The Almond Blog

Menopause is a natural and beautiful transition in a woman’s life, but it can also bring unexpected and wild changes. From shifting hormones to changes in energy, sleep, and emotions, this phase can feel like an emotional and physical rollercoaster. But the good news? You don’t have to go through it alone. By blending the wisdom of traditional OB-GYN care with the whole-body approach of functional medicine, we can create a path that supports you with love, patience, and care. Why Menopause Can Feel Challenging

 Ever wondered about the rollercoaster ride of perimenopause? Perimenopause is the period of time when your ovaries produce less estrogen and your body transitions to menopause. This transitional phase before menopause typically sneaks up in your 40s, but for some, it crashes the party as early as the mid-30s. During this time, estrogen levels fluctuate up and down, often erratically, which causes all kinds of wild symptoms. Perimenopause is a no-size-fits-any phenomenon that can show up in many different ways. This means it’ll look very different for different women, and even for the same woman, many different ways over time. Some women endure severe symptoms for years, while others transition to menopause much more easily. It can last for several years, bringing with it a delightful mix of surprises. But don’t worry—we’ve got your survival guide right here. But first, how do you even know that this is Perimenopause?

Sex should be a fun, intimate experience, but for some women, it can sometimes feel painful instead. If you're experiencing discomfort during sex, you're not alone. In fact, pain during sex—known as dyspareunia—is a fairly common issue. There are several reasons why sex might hurt, and understanding a bit about female anatomy can help explain what’s going on.

At Almond ObGyn, we know that your birth control needs are as unique as you are. Whether you're avoiding hormones for medical reasons or simply prefer a more natural approach, we offer a variety of non-hormonal and alternative birth control methods designed to fit your lifestyle.

Delivering a baby is a major event. There’s excitement, there’s anxiety, and there’s a lot of new information to learn – it feels like something we should have a class for but we don’t. Birthing a baby can also be scary. We know from the beginning there are risks to childbirth, and there’s a chance of having major surgery, which carries additional risks of its own. This leaves a lot to consider, especially as the cesarean section rate in the US has been rising, recently reaching 32% of births. Deciding on our pregnancy care team is one of the areas you have the most control over, and we spend a lot of time talking with patients about how to choose. ObGyn or Midwife? Doula or not? Acupuncture? The list goes on. One thing we hear a lot is this unique pregnancy conflict: between wanting to have an ObGyn who will be there end-to-end throughout pregnancy, to have a friendly face who knows us and who can help to minimize any risks – and also that ObGyns can tend to be unavailable, especially when it comes to the critical moments in the delivery room. They might be very late, or rushed, or not present for the critical moments. They might be out of town altogether. On the one hand, we want to know the person who is going to be responsible for guiding us through this intense event, and it can feel frustrating or isolating when they’re not there. So we chose a model that removes this conflict – that can deliver better outcomes and a more personal,supportive connection with your birth team. Because we believe it’s possible to have both. Our vision for great prenatal care involves Group Pregnancy Care and delivering with what is called a “laborist” instead of your Primary ObGyn. Today we’re going to talk about who to deliver with and why. What Are the Options for Your Delivery? Before we dive in, some definitions. There are three common models of care when it comes to who delivers your baby: Your Primary ObGyn or Midwife The primary provider you’ve seen throughout your pregnancy handles your delivery, assuming they are available. Another ObGyn from Your ObGyn’s Practice Your primary ObGyn might deliver as part of a group of ObGyns that rotate labor responsibility. That means whoever is on-point for deliveries that day will deliver you. It might be your primary ObGyn, but it might not. Often you can arrange to have a prenatal visit with some or all of the other ObGyns in the group so you get acquainted with them ahead of time. A Laborist A laborist is an ObGyn who specializes in women in labor, delivering babies, and surgeries like cesarean sections. They work on-site at the hospital, devoting their full attention to caring for birthing women. Why We Like Laborists First and foremost, the data shows that laborists can deliver better health outcomes for mothers and babies: Fewer inductions of labor : Inductions—when labor is started artificially—can sometimes lead to complications or a cascade of interventions. With laborists, hospitals have seen a 15% reduction in the number of parents needing their labor induced.¹ Fewer NICU stays : Full-term babies are 25% less likely to need intensive care in the NICU when laborists are involved.¹ Lower C-section rates : In some hospitals, particularly ones with high rates of cesarean sections or where laborists work closely with midwives, cesarean rates have dropped dramatically—from 32% (the national average) to just 17%.² Reduced severe maternal complications : Laborist-led care has been linked to a lower rate of severe maternal morbidity.² Shorter hospital stays : Laborist-led care has been linked to fewer cases of staying longer than necessary in the hospital after delivery, with about an 8% decrease in prolonged stays. This can mean a significant cost saving, and getting to enjoying your baby at home sooner.¹ It makes sense: laborists’ specialized focus on labor and delivery can make a significant difference in creating safer birth experiences. How Laborists Work Differently How is it that laborists can deliver better outcomes? Here are a few reasons: 1. Expertise in labor and surgery Laborists are specialists in caring for women in labor. Unlike a traditional ObGyn who splits their time between office visits and deliveries, laborists handle births every shift. That is their main focus. When prenatal care and delivery are handled by different specialists, each provider can focus on their strengths. Your primary ObGyn manages your overall health and pregnancy, while the laborist ensures expert care during labor and delivery. A full-time laborist at a large hospital could deliver over 100 babies a month, versus 8-12 for a typical full time ObGyn that works primarily in an office. The laborist’s high volume of deliveries sharpens their skills in labor management and in surgery when needed. 2. They’re always there Laborists are constantly at the hospital, 24/7. Regardless of when you go into labor – in the middle of the night, during a birthday party, or on NYE – you’ll have a skilled ObGyn ready to care for you without delay. They won’t be late because they’re stuck in traffic from across town. 3. Less likely to be rushed or tired Laborists aren’t being called out of bed in the middle of the night by surprise, so they are well-rested and fully focused on their patients, which is critical when quick decisions are needed. Potential Downsides of Laborist Care No system is perfect. Delivering with a laborist does have potential challenges: Lack of Personal Connection A laborist won’t have the same familiarity with your medical history or birth preferences as your primary ObGyn. Shift Changes Laborists typically work shifts, which means you might have more than one doctor involved in your care if your labor spans multiple shifts. Overcoming the Downsides Here are some ways to deal with these challenges: Share Your Birth Preferences Early At Almond we’re all about detailed, thoughtful birth plans (or as we like to say, “birth preferences ” because labor is inherently unpredictable) – we like to cover everything from medication preferences to what music you prefer to who should be allowed in the delivery room. We will spend lots of time during your prenatal sessions discussing your individualized preferences in detail. Print and review your birth preferences with your laborist and nurse when you’re admitted to the hospital. Developing a shared understanding of your preferences before labor progresses can improve communication down the line. Have your Primary ObGyn Warm Handoff At Almond, we share and discuss your entire medical record with the hospital. Our Midwife will also send specific notes on your birth plan to share additional thoughts from a medical perspective. Get a Doula A doula can provide continuous support before, during, and after delivery, serving as both an advocate and a source of emotional comfort. Coordinate with Your Primary ObGyn Your laborist can keep your Primary ObGyn updated and check in as needed. Do a Hospital Tour It can help to get familiar with where you’re going to be, where you need to go, and what the feel of the hospital is going to be. There You Have It. That’s Why We Are Fans of Laborists At Almond, we’ve seen how the laborist model can transform the birthing experience. By combining group pregnancy care led by midwives with laborist-led deliveries, we ensure both exceptional prenatal care and expert delivery support. This approach balances the benefits of specialized expertise with our patients' emotional and physical needs. Whether you’re planning your first birth or navigating a subsequent delivery, considering a laborist could be a step toward a safer and more positive experience. Your care team should always align with your needs, values, and preferences. If you have questions or want to explore this option further, we’re here to help. Sources American Journal of Obstetrics and Gynecology: Laborists and Lower Labor Induction Rates. Read study Torbenson, “Use of Obstetric and Gynecologic Hospitalists.” Read study ScienceDirect: Impact of Laborists on Maternal and Neonatal Outcomes. Read study

