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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The concept of having a loose vagina is one that’s been around for centuries. But the truth is that vaginal elasticity is complex. It’s surprisingly resilient. However, it can change throughout your life due to hormonal fluctuations, major life events, and more.

Here’s the truth about some common myths about a loose vagina.

Vagina Looseness and Sex

Everyone’s heard this myth and all of its associated jokes before. Contrary to popular belief, the vagina doesn’t become loose after having “too much” penetrative sex. No matter how much a woman has sex, the vagina can bounce back. It’s an incredibly elastic organ that adjusts for sexual activity.

Sure, the tissue becomes more relaxed before, during, and after sex. However, this “looseness” is no different than your mouth opening wide to eat or yawn! No matter how many times you stretch your mouth, it always rebounds back to its original shape. The same applies to the vagina.

Another misconception is that the hymen causes the feeling of a tight vagina. Despite the myth of virgins and broken hymens, this thin tissue doesn’t totally cover the vaginal opening. It merely surrounds the opening. After penetrative sex, the hymen can stretch and make the vagina feel more open. However, it doesn’t always tear or impact sensation.

Women with vaginal looseness are likely experiencing other issues. It’s not a product of too much penetrative sex.

The good news is that there are several ways to address tightness concerns. Vaginal tightening encompasses surgical procedures, laser treatments, and more. Tightening can improve elasticity to increase sensation for both partners.

RELATED: Does Sex Cause Elongated Labia?

Childbirth Causing Loose Vagina

The female body goes through some extreme changes during pregnancy and after delivery. While many believe that childbirth can loosen a tight vagina, the reality is a little more complicated than that.

The vagina is a powerhouse of elasticity that can stretch to accommodate a baby during birth. The tissue does loosen as the muscles relax to make way for the baby. However, the tissue usually shrinks back down to its pre-pregnancy state with time.

So, why do many women report changes to vaginal elasticity and sensation after birth?

In many cases, it’s because of damage to skin, tissue, and muscles.

The pelvic floor muscles are particularly prone to damage after giving birth multiple times or a difficult vaginal delivery. In addition to changes in sensation, pelvic floor issues can lead to a host of health problems in the future. The same goes for damage to connective tissue. Vaginal changes are common after giving birth.

Fortunately, vaginal tightening is available to address them. A Vaginoplasty can repair the pelvic floor and walls for a tightening effect. Meanwhile, a Perineoplasty can repair the muscular and connective tissue that supports the opening of the vagina.

RELATED: Pelvic Floor Disorder Symptoms in Women

Aging and Hormonal Changes

The most common cause for a loose vagina is aging. As a woman nears the end of her reproductive life, hormone production starts to wane. During perimenopause, the transitional phase before menopause, estrogen levels drop significantly. The decline directly impacts an otherwise tight vagina.

The vaginal lining can become dry, resulting in less tightness. During intercourse, the vagina will produce less natural lubrication as well. Overall, the tissue becomes less elastic as it loses resiliency.

Many of those changes are manageable with treatment, but some changes are expected as women approach menopause.

RELATED: Are You Experiencing Perimenopause Symptoms?

Loose vagina myths have created a lot of confusion in the women’s health sphere. While most of the misconceptions about the vagina have no basis in fact, there are instances in which women can benefit from tightening procedures.

Dr. Michael Tahery is a urogynecologist that provides vaginal tightening services to women in Los Angeles and the surrounding areas. If you’re looking to increase sensation or address elasticity issues, give us a call. Dr. Tahery can perform a consultation and see if you’re a good candidate for one of the many available procedures

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In most cases, incontinence isn’t a life-threatening ailment. However, it can negatively impact a woman’s quality of life. Women are twice as likely to suffer from this debilitating problem as men. There are many potential causes of urinary incontinence in women. Here are some of the most common.

Pregnancy & Childbirth

Healthcare professionals estimate that about 40 percent of all women experience urinary incontinence during pregnancy. During and after childbirth, women are at a high risk of experiencing stress incontinence. This form of incontinence refers to accidental leakage due to sudden pressure on the bladder, with laugh, cough, or exercise.

As babies develop during pregnancy, the uterus expands significantly. This process leads to excess pressure on the bladder and urethra. All it takes is one cough, laugh, or intense physical motion to lose control.

Incontinence in women during pregnancy can also stem from hormonal changes. Fluctuations and the general increase in progesterone levels weaken the pelvic floor. One job of progesterone during pregnancy is to loosen ligaments and joints, making room for the womb. But, the hormone is also capable of weakening the pelvic muscles that impact urine control.

Giving birth can result in urinary incontinence in women that lasts for several weeks. Vaginal delivery, in particular, is known to stretch and weaken the pelvic floor muscles. These muscles act as a sling to support the pelvic organs, including the bladder. When damaged during childbirth, some women might experience pelvic organ prolapse and continued incontinence issues. 

Childbirth may also damage the nerves that communicate with the bladder. Generally, incontinence troubles resolve themselves six weeks or so after delivery. But in some women, they can be the start of lifelong bladder control battles.

• 30% of women will continue to suffer from urinary incontinence as a result of a pregnancy.

RELATED: Urinary incontinence and vaginal prolapse after vaginal delivery

Aging

Urinary incontinence is more common in older women. Roughly 30 percent of all women between the ages of 45 and 64 experience it. For women 65 and older, that figure jumps up to about 50 percent.

