Clinical Depression: Signs and Symptoms to Watch For

It’s only human to feel sad, alone, and detached from time to time, but if these feelings seem to stick around longer than usual or you start to feel like they’re significantly interfering with your life, you could be suffering from clinical depression.

Sad young tired woman sitting on the bed

Clinical depression (also known as major depressive disorder) is a mood disorder that manifests emotionally and physically and is known to cause persistent feelings of sadness and apathy. If you’re suffering from depression, you’re likely to feel alone, emotional, and uninterested in many of the activities that you used to enjoy. For example, maybe you used to go to a yoga class followed by dinner with friends every Wednesday night, but recently have been feeling withdrawn and haven’t had much interest in attending.

If it feels like you hear about depression a lot, this is probably because it’s one of the most common illnesses out there. In the United States, clinical depression affects about 7% of the adult population, and about a quarter of all adults will experience it at some point in their lives.

Clinical depression can strike suddenly and seemingly for no reason, but it’s often brought on by significant life events such as the death of a loved one, relationship troubles (including friendship, family, or a partner), the end of a relationship, moving, loss of a job or changing jobs, social isolation, graduation, abuse, and more. One notable factor about clinical depression is that it affects women at nearly twice the rate as men. This is due to a number of factors, but many are tied to hormonal changes that occur throughout the lifespan alongside menstruation, pregnancy, menopause, and miscarriage. Should you notice changes in your mood surrounding any of these situations, or even seemingly out of the blue, it’s always a good idea to speak with your doctor.

Here are some common signs and symptoms to look out for if you suspect that you’re suffering from clinical depression:

  • Trouble concentrating and focusing
  • Restlessness
  • Fatigue
  • Changes in sleep patterns, whether sleeping more or less than usual, or suffering from insomnia
  • Loss of interest in activities
  • Withdrawal from close friends and family
  • Having a short temper
  • Suicidal thoughts
  • Changes in appetite
  • Feeling more emotional than usual
  • Feeling apathetic
  • A diminished sex drive
  • Significant change in body weight, whether weight loss or weight gain

If you have any concerns or questions about clinical depression and want to speak with a knowledgeable doctor, call Arizona OB/GYN Affiliates (AOA) at 602-343-6174 or visit

What is Lupus? Everything you Need to Know

If you’ve been experiencing fatigue, a face rash, sensitivity to sunlight, and other conditions that hint that something may be off, it might be time to see a doctor. While many of these symptoms may be nothing to worry about, they could also be signs of Lupus.

Woman lying on sofa having headache. Stressed girl suffering of fatigue, migraine, trying to cope with nervous tension, worries because of problems, unwanted pregnancy, negative thoughts and emotions

Lupus is an autoimmune disease in which the body’s immune system mistakenly attacks its own cells. It’s chronic, meaning it lasts at least three months and often longer, and is known to cause major problems with skin, joints, and organs. Lupus can show up at any age but is most common among women who are between the ages of 15 and 44. Frequently, lupus goes untreated for quite some time because its symptoms are often similar to those of other ailments.  If you suspect you may be suffering from lupus, here are some signs to look out for:

  • Face rash: One of the most common signs of lupus is a facial rash that forms a butterfly-like shape across the nose and cheeks. This rash isn’t present in all cases of lupus but appears in many of them.
  • Fatigue: Another common sign of lupus is fatigue. Though it’s hard to measure scientifically, this sign is present within 50-90% of people suffering from lupus and is often strong enough to impact quality of life.
  • Sensitivity to sunlight: Nearly two out of every three individuals with lupus become sensitive to sunlight, and many of them develop a rash after spending time in the sun. More formally, this condition is known as photosensitivity.
  • Shortness of Breath: In some cases, lupus can cause lung inflammation that may contribute to difficulty breathing.
  • Headaches, Confusion, and Memory Loss: Lupus is known to cause headaches and various forms of cognitive impairment. Typically, these issues are worse during flare ups of the illness.
  • Joint Pain: Joint pain, swelling, and inflammation are common among individuals with lupus. This is so common that around 95% of people with lupus will experience arthritis or joint pain at some point.