The percentage of U.S. women in the workforce and the number of hours we work have steadily increased over the last several generations. But what about the amount of work involved in pregnancy? That has largely stayed the same — or, arguably, increased. Pregnancy risks have risen over time: women are having children later in life, maternal mortality rates have increased, and there is a growing need to protect against higher levels of toxins in our environment and the stressors we face in daily life. It’s time for our model of pregnancy care to change. The standard that worked for our mothers is no longer enough for us. What is the standard pregnancy care model today? To begin, we need to understand what the traditional model looks like and where it falls short. In a typical ObGyn practice that accepts your insurance, the standard of care today involves about 15 individual appointments. The longest visit often lasts around 20 minutes, and many appointments are as short as 5 minutes. Many women report feeling anxious, uncertain, or afraid during their pregnancies. Between visits, they are often left with unanswered questions or overwhelming anxiety. It doesn’t have to be this way. As we set out to build better ObGyn care at Almond , we asked ourselves: What’s working well today, and how can we make it even better? We discovered a model that works significantly better than traditional pregnancy care: group pregnancy care . What is group pregnancy care? This model involves around ten 90-minute sessions led by a midwife, along with 4-5 individual appointments with an ObGyn. The longer sessions provide more thorough education on pregnancy, giving each woman the information she needs to make informed decisions, rather than relying on brief, intermittent medical visits. Even more importantly, the group format fosters community —something that is essential in a country where loneliness has become so widespread that the Surgeon General has classified it as an epidemic. Pregnancy is no exception. Historically, women have been socialized to experience pregnancy within a supportive community, and research has repeatedly shown that this group format is linked to better outcomes for both mother and baby. This is one of the things we love about group pregnancy care — we didn’t invent it at Almond. The program, officially named Centering Pregnancy , was developed by Sharon Schindler Rising, a Yale-trained midwife and professor, and has been extensively studied and tested over the past couple of decades. How does group care impact outcomes? The better outcomes of this model speak for themselves. Studies have shown that group care reduces NICU admissions over 30% across various populations. A South Carolina Retrospective Cohort Study found that participation in group care reduced the risk of premature birth by 36%, resulting in an average cost savings of $22,667. The study also found that group care reduced the rate of low birthweight by 44%, saving an average of $29,627 per birth, and reduced the risk of a NICU stay 28%, with average savings of $27,249 . March of Dimes also reported that of group care helped patients “ decrease c-sections from 28% to 21%, preterm births from 8.3% to 1.8% and decreased low birthweight from 8.3% to 2.65%. ” Additionally, a pilot program run by BlueChoice Health Plan South Carolina resulted in a 3.5% NICU admission rate compared to a 12.0% to those receiving individual care . A retrospective study found that 83% (24 of 29) of studies found that low social support increases postpartum depressive symptoms . How do Midwives impact care quality? There is another significant impact to consider as well – how midwives impact prenatal care. The Cesarean birth rate is shown to be 12% lower when midwives are on the birth team . Midwives have shown to improve outcomes by 56 different measures—including lower morbidity and mortality among mothers and newborns, fewer preterm births and low birthweight infants, and reduced interventions during labor. A recent analysis found that a midwife workforce, integrated into health care delivery systems, could provide 80 percent of essential maternal care globally. This approach has the potential to avert 41% of maternal deaths, 39% of neonatal deaths, and 26% of stillbirths globally. How do modern care models impact Black women? The impact is especially promising for Black women, who have long faced health discrimination and continue to experience worse outcomes. In the U.S., Black women experience a postpartum death rate that is 2.6 times higher than that of white women.

