Many women have shared with us feelings of extreme stress, guilt, shame or embarrassment related to some of the most important issues affecting their reproductive or sexual health. We understand these issues affect each woman differently and are committed to empowering women to feel comfortable and confident about their health care and to work through these feelings.
Fertility, Pregnancy and Postpartum Mental Health
Pregnancy planning can be exciting and stressful. We help you focus on your mental and emotional well-being to be as healthy as possible. Our providers are experts in helping you decide what treatment options are best for your unique situation, including starting, stopping, or changing psychiatric medications.
Infertility affects about 12% of women. It can take a huge emotional toll. Women often describe feelings of hope, grief, and even shame with each attempt to get pregnant. Many fertility treatments affect hormones, which can have a big impact on mood. Dealing with the emotional side of infertility is different for each woman. Our providers collaborate with reproductive endocrinologists to promote emotional well-being for women struggling to get pregnant.
Fifty percent of all pregnancies in the U.S. are unplanned. Unplanned pregnancy can be stressful, especially if you are unsure about your resources or options, and feel pressure to make a decision “before time runs out.” We offer supportive and non-judgmental counseling to help women cope emotionally with unplanned pregnancy and making the best decision, including collaborating with OB-GYNs who offer a range of family planning services (e.g., counseling, pregnancy termination, adoption resources).
Not all women feel “the glow” when pregnant. Pregnancy is a life-changing event and emotional ups and downs due to hormones, issues with body image, not feeling like “yourself,” relationship stress, and financial stress are all common. We provide a variety of approaches tailored to each individual to promote positive coping and emotional well-being throughout all stages of pregnancy.
Medical complications are a scary and stressful part of pregnancy for some women. Complications are often unpredictable and not related to anything a woman did wrong. We collaborate with OB-GYNs who are specially trained in high-risk pregnancy to help women overcome stress from these challenges.
As many as 20% of women experience mood or anxiety disorders during pregnancy, including depression, generalized anxiety, post-traumatic stress disorder, obsessive-compulsive disorder and panic disorder. Women with histories of mental health problems who stop medications during pregnancy may be at risk for symptoms to come back. Mental health problems affect both the mother and baby and often need treatment. We offer treatments, including therapy and medication management, which are highly effective in ensuring the best mental health outcome.
Miscarriage and stillbirth are types of pregnancy losses. Up to 25% of pregnancies end in miscarriage (loss of a pregnancy before 20 weeks). About 1% end in stillbirth (loss of pregnancy after 20 weeks). Pregnancy loss can be devastating no matter when it happens and is sometimes traumatic. Grief is a normal response and often important for emotional recovery. We offer support and treatment to help women mourn the loss and process their grief.
Having a baby is a major life change. Although the birth itself may be brief, becoming a mother and bonding with baby do not always happen right away. Moms often struggle to balance new and old roles, work and parenting, and manage child care. Most women do not get enough support. We help women adjust to these changes and find support that fits their life and values.
Research shows that two-thirds of women have difficulty breastfeeding for as long as planned. Breastfeeding difficulties such as pain, low milk supply, breast infection, and latch problems may even increase risk of postpartum depression. Sometimes, breastfeeding may simply be more challenging than expected and women may feel pressure about the “right way” to feed a baby. Our providers are knowledgeable about how breastfeeding difficulties can affect mood and consider this to be an important part of postpartum mental health. We support moms in any feeding choice, including breastfeeding only, a combination of breastfeeding and formula, extended breastfeeding (greater than one year), and formula feeding.
Up to 50% of women experience the “baby blues” in the first week or so following a baby’s birth, which includes sadness, frequent crying, mood swings, anxiety, and trouble sleeping even when the baby sleeps. These symptoms are considered mild and short term and women generally feel better without treatment. However, some women feel distressed by how these symptoms affect them. We can offer coping tools and support through this time of transition.
As many as 20% of new mothers go through postpartum depression, which is longer lasting and more severe than “baby blues.” Symptoms include sadness, loss of enjoyment, feelings of guilt, worthlessness or hopelessness, thoughts of harming yourself or the baby, and problems with appetite, sleep or concentration. Many women feel guilty for having these feelings and may think “I’m supposed to be happy” or “I’m a bad mom,” which can make these feelings seem worse. You are not to blame if you have these feelings. We offer treatments (medication and therapy) to help recover and gain a sense of confidence.