You should consider seeing a doctor if you’re concerned about any of these symptoms, but especially if you’re experiencing persistent fatigue and fevers or a rash that can’t be explained. It’s important to see a doctor rather than brushing the symptoms aside, because sometimes the inflammation that’s triggered by lupus can cause other serious problems throughout the body, such as kidney damage, issues with the brain and central nervous system, blood issues like anemia, heart issues, and even pregnancy complications such as higher risk of preterm birth and preeclampsia.

While lupus is certainly a serious condition, it’s also treatable and can be managed to allow you to live a full and relatively normal life.  Lupus typically ranges from a mild condition to one that’s more life threatening, so it’s important to stay on top of your medical care to manage the illness. If you’re concerned you may be suffering from lupus and want to speak with a knowledgeable physician, call Arizona OB/GYN Affiliates (AOA) at 602-343-6174 or visit

Understanding the Risks Involved in Having a Baby Later in Life

It’s not uncommon for many women to start thinking more seriously about childbirth as they get older. But while having a healthy pregnancy at an older age is possible for many women, it’s important to be mindful that it can be significantly more difficult and involve a number of risks. For many women, fertility begins to decrease slowly around age 32 or so, and then much more rapidly around age 37, which can make for a challenging experience in many ways. Read on to learn about some of the challenges women may face as they try to get pregnant as they hit their mid-thirties or forties.

Close Up Of Pregnant Businesswoman In Office

Increased time to conceive: As women get older and their bodies experience typical age-related changes, it often takes them much longer to conceive. Statistics show that while a woman may have a 20 percent chance of getting pregnant during each menstrual cycle when she’s in her twenties, these chances drop to about 15 percent by the time she reaches her mid-thirties, and down to around 5 or 10 percent by age 40. This doesn’t necessarily mean a woman cannot conceive altogether, but the process will typically be more challenging.

Infertility: Women have a harder time conceiving as they age, and may not be able to conceive altogether. It’s believed that somewhere between 10 and 15 percent of couples in the United States struggle with infertility, which is defined as an inability to get pregnant after having frequent, unprotected sex for more than one year. For many women, fertility declines gradually as they age, and then advances more rapidly around age 37.  Many causes contribute to female infertility, such as early menopause, ovulation disorders, age, and other health issues.

You may need to see a fertility specialist: If you’re over age 35 and have tried conceiving for six months without success, it may be time to see a reproductive endocrinologist for help. A reproductive endocrinologist is a fertility specialist who can help you work towards pregnancy by checking your health, making sure your fallopian tubes and eggs are functioning as they should, and recommending treatments like in-vitro fertilization or medication that can encourage ovulation. Your gynecologist should be able to recommend a fertility specialist if you’re interested in exploring this path.

Higher likelihood of complications: When women hit age 40 or so, they are more likely to develop pregnancy-related health complications like high blood pressure and gestational diabetes. Not only do these complications pose risks to a woman’s health, they also can contribute to pregnancy-related problems such as birth complications, miscarriage, and issues with the placenta.

Increased risk of miscarriage: After the age of 35 or so, women start to encounter a higher risk of miscarriage. Statistics show that at age 35, a woman’s risk of miscarriage is around 20 percent, but jumps much higher to around 80 percent by age 45.

Many women can still conceive and carry healthy pregnancies in their late thirties or forties, but the process is often far more challenging than it may be for younger women, given the issues we mentioned above, such as increased time to conceive, fertility issues, health risks, and more. If you have concerns about getting pregnant later in life and would like to speak with a physician, call Arizona OB/GYN Affiliates (AOA) at 602-343-6174 or visit

Six Quick Tricks for Spicing Things Up in the Bedroom

As life goes on, our sexual needs and interests inevitably change—you may find yourself more interested in sex, less interested in sex, or completely indifferent to sex all together. The fact is, at any point in life there are going to be a ton of different factors that might influence your sex life or libido. These include your overall health, where you’re at in the aging process, past illnesses, your relationship with your partner, medications, and more. Since an active and healthy sex life is one of life’s greatest pleasures, we thought we’d fill you in on six tips for keeping your sex life healthy and exciting. Read on for the low-down.

