The third trimester can be exciting, uncomfortable, emotional and physically demanding, sometimes all in the same day. Staying hydrated is one of the easiest ways to support your body as you prepare for delivery, but it is not the only thing that matters. Rest, nourishment, symptom awareness and staying connected to your care team all play an important role too.

Hydration

One of the simplest and most important ways to support your body right now is staying well hydrated. In late pregnancy, hydration plays a bigger role than many might realize. Drinking enough fluids helps support increased blood volume, regulate body temperature, aid digestion and help your body function more comfortably overall.

It can also help reduce some common third-trimester issues such as:

• constipation

• headaches

• dizziness

• fatigue

• overheating

• uterine irritability or cramping

When you are dehydrated, your body feels it. You may notice dry mouth, dark urine, lightheadedness, increased thirst, or just a general sense that you are worn down more quickly than usual.

How much water do you need?

A good rule of thumb during pregnancy is to drink water steadily throughout the day rather than trying to catch up all at once. Needs can vary depending on the weather, your activity level, and how you are feeling, but in general, keeping a water bottle nearby and sipping often is a smart habit.

You may need even more fluids if:

• it is hot outside

• you are more physically active

• you are sweating more than usual

• you have vomiting or diarrhea

• you are noticing Braxton Hicks contractions that improve with rest and water

If plain water is unappealing, try adding lemon, berries, cucumber or ice. Water-rich foods like melon, oranges, cucumbers and soups can help too.

Other smart third-trimester habits

Hydration is important, but it is only one piece of feeling your best in the third trimester. A few other simple habits can go a long way.

Eat small, balanced meals

As your baby grows, heartburn and fullness often become more common. Smaller meals eaten more often may feel better than three larger meals. Focus on protein, fiber and foods that help support steady energy.

Rest when you can

Fatigue often returns in the third trimester. Your body is carrying more weight impacting bones and joints, sleep can be disrupted, and daily tasks may take more out of you. Rest is not laziness. It is part of caring for yourself during pregnancy.

Pay attention to swelling and heat

Some swelling in the feet and ankles can be normal in pregnancy, especially later in the day or in hot weather. But staying cool, elevating your feet when possible and drinking enough water can help.

Keep moving gently

Light movement like walking or stretching can help support circulation, energy and comfort. Your activity prior to pregnancy can also be a reference point. Talk with your provider about exercise later in your pregnancy.

Notice your baby’s movement

As you near labor and delivery, becoming familiar with your baby’s typical movement pattern is important. If movement seems noticeably different, it is worth a call.

What symptoms should not be ignored?

Some discomforts are common in late pregnancy. Others deserve prompt attention. Contact your care team if you have:

• regular contractions

• leaking fluid

• vaginal bleeding

• severe headache

• vision changes

• sudden swelling of the face or hands

• fever

• significant dizziness

• shortness of breath that feels unusual

• decreased fetal movement

• anything that simply feels off to you

Trust your instincts. You do not need to have the perfect words or know whether something is serious before reaching out.

A few practical third-trimester reminders and a few important details to get in place

• Keep a water bottle with you.

• Take breaks when you need them.

• Avoid getting overheated.

• Snack regularly if large meals are uncomfortable.

• Wear supportive, comfortable clothing and shoes.

Third trimester is an exciting time — and a great moment to make sure a few important details are in place before baby arrives. Here’s a quick checklist:

• Have you registered with the hospital where you plan to deliver?

• Have you chosen a pediatrician or family medicine provider for your baby?

• Do you need a breast pump? Our team can help send a prescription if needed.

• Have you taken a childbirth or breastfeeding class?

• Would you like to schedule a visit with one of our lactation consultants?

• Have you talked through your early newborn feeding, sleep, and support plan?

If you have questions about symptoms, hydration, swelling or other third-trimester changes, our team is here to help. Talk with your provider at your next prenatal visit or contact us if something does not feel right. Talk with your care team if you have questions — we’re here to help. Visit premierwomenshealthmn.com.

This content was review by Dr. Taryn McEvoy and Bethany Hjelle, CNP, WHNP-BC at Premier Women's Health - Oakdale OBGYN.

Heat, humidity, wet swimsuits, and sweaty workout clothes can all make vaginal symptoms more noticeable. Here’s how to understand common differences, support vaginal health, and know when it may be time to check in with your Premier Women’s Health provider.

