Medically reviewed on February 7, 2022 by Jordan Stachel and Jasmine Thompson. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.
Aging comes with changes to the brain and body, including hormonal changes. In women (and/or people with ovaries), a natural part of getting older is going through menopause. This marks the end of the ability to get pregnant naturally.
Leading up to menopause is a transition phase known as "perimenopause." Many people wonder if they can still get pregnant during perimenopause. Read on to learn more about perimenopause and the chances of getting pregnant below (and consider checking up on key hormones with the at-home Perimenopause Test).
Can you get pregnant during perimenopause? Simply put, yes, but the chances are much lower. The exact pregnancy rate during perimenopause is unknown, though some experts suggest it may be as low as two percent .
Menopause signals the end of the ability to have children naturally. While perimenopause precedes menopause, there is still a menstrual cycle during this time. The menstrual cycle might become more irregular, but as long as a woman is still actively menstruating, there is still a chance of becoming pregnant.
While it can come with changes, perimenopause is a natural part of getting older, and it does not necessarily mark an end to family planning. If you want to become pregnant during perimenopause, one step you take is to learn about raising your progesterone levels, as this hormone prepares the body for pregnancy once an egg is fertilized.
Perimenopause differs from menopause in several ways. Peri is derived from the Greek word for “near” or “around,” so it generally means “around menopause.” Perimenopause is the transitional phase that takes a woman from child-bearing age to menopause. While that might sound straightforward, perimenopause can vary widely from person to person. On average, perimenopause lasts about three to four years, but it may last just a few months for some women. For others, it may last upwards of a whole decade .
The exact age when perimenopause begins varies. Some begin to experience symptoms in their late 40s, while others as soon as their mid to late-30s .
The process of perimenopause leads up to menopause, which marks the end of child-bearing years. Once there have been 12 consecutive months since your last period, menopause officially begins .
Much like menopause, perimenopause is caused by hormonal changes and fluctuations. While several hormones may be involved, estrogen is the main hormone involved in perimenopause. During perimenopause, estrogen levels can fluctuate quite a bit.
Typically, estrogen rises and falls in a predictable pattern during a regular menstrual cycle. Estrogen levels are primarily controlled by follicle-stimulating hormone and luteinizing hormone. The follicle-stimulating hormone causes the follicles to produce estrogen. Once that estrogen has hit a certain level, the brain sends signals to stop producing follicle-stimulating hormone and start producing luteinizing hormone. This stimulates the release of an egg from the ovaries (the process known as ovulation). Excess follicles remaining on the ovaries produce estrogen and progesterone to prepare the body for a potential pregnancy. If pregnancy does not occur, progesterone and estrogen diminish, and there is a period, signaling the start of the next menstrual cycle .
However, as you get older, the number and quality of the follicles produced decreases, which causes a similar reduction in estrogen. These drastic drops in estrogen can cause the body to overcompensate, which can lead to sudden spikes in estrogen. This is often caused by high FSH levels, which is why it can be helpful to have an at-home perimenopause test, like the one from Everlywell, which looks at FSH levels .
Most people associate hot flashes with menopause, but they can start during perimenopause as well. About 35 to 50 percent of those who experience perimenopause have hot flashes, which are characterized by sudden waves of body heat, flushing, and sweating that can last up to 10 minutes at a time. The intensity of hot flashes can vary. For some, hot flashes can feel like some slight warmth, while others may end up soaked with sweat from the sensation of heat .
Hot flashes typically start in the face, neck, scalp, and chest before spreading to the rest of the body. They are also more common at night, which can lead to the associated night sweats. This can contribute to sleep disruptions and insomnia, affecting overall health and behavior while awake .
Many people will have irregular periods during perimenopause. There is less progesterone, a hormone that helps regulate the uterine lining, resulting in the uterine lining growing thicker during the menstrual cycle. A larger, more ample uterine lining means more blood and tissue shed, resulting in heavier menstrual periods .
Vaginal dryness, also known as vaginal atrophy, results from less estrogen, which regulates the health of vaginal tissue. With less estrogen, the vaginal tissues become thinner and dryer. This can contribute to itching, irritation, and general discomfort. Sex can also be painful without lubrication .
Related to the above, After menopause, women produce less estrogen, a hormone that helps keep the lining of the bladder and urethra healthy. Deterioration of these tissues can aggravate incontinence .
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2. Perimenopause: Rocky road to menopause. Harvard Health. URL. Accessed February 7, 2022.
3. Perimenopause - symptoms and causes. Mayo Clinic. URL. Accessed February 7, 2022.
4. Urinary incontinence. Mayo Clinic. URL. Accessed February 7, 2022.