Do You Still Ovulate During Perimenopause
While the level of estrogen in your body may rise and fall unevenly during perimenopause, estrogen is gradually on the decline and with that comes a decline in ovulation. As changes happen to your menstrual cycle, you may begin having cycles where an egg isnt released or ovulation doesnt occur.
That doesnt mean that ovulation has stopped altogether. Irregular periods may be the result of not ovulating every month, but your body is still able to ovulate, the schedule just might be more erratic.
How Does Natural Menopause Occur
Natural menopause is the permanent ending of menstruation that is not brought on by any type of medical treatment. For people undergoing natural menopause, the process is gradual and is described in three stages:
Perimenopause or “menopause transition”: Perimenopause can begin eight to 10 years before menopause when the ovaries gradually produce less estrogen. It usually starts when you’re in your 40s. Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last one to two years of perimenopause, the drop in estrogen accelerates. At this stage, many people may experience menopause symptoms. But you are still having menstrual cycles during this time and can get pregnant.
Menopause: Menopause is the point when you no longer have menstrual periods. At this stage, your ovaries have stopped releasing eggs and producing most of their estrogen. Menopause is diagnosed when you’ve gone without a menstrual period for 12 consecutive months.
Postmenopause: This is the name given to the time after you have not had a period for an entire year . During this stage, menopausal symptoms, such as hot flashes, may ease for many people. However, some people continue to experience menopausal symptoms for a decade or longer after the menopause transition. As a result of a lower level of estrogen, those in the postmenopausal phase are at increased risk for several health conditions, such as osteoporosis and heart disease.
How Can I Treat The Symptoms
There are a bunch of ways.
Lifestyle changes. A healthy diet and regular exercise program will help manage your symptoms and boost your health. This is a great time to finally kick any old, unhealthy habits like smoking or drinking too much alcohol. To help with hot flashes, dress lightly and in layers. Avoid triggers like caffeine and spicy foods. And if you stay sexually active, that may help preserve your vaginal lining.
Prescription medication for hot flashes. If you still have your uterus, your doctor might prescribe treatment with estrogen and progesterone. This is called combination hormone therapy or hormone replacement therapy . It helps with hot flashes and night sweats, and it may help prevent osteoporosis. If you donât have a uterus, you might get estrogen alone.
Hormone therapy isnât for everyone. Donât take it if you’ve ever had breast cancer, uterine or “endometrial” cancer, blood clots, liver disease, or a stroke. Also don’t take it if you might be pregnant or you have undiagnosed vaginal bleeding.
If you can’t or don’t want to take hormones, other medications can ease symptoms. They include antidepressants, antiseizure drugs, or blood pressure medications to help with hot flashes and mood swings.
Prescription and OTC medication for vaginal dryness and sleep problems. You can try topical estrogen, lubricants, and non-estrogen prescriptions for dryness and painful sex. OTC or prescription sleep aids can help if you have trouble falling asleep.
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As you head toward the big change, keep in mind that diaper changes arent quite out of the picture just yet. You can still get pregnant during perimenopause defined as the years leading up to your final period.
This menopausal transition brings unpredictable ovulation cycles as estrogen and progesterone hormone levels go up and down. During these years of yo-yoing hormone levels, your ovaries continue to release eggs for fertilization. Translation: You can still become pregnant.
Premier Health Ob/Gyn physician J. Scott Bembry, MD, says hes seen a handful of patients in his own practice whove become unintentionally pregnant in their late 40s.
Can Menopause Cause Facial Hair Growth
Yes, increased facial hair growth can be a change related to menopause. The hormonal change your body goes through during menopause can result in several physical changes to your body, including more facial hair than you may have had in the past. This is caused by testosterone being relatively higher than estrogen. If facial hair becomes a problem for you, waxing or using other hair removers may be options.
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Can You Get Pregnant During Menopause
Once upon a time, it was common to see that most pregnant women were in their twenties. And while pregnancy in that decade is still common, it has also become the norm for women to wait until they are more established in their careers before starting a family. Or sometimes, they just dont feel the desire to have children until theyre in their 30s or 40s, and they go on to carry successful pregnancies.
But how late is too late to wait? Is it possible to get pregnant after menopause?
What Causes Postmenopausal Bleeding
Vaginal bleeding during postmenopause isn’t a normal side effect of decreasing hormone levels. In some cases, the dryness in your vagina could cause some light bleeding or spotting after sex. In other cases, it could indicate a condition like endometrial hyperplasia or uterine fibroids, infections like endometritis, or cancer. Contact your healthcare provider if you experience any vaginal bleeding so you can be evaluated.
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How To Tell If Youre Pregnant Or Perimenopausal
Many pregnant women have no symptoms other than a missed period, which could be confused with perimenopause. If youre in perimenopause and are having irregular periods, pregnancy should be considered, Dr. Bembry explains, especially if youre not using contraception.