Beautiful couple in love in morning

See a sex therapist

Many people would rather do almost anything than talk about their sex life with someone they don’t know. But seeing a sex therapist can be so helpful in spicing up your sex life that it might be time to get over your fears. Sort of like a visit to a psychologist or counselor, a sex therapist can help you unravel the psychological and physiological aspects of your sex life, while also helping you bring in more mindfulness and communication with your partner. Overall, this is a form of psychotherapy that can play a huge role in getting your sex life back on track.

Experiment with sex positions

Sometimes, when you find yourself uninterested in sex, there isn’t a complex underlying cause—you might simply be bored. Fortunately, this is one of the easiest situations to fix. One of the simplest ways to bring some excitement into the bedroom is to experiment with different sex positions. When experimenting with sex positions that typically fall out of your norm, you might find yourself being stimulated in new ways and enjoy the adventure of it all along the way. Start by setting a goal of trying one or two new positions each week for a month. Here are a few ideas for getting started, but with a creative imagination (or a quick google search!) the opportunities are endless.

Kindness counts: Show your partner you care

Introducing oils into the bedroom is a great way to slow things down and really pay attention to your partner. Find a nice oil and surprise your partner with a massage—you’ll be surprised at how quickly one thing might move to another from there.

Maybe massage isn’t your thing. If that’s the case, why not try cooking a romantic dinner for your partner? Wear something fancy and request the same of your partner, grab a nice bottle of wine, and enhance the atmosphere with candles and dim lighting. Even if your romantic evening doesn’t lead to sex, kind actions of this variety will almost certainly strengthen your relationship and leave your partner feeling appreciated.

Get flirty

Flirtation brings so much fun and excitement into the early stages of a relationship, but often disappears after things get serious. Whether it’s teasing, making serious eye contact, texting, or sexting, it’s important to remember that a bit of flirtation can go a long way in keeping your relationship and sex life thriving.

Stay on top of your sexual health

Your sexual health plays a huge role in your sex life. After all, when you’re not feeling right, you’re often far less interested in engaging in any form of sexual activity. It’s important to see and talk to your doctor about any signs that are troubling you or interfering with your sex life. This could mean anything from pain during sex or urination to new smells down there that you haven’t experienced before, or even simply when you’re experiencing a lack of interest in sex. And remember it’s not just sexual health that plays a role in your sex life—your overall health does too. Too keep things running smoothly, make sure you’re eating healthy foods, getting enough sleep, exercising, and taking care of any health conditions you’re experiencing.

Change up your birth control

Many people don’t realize it, but hormonal birth control can have a big impact on your sex drive, depending how your body reacts with the type you’re taking. Most people don’t experience a change in libido from birth control pills, but some do. Some women see a rise in their libido, whereas others feel less desire for sex. If you notice a change in how you feel about sex since starting a new type of birth control, bring the issue up with your gynecologist. It’s important to keep your doctor in the loop so they can check for other underlying conditions and consider prescribing you a different type or method of birth control.

Remember that whenever you have concerns about your sex life or sexual health, it’s always a good idea to have an open and honest conversation with a health professional. To speak with a knowledgeable doctor, call Arizona OB/GYN Affiliates (AOA) at 602-343-6174 or visit

Anorgasmia in Women

Orgasms vary in intensity and duration and can present differently from woman to woman, but for those who suffer from a medical condition called anorgasmia, it can be difficult, or even impossible, to reach orgasm at all. Essentially, anorgasmia is a type of sexual dysfunction where a person isn’t able to reach orgasm even with ample sexual stimulation. Given that many women experience anorgasmia at some point in time, we thought we would fill you in on everything you need to know about this condition.