When it comes to managing PCOS, many people immediately think of food and exercise. But if I had to choose one thing to focus on, it would be managing stress. Every. Single. Time.

Ever wondered what makes the female body so uniquely designed for life and creation? The female reproductive system is more than just a series of organs—it’s a fascinating, intricate network that plays a crucial role in everything from hormone regulation to overall health. Whether you're a woman or someone looking to understand the body better, the mysteries of this system deserve more attention. Let’s embark on a journey through its anatomy and uncover some jaw-dropping facts along the way. Anatomy of the Female Reproductive System The female reproductive system is like a well-coordinated orchestra, with each part playing a critical role in reproduction, hormone production, and even mood regulation. Let’s break it down: 1. Ovaries The ovaries are two almond-shaped organs located on either side of the uterus. They are responsible for producing eggs (ova) and hormones such as estrogen and progesterone. Each month, one ovary releases an egg during a process called ovulation. Fun fact: Did you know the ovaries do more than just produce eggs? The hormones they release can impact everything from your mood to your skin health! 2. Fallopian Tubes Think of the fallopian tubes as the highways where fertilization often happens. After ovulation, the egg journeys through these thin tubes, where it can meet sperm. If fertilization occurs, the embryo travels further into the uterus to begin development. Fun Fact: These tubes are lined with tiny, finger-like projections called fimbriae that help "catch" the egg after ovulation—a tiny miracle in motion! 3. Uterus The uterus, often referred to as the womb, is a muscular organ where a fertilized egg can implant and grow into a fetus. The lining of the uterus thickens each month in preparation for a potential pregnancy and sheds during menstruation if pregnancy doesn’t occur. Fun Fact: The uterus can expand dramatically during pregnancy, going from the size of a pear to accommodating a growing baby! It also has the remarkable ability to contract powerfully during childbirth. 4. Cervix The cervix is the gatekeeper of the uterus, allowing menstrual blood to flow out and sperm to enter. It also produces mucus that changes throughout the menstrual cycle, either aiding or hindering sperm passage. Fun Fact: Did you know that the cervix is packed with blood vessels? This rich supply can lead to light bleeding or spotting after sex, especially if there’s any friction or pressure. It’s a reminder of just how sensitive and vascular this area is! 5. Vagina The vagina is a canal that connects the cervix to the outside of the body. It serves multiple purposes: it is the birth canal during delivery, the passage for menstrual fluid, and the site for sexual intercourse. Fun Fact: The vagina is a self-cleaning organ with a unique ecosystem of bacteria that helps maintain pH balance and ward off infections. Let’s not forget our Pelvic Floor The pelvic floor is a group of muscles and connective tissues that form a supportive hammock across the bottom of the pelvis, playing a crucial role in supporting the bladder, uterus, and rectum. Maintaining pelvic floor health is vital for women, as these muscles help control urinary and bowel functions, support sexual health, and facilitate childbirth. Weakness or dysfunction in the pelvic floor can lead to issues such as incontinence, pelvic pain, and prolapse. Regular pelvic floor exercises, such as Kegels, reformer pilates and awareness of pelvic health can significantly enhance overall well-being and quality of life. Prioritizing pelvic floor health is essential for every woman, as it directly impacts both physical and emotional wellness. Fun Fact: The pelvic floor muscles can enhance sexual pleasure by allowing for greater control and strength during arousal and orgasm. Importance of Reproductive Health Maintaining reproductive health is vital for overall well-being. Regular check-ups, understanding one’s menstrual cycle, and being aware of changes in the body can help detect issues ea rly on. Tips for Maintaining Reproductive Health: Regular Gynecological Exams: Essential for monitoring reproductive health and early detection of issues. Fun Fact: In observational studies, Pap smears can reduce cervical cancer deaths by, in some studies, up to 92% . The key concept is that early detection through Pap smears and HPV testing can catch precancerous cells or early-stage cervical cancer before it becomes life-threatening. Fun Fact : A Well-Woman exam is not the same as a Pap smear. While Well-Woman exams are recommended annually and play a crucial role in overall preventive health, Pap smears are specifically for cervical cancer screening. The recommended frequency for Pap smears depends on your age and health history. Regular Breast Exams Early detection through breast exams and mammograms is crucial for improving outcomes and reducing the risk of breast cancer-related deaths. Self-breast exams help you become familiar with your body and can alert you to any changes that may require medical attention. Regular mammograms can identify tumors at an earlier, more treatable stage, which can make all the difference in survival rates. Fun Fact: Women who participated in mammography screening had a statistically significant 41% reduction in their risk of dying of breast cancer within 10 years. Healthy Lifestyle Choices: A balanced diet, regular exercise, and avoiding smoking and excessive alcohol can positively impact reproductive health. For personalized guidance on lifestyle choices, don’t hesitate to consult your OB-GYN during your annual check-up. They can help you develop a plan that’s right for you, boosting your overall reproductive and long-term health. Fun Fact: Meeting the minimum for moderate and vigorous activity (150 -300 minutes per week) can reduce cardiovascular disease mortality by 22% to 31% . A separate study published in JAMA Oncology shows that small amounts of vigorous intermittent lifestyle physical activity were associated with lower cancer risk. The female reproductive system is a remarkable and complex network that plays a vital role in life. With knowledge comes empowerment—enabling informed decisions about health, family planning, and overall wellness. By taking the time to educate ourselves and others about women's reproductive health, we can foster a more supportive and informed community. Remember, your body is a masterpiece—embrace it, understand it, and take care of it!

