Symptoms of Female Infertility

The most obvious symptom of infertility is an inability to become pregnant. Diagnosis criteria can be met when attempting to become pregnant with frequent, unprotected sex for at least a year (six months after age 35) unsuccessfully. However, even someone who isn’t actively attempting to become pregnant at the moment may notice signs of infertility. An irregular menstrual cycle that is either too long or too short can also be a telltale sign. Finally, an absent or unpredictable menstrual cycle can indicate that ovulation isn’t taking place. Some women don’t experience any signs of infertility.

Causes of Infertility in Women

Infertility is a complex issue that can have many causes. It’s important to note that infertility is not just a female problem. It’s estimated that female infertility is the cause of 37% of couples experiencing infertility. Age can be a factor for many couples. Accelerated ovarian aging following age 35 is known to contribute to reduced fecundity that is associated with reduced ovarian reserve. As a woman ages, dwindling follicle reserve combined with the accumulation of DNA damage stemming from a lifetime of genotoxic exposure and oxidative burden can reduce fertility.

Fertility care is constantly evolving as the medical world learns more about the underlying mechanisms that contribute to the causes of female infertility. In recent years, the impact of cell-regulating proteins called sirtuins (SIRTs) has gained attention. SIRTs are involved in regulating cellular processes that include cell aging, cell death, and stress resistance. They’re also indicated in cellular homeostasis, energy metabolism, and apoptosis. Here’s a look at the leading causes of female infertility:

• Ovulatory disorders (25%): This can include polycystic ovary syndrome (PCOS), hypothalamic dysfunction affecting follicle-stimulating hormone (FSH) and luteinizing hormone (LH), and primary ovarian insufficiency.

•  Endometriosis (15%): Endometriosis is a condition that occurs when tissue that typically grows in the uterus implants and grows in other areas. Dense tissue growth can cause scarring that prevents the egg and sperm from meeting. In cases where egg and sperm do meet, endometriosis can disrupt implantation.

• Tubal blockage (11%): Blocked or damaged fallopian tubes can block passage of ovulatory or fertilized eggs. Tubal impairment can stem from a wide range of causes that can include previous abdominal or pelvic surgeries, pelvic inflammatory disease, and STIs.

•  Hyperprolactinemia (7%): Marked by excessive prolactin in the blood, this condition is most commonly caused by a benign tumor in the pituitary gland. It can also be triggered by certain medications, underlying health conditions, or random and unexplained causes. Hyperprolactinemia is considered one of the most treatable causes of female infertility.

•  Pelvic adhesions (12%): Pelvic adhesions occur when scar tissue causes the surfaces of organs to fuse together. Infertility-associated adhesions are commonly found in the uterus and cervix. Causes include endometriosis, pelvic infections, STIs, and past abdominal or pelvic surgeries.

• Other tubal/uterine abnormalities (11%): Abnormalities can be caused by both genetic issues and injuries/surgical scarring. For example, a narrow or malformed uterus can make implantation more difficult.

RELATED: Fertility After 35

Female Infertility Treatment

For the millions of people struggling to conceive, female infertility treatments can provide a bright light on the journey to parenthood. The first step in any infertility treatment is diagnosing the underlying causes of female infertility that could be in play for a particular patient. From there, the pathway to treatment is highly individualized based on the health factors and personal goals in mind. It may be determined that surgery for correcting pelvic adhesions, scar tissue, fibroids, endometriosis, or polyps is necessary to increase the odds of pregnancy. Removing barriers to implantation can sometimes be enough to achieve natural pregnancy without further intervention.

In some cases, triggering ovulation using infertility drugs that mimic FSH and LH may be enough to facilitate a healthy pregnancy. Other patients may require intrauterine insemination (IUI) in order to achieve fertilization during ovulation. For patients who don’t find success with female infertility drugs or IUI alone, in vitro fertilization (IVF) that harvests mature eggs to create an embryo for transfer into the uterus is the next recommended step for some causes of female infertility.

Dr. Michael Tahery is a board-certified obstetrician-gynecologist (OB/GYN) and urogynecological surgeon in Los Angeles. Specializing in fibroid tumors, endometriosis, and pelvic pain, Dr. Tahery is committed to helping his patients find the right female infertility treatments to help them get the best outcomes possible. Treatments that address female infertility are also essential for improving overall health and quality of life. If you’ve been struggling to get pregnant don’t hesitate to book a consultation with Dr. Tahery. Contact our office today!

