By: Danielle Inman, M.D. Illustrations by: Trisha Thompson Adams
Danielle Inman, M.D. is an OB/GYN generalist here in Corpus Christi. Nine years ago she and her husband relocated here from the East Coast, and they never looked back. Partnering in a bustling practice that has served the Coastal Bend community for over 30 years now, Dr. Inman enjoys helping women and their families through various stages of their lives.
Her second passion is teaching. There is an enormous amount of information out there for patients to process and analyze, and Dr. Inman has a unique style of putting that mountain of information in perspective to the patients’ individual situations.
Over the years, Dr. Inman has answered countless questions regarding women’s health, with menopause, libido, and infertility topping the list of most common subject matters. We asked her a few questions regarding these three women’s health topics, and she’s here to provide expert answers.
If I’ve already had a baby once, is it possible to be infertile now?
Many people ask me this very same question. However, it’s a difficult answer to generalize. Infertility is a multifaceted problem and more than one thing can be the cause. Unfortunately, there is no lab test that can give us a definitive answer on the status of your individual fertility.
Age is important, because in the late 30s to early 40s, the genetic quality of our eggs decline in an exponential way. I ask several questions when a patient inquiries about their fertility status revolving around various factors, menstrual cycle regularity being one of them. Regular menstrual cycles are a good indicator that a woman is still fertile. Unpredictable cycles decrease the chance of spontaneous pregnancy. Certain histories of surgery or infection in the abdomen and/or pelvis can play a role in infertility too.
Properly timed intercourse is also important. The ovulation period is a narrow five- to seven-day window. It’s important to take a look at your partner, as well. Is this a new partner? Do they have any of their own kids already? Have you tested his semen? These are all important questions to ask regarding this topic.
With these questions and answers in your mind, you and your OB/GYN can come up with an individualized plan to help you and your partner conceive.
I’ve been thinking about freezing my eggs. What are the things I should consider prior to making the decision?
What a great question! It will be difficult to answer in a generalized way. For any individual considering egg freezing, I would want to know their age, health status, and motivation for doing so.
The process itself is expensive and rarely covered by insurance. Egg freezing involves a detailed consultation with an OB/GYN sub-specialist called a reproductive endocrinologist (REI). If you are a good candidate, then you’ll give yourself injectable hormones (for about one week) to stimulate your ovaries in order to “superovulate.” Meaning instead of ovulating one egg, depending on your age, you could get as many as 20-25 eggs!
These eggs are “harvested” during a procedure called an egg retrieval. Under light sedation and ultrasound guidance, your REI will place a needle through the upper vagina and into the ovarian follicles where the eggs are aspirated. Then you pay a fee to keep the eggs frozen until you use or donate them. Donation of eggs is usually compensated handsomely, however, and all expenses are covered by the recipients of your eggs.
As you can tell, it’s an ordeal to go through, but it depends on why you want to do it. Some examples for why egg freezing might be right for you include preparing for treatment that will make you sterile afterwards; a medical condition that would be lethal if you became pregnant (your eggs could then be used for a surrogate pregnancy); you are young with a demanding career and you want to increase your chances of having children later; you want to donate; or your family risk of genetic disorders.
There are many other reasons! Whatever your reason is, do not be afraid to ask your OB/GYN about your specific situation and health status.
Menopause sounds terrible … What should I expect?
Menopause IS terrible for some! However, it doesn’t have to be. Similar to adolescence, menopause is a transition into the next phase of your life. For some, menopause can be empowering.
Beginning as early as your 40s, you may notice changes in your menstrual periods, as well as other changes in your body. This includes things such as the interval between periods getting shorter, skipping periods, and longer or heavier periods; hot flashes and night sweats; sleep disturbances; a low sex drive; mood disturbances; and trouble losing weight.
Once your periods have stopped for at least one year, then you are considered menopausal. The hormonal symptoms may linger but will usually subside. About 2-5 years after the end of your periods, other changes in your body will begin to occur. This ranges from vaginal dryness to pain with intercourse, decrease in bone density, and change in sleep patterns.
But, do not fear! There are many strategies and treatments that can make the transition into menopause and beyond very manageable. I have found that the women whose transitions into menopause are more graceful typically have similar qualities and mindsets.
There are a few things you can do before menopause to prepare yourself for the changes, the first being to learn and recognize the symptoms in yourself. Also, both understanding and learning how good nutrition, supplements, and exercise can reduce and even eliminate some of the symptoms helps. Developing healthy sleep habits and identifying and minimizing the people and situations in your life that cause you stress are two things you can and should do now. I’d also recommend talking to other women who have gone through the changes, to ask them what they have done that works for them. Lastly, make an appointment with an OB/GYN to discuss your unique situation.
And remember, ALL women go through this and you are not alone!
How will menopause affect my libido?
The short answer is that most women will experience a decrease in libido as they move through and beyond menopause.
The long answer is that it depends on a few factors: the frequency, comfort, enjoyment, past experience, and creativity of intimacy prior to menopause; the general health of you and your partner; the medications you take (e.g., hormone replacement therapy); alcohol and drug use; and self-image.
I will say that with a few exceptions, most women can experience a satisfying sex life well into their golden years with an open mind and willingness to seek help. That being said, for some women, as they age, intercourse becomes something they genuinely have no interest in—and that’s OK, too!
Speaking of sex drives, is there such thing as too low or too high libido?
Absolutely not! Everything in life is about finding your groove, your bliss, your balance. Libido is complicated and it can change in certain situations, it can change over time, and it can change depending on the time of day. What I think may be too much you might find is not enough. So, do what feels good for you, as long as you’re not breaking laws, hurting yourself, or hurting others. Also, be safe and cherish and protect your fertility. If you are still worried if your libido is “normal” or not, ask your OB/GYN … most times, they’ve heard it all.