Can you get pregnant during perimenopause?

Yes, you can absolutely get pregnant during perimenopause. As long as you are still having periods, even irregular ones, you are still ovulating at least sometimes, and pregnancy is possible.

This catches many women out. Fertility does decline in your forties, and cycles become unpredictable, but less fertile is not infertile. You can still release an egg in any given month, often without warning, because ovulation in perimenopause is erratic rather than absent. Pregnancies do happen at this stage, both wanted and unplanned. You are only considered no longer fertile once menopause is confirmed, and the usual contraception guidance reflects that:

• Keep using contraception until 12 months after your last period if you are over 50
• Keep using it for 24 months after your last period if you are under 50

The longer window under 50 exists because periods can stop and then briefly return, so an apparent end is not always the real one. It is also worth knowing that some hormonal contraceptives can mask perimenopause symptoms, which can make it harder to tell which stage you are in, a point that connects to the difference between perimenopause and menopause. One thing catches women out more than any other: HRT is not contraception and does not reliably stop ovulation, so it does not replace a method.

If you do conceive at this stage, it is worth knowing pregnancies in the forties carry somewhat higher risks and usually warrant closer monitoring, which is another reason to plan rather than leave it to chance. On contraception choice, several options suit this age group well, and some even ease perimenopause symptoms, so it is worth a tailored conversation rather than defaulting to what you used in your twenties.

What to do: if you do not want to become pregnant, keep using contraception through perimenopause until you have passed that period-free window, and do not assume irregular cycles mean you are safe. If you do hope to conceive in your forties, speak to your doctor sooner rather than later, since timing matters more now. Either way, talk to your GP about the right option for your age and stage.

Go deeper: our full guide, can you get pregnant in perimenopause?, covers the exact rules for stopping, why no blood test can tell you it is over, and which method suits this stage best.