Contrary to popular belief, urinary incontinence in women is not a normal part of getting older. It’s a medical condition that’s likely a byproduct of another underlying health concern. For older women, the potential causes of incontinence widen.

In many instances, the culprit is pelvic floor atrophy. The effects of previous pregnancy and childbirth can also come into play. Several neurological disorders, such as Alzheimer’s disease, stroke, and Parkinson’s disease, might be to blame for urinary incontinence in women as well.

Menopause

In addition to hot flashes, night sweats, and mood changes, urinary incontinence is a common complaint during menopause. During this life stage, the body stops producing estrogen and progesterone. Researchers believe that these lower estrogen and progesterone levels weaken the urethra and the pelvic floor muscles.

Less estrogen also makes vaginal tissue less elastic while thinning the lining of the urethra. All of these seemingly minor changes add up. Plus, additional biological changes like weight gain and pelvic organ prolapse can occur after menopause. These events make urinary incontinence in women much more likely during and after menopause.

RELATED: How to Prevent Genital and Urinary Problems During and After Menopause?

Many women will start to experience incontinence during perimenopause when hormonal changes first begin. But, the brunt of bladder control issues happens during menopause and continues long after. Women can experience all forms of urinary incontinence, including frequent stress accidents, sudden urges to urinate, and overactive bladder.

Urinary incontinence in women is far more common than most think. That said, it doesn’t have to affect your life. Problems with bladder control are usually very treatable with the right care.

Dr. Tahery is a urogynecologist in Los Angeles. His gynecology and urology knowledge provides a deeper understanding of urinary incontinence in women and other pelvic floor issues.

Contact Dr. Tahery’s offices in Los Angeles and Glendale today to schedule a consultation and learn more about potential treatment options.

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To reverse these adverse effects of childbirth, the mommy makeover was introduced. In essence, a mommy makeover refers to a set of cosmetic procedures designed to help women get their pre-baby body back. Most commonly, this involves a bladder tuck, vaginal muscle repair, and labiaplasty. These surgeries can be performed either individually or in conjunction to produce optimal results. Not every woman has the same needs, so it’s essential to target specific areas that have changed due to childbirth.

RELATED: Ok, I had my baby. Now, what is going to happen to my body

As more women notice drastic shifts in the appearance of their vagina, they’re opting for vaginal rejuvenation surgery which is a combination of the three and more. In addition to changing the size, shape, and look of the vagina, vaginal looseness can also impact a woman’s sexual gratification. Fortunately, vaginal rejuvenation surgery hones in on problem areas and, in turn, improves the function, feel, and look of the vagina.

It’s important to note that other factors can also give rise to vaginal laxity. For instance, weight gain during pregnancy. Depending on how much weight is gained, it can cause the labia to become looser and sag. For many women, this leads to decreased confidence and comfort. No matter what’s responsible for these significant and permanent changes, vaginal rejuvenation surgery can aid in tightening female genitalia. Labiaplasty, which is a form of vaginal rejuvenation surgery, is another viable solution.

RELATED: Vaginal Tightening in Los Angeles

Better known as aesthetic vaginal surgery, labiaplasty reduces or reshapes the lips of the vagina. For women who are anatomically displeased with their vagina, labiaplasty has proven a godsend. The labia, specifically, is modified, which influences the clitoris, vaginal opening, and overall outward appearance of the vagina. As cosmetic procedures like vaginal rejuvenation and labiaplasty are becoming more popular, women are uncovering the many benefits of these enhancing surgeries. What’s more, they’re slowly becoming normal components of the mommy makeover.

RELATED: What is the difference between Vaginal Rejuvenation and Labiaplasty?

As a urogynecologist, Dr. Tahery has spent years perfecting and designing techniques in vaginal surgery. With his vast expertise, he ensures that patients receive the care and results that they deserve. Thanks to Dr. Tahery, women experience life-changing transformations that allow them to feel happier and more confident. Dr. Tahery performs many of these procedures in his surgical centers designed and set up especially for this type of operation. To learn more about mommy makeovers, the advantages of these surgeries, and what procedures might be right for you, book an appointment with Dr. Tahery at our Glendale or Los Angeles office.

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The use of NSAIDS in pregnancy have been restricted. It is well established that NSAID use in the third trimester of pregnancy significantly prohibits fetal urine production and amniotic fluid volume. It also increases the risk of premature constriction of the ductus arteriosus leading to fetal heart failure and even death.

Recent research from Kaiser Permanente has found more bad news. Use of Nonsteroidal anti-inflammatory drugs in the first trimester also increases the rate of miscarriage. NSAIDS prohibit prostaglandin production essential to successful implantation of the embryo. Abnormal implantation increases the risk of miscarriage. Nonsteroidal anti-inflammatory drugs effect on the risk of miscarriage has been shown to be dose-related. The higher the frequency and the dosage the higher the risk of miscarriage. Women at lower body mass index may be most vulnerable to this effect.

My policy in pregnancy and otherwise has been the least use of medication possible. History and experience have shown that many of the medications we use and take their safety for granted will be found to be harmful in ways we never imagine today. Natural remedies and holistic approaches are always best when possible.

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