9 Facts You Didn’t Know About Menopause and Pregnancy
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.
- You can still get pregnant during perimenopause
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.
- Contraception still matters during 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.
- Menopause and pregnancy share similar symptoms
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
- Hot flashes and night sweats
- A missed period
- Breast swelling and pain
- Bloating and cramping
- Changes in feelings about sex
- General fatigue or trouble sleeping
- Mood swings
- Weight gain
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.
- Pregnancy during perimenopause may take a while
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.
- Risks increase for pregnancies after age 35
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.
- There are some steps you can take to ease the pregnancy journey before perimenopause
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.
- Make an appointment before you conceive. Meet with your health care practitioner to discuss your overall health. They might have some suggestions for lifestyle changes that could have a positive effect on improving your chances of a healthy pregnancy.1
- Explore prenatal testing options. There are DNA screenings available to see if your developing baby is at risk. Talk to your doctor about these options.
- Avoid alcohol and tobacco. These substances are definitely off-limits during pregnancy, but given their stress on the body in general, it can’t hurt to limit your exposure to them while trying to get pregnant as well.
- Pregnancy during perimenopause means extra steps to ensure healthiness
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.
- Stay in touch with your doctor once you’re pregnant. You’ll want to check in regularly with your doctor and mention any signs or symptoms you’re feeling. Don’t be afraid to be honest. Even if there’s nothing wrong, talking to your doctor can help put your mind at ease.1
- Keep an eye on your vitamins and minerals. During pregnancy, your body needs and craves all sorts of nutrients in higher quantities. Learn which ones to get more of (folic acid, calcium, iron, vitamin D, etc), and ensure you’re getting it every day. A prenatal vitamin can help fill in any gaps in your diet and is generally recommended during and after pregnancy, especially if you decide to breastfeed.1
- Watch for healthy weight gain. Talk to your doctor about how much weight is right for you to gain. Keeping an eye on this during pregnancy can help support your baby’s health and make it easier to bounce back after delivery.1
- Stay as active as you can. Exercising while pregnant has all kinds of benefits from strengthening important birth muscles to helping boost your energy levels and stamina.1 Pregnancy can present unique challenges to stay active. You may find yourself unable to do certain activities, but don’t worry. There are lots of resources and creative ways to stay active during pregnancy. Chat with your doctor to ensure how best to move your body, especially if you have any preexisting conditions.
- It can help to think about IVF years before perimenopause
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.
- You can’t get pregnant after menopause
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.
- Mayo Clinic. “Pregnancy after 35: Healthy moms, healthy babies.” 2020. Accessed on: March 2, 2020. <https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/pregnancy/art-20045756>
- US Department of Health and Human Services. “Menopause symptoms and relief.” 2018. Office on Women’s Health. Accessed on: March 2, 2020. <https://www.womenshealth.gov/menopause/menopause-symptoms-and-relief>
- US Department of Health and Human Services. “Body changes and discomforts.” 2019. Office on Women’s Health. Accessed on: March 2, 2020. <https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/body-changes-and-discomforts>
- Fritz, R et al. Reproductive aging and elective fertility preservation. J Ovarian Res. 2018; 11: 66.