to your body and pay attention to any changes. Here are just a few examples of the symptoms that perimenopause and pregnancy share:2, 3
You can always take an at-home pregnancy test and it’s highly unlikely you’ll get a fake positive, even though hormones can fluctuate a lot during perimenopause. If you’re still curious about what’s causing your symptoms—go to the doctor and get your hormones checked. You may not be pregnant, however, there may be other health conditions that are influencing your hormones and therefore your symptoms. By the time a woman reaches the menopausal transition, the number of immature egg cells available for fertilization has gone from roughly 1–2 billion at birth to approximately 1,000.4 The eggs that are available later in life also aren’t fertilized as easily.1 These are all reasons why it may take longer to get pregnant later in life, but they shouldn’t discourage you from trying if you really want children. This natural decline of reproductive function and specific hormones can lead to some complications during pregnancy. For example, it’s more common for women over 35 to develop complications like gestational diabetes and high blood pressure during pregnancy.1 Babies born to older women a higher risk to have chromosome abnormalities (such as Down’s syndrome), and low birth weight or even premature births.1 These complications may also lead to an increased risk for a C-section delivery.1 Many and most women, however, still have very healthy pregnancies well into their forties. If you or someone you know is interested in trying to get pregnant later in life but before reaching perimenopause, there are some general guidelines that could help ease the transition.
Staying healthy and active during pregnancy is important at any age, but especially for older women. If you’re looking to have children later in life, it can help to be extra diligent about keeping up with your healthier habits.
While in-vitro fertilization (IVF) is a popular option for many women waiting to start their families, it’s not an option for everyone. For example, freezing your oocytes (immature egg cells) before age 35 can contribute to healthier IVF pregnancies and births later in life.4 Starting these conversations earlier with your doctor can help you best match your life stage to your life goals, and stay in control of your reproductive health. Once you’ve had a full year without your period the reproductive stage of life is over—and so begins a whole new era of life free from periods and fear of pregnancy. If you still want to start a family, there are other options available like adoption. There are still plenty of children out there in need of love and attention, just waiting for someone like you to say hello. We’re lucky to live in an era in which waiting to have children is not only an option but happening with increasing frequency. As long as you’re aware of the risks, you can forge ahead down this new path freely empowered by the knowledge that some things may be more complicated, but at the end of this road you can still have the family you’ve always wanted. References
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How to tell if its pregnancy or menopause
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