Summer often means more time at the pool, more workouts, more travel, and more days spent in heat and humidity. It can also be a time when women notice more vaginal irritation, odor, discharge, or discomfort. When that happens, it is easy to assume every symptom means the same thing, but that is not always the case. Vaginal symptoms are common, and several different conditions can cause them.

What is vaginitis?

Vaginitis is a broad term for inflammation or irritation of the vagina. It is not one specific diagnosis. Instead, it is an umbrella term used to describe symptoms such as itching, burning, discharge, odor, or discomfort that may be caused by different conditions. Common causes include yeast infections and bacterial vaginosis, also called BV.

What is a yeast infection?

A yeast infection happens when yeast that normally lives in the vagina grows too much. It commonly causes itching, soreness, burning, irritation, discomfort with sex, and abnormal discharge. Yeast infections are often associated with thicker white discharge and more irritation than odor. Symptoms alone are not always enough to confirm yeast, which is one reason it can be important to check in if symptoms are new or not improving.

What is BV?

Bacterial vaginosis happens when the normal balance of vaginal bacteria is disrupted. When that balance shifts, certain bacteria can overgrow and lead to symptoms. BV often causes a thin white, gray, or milky discharge and a noticeable fishy odor, sometimes especially after sex. Some women also notice burning or mild irritation, while others may have no symptoms at all.

So how can you tell the difference?

A simple way to think about it is this:

• Vaginitis is the umbrella term

• A yeast infection is one common “type” of vaginitis

• BV is another common type of vaginitis

In general, yeast tends to cause more itching, soreness, redness, and thicker white discharge, while BV is more likely to cause thinner discharge and a strong fishy odor. But there can be overlap, and not every vaginal symptom is caused by yeast or BV.

Signs it may be a yeast infection

A yeast infection may be more likely if you notice:

• Intense itching

• Burning or soreness

• Redness or irritation around the vaginal opening

• Thick white discharge

• Discomfort with urination or intercourse

For many women, yeast feels more irritating than anything else.

Signs it may be BV

BV may be more likely if you notice:

• Thin white, gray, or milky discharge

• A noticeable fishy odor

• Mild irritation or burning

• Symptoms that seem more about odor and discharge than itching

For many women, BV is less about intense irritation and more about a change in odor or discharge.

Why it can be hard to self-diagnose

Even though these symptoms can follow a pattern, they do not always read like a textbook. Some women have mild symptoms. Some have overlap. And sometimes the cause is something else entirely. CDC notes that the typical symptoms of yeast infection are not specific to yeast alone.

Many women with vaginal symptoms often try over-the-counter products before getting evaluated. So, it’s important to not assume every vaginal symptom is a yeast infection. If your self-diagnosis is wrong, the treatment may not help and may delay getting relief.

Why summer can make symptoms more likely & noticeable

Summer itself does not directly cause every vaginal infection, but it can create conditions that make irritation more likely and noticeable. Heat, moisture, tight clothing, wet swimsuits, sweaty workout clothes, and changes in routine can all make the vaginal area feel less comfortable. The American College of Obstetricians and Gynecologists (ACOG) also notes that sexual activity can introduce new bacteria into the vagina, which can play a role in vaginal infections.

Healthy vaginal rules of thumb for summer

A few simple habits can go a long way during the warmer months:

1. Change out of wet or sweaty clothes: After swimming or exercising, try not to stay in damp clothing longer than necessary. Dry, breathable clothing is better for comfort and can help reduce irritation.

2. Choose breathable underwear: Cotton underwear and lightweight clothing can help reduce trapped moisture in hot weather.

3. Avoid scented products: Scented washes, sprays, wipes, and bubble baths can irritate sensitive tissue.

4. Skip douching: The vagina is self-cleaning, and douching can disrupt the natural balance of bacteria and raise the risk of irritation or infection.

5. Don’t guess if symptoms are new: If symptoms are different than what you have had before, or they are not improving, it is worth checking in with our team. Not every itch or change in discharge is caused by yeast.