Happy couple looking through window at home

The various types of anorgasmia

Anorgasmia can present itself in many different forms. Here are a few you might experience:

Acquired anorgasmia: In this form of anorgasmia, a woman who previously was able to achieve orgasm is no longer able or has trouble reaching climax.

Lifelong or generalized anorgasmia: Women with lifelong or generalized anorgasmia are unable (and never have been able) to reach climax and experience an orgasm in any situation.

Situational anorgasmia: Women with situational anorgasmia can only achieve orgasm during specific circumstances and possibly even with a specific partner. Women with this type of anorgasmia may be able to reach climax during oral sex, but not through vaginal penetration.

What causes anorgasmia?
Anorgasmia can arise for a number of reasons, with medication side effects being one of the most common causes. Antihistamines, antidepressants (SSRIs in particular), and blood pressure medications are among the more common medications that can be problematic. Diabetes, neurological diseases such as multiple sclerosis, and other illnesses can also contribute to anorgasmia. High alcohol intake and smoking are also problematic for some women. And sometimes, aging is a big contributor, especially because blood flow to the clitoris and vagina may slow down as women move toward menopause and estrogen levels fall.

Anorgasmia may also have psychological roots, including poor body image, anxiety, depression, past sexual trauma, stress, or even embarrassment. Or the cause may be relationship related, such as trust issues, communication challenges, or lack of a strong connection between partners.

Is it necessary to see a doctor?
If you’ve never achieved an orgasm or are experiencing periodic or recent troubles climaxing, consider seeing a doctor to discuss your experience. They may be able to help you remedy or manage the situation in a simple way, such as helping you minimize stress or treating underlying medical conditions. If you decide to see a doctor, you can expect them to ask about your sexual history, symptoms, and medical history.

Treating anorgasmia
Anorgasmia can be treated in a variety of ways depending on the type of anorgasmia and the reasons it’s occurring. Here are a few common treatment recommendations:

  • Address relationship issues and challenges through improved communication, relationship counseling, or other means.
  • Manage stress and anxiety.
  • Increase the amount of sexual stimulation, especially either directly or indirectly to the clitoris. Vibrators and other devices can be helpful here.
  • Experiment sexually to find out what works for you and gain a better understanding of your body.
  • Explore cognitive behavioral therapy, which can reframe the way you think about sex.
  • Explore sex therapy.
  • Receive medical treatment for underlying conditions that may contribute to or cause your anorgasmia.

If you are experiencing anorgasmia and want to speak with a knowledgeable doctor, call Arizona OB/GYN Affiliates (AOA) at 602-343-6174 or visit

What You Need to Know about Anemia and Your Period

Anemia is a common health condition characterized by low red blood cell count that affects more than 3 million Americans. Having an insufficient amount of red blood cells can be problematic because the body’s cells are unable to get enough oxygen, leading to fatigue and other symptoms.

Anemia and Your Period

Anemia comes in many forms, with many caused by blood loss or iron deficiency. In general, many women experience anemia because of heavy menstrual periods that cause their iron levels to fall. Overall, women are at higher risk of anemia than men. Specific high risk groups include the elderly, Hispanic women, women of color, people with chronic illness, and women of childbearing age. Here we’ll get into the specifics of anemia and the ways in which menstruation can affect and contribute to anemia.

Anemia due to blood loss

Women who suffer from heavy menstrual periods are more prone to forms of anemia where red blood cells are lost to bleeding, which makes sense when you think about it. Women with anemia due to blood loss may be left feeling tired, weak, and possibly even out of breath. One sign that your period is abnormally heavy is if you’re going through a tampon or pad every hour for at least a few hours in a row. Other signs include passing large blood clots and bleeding for more than seven days in a row. If you’re experiencing any of these situations, you should speak with your doctor about getting tested for anemia.

Iron-deficiency anemia

Iron-deficiency anemia comes about when the body is low on iron. Not having enough iron in the body is problematic because it’s needed to produce hemoglobin for red blood cells. While this form of anemia can arise from a number of factors, including diet, menstruation is a common contributor. Women of childbearing age are at a higher risk for this form of anemia due to blood loss during menstruation and the increased demands on blood supply during pregnancy. People suffering from iron-deficiency anemia may experience strange cravings, such as for paper, dirt, or ice.