Establishing habits now can help prevent chronic disease and promote long-term health. Here are a few key practices women in their 20s and 30s should consider for better health today and tomorrow.

Hormonal imbalance is a term that’s frequently tossed around, but what does it really mean? Hormones are chemical messengers that regulate almost every bodily function—ranging from metabolism to mood, energy levels, and reproductive health. A slight fluctuation in hormone levels can have a profound effect on how we feel and function. However, when these hormones become too imbalanced—either too high or too low—our bodies often send clear signals that something isn’t quite right. In this post, we’ll dive into the tell-tale signs of hormonal imbalance, what causes it, and how you can take control of your health by addressing it head-on. What Does Hormonal Imbalance Really Mean? Hormonal imbalance refers to a disruption in the normal levels of hormones in your body. These hormones could include estrogen, progesterone, testosterone, thyroid hormones, cortisol (the stress hormone), insulin, and others. An imbalance can occur at any stage of life—whether you’re dealing with stress, starting or ending a pregnancy, going through menopause, or experiencing thyroid issues. Hormonal imbalances can manifest in various ways, and you may not always associate these symptoms with your hormones. But when things go awry, it’s important to listen to your body and understand what these signals could mean. Signs of Hormonal Imbalance: How Your Body Tells You Something’s Off Here are some common clues that your hormones might be out of whack: 1. Irregular Menstrual Cycles What to look for : Unpredictable or missed periods, extremely heavy or light bleeding, or cycles that are shorter or longer than usual. What this could mean : Irregular cycles can be caused by hormonal disruptions such as PCOS (polycystic ovary syndrome), thyroid disorders, or perimenopause. These conditions affect your ovaries, thyroid, and other hormone-producing glands, leading to cycle irregularity. 2. Difficulty Getting Pregnant What to look for : Trouble conceiving after several months of trying, even though you are otherwise healthy. What this could mean : Difficulty getting pregnant can stem from hormonal imbalances that affect ovulation, such as low levels of progesterone (which helps maintain pregnancy) or high testosterone levels (common in women with PCOS). 3. Weight Gain or Difficulty Losing Weight What to look for : Unexplained weight gain or persistent belly fat, or difficulty losing weight despite eating healthily and exercising. What this could mean : Imbalances in insulin, thyroid hormones, or cortisol (the stress hormone) can lead to weight gain. Insulin resistance, often linked to higher levels of estrogen or testosterone, can also affect your ability to lose weight . 4. Low Energy, Mood Swings, Insomnia, and Brain Fog What to look for : Feeling sluggish or fatigued despite adequate sleep, experiencing mood swings, anxiety, depression, or having difficulty concentrating. What this could mean : These symptoms often signal an imbalance in thyroid hormones, estrogen, or progesterone. Cortisol spikes related to stress or poor sleep can also contribute to brain fog and fatigue. What You Can Do to Balance Your Hormones As a women’s health clinician, I’ve seen firsthand how lifestyle changes can positively affect hormone balance. Hormonal imbalances don’t always require medications or drastic interventions. In many cases, small but impactful lifestyle changes can restore balance and help you feel your best. Here are the main things I recommend: 1. Exercise Regularly Why it matters : Regular exercise helps balance hormones by improving insulin sensitivity, boosting endorphins (the “feel-good” hormones), and promoting better sleep—all of which have a direct impact on your hormonal health. How much exercise? : Aim for 75-150 minutes of moderate-intensity exercise per week. This can be achieved through activities like brisk walking, swimming, or cycling. In addition, include resistance training at least 3 times per week. This can help balance testosterone and growth hormones that are essential for metabolic function and muscle health. Pro tip: Walking 7,000 steps per day is a great baseline goal for daily movement. 2. Eat Clean and Cut Out Processed Foods Why it matters : Processed foods, particularly those high in sugar, can spike insulin levels and disrupt the balance of estrogen and testosterone. High insulin levels are associated with hormonal conditions like PCOS and weight gain. What to eat : Focus on whole, unprocessed foods—vegetables, fruits, lean proteins, and healthy fats (like avocados, olive oil, and nuts). Incorporating more fiber-rich foods can help your body eliminate excess estrogen and improve digestion. Why protein matters : Protein is essential for building and repairing cells, and it helps to stabilize blood sugar levels. Aim for at least 1 gram of protein per kilogram of body weight daily ( quick conversion note 1kg =2.2lb ). 3. Get the Right Nutrient Balance Why it matters : Nutrient deficiencies can worsen hormonal imbalances. For example, Vitamin D, omega-3 fatty acids, iron, and B vitamins are critical for hormonal health. A deficiency in any of these nutrients can lead to symptoms like fatigue, mood swings, and irregular periods. How to test your nutrient levels : It’s important to understand your current nutritional status to know whether supplementation is necessary. Testing your micronutrients can provide crucial insight into any deficiencies. Baselines for women : We designed Baseline, our comprehensive program, to help women assess their micronutrient and hormonal levels with easy-to-understand testing. This helps identify any deficiencies and guide personalized changes. We specifically developed it for women because, as we know, women need different tests and analysis than men—we're not just “small men” after all! 4. Manage Stress and Get Enough Sleep Why it matters : Chronic stress can elevate cortisol, the stress hormone, which can affect everything from thyroid function to reproductive health. Stress also often leads to poor sleep, which further exacerbates hormonal imbalances. What to do : Focus on stress reduction techniques like meditation, yoga, deep breathing, and journaling. Aim for 7-9 hours of quality sleep per night to allow your body to restore hormone balance naturally. Get to the Bottom of It: Hormone Testing If you're experiencing symptoms of hormonal imbalance, it’s important to get to the root cause with proper testing. Baseline, our comprehensive testing program, offers a convenient way to test for key biomarkers such as vitamin levels, thyroid function, and hormonal balance. Knowing where you stand with these essential markers makes it easier to make informed decisions about lifestyle changes and supplementation that can improve your health. Hormone testing is an excellent starting point, but it’s equally important to work with a healthcare provider who can interpret the results and help you implement a balanced approach to wellness. Final Thoughts: Don’t Ignore the Signs Hormonal imbalance is more common than you might think, and the signs are often overlooked or chalked up to something else. Whether you’re dealing with irregular cycles, unexplained weight gain, or fatigue, your hormones may be trying to tell you something. But the good news is, you have the power to restore balance through smart lifestyle choices—diet, exercise, stress management, and targeted supplementation. At Almond, we’re committed to helping women understand their bodies and take charge of their health. With the right tools, resources, and guidance, you can balance your hormones and feel your best, every day. Ready to Take Control of Your Hormones? If you’re ready to get to the bottom of your hormonal imbalance, explore our Baseline testing program to track your essential biomarkers and receive personalized recommendations. Let’s work together to create a wellness plan that’s right for you!