6. Pay attention to odor: A strong fishy odor is more suggestive of BV than of a yeast infection.

Know when to call your provider

Reach out if symptoms are severe, recurrent, not improving, or paired with pelvic pain, sores, fever, bleeding, or burning with urination. If something feels off, do not feel like you have to guess. Getting the right diagnosis is the best way to get the right treatment and feel better faster. Visit premierwomenshealthmn.com

This content was review by Rebekah Roverrud, PA-C at OBGYN West.

Summer break can be a welcome change of pace if you’re a college student. Between being home, catching up with friends and family, and settling into a different routine, it can also be a practical time to take care of important health needs that are easy to put off during the school year.

For many young people, summer is an ideal time to schedule a women’s health visit. Why? Read on.

What a summer visit can cover

A women’s health visit is not just for annual exams. It is also a good time to check in on the things that may have changed over the past year or to talk through questions you have been meaning to ask.

A summer appointment may be a good time to discuss:

• well-woman care and preventive health

• recommended screenings (think cervical cancer, breast, STIs)

• birth control questions or prescription refills (still meet the need?)

• irregular periods or painful periods

• heavy bleeding

• pelvic pain

• vaginal irritation, discharge, or other symptoms

• sexual health concerns

• preconception questions

• breast concerns

• new products, such as menstrual cups

• talk about general changes in health, stress, or lifestyle

• vaccines

• mental health

For college students, even a quick visit can be helpful in making sure current medications, contraception, and preventive care needs are still working well for this stage of life.

Birth control check-ins matter

If you are using birth control, summer is a great time to make sure your method still fits your needs. Maybe things are going well and you simply need a refill. Or maybe you have noticed side effects, changes in your cycle, trouble remembering a pill, or questions about other options.

A check-in with your provider can help you review what is working, what is not, and whether a different option may make more sense moving forward.

A good time to ask questions

College often comes with a lot of new experiences, independence, and change. That can also bring new questions about women’s health and options that may not have been available just a couple of years ago. Summer visits can be a comfortable time to ask about periods, period products, sexual health, contraception, symptoms you are unsure about, or anything else that has been on your mind.

No concern is too small to bring up. Sometimes what seems minor can be worth discussing, and sometimes reassurance from our team alone can go a long way.

Care that supports this season of life

Young adulthood is a time of transition, and women’s health needs can shift right along with it. Having a trusted provider can make it easier to stay connected to care, ask questions, and make informed choices as life changes.

If you are home from college this summer, consider using the break to schedule a visit. A well-woman exam, birth control follow-up, or problem-focused visit can help you head back into the school year feeling more prepared and supported.

Why summer is a smart time to schedule

During the school year, it can be hard to find time for appointments. Class schedules, work, sports, travel, and being away from home can all make it difficult to fit in routine care. Summer often gives you a little more flexibility to take care of the things that support your long-term health and peace of mind. And keep in mind, our clinics are busy; making time for a visit now can also help avoid last-minute scrambling later, especially before returning to campus.

If you are home for the summer and would like to schedule a visit, contact your clinic or talk with your provider about the care that is right for you. Visit premierwomenshealthmn.com

This content was review by Dr. Leigh Koidahl at Southdale OBGYN and Dr. Kate Toft at OBGYN West.

For many women, weight management is about much more than diet and exercise. Hormones, metabolism, pregnancy, postpartum recovery, menopause, PCOS, fertility concerns, stress, and daily life can all play a role. That is why lasting progress often requires more than a one-size-fits-all plan.

At Premier Women’s Health, our OBGYN West and Oakdale OBGYN clinics offer physician-led weight management services that are designed specifically for women and supported by a collaborative women’s health care team. Instead of focusing only on the scale, our team looks at the bigger picture of your health and creates a plan that is personalized, medically informed, and built for long-term success.

Why Weight Management Can be Different for Women

Women experience unique health changes throughout life, and those changes can directly affect weight. Hormonal shifts, fertility challenges, pregnancy, menopause, and conditions such as PCOS can all influence how your body gains, loses, and maintains weight.

It makes sense then, that working with an OBGYN-based team can make such a difference. When weight management is approached through the lens of women’s health, care can be tailored to your stage of life, your symptoms, and your broader health goals. These can include whether you are hoping to improve fertility, support a healthier pregnancy, navigate menopause, or want to simply feel better in your body.

