Menopause is defined as a woman’s last menstrual period, but it is not diagnosed until a woman has not had a period for 12 consecutive months in the absence of other causes. The ovaries stop producing large amounts of estrogen (and progesterone) and women no longer ovulate. Many other changes take place in the body when this happens. In the United States, the average age of women when they enter menopause is 51. After menopause, spontaneous pregnancy is no longer possible. There are very rare cases when women think they are in menopause, but the menopausal transition is not yet complete. For example: there could be cases of minimal spotting that go unnoticed that represent a woman’s period. However, there have been cases of pregnancy after menopause with the assistance of reproductive technologies.
Female fertility begins to decrease long before the onset of menopause. This decline begins at around age 32 and decreases more rapidly starting around age 37. Spontaneous pregnancies after age 45 are rare, but they can occur. This is why it’s important for perimenopausal women to use birth control if they do not desire to become pregnant. Condom use continues to be important even after menopause to prevent the transmission of STDs.