Pregnancy & Perimenopause: What You Need to Know!
By Carly Hartwig, a Certified Fertility Awareness Educator and a Holistic Reproductive Health Practitioner.
Updated September 24, 2025
There’s a lot of noise out there about pregnancy after the age of 35, and much of it is tied to perimenopause. But a healthy pregnancy is possible during this phase of life—and with more and more women waiting until 35 or older to conceive, it’s time to cut through the misconceptions and focus on how to optimize your chances.
What Is Perimenopause?
Most women enter perimenopause during their 40s, but it can begin as early as the mid-30s. Perimenopause is the transitional phase when our bodies begin to shift hormonally, all leading up to the big M herself. This change can last 10–15 years, only ending when you’ve gone 12 consecutive months without a menstrual period. This milestone means that menopause has officially been reached.
During perimenopause, fluctuations in estrogen and progesterone can lead to a wide range of symptoms, including:
- Irregular periods (longer, shorter, heavier, etc.)
- Irregular ovulation (i.e. bleeding without ovulation)
- Hot flashes and night sweats
- Sleep disturbances
- Mood changes (anxiety, depression, irritability)
- Vaginal dryness
- Memory or concentration issues
Trust us, this list barely scratches the surface—there are at least 30 known symptoms of perimenopause (some experts say 100+!).
Before you get overwhelmed, here’s a tip: If you think you’re transitioning into this phase of life, start keeping a symptom journal—it’ll help so much!
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Enhancing Fertility During Perimenopause
You can support your fertility during perimenopause by focusing on egg quality, hormone balance, and timing intercourse effectively. This article will break down each of these three tips into comprehensive steps for you and your partner.
Egg Quality
Many women focus on egg quantity (measured by AMH, a hormone that serves as an indicator of a woman's ovarian reserve) but overlook egg quality—and yes, you can take steps to improve it! Since eggs go through a 90-day maturation process, what you do today impacts your fertility three months from now. What better reason to get started! Here’s how to support egg quality:
- Eat an antioxidant-rich diet – Oxidative stress can damage egg cells, but antioxidants help fight it. Think leafy greens, nuts, avocados, berries—eat the rainbow!
- Ditch alcohol, tobacco, and recreational drugs entirely.
- Exercise regularly—but not excessively. Overtraining can suppress ovulation. Aim for five workouts per week, mixing resistance training with walking or cardio.
Supporting Fluctuating Hormones
Hormonal fluctuations—especially declining progesterone—can affect conception.
Progesterone is crucial for both getting and staying pregnant! Here’s how to keep your levels steady:
- Prioritize sleep and stress reduction. Meditation, yoga, breathwork, nature walks, and journaling are great options. Chronic stress raises cortisol, and high cortisol can suppress progesterone production.
- Increase Vitamin C and B6. Rich sources of Vitamin C include citrus fruit and bell peppers. For B6, look for poultry, fish, organ meats, and starchy veggies.
- Eat for blood sugar balance -stable blood sugar = stable hormones. Prioritize protein, healthy fats, and fiber at every meal. Avoid “naked carbs” — always pair carbs with protein or fat. Eat veggies before the rest of your meal. Move your body after meals (even just a quick walk or some power squats in the kitchen can help!) Drink vinegar before meals to flatten your blood sugar curve.
- Support liver detoxification - Your liver helps eliminate excess estrogen. Eat cruciferous veggies like cauliflower, kale, broccoli, etc. Try dandelion or milk thistle tea. Look into trying castor oil packs.
If you're concerned about your progesterone levels, talk to your health care provider. Bioidentical progesterone (a form of hormone replacement therapy) might be helpful—especially in the first trimester. If you're testing your progesterone levels with lab work, try to get your blood drawn 5–7 days after ovulation. Tempdrop can help you narrow in on this window!
Timing Intercourse Effectively
News flash: there’s a very small chance you’re still ovulating on day 14 of every cycle once perimenopause begins! One of the most effective things you can do is confirm your ovulation window and time intercourse accordingly.
- Use Tempdrop to confirm ovulation! Look for a sustained rise in your basal body temperature (BBT). A good rule of thumb is 3 consecutive temperatures above the previous 6.
- Track cervical mucus. As estrogen rises during your follicular phase, you should see mucus at the vulva. It often appears creamy or sticky at first (like lotion or glue), but then becomes clear and stretchy the closer you get to ovulating. ALL pre-ovulatory mucus is fertile—even the creamy/sticky kind! Check externally with toilet paper before and after using the bathroom. If you see something shiny or wet, try stretching it between your thumb and index finger for a consistency test.
- Don’t assume the ovulation window is the same each month! Perimenopause often brings cycle variability with it. That’s why live tracking is an essential—record what you observe, not what you expect!
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And Don’t Forget Your Partner!
We put so much focus on women, but men are 50% of the fertility equation. And only 1 in 4 men have optimal sperm quality!
- Encourage your partner to take a prenatal supplement for 3–6 months before trying to conceive. Like eggs, sperm mature over 3 months, so preconception care matters.
- Follow similar guidelines: antioxidant-rich foods, no alcohol or tobacco, quality sleep, and moderate exercise.
You can optimize your fertility at any age. We hope that these tips leave you feeling empowered, educated, and encouraged—because even during perimenopause, your body is capable of amazing things. You’ve got this!
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