A Collaborative Model Built Around Women’s Health

Our services bring together specialists who understand how weight intersects with the full picture of women’s health. That team includes OBGYN physicians, a registered dietitian, and physical therapists with a keen understanding of women’s health. Together, they help people create realistic, sustainable plans that support both short-term progress and long-term wellness.

Personalized Nutrition Support

Healthy weight management is not about extreme restriction. Our registered dietitian works with patients to create nutrition plans that fit real life and support your overall health. This may include guidance on nutrient adequacy, meal planning, preserving lean muscle during weight loss, navigating side effects from weight loss medications, and building habits that can be maintained over time.

Physical Therapy Support for Movement and Function

For many women, movement comes with barriers that are often overlooked. Back pain, hip pain, urinary leakage, constipation, prolapse, and pelvic floor concerns can all make exercise feel difficult or discouraging. Our physical therapy team helps women address these challenges, build a safe starting point for movement, and develop a more consistent and confident approach to exercise.

What People Can Expect from the Program

Our weight management services are designed for women who want a sustainable, medically supported approach to better health. Depending on individual needs, care may include:

• personalized health assessments

• customized nutrition planning

• safe and effective exercise guidance

• medical support and monitoring

• emotional and behavioral support resources

The goal is not a quick fix. The goal is to help women achieve meaningful, lasting results with support from a team that understands their health from every angle.

Who May Benefit?

Our services may be a good fit for people who:

• struggle with weight gain related to hormonal changes

• want to improve fertility or pregnancy health

• need support managing PCOS or menopause

• want to reach a healthier weight before or after pregnancy

• are looking for a more personalized and medically guided approach to weight loss

Women at any age and stage can benefit from care that takes their full health story into account.

Make a First Step

Weight management can feel overwhelming, especially when you have tried to tackle it alone. But support matters, and having the right team can make a real difference.

At Premier, our collaborative weight management services are here to help women be and stay healthy with expert guidance, individualized care, and long-term support. To learn more, visit premierwomenshealthmn.com/services/weight-management/

This content was review by Dr. Matthew Bigos at OBGYN West and Dr. Robin Prugno at Oakdale OBGYN.

Spring has a way of reminding us that growth is happening all around us. Trees begin to bud. Birds build nests. Baby animals make their first appearances. And for many families, spring’s sense of newness mirrors something more deeply personal: the beginning of pregnancy.

If you’ve just found out you’re expecting, you may be feeling a mix of excitement, curiosity, and nerves. That is completely normal. Your first prenatal visit is an important step in caring for both you and your growing baby, and it is also a chance to ask questions, get oriented, and begin building a relationship with your care team. Here’s what you can expect.

Your pregnancy confirmation visit

Before your first prenatal OB visit, our team confirms your pregnancy at 8 weeks. This pregnancy confirmation visit includes an ultrasound, a review of current medications, and a nutrition consult. You will learn about your genetic screening options.

What to expect at your first OB appointment

Your first prenatal OB appointment is at 12 weeks and is often one of the longest visits of pregnancy because it lays the foundation for the months ahead. Your provider will discuss your estimated due date, what prenatal care will look like going forward, and how your baby is developing in these early weeks.

This visit will include:

• An in-depth review of your health history, medications and supplements, and discussion about whether you’d like genetic screening tests

• With you, we listen to your baby’s heartbeat with the doppler (we’re excited right along with you)

• Lab work: Blood and urine testing to check things like blood type, iron levels, immunity, and overall health

• A full physical exam

• Discussion about your physical and mental health, and next steps. Nausea, fatigue, breast tenderness, food aversions, and emotional ups and downs are all common early pregnancy experiences. Your provider can help you understand what is normal and what deserves a call.

Questions to ask at your first prenatal visit

It can be hard to remember everything once you are in the room, so bringing a short list of questions can help. Here are some good ones to start with:

1. How far along am I, and what is my due date? This helps guide the timing of future visits, tests, and ultrasounds.

2. What symptoms are normal in early pregnancy? Ask what to expect and when symptoms like nausea, cramping, or fatigue should prompt a call.

3. Are the medications and supplements I take safe in pregnancy? This includes prescriptions, over-the-counter medications, vitamins, and herbal products.

4. What prenatal vitamin should I be taking? Your provider can help confirm you are getting the right nutrients, including folic acid and iron.