He advises pregnancy tests on women up to age 52 or even 60 if menopause has not been confirmed and no form of contraception has been used. This is especially important for patients with abdominal symptoms, which could be a sign of a life-threatening tubal pregnancy.
Denying or ignoring possible pregnancy can delay medical care, which could be risky. Both the risk of miscarriage and having a baby with a chromosomal abnormality increase with age. Pregnancy can be so far out of patients minds that they seek care further along than youd normally see, he says.
The bottom line is if you havent reached menopause defined as 12 straight months without a period you can still get pregnant.
What Can I Do To Prevent Osteoporosis
Osteoporosis isnt entirely preventable, but you can take steps to strengthen your bones. Eating foods high in calcium like cheese, yogurt, spinach or fortified cereals can help boost calcium intake. Adding a calcium supplement can also help. Some people also need a vitamin D supplement because it helps their body absorb calcium.
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Should I Freeze My Eggs
Aside from lifestyle interventions, its important to consider fertility preservation sooner rather than later if you think you may be deferred in being able to start a family, whether its through lack of a suitable partner or due to career progression. Sometimes the desire to have a child is aroused later on in women and sometimes it occurs because of a new relationship, but where possible, preservation via egg or embryo freezing up to the age of 40 is something that will give the best chance of success later on.
What has recently been hailed as a new menopause cure involves the surgical extraction of ovarian tissue, currently being done for women with severe conditions that would tip them into an early menopause, such as cancer.
The tissue is frozen and then re-implanted into the woman, allowing a woman the chance to have biological children later in life and avoid the debilitating symptoms of the menopause for what could be another decade or two. However, though healthy children have been born around the world this way, it isnt clear whether this is something that should become a fertility preserving measure in women who are not at risk of an early menopause.
The key is to consider your fertility from earlier in life and to discuss it with your doctor, to help you make the best decisions.
Are There Any Tests For Menopause
The most accurate way to tell if it’s happening to you is to watch your menstrual cycles for 12 months in a row. It helps to keep track of your periods and chart them as they become irregular. Menopause has happened when you have not had any period for an entire 12 months.
Your doctor can check your blood for follicle stimulating hormone . The levels will jump as your ovaries begin to shut down. As your estrogen levels fall, youâll notice hot flashes, vaginal dryness, and less lubrication during sex.
The tissue in and around your vagina will thin as estrogen drops, too. The only way to check for this is through a Pap-like smear, but itâs rarely done. As this happens, you might have urinary incontinence, painful sex, a low sex drive, and vaginal itching.
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Can I Get Pregnant If I Have Gone Through Menopause
No, you cant get pregnant after menopause because ovulation is no longer occurring. Once you have gone 12 months without a period, you are considered to have reached menopause.
A note from Cleveland Clinic
Menopause is a natural and normal part of the aging process. Once you are in menopause, you have gone 12 months without a menstrual period. It is common to experience symptoms like vaginal dryness and hot flashes. Be open with your healthcare provider about the symptoms youre experiencing and how they impact your quality of life. They can recommend treatments to manage your symptoms and make you more comfortable.
Last reviewed by a Cleveland Clinic medical professional on 10/05/2021.
How To Protect Against Unplanned Pregnancy
To prevent a baby bump on your road to menopause, use an effective, safe and appropriate method of birth control until your menopause is confirmed.
Natural family planning is not recommended for perimenopausal women because irregular periods make predicting ovulation difficult.
Many contraception options exist. Dr. Bembry says vasectomy is the most effective form of birth control, as long as post-procedure care is followed, but admits a lot of men just dont go there.
When considering birth control options, talk to your physician. She can discuss risks, effectiveness rates, perimenopausal symptom relief and even which methods can protect against certain cancers.
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What Is Hormone Therapy For Menopause Like
During menopause, your body goes through major hormonal changes, decreasing the amount of hormones it makes, particularly estrogen and progesterone. Estrogen and progesterone are produced by the ovaries. When your ovaries no longer make enough estrogen and progesterone, hormone therapy can be used as a supplement. Hormone therapy boosts your hormone levels and can help relieve some symptoms of menopause. Its also used as a preventative measure for osteoporosis.
There are two main types of hormone therapy:
- Estrogen therapy : In this treatment, estrogen is taken alone. Its typically prescribed in a low dose and can be taken as a pill or patch. ET can also be given to you as a cream, vaginal ring, gel or spray. This type of treatment is used after a hysterectomy. Estrogen alone cant be used if you still have a uterus.
- Estrogen Progesterone/Progestin Hormone Therapy : This treatment is also called combination therapy because it uses doses of estrogen and progesterone. Progesterone is available in its natural form, or also as a progestin . This type of hormone therapy is used if you still have your uterus.