The holiday season is here, and while we're excited about family gatherings, festive parties, travel, and all the fun that comes with it, it's also a great time to think about taking care of yourself—especially when it comes to sexual health. With more social events, travel, and sometimes new connections, it can be easy to get distracted. An NHS survey has revealed that six out of ten people under the age of 25 fear they may have contracted Chlamydia over the Christmas holidays. The survey, which questioned 509 individuals aged between 16 and 24, also found that 69% of respondents had engaged in unprotected sex during the festive period. These concerning statistics are alarming and are a reminder that early detection and treatment are essential to prevent complications and transmission. To help you stay healthy and have fun this season, we’ve put together simple tips for preventing STIs, recognizing common ones, and understanding how they’re treated. At Almond, we’re committed to supporting your sexual health with comprehensive screenings, personalized care, and expert guidance. We’re here to help you make informed decisions about your health so you can enjoy the season with peace of mind. Prevention Tips: How to Protect Yourself Use Condoms Whether you're in a new relationship or a long-term one, condoms are still your best defense against most STIs, including HIV, gonorrhea, chlamydia, and HPV. They’re inexpensive, easy to use, and effective when used correctly every time. At Almond, we provide information and resources to help you choose the best protection for your needs. Get Tested Regularly If you're sexually active—especially with new partners—it’s important to get tested regularly. Early detection helps prevent the spread of STIs and allows for faster treatment. Regular testing is key to staying proactive about your health. We offer convenient and confidential STI screenings at Almond, so you can stay on top of your sexual health, even during the busy holiday season. Vaccination Consider getting vaccinated for HPV (Human Papillomavirus). The HPV vaccine can help prevent cervical cancer. If you haven’t received the HPV vaccine yet, now is a great time to ask us about it at your next visit! Know Your Partner Before becoming sexually active with a new partner, have an open conversation about sexual health. Encouraging testing and discussing boundaries may feel awkward at first, but it’s an important step in protecting both you and your partner. At Almond, we offer counseling and support to help you navigate these important conversations. Limit the Number of Partners Reducing the number of sexual partners can lower your risk of exposure to STIs. While it’s not a guarantee, fewer partners generally means a lower chance of encountering someone with an infection. Regardless of the number of partners, testing and communication are key. The Most Common STIs and Their Symptoms Chlamydia Symptoms: Often asymptomatic, but it can cause abnormal discharge, pelvic pain, and painful urination. Treatment: Easily treated with antibiotics (usually azithromycin or doxycycline). Gonorrhea Symptoms: Painful urination, abnormal discharge, and in some cases, swollen lymph nodes or pelvic pain. Treatment: Treated with antibiotics, but antibiotic resistance is a growing concern. Regular testing is key. Human Papillomavirus (HPV) Symptoms: Many types of HPV are asymptomatic, but some strains can cause genital warts or, in rare cases, lead to cervical or other cancers. Treatment: No cure for the virus itself, but the symptoms (warts) can be treated. Vaccines like Gardasil help protect against high-risk types of HPV. Herpes Simplex Virus (HSV) Symptoms: Painful blisters or sores around the genital area, mouth, or other areas. Treatment: There’s no cure, but antiviral medications (like acyclovir) can reduce outbreaks and transmission. Syphilis Symptoms: Painless sores at the site of infection, followed by a rash, fever, and swollen lymph nodes. Treatment: Early syphilis is easily treated with antibiotics, typically penicillin. Trichomoniasis Symptoms: Unusual vaginal discharge, itching, or painful urination. Treatment: Treated with a single dose of antibiotics (usually metronidazole or tinidazole). What to Do if You Think You Have an STI If you think you might have an STI, don’t wait—get tested! Many STIs don’t show symptoms right away (or at all), so it’s important to stay proactive about your sexual health. If you test positive for an STI, don’t panic—most can be treated with medication. Early treatment helps prevent complications and the spread of the infection to others. At Almond Health, we offer private, non-judgmental consultations and testing to ensure you receive the care and support you need. If you're concerned about your sexual health, contact us to schedule an appointment. Bottom Line: Enjoy the Holidays, but Keep Your Health in Mind! The holiday season is a time for celebration, connection, and joy. Just remember, taking a few steps to protect your sexual health can ensure you enjoy the festivities safely. If you have any concerns about your sexual health or need to schedule a screening, don’t hesitate to contact us. We’re here to provide you with the information, care, and resources you need to make informed choices and stay healthy. Wishing you a happy, healthy, and safe holiday season!