5. What foods, drinks, or activities should I avoid? This is a good time to ask about caffeine, exercise, lifting, travel, hot tubs, alcohol, and foods to be cautious about.

6. When should I call the office? Knowing what symptoms are urgent can give you peace of mind.

7. What testing or screenings will I be offered? Your provider can walk you through genetic screening options and the general prenatal timeline.

8. How often will I come in during pregnancy? Understanding the rhythm of prenatal care can help you plan ahead.

9. Who will I see for my prenatal visits and delivery? This is especially helpful in some of our larger practices where you may meet multiple providers.

10. What can I do now to support a healthy pregnancy? From sleep and nutrition to movement and stress management, small steps can make a big difference.

Final Thoughts

Whether this is your first pregnancy or your first pregnancy after a long road getting here, it is okay to come in with questions, emotions, and uncertainty. That is what prenatal care is for. This first visit is about getting started and understanding your next steps. Our team is here to help guide you, answer your questions, and care for you every step of the way.

Our team is here for you, preconception to labor and delivery. Learn more about our services at premierwomenshealthmn.com

This content was review by OBGYN physician Taryn McEvoy, MD, and women’s health nurse practitioner Bethany Hjelle, WHNP-BC. They see women at Premier Women’s Health – Oakdale OBGYN.

If you’ve been told you might need a hysterectomy—or you’re exploring options—it’s normal to have a lot of questions. The good news is that hysterectomy is not “one-size-fits-all.” Today, there are multiple surgical approaches, and your best option depends on your anatomy, your health history, the reason for surgery, and your OBGYN’s expertise.

Here’s an overview of hysterectomy, why you may need one, and hysterectomy options.

What is a hysterectomy?

A hysterectomy is surgery to remove the uterus. Depending on your medical needs, your OBGYN may also recommend removing other structures:

• Cervix (the lower part of the uterus)

• Fallopian tubes (often removed to reduce future ovarian cancer risk)

• Ovaries (sometimes removed, sometimes preserved)

Common terms you may hear:

• Total hysterectomy: uterus + cervix removed

• Supracervical (partial) hysterectomy: uterus removed, cervix left in place

• Hysterectomy with salpingectomy: uterus removed + fallopian tubes removed

• Hysterectomy with oophorectomy: ovaries removed (one or both)

Why have a hysterectomy?

A hysterectomy may be recommended for:

• Heavy or abnormal bleeding that doesn’t improve with other treatments

• Fibroids

• Endometriosis or adenomyosis

• Chronic pelvic pain

• Uterine prolapse

• Precancer or cancer of the uterus/cervix/ovaries

Your main hysterectomy options

The most common hysterectomy options are:

1. Laparoscopic hysterectomy (including robot-assisted)

2. Abdominal (open) hysterectomy

3. Vaginal hysterectomy

4. vNOTES hysterectomy (vaginal + laparoscopic technology through the vagina)

Here’s a breakdown of each.

1) Laparoscopic hysterectomy (small incisions on the abdomen, performed with or without robotics)

What it is: Your OBGYN uses a camera and instruments inserted through small abdominal incisions (often 3–5 small cuts). The uterus is removed in a controlled way—sometimes through the vagina.

Benefits:

• Minimally invasive approach with smaller incisions

• Often less pain and quicker recovery than open surgery

• Excellent visualization of the pelvis—helpful for conditions like endometriosis. This is particularly true with robotic technology.

Considerations:

• Requires specialized training and equipment

• As with any surgery, there’s a small risk of bleeding, infection, or injury to surrounding organs

2) Abdominal (open) hysterectomy

What it is: The uterus is removed through a larger incision in the abdomen (similar to a C-section incision or a vertical incision, depending on the case).

When it’s used:

• Very large uterus or large fibroids

• Significant scarring/adhesions from prior surgeries

• Certain cancers or complex cases where open access is safest

• When minimally invasive approaches aren’t appropriate

Tradeoffs:

• Longer recovery compared to minimally invasive approaches

• More post-op discomfort and a larger scar

• Often will require a short stay in the hospital

3) Vaginal hysterectomy (no abdominal incisions)

What it is: The uterus is removed through the vagina. There are no cuts on the belly.