Hormone therapy can relieve many of the symptoms of menopause, including:
- Hot flashes and night sweats.
- Vaginal dryness.
- Pulmonary embolism.
These risks are lower if you start hormone therapy within 10 years of menopause. After that point, your risk for cardiovascular diseases is higher.
Health Risks For Pregnancies Later In Life
Health risks in pregnancy increase with age. After age 35, the risks of certain problems rise in comparison to younger women. These include:
- Multiple pregnancy, especially if you have IVF. Multiple pregnancies can result in early birth, low birth weight, and difficult delivery.
- Gestational diabetes, which can cause health problems for both mom and baby.
- High blood pressure, which requires careful monitoring and possibly medication to ward off complications.
What Medications Are Used To Treat Postmenopausal Symptoms
Hormone therapy could be an option, although healthcare providers often recommend using it for a short amount of time and in people under the age of 60. There are health risks associated with hormone therapy like blood clots and stroke. Some healthcare providers do not recommend using hormone therapy after menopause has ended or if you have certain medical conditions.
Some medications your healthcare provider may consider helping with postmenopausal symptoms are:
- Antidepressants for mood swings or depression.
- Vaginal creams for pain related to sexual intercourse and vaginal dryness.
- Gabapentin to relieve hot flashes.
Oftentimes your provider will recommend lifestyle changes to help manage your symptoms.
Can Menopause Be Treated
Menopause is a natural process that your body goes through. In some cases, you may not need any treatment for menopause. When discussing treatment for menopause with your provider, its about treating the symptoms of menopause that disrupt your life. There are many different types of treatments for the symptoms of menopause. The main types of treatment for menopause are:
It’s important to talk to your healthcare provider while you are going through menopause to craft a treatment plan that works for you. Every person is different and has unique needs.
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In Vitro Fertilization After Menopause
IVF after menopause has been successfully demonstrated.
Postmenopausal eggs are no longer viable, but there are still two ways you can take advantage of IVF. You can use eggs you had frozen earlier in life, or you can use fresh or frozen donor eggs.
You will also need hormone therapy to prepare your body for implantation and to carry a baby to term.
When compared with premenopausal women, postmenopausal women are more likely to experience both minor and major complications of pregnancy after IVF.
Depending on your overall state of health, IVF after menopause may not be an option for you. Its worth consulting with a fertility expert who has worked with postmenopausal women.
Why Does Menopause Happen
Natural menopause menopause thats not caused by surgery or another medical condition is a normal part of aging. Menopause is defined as a complete year without menstrual bleeding, in the absence of any surgery or medical condition that may cause bleeding to artificially stop such as hormonal birth control, overactive thyroid, high prolactin, radiation or surgical removal of the ovaries.
As you age, the reproductive cycle begins to slow down and prepares to stop. This cycle has been continuously functioning since puberty. As menopause nears, your ovaries make less of a hormone called estrogen. When this decrease occurs, your menstrual cycle starts to change. It can become irregular and then stop. Physical changes can also happen as your body adapts to different levels of hormones. The symptoms you experience during each stage of menopause are all part of your bodys adjustment to these changes.
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What Happens After Menopause
After menopause you will no longer be able to get pregnant and you will no longer get a period. If you have any type of vaginal bleeding after menopause, you should see a doctor as soon as possible. Vaginal bleeding after menopause is not normal and can mean that you have a serious health problem.
You may experience any of the following after menopause:
- Low hormone levels. With menopause, your ovaries make very little of the hormones estrogen and progesterone. Because of changing hormone levels, you may develop , including osteoporosis, .
- Menopause symptoms instead of period problems. After menopause, most women get relief from or menopause . However, you may still experience symptoms such as hot flashes because of changing estrogen levels. One recent study found that hot flashes can continue for up to 14 years after menopause.,
- Vaginal dryness. Vaginal dryness may be more common post-menopause. Learn more about for vaginal dryness.
What Is Menopause Its A Moment In Time
Menopause is a specific point in time. Menopause occurs when periods stop and youve gone 12 consecutive months since having your last period. Once youve hit that moment, you enter post-menopause.
Reaching menopause means that youre no longer able to bear children. Every woman except for those whove had their ovaries removed before puberty will go through menopause.
When does menopause start?
The average menopause age is around 51. But some women experience menopause in their 40s with a small percentage experiencing menopause even younger. Some women may not reach menopause until their 60s.
Theres no way to know your exact menopause age until it happens, but genetics seem to play a strong role. You may get a general idea of when to expect menopause based on when your family members went through it, particularly your mother.
Genetics arent the only thing that can impact when menopause starts. Medical factors can also influence menopause timing. When the ovaries are removed, symptoms will begin to show immediately.
Certain medical conditions like autoimmune diseases have also been associated with early menopause. Women whove undergone treatments like radiation therapy or chemotherapy are also more likely to show symptoms earlier.
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