If your periods are changing and you’re starting to wonder whether you’re in perimenopause, you might also be asking yourself: Can I still get pregnant? The short answer is yes - pregnancy is still possible during this stage.

Table of contents

1. What happens to fertility in perimenopause

2. How likely is pregnancy after 40

3. If you’re trying - or not trying - to conceive

4. Key takeaway

What happens to fertility in perimenopause

Perimenopause is the transition leading up to menopause, when your hormone levels - especially oestrogen and progesterone - start to fluctuate. Your cycles may shorten, lengthen, or become irregular, and ovulation doesn’t always happen each month. But “not always” is not the same as “never.” As long as your ovaries occasionally release an egg, it’s possible to conceive.

How likely is pregnancy after 40

Fertility naturally declines with age. By your early 40s, the chances of conceiving each cycle are much lower than in your 20s or 30s. The risk of miscarriage or complications is also higher. Still, unplanned pregnancies in perimenopause are more common than many women realise, which is why doctors often advise using contraception until you’ve gone a full year without a period: the official marker of menopause.

If you’re trying - or not trying - to conceive

If you’re trying to conceive, it may take longer and possibly require support from a fertility specialist. If pregnancy is something you want to avoid, talk to your doctor about safe contraception options that work well during this stage of life.

Key takeaway

• Yes, you can still get pregnant in perimenopause.

• Fertility is lower, cycles are irregular, and risks are higher - but ovulation can still occur.

• Use contraception until you’ve gone 12 months without a period if you want to avoid pregnancy.

• If you’re trying to conceive, it may help to get medical support sooner rather than later.

References:

Voedisch, A. J., & Ariel, D. (2020). Perimenopausal contraception. Current opinion in obstetrics & gynecology, 32(6), 399–407. https://doi.org/10.1097/GCO.0000000000000667

Soltes B. A. (2025). Contraception in perimenopause. Menopause (New York, N.Y.), 32(5), 472–474. https://doi.org/10.1097/GME.0000000000002554

O'Connor, K. A., Ferrell, R., Brindle, E., Trumble, B., Shofer, J., Holman, D. J., & Weinstein, M. (2009). Progesterone and ovulation across stages of the transition to menopause. Menopause (New York, N.Y.), 16(6), 1178–1187. https://doi.org/10.1097/gme.0b013e3181aa192d