Checking for pregnancy during perimenopause?

[MemorialBeach]

If I am perimenopausal, with irregular periods and am often missing one or more periods (currently my last one was end of September 2018) should I be taking a pregancy test every so often just to check I am not pregnant? Would that be normal/something other perimenpausal women would do? As I am not having a period every month anyway, I can't used missed or late period as a sign to take a test. I am using condoms so in theory shouldn't get pregnant, but obviously I am aware that no contraception is 100% effective.
Thank you

Never did that. How old are you?

If the condoms are not splitting and you are using them properly- ie every time and before any contact- you should be okay.

I'm 44, and we are using the condoms properly and none have split or come off. I just know that even with perfect use they aren't 100% effective.
I think I am just feeling a bit unsure as this is my first sexual relationship so using contraception, thinking about its reliability, thinking about the possibility of contraceptive failure and of pregnancy is all very new to me. I haven't a clue whether I am even fertile having never tried to get pregnant in the past.

I do this! Unplanned pregnancies in perimenopausal women do occur, even in those using contraception, and tend to be the ones where the woman only realises she's pregnant when she goes into labour. I do a pregnancy test if more than about six weeks have passed since my last period, because if I did become pregnant I wouldn't want the baby to be damaged by alcohol, lack of folic acid etc.

Congratulations on your relationship, by the way! You are doing the right thing by using condoms - many women in their 40s assume that they are no longer fertile and don't always use contraception. It's great that you're so well informed.

You will need contraception for at least 2 years after your last period since you are under 50.

Since you're looking at a long time, I'd consider something more reliable like the POP or mirena coil.

(GP)

@theconstantinoplegardener thank you for the congratulations! Good to know I am not alone in thinking taking an occasional test is sensible. We've been having sex since October (so last period was before then) and I took one just before Christmas which seemed very weird to be doing when not TTC.

I have to say, threads on MN asking for people to check for lines on pregnancy tests have been a eye opener for me - I had assumed that a positive test would be completely obvious with a clearly visible line, but I have seen several where the line is so faint it is hardly visible unless the photo is enlarged. If they were mine I wouldn't have noticed as I wouldn't have been expecting to have to squint and look very closely at it.

@Hiphopopotamous Thank you. The GP I saw when my periods started to get irregular incorrectly told me I only needed contraception for one year after my last period. It was only from researching menopause online that I found it was two.

I appreciate that the POP or coil are more reliable, but I really don't want to start experimenting with hormonal contraception at my age, when I have never used it and have no idea if it would suit me. If I was 20, and had 30 years of potentially being fertile and sexually active ahead of me, which would give me time to try different options, to see what side effects I got, and to swap to different contraception if the first one(s) I tried didn't suit me, I might give it a try. Also, I already have some mood changes/swings and mild anxiety from being perimenopausal, and I don't want to add to that with possible side effects from hormonal contraception.

I do have a caya diaphragm which I haven't used yet which I will probably use with the condoms for even more reliable contraception.

If I were you and in a new relationship at only 44, I'd go back on the Pill. If you have no risk factors, you could use it till you are 50.

The advice is one year post meno for women over 50 and 2 years under 50 (contraception.)

44 is young for peri menopause and if your periods stop before 45-47, the medical advice is to use HRT to protect yourself from losing bone density, and having a higher risk of heart disease. see link below

www.menopausematters.co.uk/menopause.php

@JinglingHellsBells this isn't a new relationship, it's my first ever relationship and first time I have ever had sex. Thus I have never been on the pill (or any other contraception) so don't know what, if any, side effects it would give me, and I don't want to spend the next couple or more years suffering side effects, changing contraception, and finding which suits me.

Official NHS advice seems to differ to your link:
www.nhs.uk/live-well/healthy-body/menopause-and-your-bone-health/
I am almost 45 and have no other risk factors.

It's not MY advice, it's the advice of Dr Heather Currie who is a consultant gynaecologist who wrote the info on the site I linked to. There are other references to early menopause in the section where she says that in the western world, early menopause is classed now as before 47 (rather than 45.)

In any case the NHS link says the same thing- it says that cessation of periods before age 45 is classed as 'early' and HRT is recommended.

You sound very negative about trying the Pill. You might get on brilliantly with it! Why might you get side effects or suffer for two years trying it all? Anyway, up to you! But I think your PG testing is OTT and if it worries you that much, it's better to try other methods, like a coil or Pill or mini Pill.

@JinglingHellsBells apologies, I should have said the advice you linked to rather than your advice. I may be reading the NHS link incorrectly, but I don't think it's the same as menopause matters? It only advises HRT for women with early menopause if they also have other risk factors. Anyway, I didn't post to discuss HRT, so would prefer not to get into a debate about it

Yes I guess I am pretty negative about the pill, and hormonal contraception in general. As you say, I might get on great with it, and I know that lots of women do. But equally I am aware of many women, on MN and women I know IRL who have tried one pill for while, didn't get on with it, and changed to another, and then perhaps another, before finding one that suits. Or women who tired Mirena and had unacceptable side effects and hated it and had to live with it for months before a doctor would agree to take it out.
I appreciate that unacceptable side effects only happen to some women, but having only just started to have sex I just want to get on and enjoy doing it, learning about it and getting better at it. I don't want to risk side effects that might decrease my libido, or make me bleed and not want sex. I have spent over 25 years missing out on having sex, I feel I have a lot of catching up to do and don't want miss out again for any reason.

