Menopause and Pregnancy

Menopause and Pregnancy

“…women do still get pregnant in their late 40s and
even into their 50s (without using assisted reproduction
techniques). Contraception should be continued until…”.1

Umbrella

What may the Menopause and Pregnancy Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Birth Control
  • Contraception
  • Fertility
  • Pregnancy
  • Unplanned Pregnancy

Perimenopause Pregnancy

Is it possible to become pregnant during perimenopause?

In Menopause: Fertility and Contraception Around Menopause the (Australian) Jean Hailes for Women’s Health (JH) explain:

“You can become pregnant during perimenopause because you might continue to ovulate (produce eggs), even if your periods are irregular”.2

In Menopause Basics: Should I Use Birth Control During the Transition To Menopause? the Office on Women’s Health, United States Department of Health and Human Services, Womenshealth.gov explain:

“Yes. You can still get pregnant during perimenopause, the transition to menopause, even if you miss your period for a month or a few months. During perimenopause, you may still ovulate, or release an egg, on some months”.3

On page one in Contraception in Women Over the Age of 40 the (British) Women’s Health Concern (WHC) elaborate on:

“Many women are aware that their fertility declines from their mid-30s and they think that they can stop using contraception once they are in their 40s. They wrongly assume – because their fertility is lower and their periods may have become irregular – that contraception can be abandoned. However, women do still get pregnant in their late 40s and even into their 50s (without using assisted reproduction techniques). Contraception should be continued until menopause, which is defined as two years after the last natural menstrual period in women under age 50 and until one year after the last natural menstrual period in women over age 50. If menopause cannot be confirmed, contraception should be continued until age 55”.4

Pregnancy 45-49 Years

What is the chance of pregnancy for women aged 45-49 years?

In Menopause: Fertility and Contraception Around Menopause the JH explain:

“Fertility naturally declines with age. For women aged 45 to 49 years, the chance of pregnancy is about 2% to 3% per year”.5

Pregnancy After 50

What is the chance of pregnancy for women after the age of 50?

The JH note:

“After the age of 50, it’s less than 1%”.6

Contraception Under 50

If you’re under 50 and don’t want to fall pregnant, how long should you use contraception?

In Menopause: Fertility and Contraception Around Menopause – How Long Should You Use Contraception? the JH explain:

“If you’re under 50, use contraception until you’ve had 2 years without a period”.7

Contraception 50 or Older

If you’re 50 or older and don’t want to fall pregnant, how long should you use contraception?

The JH note:

“If you’re 50 or older and you don’t want to fall pregnant, you should use contraception for at least one year after your final period”.8

Contraception 55

Can contraception be stopped at the age of 55?

On page four in Contraception for Women Over the Age of 40: Hormone Replacement Therapy, reviewed December 2025, the (British) Women’s Health Concern (WHC) explain:

“Contraception should be continued for at least one year after your last menstrual period if this was after the age of 50, and for two years if your periods stop before the age of 50. This is because periods may restart even after several months with no bleeding. Otherwise, contraception can be stopped at the age of 55, even if you are still having occasional periods, as the risk of pregnancy at this age is extremely low”.9

Combined Oral Contraceptive Pill

What can be recommended for the perimenopausal woman needing contraception?

In The 2023 Practitioner’s Toolkit for Managing Menopause, published online 30 October 2023, the authors include:

“For the perimenopausal woman needing contraception, the combined oral contraceptive pill (COCP) provides contraception, menstrual cycle control and relief from VMS and other symptoms. It also prevents bone loss and treats acne that can occur at this time. Each woman’s risks must be assessed including smoking status, blood pressure, lipid profile, migraine with aura history, thrombosis and cardiovascular disease risk, and family history”.10 

Hormone Replacement Therapy

Is hormone replacement therapy (HRT) a method of contraception?

No. In Contraception: Hormone Therapy Is Not A Contraceptive the JH note:

“Hormone therapy, such as menopausal hormone therapy (MHT), hormone therapy for endometriosis and gender-affirming hormone replacement therapy, is not a contraceptive”.11

HRT + Contraception

Can HRT + contraception be necessary?

On page five in Contraception for Women Over the Age of 40: Hormone Replacement Therapy the WHC explain:

“It is important to realise that HRT is not a method of contraception. Combined hormonal contraception is an option for some women that will provide effective contraception, manage menopause symptoms and manage menstrual disorders. Otherwise, sexually active women whose periods have not stopped before starting HRT should use a method of contraception in addition. Suitable methods to consider would be barrier methods, an IUD, the progestogen-only pill or the hormonal IUD. The 52 mg LNG-IUD has the additional advantage of providing the progestogen component of HRT, minimising the side effects that some women experience with progestogen tablets, while also managing menstrual disorders.

Some HRT products produce regular monthly bleeds so it can be difficult to know when contraception can be stopped. It is best to continue contraception alongside HRT until the age of 55 when contraception is no longer needed”.12 

Emergency Contraception

Is emergency contraception available?

Depending on the Country, emergency contraception may be available. Your Country may have a Link similar to the American College of Gynecologist’s Emergency Contraception: Frequently Asked Questions.

Health Care Provider

What if I am not sure which contraception to use?

The JH advises:

“If you’re not sure which contraception to use, see your doctor. They can explain the benefits and risks of each method”.13

Health Topics A-Z

Where may I find Health Topics A-Z related to Menopause and Pregnancy?

In Health Topics A-Z you may find:

Health Topics A-Z

Links

Where may I find Links related to Menopause and Pregnancy?

