Pregnant or Menopausal? Quiz

There comes a time in your late 30s to mid-40s when it’s biologically possible to conceive — but also possible to be in the menopause transition (i.e., perimenopause). 

To make matters even more confusing, sometimes early pregnancy symptoms can be mistaken for the signs of perimenopause. For example, missed periods, breast tenderness, mood changes, and sleep disturbances are all common symptoms of both perimenopause and pregnancy.

To help, we’ve put together a quiz for you to: 

• Explore your symptoms and 

• Better understand what’s going on with your body and hormones

We’ll also provide you with some practical next steps you can take based on your results. 

Perimenopause and Early Pregnancy: Understanding the Symptom Overlap

Even though perimenopause and pregnancy are two completely different biological processes, they’re driven by one key factor: hormonal changes. 

• In pregnancy, hormonal shifts support embryo and then fetal development, while also preparing the body for the pregnancy, birth, and breastfeeding. 

• In perimenopause, hormonal shifts indicate the body is approaching the end of its reproductive era. 

These changing hormone patterns — regardless of whether they’re due to pregnancy or perimenopause — are to blame for many of the shared symptoms.  

Putting Your Symptoms Into Context

If you feel puzzled by your symptoms, the following factors can help you put them into context.

What’s the Difference Between Pregnancy and Menopause?

Key Symptoms

Again, perimenopause and early pregnancy can feel very similar. Here are some of the most common symptoms for each and how they overlap.

It’s important to note that with pregnancy, symptoms typically intensify over a few weeks. Perimenopause symptoms, on the other hand, can be irregular and show no clear pattern over months or even years. 

Hormonal Shifts

Despite the similar symptoms, the underlying hormonal shifts of pregnancy and perimenopause are completely different. 

• During Pregnancy: After implantation, embryonic tissue produces human chorionic gonadotropin (hCG). The role of hCG is to tell the body to halt the menstrual cycle and continue producing progesterone and estrogen. HCG, progesterone, and estrogen levels remain elevated throughout pregnancy to support fetal development. 

• During Perimenopause: As the body approaches menopause, the menstrual cycle becomes increasingly irregular. The hormones that control the menstrual cycle, progesterone and estrogen, gradually decline. As a result, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels rise. 

Typical Age

The chances of getting pregnant are highest during your 20s and early 30s. After 40, it’s still possible to conceive but less likely. According to the American College of Obstetricians and Gynecologists:

• Among women in their 20s and early 30s, 25% will conceive naturally in any given menstrual cycle. 

• By age 40, 5% will conceive naturally in any given cycle. 

• The chances continue to decrease every year after 40. 

The average age of menopause is 52, with the menopause transition (i.e. perimenopause) typically beginning around age 45. 

How This Quiz Can Help

This quiz is intended to help you assess your symptoms and chances of pregnancy. While it cannot confirm whether you’re pregnant or approaching menopause, it can provide you with insights into your body and practical next steps. 

This quiz is based on common patterns and hormone-related indicators. It is intended for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. 

What to Do After Taking the Pregnant or Menopause Quiz

If Your Results Lean Toward Pregnancy…

If your results lean toward pregnancy, you should take a pregnancy test no sooner than the first day after your missed period. 

If your result is negative, wait a few days and then test again. 

If your pregnancy test is positive, you should:

• Make an appointment with your doctor as soon as possible

• Start taking a prenatal multivitamin

• Follow a healthy pregnancy diet by avoiding potentially harmful foods

If your pregnancy test is negative but you want to plan a pregnancy, consider making an appointment with your doctor or a hormone health specialist. They can provide tailored guidance on the best strategies for conceiving in your late 30s or 40s. 

If Your Results Lean Toward Menopause…

If your results lean toward menopause, now is a good time to start tracking your symptoms more closely in a diary or fertility tracking app (like the Mira App).

Having a record of your symptoms, period dates, and intercourse dates will help you better understand your perimenopause journey and chances of pregnancy. It will also serve as a helpful reference point when discussing your symptoms with your doctor. 

For even more clarity on what’s going on in your body, it’s also a good idea to start tracking your hormones directly. This can be done with Mira’s Menopause Transitions Kit, which enables you to:

• See where you are in your menopause transition

• Monitor your unique hormone patterns and how they change over time

• See whether or not you’re still fertile

• Track your symptoms alongside hormonal fluctuations

If your symptoms intensify or if you have missed a period for at least three months in a row, make an appointment with your healthcare provider. They can assess your symptoms, run tests (if needed), and advise on appropriate treatments for symptom relief. 

If Your Results Are Mixed… 

If your results are mixed, you should go ahead and take a pregnancy test no sooner than the first day after your missed period. If your results are negative, wait another few days and then test again to make sure. For even more clarity, you can also take a blood test at your doctor’s office to check your hCG levels.

If you are pregnant, make an appointment with your doctor as soon as possible and start taking a prenatal multivitamin. 

If you are not pregnant, it’s worth scheduling a wellness checkup with your doctor — especially if you:

• Are actively trying to plan a pregnancy

• Suspect you might be approaching menopause early

• Are struggling to cope with your symptoms on your own

When to Seek Medical Advice

You should seek immediate medical attention if you experience sudden or severe symptoms that interrupt your day-to-day life, such as:

• Intense hot flashes

• Extreme fatigue

• Unusual bleeding

• Excessive lower abdominal pain

Final Note: You’re Not Alone

We understand the perimenopausal years can be overwhelming — but you don’t have to navigate them alone.

Whether your goal is to plan a pregnancy or just get support for your symptoms, it’s worth seeking support from specialists who can help you. 

Here are some practical tips to get started: 

• Track your symptoms closely so you can have a confident and informed conversation with your doctor.

• Book an appointment with your doctor immediately if you want to plan a pregnancy, think you’re approaching menopause early, or are struggling to manage perimenopausal symptoms.  

• Get your hormones tested to better understand your fertility and how far away you are from menopause (ask your doctor for a blood test or start tracking at home with Mira’s Menopause Transitions Kit). 

• Seek expert guidance and emotional support from a hormone health specialist — we’d love to see you in our virtual Hormone Health Clinic!

We also recommend The Menopause Charity, The Menopause Society, and Let’s Talk Menopause for additional support and community resources.

Frequently Asked Questions

Can you get pregnant during menopause?

No, you cannot get pregnant naturally after menopause. Although rare, pregnancy may be possible with in vitro fertilization after menopause. 

Can perimenopause cause nausea?

Nausea is not a typical symptom of perimenopause. However, it can happen in some cases. 

How many women become pregnant during menopause or after it?

Natural pregnancy is possible during perimenopause. At age 40, an estimated 5% of women will conceive naturally in any given cycle. The chances decrease each year after 40. Once menopause is reached, natural pregnancy is not possible. 

Can a person experience symptoms of menopause while being pregnant?

Pregnancy and perimenopause symptoms are similar. However, symptoms experienced during pregnancy are caused by hormonal changes due to pregnancy, not menopause. 

Can you get hot flashes in early pregnancy?

Hot flashes are not a common symptom of early pregnancy. It is more common to experience hot flashes in the second or third trimester. 

Can you still get pregnant at 40?

Yes. It is possible to be 40 and pregnant. At age 40, an estimated 5% of women will conceive naturally in any given cycle.

Can you get night sweats in early pregnancy?

Yes. Night sweats are a common symptom in early pregnancy due to fluctuating hormone levels and increased blood flow. 

Do you have sore breasts in perimenopause?

Yes. Breast tenderness is one of the most common symptoms of perimenopause.