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SYMPTOMS AND DIAGNOSIS OF VAGINA ATROPHY

How can you know if the symptoms you’re experiencing are caused by vaginal atrophy? It’s actually quite common to confuse symptoms of vaginal atrophy with symptoms of a yeast infection. Treatments for yeast infections won’t work for vaginal atrophy because this condition is caused by a lack of estrogen instead of a fungal infection. Of course, it’s always important to rule out a yeast infection with help from a medical provider before assuming that your symptoms are caused by vaginal atrophy. Here’s a look at vaginal atrophy symptoms:

• Vaginal dryness.
• Vaginal burning.
• Burning during urination.
• A sense of urgency during urination.
• Changes in vaginal discharge.
• Genital itching
• Recurrent urinary tract infections (UTIs).
• Light bleeding after intercourse.
• Painful or uncomfortable intercourse.
• Decreased vaginal lubrication during sexual activity.
• Tightening of the vaginal canal.

RELATED: Why Is My Labia Shrinking?

It’s not necessary to experience all symptoms to be diagnosed with vaginal atrophy. In many cases, women only experience the symptoms of burning, dryness, and itching. A pelvic exam is generally needed to confirm a diagnosis of vaginal atrophy. During your examination, your healthcare provider will be looking for signs of swelling, redness, vulvar lesions, lacerations near the vaginal opening, sparse pubic hair, narrowing of the vagina, and other telltale signs that you’re in a state of decreasing estrogen levels. Urine and fluid analysis may also be used.

VAGINAL ATROPHY TREATMENT

Many women never talk to their care providers about vaginal atrophy because they assume that nothing can be done to mitigate the age-related effects of diminishing estrogen levels. In reality, there are several treatment options available to help restore comfort and function. Speaking to your care provider as soon as you notice symptoms of vaginal atrophy is important because early treatment can prevent your vaginal atrophy from worsening. Vaginal dryness increases as the body goes without estrogen. This means that your condition is likely to get worse with time. In some cases, atrophy becomes so severe that the vaginal opening narrows dramatically. Trying to correct atrophy one significant symptoms are present can be much more challenging than treating early symptoms. Next, take a look at the three most common treatments for vaginal atrophy.

Hormone Therapy

A number of different hormonal therapies are available for treating vaginal atrophy. Topical estrogen is available in creams, rings, tablets, and suppositories. Hormone replacement therapy (HRT) is another option. Your care provider will discuss the pros and cons of various hormonal therapies based on your age, symptoms, and health history.

Laser Treatment

Laser treatments or vaginal rejuvenation for reducing vaginal dryness are becoming increasingly popular among women seeking non-hormonal treatments for atrophy. Lasers stimulate circulation, cellular activity, and healing that help to restore vaginal tissue to original levels. This non-invasive, surgery-free option triggers vaginal tissue’s self-healing, self-restorative properties.

RELATED: Frequently Asked Questions About Labia Majoras Puffing

Lifestyle Changes

Lifestyle changes shouldn’t be underestimated when talking about vaginal atrophy treatment options. There are many things women can do to reverse vaginal atrophy symptoms without medical intervention. Here are some tips:

• Kegel exercises performed on a regular basis can help to prevent the thinning and shrinking of vaginal tissue. Kegels can be especially effective for women suffering from urinary symptoms associated with the condition. These simple exercises involve repetitive tightening and loosening of pelvic floor muscles.
• Frequent sex can help to prevent vaginal atrophy. Regular sexual activity helps to keep vaginal tissue healthy by increasing blood flow to the vagina.
• Quitting smoking can help to resolve vaginal atrophy. Cigarette smoking restricts blood circulation to the vagina. In addition, smoking reduces the effects of the body’s estrogen levels.
• Regular exercise can be helpful for keeping blood flow in the genital area high.

If you’re struggling with symptoms of vaginal atrophy, reach out to the offices of Dr. Tahery to learn about vaginal atrophy treatment options that can help you feel like yourself again. Located in Los Angeles, Dr. Michael Tahery is a board-certified OB/GYN and female hormone specialist offering patients more than two decades of experience. Our office can address your unique needs to help you develop a vaginal atrophy treatment plan that allows you to live without pain and discomfort. Call today to schedule an appointment!