Understanding your menstrual cycle can empower you with knowledge about your body and reproductive health. Have you ever wondered why your energy levels fluctuate throughout the month? Or why you might crave certain foods during your period? In this article, we’ll break down the menstrual cycle into easy-to-follow steps, explaining what happens and why- along with some dietary tips to help you feel your best during each phase. What is the Menstrual Cycle? The menstrual cycle is a monthly process that prepares the female body for pregnancy. It typically lasts about 28 days, but it can vary from 21 to 35 days for different individuals. The cycle involves complex hormonal changes that regulate ovulation and the menstrual period. Phases of the Menstrual Cycle The menstrual cycle is divided into four main phases: the menstrual phase, the follicular phase, ovulation, and the luteal phase. Let’s explore each phase in detail along with food recommendations to support your body. 1. Menstrual Phase (Days 1-5) What Happens: The cycle begins on the first day of your period, which is marked by the shedding of the uterine lining (endometrium) when pregnancy does not occur. Hormones Involved: Estrogen and progesterone levels are low at this time. Physical Symptoms: You may experience cramping, bloating, and mood changes due to hormonal fluctuations. Foods to eat: Iron-rich foods : Spinach, lentils, and lean meats to replenish iron lost during menstruation. Hydrating foods : Cucumbers and watermelon to help with bloating. Anti-inflammatory foods : Berries, nuts, and fatty fish can help alleviate cramps. Herbal Teas : Ginger or chamomile tea which will help to soothe cramps and promote relaxation. 2. Follicular Phase (Days 1-13) What Happens : This phase overlaps with the menstrual phase and continues until ovulation. The pituitary gland releases follicle-stimulating hormone (FSH), which stimulates the ovaries to mature several follicles, each containing an egg. Hormones Involved : As follicles mature, they produce estrogen, which helps rebuild the uterine lining in preparation for a potential pregnancy. Physical Symptoms : You may notice an increase in energy and a change in mood as estrogen levels rise. Foods to Eat : Complex carbohydrates : Quinoa, oats, and sweet potatoes for sustained energy. Leafy greens : Kale and arugula to support hormone production. Protein : Eggs and legumes to fuel your body during this energetic phase. Healthy Fats : Avocado, olive oil, and nuts which helps to promote hormone production and maintain stable energy levels. 3. Ovulation (varies on length of your cycle) What Happens: Around the midpoint of your cycle, a surge in luteinizing hormone (LH) triggers ovulation, releasing a mature egg from the dominant follicle. Hormones Involved : The peak in estrogen leads to the LH surge. Physical Symptoms : Some women experience mild pain (mittelschmerz) on one side, increased libido, or changes in cervical mucus, which becomes clear and stretchy, resembling egg whites. Foods to Eat : Zinc-rich foods : Pumpkin seeds, chickpeas, and nuts to support reproductive health. Fruits : Citrus fruits and berries provide antioxidants that promote overall well-being. Fermented Foods : Yogurt, kefir, sauerkraut which will help to promote gut health, which can influence hormonal balance. 4. Luteal Phase (Days 15-28) What Happens : After ovulation, the empty follicle transforms into the corpus luteum, which produces progesterone. This hormone further thickens the uterine lining, preparing it for a fertilized egg. Hormones Involved : Progesterone rises while estrogen remains elevated. Physical Symptoms : If fertilization does not happen, the corpus luteum breaks down, causing levels of progesterone and estrogen to drop. This drop causes PMS symptoms such as bloating, irritability, and breast tenderness. If fertilization occurs, hormone levels will remain elevated to support early pregnancy. Foods to Eat : Magnesium-rich foods : Dark chocolate, almonds, and spinach to help reduce PMS symptoms. Fiber : Whole grains and vegetables to aid digestion and combat bloating. Hydration : Herbal teas and plenty of water to reduce water retention. Some Additional Tips for Cycle Syncing Stay Hydrated: Drinking plenty of water throughout your cycle helps combat bloating and fatigue. Avoid Processed Foods : Minimize sugar and refined carbohydrates, especially during the luteal phase, as they can exacerbate mood swings and bloating. Mindful Eating : Pay attention to your body’s signals and cravings. Eating mindfully can help you connect with what your body needs during each phase. By aligning your nutrition with your menstrual cycle, you can enhance your well-being and navigate each phase with greater ease. Remember, everyone’s body is unique, so feel free to adjust these recommendations to suit your individual needs. It’s important to note that not every woman experiences a 28-day cycle, and factors such as stress, diet, and lifestyle can impact the regularity and symptoms of your cycle. Tracking your cycle can help you better understand your patterns and any changes over time. When to Seek Help While variations in your cycle can be normal, certain symptoms may indicate a need for medical attention. These include: Severe pain during your period (dysmenorrhea) Extremely heavy bleeding (menorrhagia) Irregular cycles (more than 35 days apart or less than 21 days apart) Significant mood changes If you have concerns about your menstrual cycle or reproductive health, please don’t hesitate to contact our office. We’re here to help!

