Ovulation During Perimenopause: Why Contraception Still Matters

Many women believe that once they reach their 40s and begin experiencing irregular periods, their chances of getting pregnant naturally disappear. But that’s not entirely true. During perimenopause—the transitional phase before menopause—your body may still release eggs, even if your menstrual cycle is unpredictable. This means that ovulation, and therefore pregnancy, is still possible.

What is Perimenopause?

Perimenopause is the stage leading up to menopause, usually starting in the mid-40s (though it can begin earlier or later). It can last anywhere from 4 to 10 years. During this phase, the ovaries gradually produce less estrogen, leading to changes such as:

• Irregular or skipped periods

• Hot flashes and night sweats

• Mood swings and sleep disturbances

• Vaginal dryness

• Decreased fertility—but not zero fertility

Can You Still Ovulate During Perimenopause?

Yes. Ovulation does not stop immediately when perimenopause begins. Instead, your cycles become less predictable—sometimes shorter, sometimes longer. Even if your periods are infrequent, your ovaries may still release an egg. If this coincides with sexual activity, pregnancy is possible.

Why Contraception is Important

If you are sexually active and do not wish to conceive, contraception remains important during perimenopause. Many women mistakenly assume they can no longer get pregnant, which can lead to unplanned pregnancies.

Additionally, contraception during perimenopause has benefits beyond preventing pregnancy:

• Regulates menstrual cycles and reduces heavy bleeding.

• Helps with perimenopausal symptoms such as hot flashes.

• Protects against certain cancers, such as endometrial and ovarian cancer (depending on the type of contraception used).

Options for Contraception in Perimenopause

The right method depends on your health, age, and medical history. Common options include:

• Barrier methods: Condoms, diaphragms—also protect against STIs.

• Hormonal methods: Pills, patches, vaginal rings, injectables—help regulate cycles and manage symptoms.

• Intrauterine devices (IUDs): Both hormonal and copper IUDs are effective and long-lasting.

• Permanent contraception: Tubal ligation for women or vasectomy for men, if the decision is final.

Always consult your doctor before choosing a method, as some contraceptives may not be suitable if you have risk factors such as high blood pressure, smoking, or clotting disorders.

When Can You Stop Using Contraception?

Doctors generally recommend continuing contraception until you have gone 12 consecutive months without a period, which confirms menopause. At that point, natural conception is no longer possible.

Key Takeaway

Even during perimenopause, ovulation can still occur. If you are not planning to have children, it is essential to use contraception after consulting your doctor. Protecting yourself now will help you transition into menopause safely and with peace of mind.