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.

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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

The 8 Most Common Symptoms of Endometriosis

Most women experience cramps and menstrual pain from time to time. But how do you know if the pain is just caused by your period or Endometriosis? An estimated 1 out of 10 women suffer from Endometriosis in the United States, however many remain undiagnosed.

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What is Endometriosis?

Endometriosis affects women and it is a painful disorder. It’s caused when tissue which usually lines the inside of your uterus starts to build up outside the uterus around the ovaries, fallopian tubes and the tissue lining your pelvis. The buildup of tissue can lead to cysts, pain and sometimes fertility problems.

Endometriosis can occur anytime after a woman’s first period, but mostly affects women aged between 25-35. The cause of endometriosis is unknown.

What are the symptoms of endometriosis?

  1. Severe Cramps

Many women suffer from cramps during their period, so it can be hard to judge what is ‘normal’ and what is abnormal pain. This is one of the reasons endometriosis often goes undiagnosed. Cramps may be a sign of endometriosis when they prevent you from working or going about your day and when they are not improved by over the counter medicine. Particularly when combined with other symptoms.

  1. Long periods

Most women have a period that lasts between two and seven days and occurs every 21 to 35 days. If you regularly have your period at shorter intervals or experience prolonged periods, this may be a symptom of endometriosis.

  1. Heavy menstrual flow

Heavy bleeding, known as menorrhagia, is usually defined as menstrual bleeding that lasts more than 7 days. It can also be bleeding that is very heavy. If you are changing your pad or tampon at intervals of less than 2 hours or have large visible blood clots the size of a quarter then you may have Menorrhagia.

  1. Bowel and urinary disorders

Painful bowel movements or urination, gassiness or diarrhea during your period may all be signs of endometriosis.

  1. Nausea and/or vomiting

If you experience vomiting, nausea, headaches, or migraines with your period this may be a sign of endometriosis.

  1. Pain during sexual activities

Pain during sex can be a sign of endometriosis and may be more severe in different positions. The pain is caused inflammation and fibrosis fusing the front wall of the rectum to the back wall of the vagina. This can be a difficult symptom to discuss with your doctor and partner, but it is important to voice this symptom to get an accurate diagnosis.

  1. Infertility

If you are struggling to conceive, endometriosis could be the cause. Endometriosis can also impact pregnancy and it impacts the ability to carry a pregnancy to full term, with women often suffering miscarriages.

  1. Chronic Fatigue

If you find yourself sleeping or napping more than usual, lacking energy, or feeling dizzy this may be a sign of Chronic Fatigue. Fatigue alone without other symptoms is not necessarily a sign of endometriosis and could be due to many other causes including anemia, thyroid issues or low blood sugar. If you suffer from fatigue, with or without other symptoms, you should speak to your doctor to identify the cause.

Track your symptoms

If you’re unsure how severe of frequent your symptoms are you may find it helpful to use a period app to track your period over the course of a few months. Noting the length of periods, the severity of cramps on different days of your cycle, and the frequency of other symptoms, such as nausea or diarrhea, will help you assess your symptoms. There are many free apps that will help you do this, or you can make detailed notes in a diary.

Treatment options for endometriosis

Treatment options for endometriosis are unfortunately limited, the most common is minimally invasive laparoscopic excision surgery.

However, there are many options for endometriosis relief, but these forms of treatment do not treat the endometriosis itself. Treatment options include acupuncture, changes in diet, the contraceptive pill, a hormonal intrauterine device (IUD), painkillers, or gonadotropin-releasing hormone (GnRH ) therapy.

Unfortunately, many endometriosis patients are misdiagnosed or may suffer from symptoms for a long time before establishing the cause. Tracking your symptoms over a few months and being honest when speaking to your doctor, even about uncomfortable topics such as pain during sex, can help you get the right diagnosis.

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Speak to your doctor if you are suffering from a combination of these symptoms. Call Arizona OB/GYN Affiliates (AOA) at 602-343-6174 or visit