What are some symptoms of anemia?

Some common symptoms of anemia include lethargy, dizziness, pale skin, abnormally rapid heartbeat, shortness of breath, irritability, trouble with concentration, sexual dysfunction, and insomnia. Though these symptoms will vary depending on the form of anemia, its severity, and the cause. It’s important to speak with your doctor if you’re experiencing a combination of these symptoms, especially if you’re also suffering from a very heavy menstrual period. Your physician will be able to carry out further testing to determine if you are suffering from anemia. These tests are likely to include a physical exam, medical history, and blood work that assesses your levels of red and white blood cells, hemoglobin, and platelets.

Should I be worried about anemia?
Whether you should worry about anemia depends on the situation. Anemia that develops during pregnancy affects up to 40% of pregnant women and is often seen as normal. For women who are considering becoming pregnant, doctors will usually recommend supplements including iron and folate. And anemias due to blood loss and iron-deficiency can usually be treated with iron supplements and even dietary adjustments. However, some forms of anemia can be much harder to treat and require procedures such as blood transfusions and bone marrow transplants.

If you have any concerns about anemia and want to speak with a knowledgeable physician, call Arizona OB/GYN Affiliates (AOA) at 602-343-6174 or visit

10 Things to Know Before Your First Gynecologist Appointment

For many teens and women, seeing a gynecologist for the first time can be a daunting and fearful prospect. But the truth is, visiting a gynecologist isn’t actually a bad experience at all. Follow along as we let you know what to expect and answer some common questions related to seeing a gynecologist for the first time.

Female Doctor Meeting With Teenage Patient In Exam Room

What’s a normal age to first see a gynecologist?

Many recommend that girls see a gynecologist for the first time somewhere between the ages of 13 and 15.  But if you’re older and have never seen a gynecologist, don’t let this guideline put you off from making an appointment.

Will the visit be uncomfortable or awkward?

While it’s completely normal to be nervous before your first gynecological exam, there’s really no reason to be. Most likely, the appointment won’t be nearly as awkward or scary as you might expect.

Your doctor will thoroughly explain everything they do, and will likely be friendly and talkative, putting you at ease the entire time. You can expect to talk about things like your health history, your family and their health, your menstrual cycle, whether or not you’re sexually active, whether you consume alcohol, and other personal topics. It’s important to answer honestly so that your doctor is able to get an accurate understanding of your health.

Can I bring someone along for support?

If it makes you feel more comfortable to have a family member or friend by your side, most doctors will allow you to bring someone along to your exam.

What should I expect during my exam?

When you visit the gynecologist, many doctors will want to run a few tests. These exams will vary depending on why you’re there, whether you’re sexually active, and how old you are.  Height, weight, and blood pressure measurements are common, as are external genital exams, pelvic exams, breast exams and pap smears. However, a first visit may simply involve conversing with the doctor, and not include any tests.  For young patients, a doctor may not perform a pelvic exam, and pap smears aren’t performed on women who are under 21.

What to expect during an external genital exam

During an external genital exam, a doctor will take a look at the area around your vaginal opening, which includes the labia, vulva, clitoris, and anus. Your doctor may even use a mirror so you’re able to see what these body parts look like.

What to expect during a pelvic exam and pap smear

A pelvic exam is performed yearly once patients hit age 21 or so. During this quick test that usually lasts little more than ten minutes, your doctor will look for signs of abnormalities and illness. They will look at body parts including the vulva, ovaries, cervix, uterus, and bladder. The doctor will also insert a metal device called a speculum into the vagina. The test may be a little bit uncomfortable and the speculum may feel cold, but it won’t be painful.

Your doctor may also do some other tests during the pelvic exam, such as check for STDs or do a pap smear. A pap smear is a gentle and pain-free test in which your doctor will scrape some cells from your cervix to test for cervical cancer. For women who fall somewhere between 21- and 30-years-old, the test is usually performed every three years. For those above 30, the time period between tests may be longer.