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Not to be confused with premenopause, perimenopause affects all women differently. Some will notice changes in their 30s. However, others may go through this stage for only a few months before reaching menopause.

Either way, the body’s production of estrogen rises and falls unevenly. As a result, women experience a wide range of perimenopause symptoms. Fortunately, treatment options are available to ease the transition. Here are some of the most common symptoms women can experience:

Irregular Periods

Erratic periods are standard during perimenopause. Ovulation becomes more unpredictable, leading to changes in the flow and length of periods. The space between periods can vary as well.

The changes can be so significant that some women assume they have entered menopause. Despite the drop in fertility, it’s still possible to get pregnant during perimenopause. It’s only when a period doesn’t occur for 12 months that doctors typically diagnose full menopause.

A specialist may recommend treatment options if symptoms begin to interfere with daily life. These may include hormone therapy, lifestyle changes, and more.

RELATED: 4 Common Reasons You Might Be Experiencing Irregular Periods

Hot Flashes

Hot flashes are an infamous sign of menopause. However, these bouts of sudden body heat can occur during perimenopause, too. They’re one of the most common symptoms, affecting more than two-thirds of women heading into menopause.

Characterized by an intense wave of heat over the face, neck, and chest, hot flashes can result in profuse sweating and sleeping issues. The frequency and severity of hot flashes vary based on the hormonal changes within.

Luckily, a specialist can help manage hot flashes with hormone treatments like birth control, patches, gels, and more.

Mood Swings

Not all perimenopause symptoms are physical. In many cases, the transitional period causes noticeable emotional instability. Sometimes called “Perimenopause Rage,” these mood swings differ from standard anger or frustration.

Some women describe it as a sudden shift to intense irritation, resentment, or a lack of patience.

Mood swings occur for a variety of reasons. They could be a product of sleep disruption from hot flashes or outside factors. Internally, there’s a chemical reason for the emotional shift.

Estrogen impacts the release of serotonin, the body’s mood regulator hormone. With erratic estrogen production, serotonin levels become unstable. With time lost symptoms improve as the body adjusts to a low hormonal environment.

RELATED: Menopause and Brain Fog

Weight Gain

Weight fluctuations are prevalent in perimenopausal women. Studies suggest that lower estrogen levels change how the body stores fat. Throughout the reproductive stage, women store fat in the hips and thighs. It’s subcutaneous fat, which is usually harmless and doesn’t increase one’s risk of disease.

However, during perimenopause, the dip in estrogen causes the body to store fat in the belly area. It takes the form of visceral fat. Unfortunately, visceral fat comes with higher risks of heart disease, insulin resistance, and a range of health problems.

Of all the perimenopause symptoms, this is one that many women overlook. A crucial part of treatment is to adopt a healthier lifestyle to combat weight gain.

RELATED: Weight management in Los Angeles

Vaginal Dryness

The vaginal tissue can suffer significantly during perimenopause. Estrogen is a vital hormone that governs vaginal elasticity and natural lubrication. When this hormone’s presence in the body decreases, dryness occurs, and vaginal tissue thins. 

The dehydration is not just limited to the vaginal tissue. Many women experience it on the face and other parts of the body as well. However, vaginal dryness can affect sexual health and comfort. Furthermore, a lack of moisture and resilience may make women more vulnerable to vaginal and bladder infections. 

Vaginal dryness is one of those perimenopause symptoms that many women don’t bring up to their specialist. But, there are plenty of treatment options to stave off the effects of hormonal changes.

If you notice any of these perimenopause symptoms, go to a specialist like Dr. Tahery for professional care. Dr. Michael Tahery is a urogynecologist who specializes in both women’s health and urology. He’s spent the last two decades helping women in the Los Angeles area manage this life change. Call us today to schedule an appointment.

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A standard menstrual cycle can range from 21 to 35 days. Meanwhile, the period itself lasts four to seven days. Every woman’s biological process is different. However, most women know what to expect and when.

If things do not proceed as expected, it’s a cause for concern. Abnormal Uterine Bleeding includes everything from unusually light or heavy menstrual cycles and unorthodox timeframes to missing periods and unexpected pain.

Due to your menstrual cycle’s impact, there are many potential explanations for irregularities. Some are benign and easily remedied. However, others are far more pressing. Here are four of the most common causes for irregular periods.

