Written by: Dr. Amy Beckley, PhD, Founder and Inventor of the Proov test — the first and only FDA-cleared test to confirm successful ovulation at home.
Written on 9/13/21
Everyone’s journey to and through menopause is a little different, meaning we can get a lot of conflicting information.
Perimenopause and menopause are changes that we will all experience. But, if you’re anything like us, you may not know what to expect. Everyone’s journey to and through menopause is a little different, meaning we can get a lot of conflicting information.
Because of this, we wanted to start by answering some basic questions to lay the foundation to help us better understand our hormonal health. First question: can you get pregnant after menopause? Let’s find out!
What is ovarian reserve?
Your ovarian reserve refers to the amount of eggs left in your ovaries. Unlike men who produce sperm daily, women are born with all the eggs we will ever have.
From the moment a girl is born, her ovarian reserve decreases over time until she reaches menopause. Each cycle, many follicles containing eggs are recruited to prepare for ovulation, but only one egg will actually mature and ovulate. The others will die off.
Since our eggs are the same age we are, they also age over time. This can impact their quality, basically meaning their ability to be fertilized by sperm and create a healthy embryo. Generally, the older your eggs are, the less likely they are to be healthy.
Because of this, it is generally accepted that a woman’s prime reproductive years are in her 20s, with fertility starting to decline around 35. This is when the quality and quantity of our eggs begins to decrease.
Of course, fertility and ovarian function is not one-size-fits-all. There are women who maintain optimal fertility until well into their 40s. In fact before the pill, when women did not have access to family planning and contraception, the average age at last birth was 41-43 years old!
On the other hand, there are women who, due to genetic heritage or poor lifestyle choices, may experience diminished fertility even before turning 35. The reality is that age and ovarian reserve are just a few pieces of the pregnancy puzzle and there are many other factors to be taken into account.
What’s the difference between perimenopause and menopause?
Menopause is a natural biological process marking the end of menstrual periods. In order to be considered in menopause, a woman needs to have gone 12 months without a period and have her hormones tested to confirm her ovaries have stopped functioning.
For women in the U.S., the average age of menopause is 51. But menopause doesn’t happen overnight. As we know, our ovarian reserve slowly decreases over time as we experience cycles and ovulate. As our ovarian reserve decreases, our ovaries stop functioning optimally and our hormones may become imbalanced.
This transition period may last anywhere between 2 to 10 years and it is known as perimenopause. You might suspect you are entering perimenopause if you are into your early 40s (sometimes even late 30s) and:
- Your cycles all of a sudden become irregular
- Your luteal phase gets shorter
- You are suspecting more and more anovulatory cycles
- You skip a period once in a while
- Your PMS symptoms are more severe
In the late stages of perimenopause, you may also experience a hormonal imbalance which can lead to hot flashes, painful intercourse, weight gain, or lack of focus. Once you officially enter menopause, these symptoms should go away.
In the late stages of perimenopause, you may also experience a hormonal imbalance which can lead to hot flashes, painful intercourse, weight gain, or lack of focus.
Can you get pregnant after menopause?
Once menopause is officially diagnosed once you have gone 12 months without a period. This signifies that your ovaries have stopped working properly, meaning they are no longer releasing eggs.
So, you cannot get pregnant naturally once you're in menopause. While it is possible to get pregnant with the help of a donor egg and hormone supplements, it is not very common.
Although menopause is the end of a woman’s reproductive years, perimenopausal women are still fertile, even if they may start having signs that things are changing. This is because it is still possible to conceive naturally while you are ovulating.
Some doctors may recommend birth control for perimenopausal women who are not trying to conceive. If this applies to you, it’s best to discuss these options with your doctor.
How do I know if I’m in menopause?
Long before you begin to think you might be in menopause, you may become aware of symptoms that can signal you are in perimenopause. The most common symptoms are:
- Hot flashes
- Night sweats
- Frequent urination
- Dry skin, eyes, or mouth
- Vaginal dryness
- Mood changes
- Depression
- Insomnia
- Anxiety
- Diminished libido
- Headaches
- Breast tenderness
- Hair loss
- Abnormally heavy or light periods
Another way to tell if you are close to or in menopause is by testing your FSH (follicle stimulating hormone) levels. When you have less eggs you have left in your ovaries, more FSH is required to stimulate your ovaries to produce eggs, meaning the FSH levels in your body will be elevated.
You can test your FSH levels at home with Proov FSH tests.
You can test your FSH levels at home with Proov FSH tests. Our FSH tests are designed to turn positive when 25 mIU/ml of FSH is present in urine, which is the level of FSH that signals menopause.
We recommend testing on cycle days 5, 7, and 9. If you get two or more positive FSH tests in one cycle of testing, we recommend consulting your doctor.
With the Proov Insight app (available on iPhone and Android), you can scan your FSH tests and get numerical FSH values, which can help you and your doctor understand your ovarian status and function. If you continually see elevated FSH levels, you may be approaching menopause.
While you cannot get pregnant naturally after menopause, understanding your ovarian status now can help set you up for success later in life!