Should I shave or wax before my appointment?

It’s not necessary to shave or wax around the vagina before your first visit to a gynecologist. You will want to be clean though, so be sure to shower that day, using a gentle soap to maintain proper vaginal hygiene.

Will the doctor keep everything confidential?

Conversations that take place during your visit will be kept confidential for patients who are older than 18. For patients younger than 18, some information may be shared with parents or guardians if the doctor feels it is important to do so.

Is it ok to ask questions?

It is definitely ok to ask questions when you visit a gynecologist, in fact it’s encouraged. Keep in mind that no topic is too weird to discuss, so don’t hold back from voicing a concern or seeking an answer just because you think the question may be taboo or embarrassing.

Should I follow up?

If your doctor performs any tests during your visit, you’ll want to follow up about a week later (if you haven’t already heard back) to check on the results. With some doctors you’ll simply call the office, while with others you can check results within an online portal.

If you have any concerns about your first gynecologist visit and want to speak with a knowledgeable physician, call Arizona OB/GYN Affiliates (AOA) at 602-343-6174 or visit

Pelvic Organ Prolapse: Common Yet Misunderstood

Pelvic organ prolapse is a common yet frequently misunderstood health condition where one of the pelvic organs—the bladder, uterus, rectum, small intestine, or vagina—drops down from its usual position and pushes against the walls of the vagina. Up to one-third of women experience pelvic organ prolapse or a similar pelvic disorder at some point in their lives, and the experience can be embarrassing, uncomfortable, and painful.

Pelvic Organ Prolapse image

When pelvic organ prolapse isn’t present, the pelvic floor muscles hold the pelvic organs in place. But in some cases, such as after surgery or childbirth or simply with aging, these muscles weaken and fail to do their job. Instead of holding the pelvic organs in position above the pelvic opening, they allow the organs to drop and bulge into the vagina. Aside from what we’ve already mentioned, some other common causes and risk factors for pelvic organ prolapse are obesity, family history, constipation, a chronic cough, pelvic organ cancer, a past hysterectomy, or another situation where a lot of pressure is placed on the abdomen.

Types of Pelvic Organ Prolapse

Here are a few types of pelvic organ prolapse, each of which corresponds to a different organ involved:

Cystocele: This is the most common form of pelvic organ prolapse and is when the bladder drops down and bulges into the vagina.

Uterine prolapse: Prolapse of the uterus.

Enterocele: Prolapse of the small intestine/small bowel.

Urethrocele: Prolapse of the urethra.

Rectocele: Prolapse of the front wall of the rectum into the vagina.

Vaginal vault prolapse: Prolapse of the upper section of the vagina into the vaginal canal or outside the vagina.

The Symptoms

The symptoms of pelvic organ prolapse vary depending which organ has dropped. Here are some common symptoms you may notice:

  • Bulging at the opening of the vagina
  • Vaginal pressure
  • A constant urge to urinate
  • Leaking urine
  • Incontinence
  • Constipation
  • Pain during sex
  • Lower back pain or pressure
  • Pelvic pain, pressure, or fullness
  • Vaginal bleeding or spotting


Pelvic organ prolapse can be diagnosed during a routine pelvic exam by your gynecologist, or through other procedures including MRI, ultrasound, pelvic floor strength testing, X-ray, or CT scan. These are a few different ways it can be treated:

Physical Therapy: Physical therapy is a common early treatment used to strengthen the pelvic floor muscles. This usually involves kegel exercises.

A Pessary: A pessary is a removable device that’s inserted into the vagina and used to support organs and prevent them from dropping down. A pessary is usually fitted to the individual, and is may be used in conjunction with physical therapy or on its own if physical therapy is ineffective.

Surgery: If symptoms don’t let up after physical therapy or with use of a pessary, surgery to repair the organ or tissue may be recommended. The exact surgery will vary depending on the organ involved, with some being far more simple or complex than others. If the uterus is the organ involved, a hysterectomy is often recommended. Sometimes a procedure called a sacrocolpopexy is performed on women who are at high risk of experiencing repeated prolapse.

