Perimenopause can be a daunting time for folks who are trying to conceive. But with some knowledge and a little guidance, it can be an empowering time to gain a sense of your cycles for conception!
Cycle Changes
Typically, the most common symptom of perimenopause is a delayed period which is actually a result of delayed ovulation. Check out my previous blog post here to gain more insight on perimenopausal cycle changes.
During perimenopause, hormones are fluctuating and changing in preparation for menopause, particularly estrogen can be affected. Estrogen is responsible for producing the uterine lining AND stimulation of follicle (egg) growth, during perimenopause this hormone is often lowered, which can result in a longer follicular (pre-ovulatory) phase.
Other impacts can include
- Lighter bleeds due to decreased estrogen, due to decreased thickness of the uterine lining.
- Changes in cervical mucus production; it can be more common to see patches of cervical mucus that pop up and then dry up in the former part of the cycle (prior to ovulation).
- Shortened luteal phase caused by decreased progesterone. Typically the luteal (post-ovulatory) phase of the cycle is 11-16 days, but in perimenopause cycles it's not uncommon for this phase to drop below 11 days. There are natural methods to increase progesterone to increase your chances of pregnancy!
- Anovulatory cycles, or cycles without ovulation. While technically all cycles include ovulation, many people consider a cycle from one bleed to the next, in which case we would distinguish between ovulatory and anovulatory cycles - note only bleeds following an ovulatory cycle are periods. Anovulatory cycles are common in perimenopausal women.
This is just a quick summary of cycle changes to expect when perimenopausal. To learn more about why, check out my most recent article.
Habits & Nutrition
First and foremost, I recommend that perimenopausal folks trying to conceive start tracking their cycles with fertility awareness to gain a sense of when ovulation is occurring and how perimenopause may be impacting the process. In someone used to having a ‘regular’ cycle of 30 days and typically ovulating on day 16, this can change greatly as perimenopause sets in. For example, it’s not uncommon for someone in perimenopause to ovulate on day 20 of the cycle, and therefore experience a longer overall cycle.
When timing intercourse, you want to be getting busy on the best days for conception. As you can see with the difference in ovulation timing during perimenopause, these peak conception days can be altered greatly from those who haven't yet entered perimenopause.
To start, I always recommend people use Tempdrop in combination with cervical mucus when they are beginning to track their cycles – symptothermal methods are excellent options for tracking your cycle perimenopause! Since perimenopause can seem to be ever changing and comes with its own cycle patterns that tend to be more difficult to understand, I suggest reaching out to an instructor experienced with irregular cycles, maybe even specifically perimenopausal cycles. This will help you gain even more insight into your cycles!
Secondly, I recommend people focus on estrogen intake, as it can be impacted during this period (it tends to be low during perimenopause) – as this is a natural process, sometimes it just takes waiting out the cycle until ovulation finally occurs, but you can support your cycles with estrogen enhancing nutrition as well!
Lastly, the luteal (post-ovulatory) phase length can be impacted, it may be shorter due to the lack of progesterone, which is dominant after ovulation. I recommend a standard protocol for folks including
- Good sleep habits
- Increased water intake
- Decreased lights in sleep environment (including phones and alarm clocks)
- Increased vitamin C intake
All of these can help to boost your progesterone levels and lengthen your luteal phase (which is particularly important for pregnancy!)
Useful Tools
While you can chart your cycle in any phase - including perimenopause - without any extra tools, there are a few that can really help you in your journey. I recommend 3 in particular to help perimenopausal folks on their conception journeys.
1. Tempdrop! As mentioned previously, this is a great product to help with tracking your cycles. Whether you are a beginner or a seasoned cycle tracker, it can be invaluable to gain a sense of your overall cycle basal body temperature in relation to ovulation! And the best part is it's incredibly easy to use and gives you more accurate data.
2. Charting app. There are many excellent charting apps out there, and Tempdrop has an excellent app (Android/iOS) where you can input your charting information. This can help you to organize your cycle data to visualize and interpret ovulation and overall cycle parameters! Please make sure to work with an instructor as they can provide valuable information and counselling for trying to conceive!
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3. Luteinizing hormone test strips – Or OPKs, as some folks know them, can be valuable in cycles where ovulation is unpredictable – they can help you to gain confidence and provide a second piece of information in recognizing approaching ovulation and timing intercourse correctly.
Like I said, none of these are necessary, but they will help make your journey a little easier and give you additional insight to help you conceive faster!
Which Providers to See
I would suggest that folks struggling to conceive, or just unsure about conceiving while perimenopausal, reach out to a naturopath in their area. Naturopaths can provide extensive hormone testing, and they'll give you wholistic strategies for increasing your chances of conception. The providers complement fertility awareness - and can often even read cycle charts! - so they are working with your cycle and body to make valuable chances during your conception journey.
A physician can be a second resource and I recommend physicians who specialize in fertility during perimenopause. Extensive testing and support can be provided to increase your overall chances of conception!
Although perimenopause can seem like a daunting time to conceive, with a little advice and support, it's very possible to conceive and have a healthy pregnancy!