Can I get pregnant during perimenopause?

Yes, you can still get pregnant during perimenopause even though fertility declines significantly. Although menstrual cycles become irregular, ovulation can still occur - sometimes unpredictably. Many unplanned pregnancies happen during perimenopause because women assume they're no longer fertile. Persatuan Obstetrik dan Ginekologi Malaysia guidelines and global organisations support: use contraception until your doctor confirms full menopause - meaning 12 consecutive months without menstruation. For women 40+, suitable contraceptive options include IUD (hormonal or Mirena), progestin-only pill (mini-pill), condoms, or permanent surgery. Combined pills (estrogen+progesterone) are typically avoided after 35 if you smoke or have cardiovascular risk factors. Discuss with your Malaysian obstetrics and gynaecology specialist about the best option for your risk profile. After age 50 with 12 months no period, contraception is no longer needed.