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The perimenopause is the stage leading up to menopause — which is reached after a woman hasn't had a memnstrual period for a full 12 months. As your ovaries gradually start producing smaller and smaller quantities of the hormone estrogen, you'll notice that you can go for months without a menstrual period, only to get two in one month later. Most women spot the signs of the perimenopause in their forties, but it can also start in your thirties or twenties.

The perimenopause lasts four years on average, but it can also go on for as long as a decade. If you are in your forties and already experiencing symptoms of the perimenopause, primarily in the form of altered menstrual cycles, you may wonder if you can get pregnant.

Some women ask about the ability to get pregnant during the perimenopause because they would really like to have another baby, while others do not want to get pregnant and wonder if they can safely ditch their contraception at this point.

If You Are Perimenopausal And Don't Want To Get Pregnant...

You need to know that, while your odds of ending up with an unwanted pregnancy are much lower than ever before, they are absolutely not zero. Perimenopausal women who are sexually active and don't want to conceive will need to use birth control for a lot longer than they may think — even if they are experiencing wildly irregular menstrual cycles.

Though you have numerous contraceptives to choose from, there are indeed a few things women approaching the menopause should be aware of:

  • Perimenopausal women who smoke, have heart disease, blood clots, a history of estrogen-sensitive cancer, hypertension, or diabetes should not take contraceptives that contain estrogen!
  • If the above factors don't apply to you, you may choose hormonal contraceptives that contain estrogen for reasons besides preventing pregnancy. Taking hormonal contraceptives will give you more regular menstrual cycles, reduce hot flashes, decreased menstrual pain, help prevent osteoporosis, and decrease your risk of ovarian and uterine cancer.
  • If you're looking for permanent birth control but don't want an invasive procedure, looking into Essure or Adiana implants, or a vasectomy for your partner, is a good idea.

If You Are Perimenopausal And Want To Get Pregnant...

Are you over 40 but still experiencing regular menstrual cycles? Chances are that the perimenopause hasn't started yet. I'd advise you to attack trying to conceive aggressively, using some or all of the fertility-monitoring tools on the market. If you are not pregnant after six months of trying, see your family doctor.

If, on the other hand, you are actively experiencing symptoms of the perimenopause, you may want to skip the "TTC for six months" part, and head straight for a fertility specialist. This will maximize your chances of having a baby, even if it turns out that you don't need invasive fertility procedures such as IVF to conceive in the end. A fertility specialist can check how far away you are from menopause, and what your egg quality is like.

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