Pregnancy During Perimenopause? Yes, It's Possible

ByTarin Hussain
Updated: 30 Oct 2025, 8:00 am
Medical Reviewed by Dr. Anupama Santosh

When you hear the word perimenopause, you might instantly think your chance of getting pregnant is over. But that’s not really how it works. Your ovaries may still release eggs, even if your cycle feels unpredictable. This means there is still a chance of natural conception.

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If you’re in your 40s or noticing changes in your menstrual cycle, it’s natural to wonder what this means for your fertility. People often believe that irregular cycles or shifting hormones automatically mean the end of fertility. That’s not really the case. Your body may be changing, but your reproductive organs don't shut down overnight. Your ovaries can still release eggs, which means pregnancy is still on the table.
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You might be asking yourself if this is the right time to try for a baby. Or maybe you’re worried about the risks and want to know what it really takes to have a healthy pregnancy in your 40s. These questions are completely normal. Whatever your situation, the most important thing is to really get to know your body and keep yourself informed.

What is Perimenopause and How Does it Affect Your Body?

Perimenopause is the time when your body begins to wind down its reproductive years. Menopause comes after you haven’t had a period for a full year.

During perimenopause, your ovaries gradually produce less oestrogen, a key hormone for reproduction. Because of this, your menstrual cycle can change, and you might notice other symptoms too. This phase can last anywhere from a few months to as long as a decade.

Most people notice it in their mid-to-late 40s, but it can start earlier for some. Many also begin to wonder about the chances of getting pregnant at 45 naturally during this stage.
This is what you might notice during perimenopause:
  • Irregular periods.
  • Hot flushes and night sweats
  • Vaginal dryness
  • Mood changes
  • Sleep troubles
  • Pelvic changes
These changes happen because oestrogen and progesterone fluctuate unpredictably.

Pregnancy During Perimenopause: Is It Possible?

Yes, you absolutely can get pregnant during perimenopause. Just because your periods are irregular doesn’t mean you’re no longer fertile.
As long as your ovaries are releasing eggs, even occasionally, pregnancy is possible. Here’s why:
  • Unpredictable ovulation: Your ovaries don’t release an egg every month, but sometimes they do unexpectedly due to hormonal surges. Some people may even ovulate more than once in a cycle, increasing the chance of conceiving.
  • Fertility declines, but doesn’t disappear: Your chances of getting pregnant drop with age. It declines around 10 per cent per month in your early 40s, 2 to 3 per cent in your late 40s, and less than 1 per cent by age 50. This is why many wonder how to get pregnant at 47 naturally while navigating these changes. But pregnancy is still possible until you’ve gone a full year without a period.
  • Egg quality: Eggs released during perimenopause may be lower in quality, which can raise the risk of complications. Still, a fertile egg can lead to pregnancy.


How to Boost Your Chances of Pregnancy During Perimenopause

If you’re trying to get pregnant during perimenopause, your fertility is lower. But there are things you can do to improve your chances:
Track ovulation: Ovulation can be unpredictable, so using a fertility app or tracker helps you know the best days to conceive.
  • Eat a healthy diet: Focus on whole grains, fruits, and healthy fats to support your overall health and fertility.
  • Consider supplements: Some studies suggest that supplements like coenzyme Q, omega-3 fatty acids, folic acid, or vitamin D may improve egg quality or fertility. But never take supplements on your own, always consult your doctor first.
  • Exercise moderately: Regular, gentle exercise like walking or yoga can help.
  • Explore fertility treatments: Assisted reproductive technology (ART), like in vitro fertilisation (IVF), can improve your odds.

What Are the Risks of Pregnancy During Perimenopause?

Pregnancy in your 40s or during perimenopause comes with higher risks for you and the baby. Egg quality declines with age, so these pregnancies need closer monitoring.
These are the main risks:
  • Miscarriage: Lower egg quality can increase the chance of chromosomal problems, which may lead to miscarriage.
  • Chromosomal issues in the baby: The risk of conditions like Down’s syndrome is higher because of changes in egg quality.
  • Gestational diabetes and high blood pressure: These conditions are more common in older parents and can complicate pregnancy.
  • Ectopic pregnancy: There’s a risk of the embryo growing outside the uterus.
  • Caesarean delivery or long labour: Pregnancy at an older age can lead to delivery complications, including a higher chance of needing a C-section.
  • Premature birth or postpartum haemorrhage: These are also more likely in pregnancies during perimenopause.
For those thinking about how to get pregnant at 47 naturally, guidance from a fertility specialist can really help. They can explain your options if you have challenges like a low ovarian reserve or conditions such as endometriosis.
Your hormones fluctuate during perimenopause, and your periods may become irregular, but it doesn’t mean your fertility is gone. You can still get pregnant with proper care, support, and guidance from your doctor. Keep track of your ovulation and focus on a healthy lifestyle to give yourself the best chance!
You’re not alone in your journey when trying to conceive. Join our supportive community to connect with others, share experiences, and find encouragement every step of the way.

FAQs on Pregnancy During Perimenopause? Yes, It's Possible

  1. Do hot flushes stop if you become pregnant during perimenopause?
    No, hot flushes do not necessarily stop if you become pregnant during perimenopause. Some people continue to experience them, and they can also be a sign of early pregnancy.
  2. Can perimenopause cause false pregnancy symptoms?
    Yes, hormonal shifts during perimenopause can mimic pregnancy signs like missed periods, mood swings, breast tenderness, or fatigue.
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