What to do if you suspect you’re experiencing pelvic organ prolapse?

It’s important to see a doctor if you think you’re dealing with pelvic organ prolapse. In most cases, the condition isn’t harmful, but may get worse over time. It can also result in urinary tract infections or other urinary problems when left untreated.

If you have any concerns about pelvic organ prolapse and want to speak with a knowledgeable doctor, call Arizona OB/GYN Affiliates (AOA) at 602-343-6174 or visit

Perimenopause: What You Need to Know in Your 30s And Beyond

Many women are well aware of the signs and symptoms of menopause, but are far less knowledgeable about perimenopause. In fact, many don’t even know what perimenopause is at all. But don’t feel bad if you’re in that boat—we’re here to fill you in on everything you need to know about this life stage. Perimenopause is a transitional time period before menopause where the female body starts to produce less estrogen. It typically lasts somewhere between four and eight years, and often begins when a woman is in her 40’s, though in some cases, perimenopause may begin in the 30’s or even earlier.

Perimenopause photo

Some women experience nothing other than irregular or missed menstrual periods during perimenopause, whereas others experience far more changes in the body. If you suspect you may be going through perimenopause, here are some signature signs to look out for:

Night Sweats and Hot Flashes: A hot flash is basically a wave of increased body heat that comes on suddenly, lasts a few minutes, and may be experienced along with a rapid heartbeat, sweating, and reddening skin. Hot flashes become more common for many women as hormone levels change approaching menopause, and can also manifest in the form of night sweats, which can sometimes disturb sleep, especially when they’re frequent.

Irregular periods: It’s not at all uncommon for periods to become irregular as you enter perimenopause, whether this means going a longer or shorter amount of time between periods, or even skipping them altogether. If you notice your menstrual cycle changes by seven days or longer over a consistent period of time, this can be a sign of early perimenopause. Meanwhile, going 60 days or longer between periods could indicate that you’re in late perimenopause. Some women also experience increased bleeding and cramps during this time period.

Decreased fertility: As you would expect, as you start to ovulate less frequently, you are also less likely to conceive. It is important to keep in mind that it is still possible to get pregnant during this time period though.

Mood changes: Your hormone levels will fluctuate during perimenopause, and so will your mood. Many women experience mood swings, irritability, depression, and anxiety.

Dryness during sex and other vaginal issues: Lower levels of estrogen are a given during perimenopause. As these estrogen levels become lower, you may experience dryness and discomfort such as pain, soreness, and burning sensations during intercourse. You may also experience a higher than normal amount of vaginal infections and urinary tract infections. Some women take low-doses of estrogen to deal with these problems.

Decreased Libido: Interest in sex and arousal may decrease during perimenopause, but for many people this doesn’t change during and after perimenopause.

Decreased bone mass: As estrogen decreases, so might calcium levels and bone mass. This puts many women at risk of osteoporosis, which can leave you with weak and brittle bones that are prone to breaks. Make sure to keep an eye on your bone mass as you go through perimenopause so that you’re able to actively address any issues that arise.

Cholesterol Problems: Blood cholesterol levels may become problematic during perimenopause. Some women see an increase in low-density lipoprotein (LDL) cholesterol, which is often known as ‘bad cholesterol’ and a decrease in high-density lipoprotein (HDL) cholesterol, often known as ‘good cholesterol.’ Both of these changes can increase your risk for heart disease. Similar to bone mass, you’ll want to keep an eye on your cholesterol during perimenopause.

What you can do if symptoms are severe: If you feel that your perimenopause symptoms are causing serious discomfort or are too much to handle, there are some treatments that can help. As we mentioned earlier, taking low-doses of estrogen is helpful in certain situations, as are estrogen injections and low-hormone birth control pills. Some also take medications or make dietary changes as a way of combating cholesterol and bone mass issues. And some people find therapy helpful for dealing with a decreased sex drive. Other habits and lifestyle changes known to be helpful during perimenopause include maintaining a healthy weight, not smoking, reducing alcohol intake, and exercising.

