Although it is well known that the onset of the menopause is associated with the termination of ovarian function and the ending of fertility, it is logical that many women wonder whether pregnancy is possible during the perimenopause. In this article, as well as talking about the possibilities of pregnancy in this situation, we would like to tell you what perimenopause is, as women can sometimes confuse menopause with the period that precedes it (also called premenopause).
What is perimenopause?
To explain what perimenopause is, we must first explain what menopause is. Menopause is when a woman stops menstruating because her ovaries stop producing eggs. It usually occurs between the ages of 45 and 55. It rarely occurs before the age of 40 and in such cases is usually related to medical treatment, surgery or illness.
So when we talk about perimenopause, we are talking about the first symptoms that signal that the menopause is coming. But it does not always happen in such a mathematical way: some women start to feel these symptoms years before the menopause as such becomes effective.
What are the symptoms of perimenopause?
In fact, three out of four women may experience premenopausal symptoms because the production of hormones – oestrogen and progesterone – which regulate menstruation, also begin to decline. Here are the main physical symptoms of perimenopause.
Disrupted menstrual cycles
Hormonal changes generally make cycles shorter. Although some women may have heavier bleeding because there is less progesterone.
Progesterone is a hormone that regulates the lining of the uterus; if there is less progesterone, the lining of the uterus (what the womb wall is covered with to sustain pregnancy if it occurs) becomes thicker and, when it is shed, the resulting menstrual bleeding is heavier.
For all these reasons, hormonal changes can lead to a worsening of the so-called premenstrual syndrome (headache, pain and swelling in the breasts and irritability).
You’ve probably heard of this because it’s the most common symptom of menopause. Like the preceding one, it is related to hormonal changes and sometimes starts years before the menopause actually begins.
Hot flushes are sudden, uncomfortable feelings of heat, with heavy sweating, and are much more common at night. They are treated using hormone therapy, but with restrictions because of the risks associated with such treatment. Nocturnal hot flushes can also interfere with sleep and lead to insomnia.
Vaginal dryness and decreased libido
The drop in oestrogen production causes the skin and mucous membranes to lose moisture and smoothness. Wrinkles increase and there is dryness of the skin in general and of all the mucous membranes which, in the case of the vagina, can become painful due to a lack of lubrication during sexual intercourse. This, together with a decrease in sexual desire as a result of hormonal decline, leads to a decrease in women’s libido.
Most common vaginal and urinary tract infections
On the other hand, when the vaginal mucosa is so dry, the vagina’s defences also decrease and the woman is left without the protective barrier created by the vaginal flora, making infections more frequent. In addition, the tissues lose elasticity and urine may leak more frequently if we do not work the pelvic muscles.
Prior to the onset of the menopause, the perimenopause is often associated with weight gain for nearly all women. Hormones no longer protect us against fat gain and, if we continue with the same calorie intake without increasing physical activity, our bodies tend to put on weight.
Can you get pregnant in perimenopause?
Fertility does decline with age, but it is possible to become pregnant in the perimenopause because the ovary continues to release eggs. Until you have gone twelve months without a period, it is possible for an unplanned pregnancy to occur if you do not take precautions.
However, we mustn’t forget that the quality of eggs and sperm decreases with age, so the probability of getting pregnant spontaneously after the age of forty is much lower than at the age of twenty. During the perimenopause, some experts point to a spontaneous pregnancy rate of less than 2% (and several of these pregnancies will end in miscarriage due to the low egg quality associated with age), so if you are in a period of perimenopause and want to get pregnant, we recommend you seek help from Eugin’s fertility specialists.
In fact, thanks to technical advances in terms of assisted reproduction, there are several options that can help you increase your chances of getting pregnant during perimenopause. At Eugin, we offer you multiple treatments tailored to each case to help you, as well as healthy tips that you can find in our blog to increase your chances.
If you have gone from perimenopause to menopause, which is when there are no more menstrual periods, but you want to have children, it is essential to turn to egg donation.
Are there any risks involved in pregnancy during perimenopause?
A few weeks ago, we wrote an article in which we told you about the risks that may be associated with pregnancy after the age of 40, risks that include an increase in miscarriages, prematurity, or complications in pregnancy and childbirth (such as gestational diabetes, gestational hypertension and others), so pregnancies of mothers above this age should be closely monitored just in case.
Higher risk does not necessarily mean that perimenopausal women who become pregnant will have more pregnancy complications. Many women can – and do – have babies at this age without problems, but it is wise to take precautions and prepare a woman’s body to be as ready as possible to receive her baby.