Postpartum anxiety is common among new mothers, though it does not receive as much attention as postpartum depression. Postpartum anxiety may take the form of panic attacks, extreme worry and fears about the baby’s health or safety, obsessions and compulsive behavior, or phobias about situations that never used to be bothersome. Up to 10% of women will have an anxiety disorder in the year giving birth, including 66% of women who also have postpartum depression. Our treatments (medication and therapy) help women cope with the anxieties of motherhood, increase feelings of control, and keep anxiety and panic from getting in the way of parenting and bonding.
Childbirth is unpredictable and sometimes involves unexpected outcomes. Medical emergencies are scary and can make it hard to recover emotionally and physically. Sometimes a difficult birth can lead to symptoms of post-traumatic stress disorder (PTSD). PTSD involves unwanted or disturbing thoughts and memories of the trauma, going out of your way to avoid reminders of the trauma, and feeling watchful or “on guard.” As many as one out of three women have symptoms of PTSD after giving birth, even if there were no medical problems during delivery, but the mother still felt an extreme loss of control, fear, or poor support. These symptoms may be manageable or go away on their own. For those that do not go away and get in the way of daily life, all of our clinicians are experts in treating PTSD and can help women process and recover from birth trauma.
Sexual Functioning, Sexual Health and Other Gynecologic Concerns
Many women report temporary physical and emotional changes around the time of their period. In fact, 75 to 85% of women with regular menstrual cycles report unpleasant physical or psychological symptoms. For most women, these symptoms are mild and tolerable. However, for those who are sensitive to the normal hormonal changes, these symptoms can cause bigger disruptions in their lives. Our team understands the impact of these hormonal changes and can manage these symptoms with a variety of treatments.
Up to 40% of women experience some kind of sexual problem at some point in their lives. Problems include low sex drive, lack of arousal, and difficulty reaching orgasm. Our team can help in a number of ways. Our psychiatric providers can help address the effects of psychiatric medications on sexual functioning. Our therapists can help with concerns such as anxiety about sex or communication difficulties with sexual partner(s). No matter the problem, our team helps women work toward a more comfortable and satisfying sex life.
At some point in their lifetimes, the vast majority of women are diagnosed with STIs such as human papillomavirus (HPV), herpes, chlamydia, gonorrhea, or HIV, among many others. Living with an STI can be stressful and stress, in turn, can affect sexual health. Discussing these issues with partners can be uncomfortable or embarrassing. However, open communication is important in healthy sexual relationships. We strive to create a sensitive and empowering environment to help women address sexual health concerns, positive sexual decision-making, assertive communication with providers and sexual partner(s), and living with chronic health conditions such as herpes and HIV.
Pelvic pain can interfere with daily life and often causes emotional distress. Pelvic pain can occur anywhere in the lower abdomen, vagina, or rectum and can happen during urination, a bowel movement or sex. Common causes of pelvic pain can include endometriosis, childbirth, pelvic inflammatory disease (PID) or sexual trauma. Our team has expertise in pain management. We also help patients overcome anxiety about the medical treatments of pelvic pain (which can sometimes be invasive) and feel empowered. We work with physicians and physical therapists to help make treatment more comfortable.
For some women, routine pelvic exams or other procedures including pap smears, transvaginal ultrasound, and colposcopy can be stressful or anxiety-provoking, especially if experiences have been negative in the past. Pelvic pain or a history of sexual assault can cause additional fear and anxiety about these procedures. No matter the cause, fear and anxiety can cause some women to avoid getting OB/GYN care, which can lead to medical problems not being diagnosed or treated. Our team can help women overcome these fears and make receiving medical care more comfortable.
One in three women are the victims of sexual assault at some point in their lifetime, including childhood sexual abuse, molestation or unwanted sex as an adult. This traumatic experience can lead to a range of mental health issues, including post-traumatic stress disorder, depression, panic attacks and problems related to alcohol and drug use. All of our clinicians are experts in treating PTSD and helping women overcome traumas that interfere with life, work, and relationships.
The transition to menopause (also called perimenopause) may begin up to a decade before a woman has her last period. During this transition, many women report physical and emotional symptoms including irregular menstrual cycles, hot flashes, night sweats, changes in sleep patterns, depression, and anxiety. Some women experience more intense hormonal changes or are more sensitive to them. Our team has expertise in treating changes in mental health that come with menopause, including medication management, therapy to cope with these symptoms and other life stressors, and making referrals to a reproductive endocrinologist to evaluate for and treat with hormone replacement therapy (HRT) if needed.
For some women, having a hysterectomy or tubal ligation can be stressful. Whether it’s due to fear about the surgery itself or ending the possibility of future pregnancy, the stress of these procedures can be hard to cope with. We help our patients build coping strategies to manage this unique kind of stress.