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Q: pregnancy ( Answered 4 out of 5 stars,   1 Comment )
Subject: pregnancy
Category: Health > Conditions and Diseases
Asked by: lucyfur-ga
List Price: $5.00
Posted: 07 Aug 2004 15:30 PDT
Expires: 06 Sep 2004 15:30 PDT
Question ID: 384823
My 54 year old wife has erratic menstruation periods, sometimes
monthly, sometimes skipping a couple of months. Her doctor says the
baby factory is just gearing down. This is normal for her age AND she
can no longer conceive. I'm not convinced. Does current medical
consensus support this?
Subject: Re: pregnancy
Answered By: tlspiegel-ga on 07 Aug 2004 19:11 PDT
Rated:4 out of 5 stars
Hi lucyfur,

Thank you for your interesting question.

It's rare for a woman who is in perimenopause (pre-menopause) to get
pregnant, but there are exceptions.

Sex after the menopause Written by Dr Hilary Jones, GP

Could I get pregnant? 

A woman's fertility falls after the age of 35, but many an older woman
has been surprised when she has fallen pregnant with an unplanned baby
in her late 40s or even early 50s. Cherie Blair, the Prime Minister's
wife, was certainly not alone in assuming that her fertility was
negligible only to be surprised and delighted to be proved wrong. Late
pregnancy can and does happen, and for this reason it is important to
get correct advice about contraception even beyond the menopause. The
recommended advice is:

women over the age of 50 should use contraception for 12 months after
their last period.

women who are under 50 when they have their menopause should continue
to use contraception for two years after their last period.

if a woman started taking HRT before her last period, she should
continue using contraception until the age of 53 to be on the safe
side. This is because HRT has a different hormonal content to the oral
contraceptive pill, so is not effective contraception on its own.


CONTRACEPTION FOR OLDER WOMEN - Contraception information contributed by:
Dr.Ailsa Gebbie, MB ChB, MRCOG, MFFP, DCH.

Women are often tempted to (and frequently do!) abandon contraception
before their periods stop completely. Although fertility at this stage
of life is low, it is not zero. An unplanned pregnancy at an older age
can be devastating for the individual woman and present difficult
choices. Healthcare professionals therefore recommend that women
continue contraception until there is no further chance of ovulation
and risk of pregnancy. Women in their late reproductive years may also
have heavy, irregular or painful periods which must be taken into
account when choosing a method of contraception. Many women around
this stage of life will also be thinking about whether or not they
wish to start hormone replacement therapy (HRT).

When to stop contraception

The general rules are to continue contraception for:

* One more year following the last spontaneous menstrual period if
aged 50 years or over
* Two more years following the last spontaneous menstrual period if
aged under 50 years

Factors affecting fertility 

Fertility starts to decrease quite dramatically in women after their
mid to late 30's. The main reason for this being a decline in quality
of the eggs produced in a woman's ovaries. Pregnancies after the age
of 50 years are rare. The oldest woman on record to have a successful
pregnancy and birth in the world was aged 56 years in North America in
1956. The oldest woman in the UK was 54 years.

Women undergoing fertility treatments after the age of 40 years have
very poor success rates. However, it is widely known that an older
woman may well successfully conceive using healthy donor eggs from a
younger woman. The oldest woman to have a child by this method is
currently 65 years. The womb of an older woman can be hormonally
stimulated to support a pregnancy at ages well beyond the natural
menopause. This clearly demonstrates how the major limitation to
successful pregnancy lies in quality or lack of eggs, and not in the
function of the womb.

Another important factor affecting conception at older ages is
frequency of sexual activity. Studies have demonstrated that married
women of 40 years are likely, on average, to have sexual intercourse
half as often as married women of 20 years. However, with high divorce
rates, individuals may well be embarking on new relationships at this
stage of life and an increased frequently of sexual activity.



Perimenopause, or pre-menopause is a transitional stage of two to ten
years before complete cessation of the menstrual period. Its average
duration is six years, and can appear in women from 35 to 50 years of
age. This has not been a stage of women's lives much talked about, and
a woman can find herself experiencing puzzling changes, and not know
why. What is actually going on is a gradual decrease of estrogen. The
manifestations of perimenopause can vary. Here are some of the most
commonly reported ones:


The following are symptoms women have reported. This information is
not intended as a substitute for talking with your health

Menstrual cycles become shorter, longer, or unpredictable

Flow becomes heavier or lighter



Until you are firmly in menopause, that is, no periods for one year,
you can still get pregnant


Ask Dr. Greenfield - Getting Pregnant after Menopause,1511,10785,00.html

Dear Dr. Greenfield,
Is it possible to become pregnant at the age of 50 while going through the change?

Dear Dbaker,
It is very rare to get pregnant after age 45 without using donor eggs
or other assisted reproductive techniques. That said, we have all
heard stories about women missing periods and thinking it was
menopause when actually they were pregnant.

