Hormone replacement therapy (HRT) contains estrogen and progesterone to mimic the hormones that decrease during perimenopause and menopause. Pregnancy is still possible while taking HRT, as it is not likely to affect fertility. It does not work as a contraceptive.
There are two types of HRT — estrogen therapy and combined hormone therapy. Estrogen therapy consists of estrogen as the only hormone. Combined hormone therapy consists of a combination of estrogen and progestin.
This article looks at HRT and how it affects fertility. It examines whether people can still conceive and offers tips for those wishing to get pregnant or avoid pregnancy.
It is possible to become pregnant while taking HRT, and experts recommend that people do not take HRT if they are or could be pregnant.
A person may take combined HRT continuously or sequentially. Sequential HRT involves taking HRT in cycles. Continuous combined HRT is unlikely to affect fertility, and sequential HRT does not.
The American College of Obstetricians and Gynecologists (ACOG) advises that people do not take HRT if they are pregnant or planning to become pregnant.
If a person wishes to conceive, they must stop taking HRT. People can talk with a doctor if they have any concerns about how stopping HRT will affect them.
HRT is unnecessary during pregnancy as a person will already have high levels of estrogen and progesterone.
It is still possible to become pregnant while taking HRT. If people do not want to become pregnant, they may need to use birth control.
People cannot take HRT and the combined pill at the same time. If people take the combined pill, a doctor may recommend that they take it until age 50 and then change to using HRT.
If people use the progestogen-only pill, they may be able to use HRT simultaneously.
After the age of 55, it is unlikely that people will become pregnant through sexual intercourse, so they may no longer need to use contraception. People may still need to use condoms or other barrier methods to protect against sexually transmitted infections (STIs).
It is possible for any person with a uterus who is ovulating to become pregnant. Other forms of hormone therapy, such as testosterone, do not work as birth control. People who are only taking testosterone can use any type of birth control.
Below are some commonly asked questions about HRT and pregnancy.
How long does it take to get pregnant on HRT?
HRT is not likely to affect fertility, so it may take the same amount of time for a person taking HRT to get pregnant as someone who is not taking HRT. However, if a person is trying to get pregnant, they should stop using HRT.
The ACOG recommends that people speak with a doctor if they have not conceived after 1 year of regular sexual intercourse. This time frame changes to 6 months if a person is over the age of 35.
Those over 40 years of age should speak with an obstetrician-gynecologist about evaluating their fertility before trying to conceive.
How do perimenopause and menopause affect fertility?
If people do not wish to become pregnant, doctors advise that people over 50 continue to use contraception for a year after their last period. For people under 50, they will need to keep using contraception for 2 years.
It is possible to become pregnant while taking HRT because it does not affect fertility and does not work as a contraceptive. HRT is unsuitable to take during pregnancy or if people want to become pregnant.