A typical menstrual cycle usually spans between 21 to 35 days, with most women experiencing cycles around 28 days. However, variations in cycle length can occur due to a variety of factors, both physiological and environmental. A late period can stir up a mix of emotions- concern, curiosity and sometimes even panic! If you are sexually active without using contraception- YES, you will want to take a pregnancy test. However, if you have been using contraception or you are not sexually active- before you jump to conclusions, it’s essential to understand that a delayed period can be caused by various factors, some of which are entirely normal. Before looking at some factors that affect our period- let’s take a look at hormone regulation! How our Hormones Regulate Imagine your brain as the control center for your entire body. The hypothalamus is a tiny but powerful part of your brain that acts like a traffic cop, directing and regulating many important functions in your body. Functions: It helps regulate things like your body temperature, hunger, thirst, sleep, and emotions. Importantly, it also controls the release of hormones, which are like messengers that tell different parts of your body what to do. Hormone Messenger : It produces a hormone called gonadotropin-releasing hormone (GnRH). This hormone tells the pituitary gland to release two important hormones: follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Cycle Starter: FSH and LH travel through your bloodstream to your ovaries. They tell your ovaries to start preparing an egg for release (ovulation). Timing is Everything : The hypothalamus also helps keep your menstrual cycle regular by sensing things like stress, changes in light, and body temperature. It adjusts hormone production based on what your body needs. So, the hypothalamus is like the conductor of your menstrual cycle orchestra, making sure everything happens at the right time and in the right order each month. Now that we understand how things work in our body, let’s delve into the reasons why your period may be running behind schedule. Stress: One of the most common culprits behind a later period is stress. When you’re under pressure- be it from work, school relationships or even a major life event - your body can be impacted. Research highlights the significant role of stress in menstrual irregularities. Now, when you feel stressed out, your body releases a hormone called cortisol. This hormone can sometimes throw off the hypothalamus. It's like a switch gets flipped, and the signals that tell your body when to have a period can get mixed up. So, when your hypothalamus isn't working as it should because of stress, it can disrupt the normal flow of hormones that control your menstrual cycle. This might make your periods come at unexpected times, or you might skip them altogether some months. Hormonal Dynamics: Central to menstrual regularity are hormonal fluctuations, particularly estrogen and progesterone. Any imbalance or disruption in these hormones, influenced by stress, weight changes, or medical conditions like PCOS and thyroid disorders, can lead to delayed ovulation and subsequent late periods. Pregnancy: The most common reason for a late period is pregnancy. When conception occurs, the fertilized egg implants in the uterus, prompting hormonal changes that prevent menstruation. If you're sexually active and your period is late, taking a pregnancy test is recommended. Weight Changes: Significant changes in weight, whether rapid weight loss or gain, can impact hormone levels and disrupt the menstrual cycle. Low body weight can lead to irregular periods or even amenorrhea (absence of menstruation), while obesity can also affect hormone production. Age and Puberty: During adolescence, irregular periods are common as the body adjusts to hormonal changes. Similarly, approaching menopause (perimenopause) can cause irregular cycles before menstruation ceases altogether. When to Seek Medical Advice While occasional irregularities are normal, there are instances where medical advice should be sought: Consistently Irregular Cycles : If your periods are consistently irregular or absent for more than three cycles. Severe Symptoms : If you experience severe pain, unusually heavy bleeding, or other concerning symptoms along with a delayed period. Concerns about Reproductive Health : If you have concerns about your fertility, underlying medical conditions, or the effects of medications on your menstrual cycle. Dealing with PCOS? How Almond Can Help If you're experiencing irregular periods and are concerned about their impact on your health or fertility, Almond offers specialized counseling and diagnostic services, including a focused program for Polycystic Ovary Syndrome (PCOS). PCOS is a common hormonal disorder characterized by irregular periods, excess androgen levels, and polycystic ovaries, and affects an estimated 13% of women of reproductive age. Research has shown that diet plays a significant role in influencing symptoms and management of PCOS. As top integrative medicine Dr. Mark Hyman states, Food is medicine. You can choose foods that nourish your body and support hormonal balance, or foods that contribute to inflammation and hormonal disruption. Here at Almond, we created our PCOS program to offer a comprehensive approach in treatment, combining evidence-based medical interventions with personalized lifestyle strategies to address the diverse needs of our patients with PCOS effectively. Our comprehensive PCOS program includes: Thorough, Root-Cause Care: 4 clinical visits and 4 Health Coach visits Diagnostic Evaluation : Thorough reproductive consultation and assessment through medical history review, physical examination, and hormonal testing. Personalized Treatment Plans : Tailored management strategies focusing on symptom relief, menstrual regulation, and optimizing fertility outcomes. Lifestyle Management with our Health Coach : Guidance on diet, exercise, and stress reduction techniques to support hormone balance and overall well-being. Medical Interventions : Access to hormonal therapies, including birth control pills to regulate periods and reduce symptoms. Ongoing Support and Monitoring : Regular follow-up visits to monitor progress, adjust treatment plans as needed, and address any concerns or questions you may have. Whether you're seeking answers for irregular periods or have concerns about PCOS, our team of experienced healthcare providers is here to support you every step of the way. Schedule a consultation today to start your journey towards menstrual health and well-being. Understanding the factors influencing your menstrual cycle is crucial, and Almond is dedicated to providing compassionate care and effective solutions tailored to your individual needs. Reach out to us to learn more about how we can help you achieve menstrual regularity and optimal reproductive health.