I wouldn't say my PG testing is OTT at the moment, I have only taken one test. I am not worried at all, I just though it might be sensible to take a test every so so often, to make sure (as a PP says) that I don't end up giving birth without knowing I am pregnant and to avoid any damage due to alcohol etc

My best friend is a midwife and told me that it’s not uncommon to have a hormonal surge just before menopause, and pregnancies at this stage of life are more common than you might think.

@MemorialBeach

There doesn't seem to be any discrepancy between the info on MM site and that of the NHS.
THis is from the NHS

Early menopause
Early menopause happens when a woman's periods stop before the age of 45. It can happen naturally, or as a side effect of some treatments.

For most women, the menopause starts between the ages of 45 and 55.

If you're under 45 and have noticed your periods becoming infrequent or stopping altogether, you should speak to your GP.

The slight difference between the 2 sites is that Dr Currie says that in the Western world, 47 is now considered the youngest 'acceptable' age where the risks of early menopause would not apply.

A friend of mine had a fracture in her 50s and was told by her GP that her menopause at 47 was considered 'young'. Her bone density is now being monitored.

The treatment if your periods stop at 45 or soon after is either HRT or the Pill (Qlaira) which is very similar to our own hormones and it's suggested there are fewer side effects.

This is from the NHS site:www.nhs.uk/conditions/early-menopause/

Women who go through early menopause also have an increased risk of osteoporosis and cardiovascular disease because of their lowered oestrogen hormone levels
.
Treatments for early menopause
The main treatment for early menopause is either the combined contraceptive pill or HRT to make up for your missing hormones.

Your GP will probably recommend that you take this treatment long term, beyond the "normal" age of natural menopause (around 52 on average), to give you lasting protection.

Just to add- if your periods continue to be irregular- and you miss several in a year- you are at risk from the diseases associated with low estrogen. This is the same as women whose periods stop or are irregular for other reasons such as PCOS, anorexia or female athletes.

It's really important to keep an eye on this and discuss with a dr because it's your longer term health in your 50s and 60s which can be affected.

So does that mean you should start HRT if your only peri menopausal symptoms are erratic/late periods?

I'm nearly 47 & feel absolutely fine - but my cycles can vary from about 14 to 75 days. No hot flushes, brain fog, joint pain etc. I am overweight but do run regularly.

I'm not sure I could face a monthly bleed on HRT & absolutely do not wish to go on the pill or have a coil (not in a sexual relationship).

So does that mean you should start HRT if your only peri menopausal symptoms are erratic/late periods?

I'm not quite sure what the question is in relation to early menopause.

HRT is recommended by drs for women who have an early menopause ( periods stopping before 45, some drs would say 47 but at least 45.)

It's not routine treatment for anyone with no symptoms of menopause or menopause within the normal age range.

You aren't having an early menopause @TheEndofit.

You are in peri at 47 and this could go on for several years.

Menopause is defined as when you have not had a period for 12 months.

''Just to add- if your periods continue to be irregular- and you miss several in a year- you are at risk from the diseases associated with low estrogen.''

This is what confused me @JinglingHellsBells - whilst I realise I am not menopausal as I'm still having periods - my question was would HRT be appropriate for someone like myself who is perimenopausal with irregular periods & a couple of missed periods a year.

Endo I think that you can ask for a DEXA to see the condition of your bones. I was diagnosed with early meno with awful symptoms and with almost regular periods. I had really low estrogen and I am on hrt for a year now, at 42.

• my question was would HRT be appropriate for someone like myself who is perimenopausal with irregular periods & a couple of missed periods a year.

Probably not from the bone-protection/ heart disease protection perspective, because at 47 you are still in 'normal peri and this could carry on until you are 50.

The risk is greater for women who start peri in their early 40s, whose periods stop before 45-47, or who have had fewer cycles throughout their lives, because bone density is directly related (amongst other things) to estrogen levels.

In the UK there is a reluctance to offer NHS bone density scans unless someone has high risk factors . Your GP might use the FRAX tool to assess your risk but it's not 100% accurate (you can access this assessment online yourself.)

Bone loss is greatest in the 3 -5 years following periods stopping . Anyone who reaches menopause several years before the average age of 52 should consider having one, the same as we have smears and mammograms.

It could save your life because you will have time to do something about it before it's too late.

More women die from complications of fractures in older age than cancer.

Maybe with the new preventative measures the NHS plans, DEXA scans will be part of women's care along with smear tests and mammograms.

Thanks @JinglingHellsBells - all the women in my family have stopped their periods at 45/46 - my sister didn't start HRT (due to obesity & not seeing GP as no other menopausal symptoms).

When I persuaded her to go, her GP did send her for a bone scan, which showed osteopaenia at age 49.