Why some people love it:

• No visible abdominal scars

• Often less pain and a faster recovery than open surgery

• Frequently a strong option for uterine prolapse and some benign conditions

Possible limitations:

• May not be ideal if the uterus is very large (for example, very large fibroids)

• Prior surgeries, scar tissue, or certain anatomy can make it harder

• Not always the best approach if additional procedures are needed in the pelvis

4) vNOTES hysterectomy

What it is: vNOTES stands for vaginal natural orifice transluminal endoscopic surgery. Your OBGYN accesses the surgical area through the vagina and uses a camera and laparoscopic instruments—but without abdominal incisions.

Why it might be a fit for you:

• No belly incisions (no visible abdominal scars)

• Often less pain and a quicker return to normal activity for many patients

• Combines the cosmetic benefit of vaginal surgery with the visualization advantages of laparoscopy

Who might be a good candidate:

• Many patients needing hysterectomy for benign conditions (like bleeding, fibroids within certain size ranges, adenomyosis)

• Some patients who want a minimally invasive approach but prefer to avoid abdominal incisions

Who might not be a candidate:

• Some patients with extensive scar tissue/adhesions

• Certain complex anatomy or very large uteruses

• Some cancer-related cases (approach is individualized)

How do OBGYNs decide which approach is best?

Your OBGYN may consider:

• Reason for surgery (benign vs. cancer concern)

• Uterine size (fibroids can affect this)

• History of prior abdominal or pelvic surgeries

• Endometriosis or suspected adhesions

• Need to remove ovaries, tubes, or treat other pelvic issues

• Your overall health (including BMI, diabetes control, anesthesia risk)

• Surgeon experience and available techniques

What can I expect for recovery?

Recovery varies by approach and your individual health, but broadly:

• Minimally invasive approaches (vaginal, laparoscopic/robotic, vNOTES): often quicker return to normal routines and less pain

• Open abdominal approach: typically longer recovery time

No matter the approach, most patients are advised to avoid heavy lifting and vaginal intercourse for a set period while healing. Your OBGYN will give you specific instructions.

Frequently Asked Questions About Hysterectomy: Bring to Your Appointment

• What are the different types of hysterectomy?

• What are the main surgical approaches for hysterectomy?

• How do I know which approach is right for me?

• Will my ovaries be removed? What does that change? Pros and cons of keeping?

• How long is recovery, and when can I return to work/exercise?

• What questions should I ask my OBGYN?

• What is the plan for pain control and recovery?

Key takeaways

There are several safe and effective ways to perform a hysterectomy. Many patients can choose a minimally invasive approach and get back to work and family with minimal amount of down time for healing.

Our Premier Women’s Health team can help you weigh your options. Visit premierwomenshealthmn.com for a location or provider near you.

Blog content review by OBGYN physician Katie Toft, MD and physician assistant Becky Roverud.

If you’ve started waking up sweaty at night, feeling sudden waves of heat during the day, or noticing vaginal dryness that makes intimacy uncomfortable, you’re not alone. These are some of the most common—and most frustrating—symptoms women experience as they move through perimenopause and menopause. Mental health changes, sleep disturbances, brain fog, skin, hair and weight changes can also be part of this change.

The good news: you have options to help you manage symptoms. Below is a practical, patient-friendly guide to what’s happening in your body and what can help—especially for hot flashes, night sweats, and vaginal dryness.

(Quick note: This is general education, not medical advice for any one person. Your best treatment depends on your health history and symptoms—your Premier Women’s Health provider can help you choose the safest, most effective plan.)

What’s the difference between perimenopause and menopause?

• Perimenopause is the transition leading up to menopause, when hormones fluctuate. Periods may become irregular. Symptoms can come and go.

• Menopause is defined as 12 months without a period. After that, you’re in post-menopause.

Both stages can bring symptoms related to changing estrogen levels—and your “normal” can shift month to month, and be different from what friends and family are experiencing.

Want to learn more about perimenopause? Join this Premier Women’s Health 2-part workshop starting Feb. 11. Learn more: premierwomenshealthmn.com/classes/

Hot Flashes & Night Sweats: Why they happen

Hot flashes are sudden feelings of heat (often in the face, neck, and chest) that can come with flushing, sweating, and a racing heartbeat. When they happen at night, they’re often called night sweats—and they can seriously disrupt sleep.