In recent discussions spurred by the new CDC guidance on IUD insertion, the discomfort associated with IUD (intrauterine device) insertion has gained increased attention. It’s a procedure that many find daunting, but understanding how we work at Almond to minimize pain can help ease some of those anxieties. At the heart of our approach to IUD insertion is a commitment to patient comfort and care . We recognize that any medical procedure can be stressful, but there are several well-evidenced strategies we use to make the experience as smooth and pain-free as possible. Preparation is Key A portion of discomfort during IUD insertion comes from the unknown. To help you prepare, we make sure to provide you with all the important information you need in advance.This detailed guide helps patients mentally and physically prepare for the procedure. Knowing what to expect can significantly reduce anxiety and make the process feel less intimidating. Pain Management Strategies Optimal Timing : If possible, scheduling the insertion during your menstrual period can be beneficial. During menstruation, the cervix is naturally slightly open, which can make the insertion process smoother and less uncomfortable. Pre-Procedure Pain Relief : We recommend that patients take 600 mg of ibuprofen about an hour before their scheduled appointment, unless there are medical contraindications. Ibuprofen helps to minimize cramping and discomfort. During the Procedure : To ensure patients are as comfortable as possible, we provide a detailed walkthrough of the procedure. We keep our patients informed about each step to prevent any surprises. To help with cramping, we use a heating pad on the lower abdomen and apply topical lidocaine to numb the cervix, reducing the pain associated with the insertion instrument. Tailoring Comfort to Individual Needs We understand that every patient is different, and comfort levels can vary widely. Therefore, we offer several additional options for managing discomfort: Anxiety Management : For patients who are particularly nervous, we offer anxiety-reducing medications. These can help ease emotional stress and make the procedure more manageable. Paracervical Block : Although not universally preferred due to potential discomfort, a paracervical block is available for those who may need it. This local anesthetic is administered via an injection around the cervix to reduce pain, but its effectiveness and comfort can vary. Sedation Options : For patients who require it, we can perform the IUD insertion under sedation in the operating room. This option is particularly useful for those with severe anxiety or who have experienced significant discomfort in previous procedures. While the idea of IUD insertion may initially seem a bit overwhelming, here at Almond we are dedicated to making the experience as comfortable as possible. With careful preparation, thoughtful pain management, and personalized care, we strive to make your IUD insertion as smooth as it can be. We understand that this can be a sensitive topic, so if you have any concerns or questions about the procedure, please feel free to reach out to us at any time. We are here to support you and guide you through every step of the process with empathy and care. Book care with Almond here .

Polycystic Ovary Syndrome (PCOS) affects up to 13% of women of childbearing age, yet up to 70% of those affected remain undiagnosed worldwide. It's a leading cause of infertility and comes with a variety of symptoms that can be tricky to pin down and treat. But here's the exciting part: alongside traditional medical methods, there's growing evidence supporting an integrative approach through functional medicine for managing PCOS. That's where Almond steps in.

Here at Almond, we are noticing a real uptick in women inquiring about Ureaplasma. Let’s clarify some of the misconceptions associated with this bacteria, what it is, when to treat it and understanding the mystery behind it!