Can You Get Pregnant During Perimenopause?

A headshot of Katherine Jacobs, nurse practitioner at Haven Birth and Wellness.
Katherine Jacobs
 / 
January 21, 2025
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Perimenopause is a stage of life that often comes with more questions than answers. It’s a time when your body is transitioning, hormones are shifting, and cycles are becoming less predictable.

One question I hear often is, “Can you get pregnant during perimenopause?” The short answer is yes — you can.

Whether you’re looking to avoid pregnancy or hoping to conceive, understanding what’s happening in your body during perimenopause can help you take the right steps for your goals. Let’s break it all down.

What Is Perimenopause?

Because perimenopause is defined in relation to menopause, it’s helpful to start with a definition of menopause itself. Menopause means going a full year without a menstrual bleed. In other words, your body ceases ovulating completely.

Perimenopause, meaning “around menopause,” is the transitional time leading up to menopause. The duration varies widely, lasting anywhere from two to 10 years. During this time, certain hormones — particularly estrogen and progesterone — begin to decline. This can prompt symptoms like mood swings, hot flashes, or sleep disturbances, and leads to an increasingly irregular and unpredictable menstrual cycle.

Can You Get Pregnant During Perimenopause?

The simple answer is yes, you absolutely can get pregnant during perimenopause. Here’s why: Even if your cycles become irregular, you might still ovulate during any given month. And if you’re ovulating, pregnancy is possible.

Quote: Can You Get Pregnant During Perimenopause?

This unpredictability is one of the more tricky aspects of perimenopause. Some months you might ovulate, and other months you might not. One or two missed periods doesn’t necessarily mean your body is finished with ovulation. Until you’ve gone 12 consecutive months without a menstrual bleed, ovulation — and therefore pregnancy — remains possible.

That said, conception may be more challenging during perimenopause. Egg quality and hormone levels are declining, which can affect fertility. But “more challenging” doesn’t mean “impossible”!

If You DO Want to Get Pregnant During Perimenopause

If you want to conceive during perimenopause, there’s hope! While it may require more effort and support, pregnancy is possible. Here are some steps to consider:

  • Consult a Healthcare Professional: Working with a specialized healthcare provider to assess your hormone levels and overall health can help you create a personalized plan to optimize your likelihood of conception.
  • Boost Your Fertility: Set the stage for optimal fertility through mindful nutrition and other fertility-supporting strategies.
  • Explore Fertility Options: If conception proves challenging, there are other paths to parenthood, such as fertility treatments. Even if you’ve reached menopause, options like IVF might still be available, though this would require consultation with fertility specialists.
Graphic: Can You Get Pregnant During Perimenopause?

If You DON’T Want to Get Pregnant During Perimenopause

Though conception can become more difficult, it isn’t always. If you don’t want to become pregnant during perimenopause, it’s best to continue using some method of contraception until you’ve gone a full 12 months without a menstrual bleed.

An important note: Natural family planning methods, which involve tracking ovulation, can become less straightforward and more taxing during perimenopause. If preventing pregnancy is a priority, consider including a backup method of contraception — such as condoms — in your planning.

Is It Perimenopause or Pregnancy?

Since perimenopause and early pregnancy share some similar symptoms — like missed periods and mood changes — women aren’t always sure which they’re experiencing. The only way to know with certainty is by taking a pregnancy test. If you’re ever unclear, reach out to your healthcare provider for guidance.

Can You Get Pregnant During Perimenopause? The Bottom Line

So, the answer to “Can you get pregnant during perimenopause?” is a resounding yes. While fertility naturally declines as you age, ovulation doesn’t stop completely until menopause. This means pregnancy remains a possibility — whether you’re trying to avoid it or hoping to achieve it.

If you’re trying to avoid pregnancy, continue using contraception until you’ve gone 12 consecutive months without a menstrual bleed. And if you’d like to conceive, don’t lose hope — work with an experienced healthcare provider to optimize your chances.

Perimenopause is a unique and sometimes challenging phase of life. The experience is different for every woman, and we’re here to offer resources, support, and encouragement through it.

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A headshot of Katherine Jacobs, nurse practitioner at Haven Birth and Wellness.
Katherine Jacobs, RN, MSN, FNP-BC

Katherine Jacobs is a board-certified Family Nurse Practitioner with nearly two decades (17 years) of experience in pediatrics and women's health, along with specialized training from The Institute of Functional Medicine. She focuses on identifying the root causes of illness and guiding patients toward optimal health through personalized, holistic care. With a commitment to integrating lifestyle choices and environmental factors into her treatment plans, Katherine is dedicated to empowering her patients on their wellness journeys. Outside of work, she enjoys outdoor adventures, baking, and spending time with her family.

Disclaimer: The content on the Haven Birth and Wellness website is created and/or reviewed by qualified Certified Nurse Midwives and healthcare professionals. We strive to provide accurate and detailed information for our readers. However, this blog is intended for informational purposes only and should not be considered a substitute for professional medical advice. Your own healthcare provider is best equipped to understand your unique situation and medical history. Always consult with your healthcare provider before making any decisions that may affect your health.