“Menopause is a retrospective clinical diagnosis, made when a woman around the age of 51 or 52 has not had a period for a year. One-year amenorrhea in this age group with symptoms (hot flashesnight sweats, etc.) does not require hormonal measurements to confirm the diagnosis of menopause”, explains Dr. Letombe. The cessation of the ovarian cycle, and therefore of the production of estrogen and progesterone, marks the end of the fertile period and a menopausal woman can therefore no longer become pregnant, at least not naturally. Be careful, however, during peri-menopause, pregnancy remains possible.
What is peri-menopause?
Peri-menopause refers to the period preceding menopause. This transition phase is of varying duration depending on the woman. “Due to hormonal imbalance there may be short cycles for three or four years, heavy periods and signs of hyperestrogenism (tight and swollen breasts, etc.), then we observe an alternation of long cycles and short cycles. Finally, cycles become longer and longer, with periods only occurring every two or three months. explains the gynecologist. During this period, the woman is still fertile.
Peri-menopause and fertility: ovulatory cycles are possible
Before the age of 50, in peri-menopause, the cessation of functioning of the ovaries is not necessarily permanent. “A woman may not have her period for 5 or 6 months and then have an ovulatory cycle again. We should therefore never be so assertive in these women under 50 and we suggest continuing to use a contraceptive method up to 50 years old” explains Dr. Letombe. The latter specifies that according to international recommendations, to tell a woman under 50 that she no longer needs contraception, she must wait 2 years of amenorrhea or have hormonal measurements carried out twice at 6 weeks. interval.
Pregnancy is possible in peri-menopause
If it is not possible to get pregnant when the diagnosis of menopause is made, pregnancy is possible throughout the period of perimenopause. Carrying these pregnancies to term nevertheless remains rare. We know that from the age of 35, fertility declines considerably. This is obviously even more true in the years that follow and from the age of 40/45. “At peri-menopause, fertility is low. The cycles are irregular, the eggs are often of poor quality. Even if there is an early pregnancy, it is rare for it to be carried to term. 30% of pregnancies after age 40 lead to miscarriages”, recalls Dr. Letombe. However, the risk of pregnancy is not zero. It is therefore essential that women continue to take contraception if they do not wish to become pregnant. Even if their cycles are irregular and the first symptoms of menopause are present.
Thanks to Dr Brigitte Letombe, medical gynecologist.
Author of “Women, wake up! – Stop gynecological bashing, fake news and the diktats of social networks” (Editions First).
Thanks to Mathilde Nême – co-founder and CEO ofOmenathe mobile application for a peaceful menopause.