Perimenopausal Sex: Can You Get Pregnant? These and More Questions Answered

Perimenopause or menopausal transition is the period leading up to menopause — the end of periods. Women typically enter perimenopause around the age of 40. In some women, it can begin as early as their late 30s. During perimenopause, periods become irregular, longer, and/or shorter. In addition, you may experience hot flashes, mood swings, changes in sexual function, vaginal problems, and decreased fertility. Perimenopause can last anywhere from a few months to 14 years.

As you embark on this journey of transformation, your relationship with sex can change. In this article, we’ll answer important questions on perimenopausal sex — from your fertility to sexual challenges, and how to cope with physical and emotional symptoms.

Perimenopause and sex: what issues can you face?

Around your 40s (or even earlier) estrogen and testosterone levels begin to fall. Estrogen and testosterone are sex hormones that your ovaries produce. The two of them play important roles in the growth, maintenance, and repair of reproductive tissues. A loss of estrogen and testosterone can cause changes in your sex drive. You may notice, for example, that you’re less sensitive to touching and struggle to get aroused.

What’s more, low estrogen levels can lead to a drop in blood supply to the vagina. This, in turn, has an effect on lubrication, making the vagina too dry. In addition, it’s common to experience:

• Painful sex
• Lack of interest in sex
• Inability to orgasm
• Inability to relax

How can you make sex comfortable?

There are many ways to make sex comfortable and enjoyable during perimenopause, such as:

• Using water-soluble lubricants
• Using vaginal moisturizers (ask your doctor for recommendations)
• Counseling
• Kegel exercises
• Masturbation, foreplay, and different positions

It’s crucial to communicate openly with your partner. If you’re experiencing low libido or pain and discomfort during sex, let them know. Together, you can come up with solutions and alternatives to enhance intimacy.

Are you still fertile during perimenopause?

The short answer is yes. Now, the long answer… Pregnancy happens when a sperm fertilizes an egg after it’s released from the ovary during ovulation. Women are born with approximately 1 million follicles in the ovaries that can become eggs. This number progressively decreases as we become older. For example, by puberty, we have about 300,000 follicles. In addition, the quality of the eggs also decreases with age. Around the age of 40, conceiving naturally is more challenging.

However, as long as you continue to ovulate, conception is still possible. You must assume you’re still fertile until menopause is complete — that is when you haven’t had a period for 12 consecutive months.

Should you use contraception?

Yes. If you don’t wish to get pregnant, continue using contraception. You have many options, including barrier methods (condoms, diaphragms, sponges, etc), birth control pills, levonorgestrel intrauterine device (IUD), and sterilization procedures. Bear in mind that, if you have a pre-existing medical condition, some methods might not be beneficial for you. So it’s best to consult your doctor first.

Are you still at risk of sexually transmitted diseases (STDs)?

As long as you’re sexually active, you can get an STD. This risk doesn’t disappear during perimenopause, menopause, or postmenopause. Take all the necessary steps to keep yourself safe, for example:

• Always use a latex condom whenever you have sex
• Avoid drugs and alcohol before sex
• Ask your partner or potential partners to get checked up for STDs
• Get checked for STDs

What is the risk of a perimenopausal pregnancy?

Pregnancies after 35 years of age can come with risks for both mom and baby. Lower-quality eggs, uterine changes, and variable hormones increase the chances of pregnancy loss and birth differences. 35+ pregnancies might also lead to:

• Complications during childbirth
• Maternal health issues (preeclampsia, gestational diabetes, strokes)
• A need for a cesarean section
• Premature birth
• Stillbirth

This doesn’t necessarily mean that this will happen to you and your baby. You shouldn’t panic or feel pessimistic towards yourself or your pregnancy. If you are a mature, expectant mom, please get in touch with your doctor to discuss potential risks and solutions. It is important to be aware of any potential complications that may arise.

Can you increase your chances of conceiving?

There are ways to increase your chances of getting pregnant. You can try the following options.

• Track your ovulation. If your menstrual cycle is regular, you can track your ovulation. Try Beginning.com’s tracker to monitor your fertile window. You can also opt for ovulation test strips or identify natural signs such as breast tenderness and white vaginal discharge.
• Lifestyle changes. Following a nutritious diet, exercising regularly, and avoiding unhealthy habits (drinking, smoking, drugs) can improve your overall health, which increases your chances to conceive.
• In vitro fertilization (IVF). This form of assisted reproductive technology helps women have babies. The IVF procedure removes an egg from the ovaries. The egg is then fertilized with sperm in a laboratory. After a few days, the egg (now an embryo) returns to the womb to grow and develop. IVF can be carried out using your eggs and your partner’s sperm, or sperm and egg donors.

A final note

Perimenopause is a natural period in life full of many physical and emotional changes. It may seem daunting but know that there are plenty of ways to mindfully deal with this transition while preserving your sex life and keeping yourself safe and healthy. For more information on all things menopause, track your symptoms using Beginning.com. You’ll get personalized insights, expert tips, and related content straight to your feed.