Perimenopause

Perimenopause is a transitional period that can start several years before the last period. During this time, the body goes through many significant changes. While the effects aren’t as noticeable as menopause itself, perimenopause can influence the menstrual cycle. It turns once-regular periods into unpredictable occurrences.

Before entering perimenopause, hormonal fluctuations are relatively stable. Estrogen and progesterone levels rise and fall consistently with a woman’s cycle.

But during perimenopause, things become unpredictable. Hormones become more turbulent, which leads to irregular periods. Many women experience heavy menstrual cycles of varying lengths. Some also encounter sporadic timing that’s not consistent with their regular cycles.

On top of all that, perimenopause can cause additional symptoms. Some of the most common include hot flashes, mood changes, vaginal dryness, and sleeping difficulties.

RELATED: Are you experiencing perimenopause symptoms?

Polycystic ovary syndrome (PCOS)

PCOS is a hormonal disorder that can affect women of reproductive age. The exact cause of PCOS is unknown. However, research shows that genetics, insulin resistance, and inflammation come into play.

Women with PCOS produce higher levels of androgen, the “male hormone.” The excess androgen disrupts the menstrual cycle, resulting in irregular periods. It causes infrequency while also making it difficult for women to get pregnant.

Furthermore, the condition causes tiny fluid-filled sacs to develop in the ovaries. The sacs contain immature eggs that never reach maturity to trigger ovulation.

The condition causes a slew of symptoms. In addition to missed periods, it often causes heavy menstrual cycles due to the buildup of the uterine lining. Some women can also suffer from excessive hair growth, male pattern baldness, and acne.

Fibroids

Uterine fibroids are more common than most think. Approximately 70 percent of women in Los Angeles and beyond have fibroids.

Generally, fibroids are non-cancerous growths. There’s less than one percent chance of malignancy. Nonetheless, these tumors can cause several issues. The severity of a fibroid depends on its location and size. They can be less than an inch in diameter. However, some are capable of growing closer to the size of a grapefruit.

In addition to causing irregular periods, fibroids can cause lower back pain, leg pain, and discomfort during sex. Larger fibroids can also complicate pregnancies and impact fetal growth.

Endometriosis

Endometriosis is another widespread condition. This one affects approximately one out of every ten women. It can cause debilitating menstrual cramps and gastrointestinal pain. In many cases, it’s also to blame for heavy menstrual cycles and bleeding between periods.

The exact symptoms can vary from one woman to the next. It all depends on its severity and spread.

This health condition revolves around the endometrium, which is the tissue that lines the uterus and sheds with a regular period. When endometriosis occurs, that lining starts to develop outside the uterine cavity. It can grow around the fallopian tubes, on the intestines, and around other organs in the lower digestive tract.

Misplaced endometrium can wreak havoc on the body in many different ways. While there’s no permanent cure for endometriosis, it is manageable with some professional guidance.

RELATED: Endometriosis Diet: What To Eat and What to Avoid

If you’re experiencing irregular periods, seeking professional care is paramount. While not all causes are severe, heavy menstrual cycles, unusual timing, and unexpected pain could be a sign of trouble. The only way to know for sure is to visit a urogynecologist like Dr. Tahery.

Give the offices of Dr. Michael Tahery a call to schedule a consultation today. Dr. Tahery is a urogynecologist with more than 20 years of experience providing women’s health and wellness services to the Los Angeles area.

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The main treatment for menstrual cramps are NSAIDS and birth control pills. However many women prefer more natural options to medication. Studies have shown moderate to high intensity exercises reduce production of prostaglandins and pain associated with menstruation.

RELATED: 4 Common Reasons You Might Be Experiencing Irregular Periods

In my offices we are able to rule out conditions that cause severe menstrual cramps and bleeding, such as fibroids, ovarian cysts, endometriosis, adenomyosis, and hormonal changes through special ultrasound examinations. The ultrasound evaluations are designed to examine the uterus and the ovaries as well as the endometrial lining for evidence of disease process that can be corrected.

In case of idiopathic or severe menstrual bleeding and cramps that have no identifiable etiology, we design a treatment program that involves the use of exercise, and herbal based supplements to reduce pain and bleeding and eliminate the need for NSAIDS and birth control pills in many cases.

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