No Period for two years, yet pregnant?

Oops - Can it really happen that I accidentally get pregnant after menopause, and how does it happen?

One of the benefits of the end of menopause is that pregnancy is highly unlikely, meaning that in a partnership, the topic of contraception is no longer a concern—unless the male partner has already had a vasectomy. In same-sex partnerships, this issue doesn’t arise.‍

Menopause and pregnancy – How does it work again?

The average age of menopause is 51. Researchers define early menopause as occurring between the ages of 40 and 45, while menopause before the age of 40 is considered premature menopause. About 5% of women experience early menopause naturally, which can also be caused by medical treatments, such as the surgical removal of ovaries.

After menopause (defined as 12 months without a period), pregnancy is generally not possible. However, exceptions exist: it is possible for ovulation to occur once more, making fertilization theoretically possible. For this reason, contraception is recommended for about two years after menopause to be completely certain.

Do I Still Need Contraception?

In principle—yes. The term "menopause" refers to perimenopause, a phase where women still have their periods but may already notice changes in their body. Cycles without ovulation occur more frequently, meaning pregnancy is still possible, though increasingly unlikely, for women over 45. Interestingly, ovarian activity can vary greatly: even if menstrual bleeding stops for several months, regular bleeding—and possibly ovulation—can resume. Because of this unpredictability, hormonal blood tests aren’t particularly reliable, as they only reflect the state at the time of testing, which might differ a month later. Thus, contraception is still recommended unless pregnancy is desired.

What Is the Link Between Pregnancy and the Timing of Menopause?

Since early menopause can have health implications, understanding the contributing factors is important. Many women wonder if there is a connection between pregnancy and early menopause. Does having children later in life lead to earlier menopause? Or does it delay menopause? Is there a link between the age of the last pregnancy and the onset of menopause? Research on this topic is inconclusive, with different studies producing contradictory results.

According to a study of over 100,000 participants, it was confirmed that mothers experience their last menstruation later than childless women(1). The study investigated the likelihood of early menopause before the age of 45.

Benefits of Breastfeeding and Sexual Activity Regarding Menopause

At the start of the study, women aged 25 to 42 showed no signs of perimenopause. Led by epidemiologist Christine R. Langton from the University of Massachusetts, Amherst, participants were followed until their 45th birthday. The results showed that the risk of early menopause decreased consistently with each pregnancy lasting at least six months. One pregnancy reduced the risk by 8%, while four pregnancies reduced it by 19%, compared to childless women.

Mothers who exclusively breastfed their children for seven to twelve months had the lowest risk. With two children, the risk was reduced by 21%, and with three or more children, it was reduced by 32%, compared to women who breastfed for less than a month. Researchers attributed this to the ovulation-suppressing effect of breastfeeding.

Sexual activity may also influence the timing of menopause. A study of approximately 3,000 participants, averaging 45.88 years of age, found that women who were sexually active—at least once a week—had a 28% lower risk of early menopause than those who had sex less than once a month. With monthly sexual activity, the risk was reduced by 19%. The researchers, Megan Arnot and Ruth Mace from University College London, hypothesized that older women’s bodies may cease energy-intensive ovulation if the likelihood of pregnancy is low—i.e., if women rarely have sex.

So, ladies—explore yourselves and rediscover your sexuality. 🙂

Sources:
Langton CR et al. JAMA Netw Open 2020
Arnot M, Mace R. R Soc open sci 2020