How to get Pregnant during Perimenopause Naturally

If you are in your 40s, your periods have started to wobble, and you are hoping for a baby, you may have searched “how to get pregnant during perimenopause naturally”. Somewhere between trying and waiting, the next question is usually: when do I take a pregnancy test, and can I trust it?

This post is about testing. If irregular periods make it hard to know when to test, what a negative or positive result means, and when to talk to a doctor, this is for you.

Why testing is harder in perimenopause

Pregnancy is still possible while you are having periods, even irregular ones. Perimenopause is the transition before menopause, and you can still ovulate during it, just less predictably. Menopause is only confirmed after 12 months without a period.

The usual advice is to take a pregnancy test the day after your period was due. That works when you know when your period is due. In perimenopause, you might go six weeks without one and still not be pregnant, or be pregnant without a clear “missed” date. Late periods, tiredness, and mood changes also show up in both perimenopause and early pregnancy, so symptoms cannot tell you which it is.

For background on the chances, see Can I get pregnant during perimenopause? and Perimenopause and fertility.

When to take a pregnancy test

• If you know when your period is due: test from the first day of a missed period. The NHS says tests are most reliable from then.
• If you do not know when your period is due: the NHS advises testing at least 21 days after the last time you had unprotected sex. Tests done sooner may be too early to pick up a pregnancy.
• If you are having unprotected sex regularly, you do not have to stop and wait. Test whenever you want to check, but remember that a negative result cannot rule out a pregnancy from sex in the last 21 days. Test again if your period has not arrived or you are still unsure.
• If you test negative but still have no period: test again after a few more days, and speak to your doctor if your period does not come and the tests stay negative.

Early testing with a very sensitive test can sometimes give an answer sooner, but it is also more likely to give a “too early” negative. What does pregnancy test sensitivity mean? explains the numbers, and I feel pregnant, but test negative covers why a negative test result is not always final.

If you test regularly each month, a plain, plastic-light test such as our monthly pregnancy test is one option. Whichever you use, follow the instructions and read the result within the stated time.

If your test is positive

Treat a positive result as a likely pregnancy and see your GP or doctor to confirm it. In your 40s, an early check-up is worthwhile.

Doctors do know that the pituitary gland can make very small amounts of hCG in some women in perimenopause and after menopause. Most of what is written about this comes from blood tests in a lab, not home urine tests, and it is something a doctor sorts out with further tests. It is not a reason to dismiss a positive home test or to work out the cause yourself. If a positive result does not fit with what is happening, ask your doctor what follow-up they recommend.

Trying naturally: the short version

“Naturally” means without fertility treatment. Unfortunately, it does not mean that any diet, supplement, or routine will make pregnancy happen; there is no guarantee. Age affects egg quantity and quality, and unfortunately you cannot see or feel those changes. The basics with some evidence behind them are:

• Have sex regularly. The NHS suggests every 2 to 3 days, and the Mayo Clinic says the days from about 3 to 4 days before ovulation until one day after matter most.
• Take 400 micrograms of folic acid a day, ideally starting 3 months before, as the NHS recommends.
• Look after your general health. The NHS advises not drinking alcohol when you are trying to get pregnant, and offers support to stop smoking through your GP.

If you are not trying to get pregnant

Irregular periods do not mean you cannot conceive. If you don’t want to be pregnant or have a baby, it is best to keep using contraception until your doctor confirms you no longer need it.

When to see a doctor

You do not have to wait a year. ACOG says an infertility evaluation is recommended after 6 months of trying if you are over 35, and that if you are over 40 you should talk to your OBGYN or doctor now. If your periods change suddenly, bleeding is very heavy, or you have symptoms that worry you, then it is best to go and see your doctor sooner rather than later.

Key points

• You can still get pregnant during perimenopause naturally while you have periods, even irregular ones, but the chances fall with age.
• With unpredictable cycles, test from a missed period, or at least 21 days after unprotected sex. Testing earlier can give a false negative.
• Confirm a positive with a doctor. Do not assume it is anything other than a possible pregnancy.
• If you are trying, but it hasn’t happened after 6 months then go and see your doctor.

This post is general information, not medical advice. Speak to your doctor about your own situation.