In general, for women who really don't want any chance of conception,
we recommend using a birth control method until age 50 or until
periods have stopped for a year. Since fertility is very low as you
get towards these ages, you don't need a great method--spermicides are
often a good choice.


Childbearing at Older Ages: Getting Pregnant by Marjorie Greenfield, M.D.

Childbearing at an "older age" takes on a new meaning when you
remember that in colonial America life expectancy was only 35 years!
With better living conditions, improvements in medical care, and
changes in the role of women in society, many people are now waiting
to start having children until 30, 35, 40, or even later. Medically,
pregnancies in women over thirty-five are said to be of "advanced
maternal age."

Fertility myths and realities

Lately we've been hearing heartwarming stories almost on a daily basis
about women in their forties and even fifties getting pregnant.
Unfortunately, these stories has given some couples a false sense of
security that there is "all the time in the world" left for them to
start their families. The news reports often omit that these
pregnancies in older women were conceived with donor eggs, through
high tech in vitro fertilization (IVF) procedures. The truth is:
infertility and miscarriage are significantly more common in older


Biological clock may be ticking, but older women still hopeful

A woman's fertility decreases with age because her eggs are as old as she is;


Becoming pregnant without any help from technology after age 50 is
difficult, because most women are going through menopause, which
prevents the uterus from releasing eggs.


Becoming pregnant without any help from technology after age 50 is
difficult, because most women are going through menopause, which
prevents the uterus from releasing eggs.

But with every case, there are exceptions. 

According to the Guinness Book of World Records 2001, the oldest
mothers are two 63-year-old women: an Italian and a Californian, who
had in vitro fertilization and a frozen embryo transfer. Both gave
birth to healthy babies in 1996.

In January, a 54-year-old mother of eight and grandmother of 15 gave
birth to healthy triplets in Washington. She had a natural pregnancy.


Other Sex Stuff\Perimenopause & Menopause.doc

Q. If one's periods are fairly irregular due to perimenopause is there
less likelihood of getting pregnant during unprotected intercourse? Is
there a way to tell when ovulation occurs during this time in order to
use the rhythm method?

A. In response to your question, you've no doubt heard of "change of
life" babies where unplanned pregnancies occurred when women thought
their childbearing years were over. While statistically there is less
likelihood of becoming pregnant at this time, there are many
exceptions. If you are certain you do not want to become pregnant, you
will need to use birth control.
Because of irregularities in your menstrual cycle, it would be very
difficult to tell when you are ovulating, making the rhythm method


Q.Hi, I am 40 years old and have a two-year-old child. I am trying to
conceive again, but I am having no luck. I have been trying for about
nine months. (We conceived our first child in 1 month!) For the past
few months I have been having hot flashes. I just got over my period
yesterday. Do you think I am perimenopausal? Are there any tests that
can tell? Are my chances of getting pregnant slim now? What
complications could there be if I do get pregnant? Is there anything I
can do to help me get pregnant? Also, what can you recommend for the
discomfort of the hot flashes? (I do not want to take estrogen if
there is a chance that I can still get pregnant and have a normal
child.) Could the hot flashes be contributed to anything else besides


A. Hi, thanks for the questions. I will deal with perimenopause first,
then the questions around pregnancy. Yes, you could be experiencing
the symptoms of perimenopause. Estrogen levels may begin to fluctuate
any time after age 35. As for tests; you can ask your doctor for blood
tests to determine you levels of FSH (follicle-stimulating hormone)
and LH (luteinizing hormone). Because of your age and the fact that
you?re still having regular menstrual periods there may be quite a
variance in the hormonal levels over the monthly cycle so you may need
to have a couple of tests at different times to determine what is
happening. (These hormones usually peak during ovulation).

During perimenopause, the pituitary gland and ovaries gradually change
as ovulations decrease and FSH and LH levels increase. (The pituitary
gland continues to send out FSH and LH because it is not getting the
usual hormonal messages from the egg telling it to slow down). This
may, in part, explain why you have not become pregnant - you simply
may no longer be ovulating as regularly as you were before your last


As far as becoming pregnant is concerned, as women age their chances
of pregnancy decline each year with a more rapid decline after age 35.
For anyone over 35 the increased risks can be discussed in more detail
with a genetics counsellor. Your family doctor can give you a
referral. Among the risks, one of the most common is a chromosomal
error, such as Down syndrome. The risk for this is one in 385 at age
35, and one in 106 at age 40. Women over 35 who are pregnant have the
option of prenatal testing such as amniocentesis, which can rule out
the presence of a chromosomal error early in pregnancy. As you already
know, it is possible to have a perfectly healthy child even though you
are over 35. For more information I suggest you contact your family


Best regards,
lucyfur-ga rated this answer:4 out of 5 stars
very good answer.

Subject: Re: pregnancy
From: pinkfreud-ga on 07 Aug 2004 16:08 PDT
I don't precisely understand the question. Are you asking whether it's
likely that a 54-year-old woman is undergoing menopause, or whether it
might still be possible for her to conceive, or something else?

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