If you’re concerned about perimenopause or still have questions, you may find it helpful to speak to a doctor. Call Arizona OB/GYN Affiliates (AOA) at 602-343-6174 or visit

Seven Surprising Facts About Your Fertility

On the pathway toward conception, it turns out there are a lot of misconceptions floating around. When the time comes to add to a family, it’s important to know about all of the different factors that play a role in a woman’s ability to become pregnant. Here we’ve rounded up a series of significant and sometimes surprising facts for you to keep in mind when you’re ready to conceive, from staying on top of your overall health to getting timing just right.

Health and Lifestyle

It turns out there’s a pretty big connection between overall health and reproductive health. A number of lifestyle factors—like exercise, drug and alcohol use, weight, sleeping patterns, stress, eating habits, and more—all play a role in your ability to conceive, and this is applies to both men and women.

For women, maintaining a healthy body weight is often an important step in increasing fertility, as being underweight or overweight can lead to irregular or missed periods. Your best chances of conception are when you stay within the recommended BMI range.  And keep in mind that while exercise is healthy, excessive amounts of vigorous exercise can decrease fertility among women and sperm count among men.

Men and women alike will also want to keep stress levels down, avoid smoking and drug use, and keep alcohol intake to a minimum.


When it comes to fertility, age matters. Around age 35, fertility starts to decrease and the chance of miscarriage increases. Most women reach a fertility peak in their late 20’s. But don’t be discouraged if you’re older—women at age 35 still have more than 50% odds of conceiving naturally within the first year of trying.

Body Signs

The best time to conceive is usually one or two days prior to ovulation. Of course, many people who are trying to become pregnant use a calendar to track ovulation, but the body gives off some other helpful signs during and around ovulation as well. Here are two to keep in mind:

  • Body temperature: Basal body temperature, or your body’s temperature when you’re fully at rest (such as immediately after waking in the morning), is a good indicator of ovulation. You’ve probably ovulated if your basal body temperature rises .6 degrees or more for 10 days or longer. Ovulation occurs before this rise in temperature, so tracking your basal body temperature each morning over the course of a few months may allow you to see patterns and help figure out when you’re most likely to conceive.
  • Discharge: As you approach ovulation, your cervical mucus will probably become thin, clear, and stretchy, with a consistency close to that of egg whites.

Sperm Count and Testicular Temperature

Many people think of fertility issues as more of a woman-centric problem and fail to realize that men’s health plays a huge role in the fertility equation. It turns out that around 35% of fertility issues are related to problems with the male reproductive system, with low sperm count being the most common issue.

Sperm production tends to fare better when the scrotum (including the testicles) remains cooler than the rest of the body by around two degrees Fahrenheit. So keep in mind that jumping in the hot tub or sauna after a workout could have negative impacts on sperm production and make it harder to conceive. Even resting a laptop on the lap can have negative consequences here, especially if the computer runs particularly hot.

Sex Position

Sex position doesn’t matter when you’re trying to conceive. Stick with what you like and what works for you, because the position isn’t going to increase (or decrease) your chances of conceiving.


The path to getting pregnant can take a long time, and timing won’t be the same for everyone. Couples often feel despair or seek medical advice in the first year of not being able to conceive, but sometimes the process just takes time. Somewhere around 80% of couples who are in good health and having regular sex without birth control can expect to conceive within their first year of attempting to get pregnant, but many couples are able to conceive during their second year of trying without help or treatment.

The Pill

Many women expect to have trouble becoming pregnant if they’ve been on hormonal birth control (the pill) for many years. But in most cases, this is actually a myth. Some women are able to conceive immediately after stopping the pill, whereas others need a month or even a bit longer for their bodies to adjust to regular ovulation without the pill.

If you have further questions or concerns about your fertility, speaking to a doctor is always a good idea. Call Arizona OB/GYN Affiliates (AOA) at 602-343-6174 or visit