Your Country may have Links similar to:

Links

This Links List to third party websites is neither comprehensive nor exhaustive. Inclusion on this Links List does not imply endorsement or recommendation. Non-inclusion on this Links List does not imply non-endorsement or non-recommendation. Third party websites are not under the control of Meno Martha International Menopause Directory. Third party websites may contain explicit medical images and/or sexual references. Please read Meno Martha International Menopause Directory’s Links Policy before proceeding to a Link. Please contact Webmaster if you experience a problem with a Link.

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  21. Contraception: Methods of Contraception – Internal (Female) Condoms
  22. Contraception Choices: Know All Your Options
  23. EMAS On-Demand Webinars [European Menopause and Andropause Society] [Multiply Languages]: EMAS/ESE Webinar Part 1: Fertility In Late Reproductive Age
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  25. FAQs: Combined Hormonal Birth Control: Pill, Patch, and Ring
  26. FAQs: Emergency Contraception
  27. Female Condoms
  28. Find A Menopause Practitioner [United States and Other]
  29. Find A Practitioner [Australasian Menopause Society i.e. Australia and New Zealand]
  30. Find Your Nearest BMS Menopause Specialist [British Menopause Society]
  31. HRT Is Not #contraception and So If You Are Perimenopausal Then Added Contraception Is Needed
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  44. Menopause: Identification and Management [NICE Guideline]
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  46. Midlife Women Missing Out on Contraception Knowledge, and That Matters for Everyone
  47. Mymenoplan.org [My Menoplan, United States]
  48. Navigating Menopause: Honest Answers To All Your Questions [+ Video: What To Expect in Menopause]
  49. Online Events [International Menopause Society]: Past Webinars – 2024: Perimenopausal Contraception
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  54. Perimenopause: Can I Get Pregnant If I Am In  Perimenopause?
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  56. Sex and Sexual Health
  57. Sex and Sexual Health As You Age
  58. Stages of Menopause
  59. The Female Condom [+ Image]
  60. Vaginal Ring
  61. Videos & Podcasts: Videos – Impending Menopause: How Can Fertility Be Preserved?
  62. What Is the Difference Between Perimenopause, Menopause and Postmenopause?
  63. What Is Perimenopause and Menopause?
  64. When Does Perimenopause Start and How Do You Define the Beginning
  65. Which Contraception Is Right for You? | Live with Dr Louise Newson
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  67. Your Daily Dose: Let’s Unpack Menopause
  68. Your Daily Dose: Perimenopause, Here’s What To Know

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Contraception for Women Over the Age of 40. Reviewed: December 2025:1. British Women’s Health Concern https://www.womens-health-concern.org/wp-content/uploads/2025/12/04-NEW-WHC-FACTSHEET-Contraception-for-women-over-the-age-of-40-DEC2025-A.pdf Accessed: 28 May 2026
  2. Menopause: Fertility and Contraception Around Menopause. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-topics/menopause/#section-other-health-issues-and-concerns Accessed: 28 May 2026
  3. Menopause Basics: Should I Use Birth Control During the Transition To Menopause? Page Last Updated: 02 April 2026. Office on Women’s Health, United States Department of Health and Human Services, Womenshealth.gov https://womenshealth.gov/menopause/menopause-basics Accessed: 28 May 2026
  4. Contraception for Women Over the Age of 40. Reviewed: December 2025:1. British Women’s Health Concern https://www.womens-health-concern.org/wp-content/uploads/2025/12/04-NEW-WHC-FACTSHEET-Contraception-for-women-over-the-age-of-40-DEC2025-A.pdf Accessed: 28 May 2026
  5. Menopause: Fertility and Contraception Around Menopause. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-topics/menopause/#section-other-health-issues-and-concerns Accessed: 28 May 2026
  6. Menopause: Fertility and Contraception Around Menopause. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-topics/menopause/#section-other-health-issues-and-concerns Accessed: 28 May 2026
  7. Menopause: Fertility and Contraception Around Menopause – How Long Should You Use Contraception? Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-topics/menopause/#section-other-health-issues-and-concerns Accessed: 28 May 2026
  8. Menopause: Fertility and Contraception Around Menopause – How Long Should You Use Contraception? Jean Hailes for Women’s Health https://www.jeanhailes.org.au/health-topics/menopause/#section-other-health-issues-and-concerns Accessed: 28 May 2026
  9. Contraception for Women Over the Age of 40: Hormone Replacement Therapy. Updated: November 2025:4. British Women’s Health Concern https://www.womens-health-concern.org/wp-content/uploads/2025/12/04-NEW-WHC-FACTSHEET-Contraception-for-women-over-the-age-of-40-DEC2025-A.pdf Accessed: 28 May 2026
  10. Davis, S. R., Taylor, S., Hemachandra, C., Magraith, K., Ebeling, P. R., Jane, F., and Islam, R. M. The 2023 Practitioner’s Toolkit for Managing Menopause: Definitions. Published Online: 30 October 2023 https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783 Accessed: 28 May 2026
  11. Contraception: Hormone Therapy Is Not A Contraceptive. Jean Hailes for Women’s Healthhttps://www.jeanhailes.org.au/health-topics/sex-and-sexual-health/contraception/ Accessed: 28 May 2026
  12. Contraception for Women Over the Age of 40: Hormone Replacement Therapy. Updated: November 2025:5. British Women’s Health Concern https://www.womens-health-concern.org/wp-content/uploads/2025/12/04-NEW-WHC-FACTSHEET-Contraception-for-women-over-the-age-of-40-DEC2025-A.pdf Accessed: 28 May 2026
  13. Contraception: Hormone Therapy Is Not A Contraceptive. Jean Hailes for Women’s Healthhttps://www.jeanhailes.org.au/health-topics/sex-and-sexual-health/contraception/ Accessed: 28 May 2026
Topic Last Updated: 06 June 2026 – Topic Last Reviewed: 28 May 2026

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