These symptoms are thought to be tied to how hormonal changes affect the body’s temperature regulation.

Lifestyle changes that can help (often worth trying first)

Small changes can make a big difference, especially if your symptoms are mild to moderate:

• Dress in layers; choose breathable fabrics

• Keep the bedroom cool; use a fan

• Avoid common triggers (often: alcohol, spicy foods, hot beverages)

• Cut back on nicotine (if applicable)

• Manage stress (mindfulness, yoga, walking, therapy)

• Prioritize sleep habits (consistent bedtime, limit screens before sleep)

If symptoms are frequent, intense, or disrupting your quality of life, it’s reasonable to consider medical options.

Non-hormonal Medications for Hot Flashes & Night Sweats

Not everyone can—or wants to—use hormone therapy. There are non-hormonal prescription options that may reduce hot flashes and night sweats for some women. These are often used when symptoms are significant, sleep is suffering, or quality of life is taking a hit.

Common non-hormonal categories

SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) are commonly used for mood, but certain ones can also help reduce hot flashes.

Examples you may hear about:

• Venlafaxine (Effexor®) — an SNRI

• Desvenlafaxine (Pristiq®) — an SNRI

• Gabapentin — often used for nerve pain; can help night symptoms for some women

• Fezolinetant (Veozah®) — a non-hormonal medication specifically for moderate to severe hot flashes

A few important notes:

• These medications aren’t “one-size-fits-all.” What works well for one person may not help another.

• Side effects and interactions matter (especially if you take other medications).

• Your provider will help weigh your symptoms, medical history, and goals.

If you’re unsure whether you’re a candidate, a conversation with your clinician is the best next step.

Vaginal Dryness: common, treatable, and worth talking about

Vaginal dryness is extremely common in perimenopause and menopause—and it can show up as:

• Dryness, burning, or irritation

• Pain with sex

• Light bleeding with sex

• Increased urinary symptoms (frequency, urgency, recurrent UTIs for some)

This cluster of symptoms is often related to reduced estrogen’s effects on vaginal tissue.

First-line, Over-the-Counter relief (OTC)

For many women, a consistent routine with moisturizers plus a lubricant during sex helps a lot.

OTC options include:

• Vaginal lubricants (used at the time of sex)

  • Example: Uberlube®

• Vaginal moisturizers (used regularly, like a skincare routine)

  • Example: Replens®

• Products with hyaluronic acid (a hydrating ingredient found in some vaginal moisturizers)

• Coconut oil (some people like it as a lubricant)

Safety tip: Oil-based products (including coconut oil) can break down latexcondoms and may increase condom failure. If you rely on condoms for pregnancy or prevention of sexually transmitted infections (STI), choose a condom-compatible lubricant.

Menopause Society-certified OBGYN Dr. Robin Prugno offers this summary. Watch now.

When Over-the-Counter Isn’t Enough

If dryness is persistent, painful, or affecting intimacy and confidence, ask your provider about additional options. There are effective prescription treatments available (including local therapies) and your clinician can guide what’s appropriate for you.

When to Call Your Provider

Reach out if:

• Hot flashes or night sweats are disrupting sleep, mood, or daily functioning

• Vaginal dryness is painful, persistent, or affecting intimacy

• You have bleeding after sex, new bleeding after menopause, or symptoms that worry you

• You want to review your risks/benefits for different treatment options

You don’t have to “push through” these symptoms. There are real solutions—and you deserve support.

Quick FAQ

Is it normal for symptoms to come and go in perimenopause?
Yes. Fluctuating hormones can make symptoms unpredictable.

Do I have to take hormones to feel better?
No. Many women find relief with lifestyle changes, over-the-counter vaginal products, and/or non-hormonal prescriptions.

How do I know what’s right for me?
That depends on your symptoms, health history, and personal preferences. A quick visit focused on menopause symptoms can help you leave with a clear plan.

Premier Women’s Health Can Help

If hot flashes, night sweats, or vaginal dryness are affecting your quality of life, we’re here to help you sort through options and find a plan that feels right for you. Call your clinic to schedule a visit and discuss symptom relief—including telehealth when appropriate.

Blog content review by menopause-certified Premier Women’s Health board-certified OBGYN physicians Robin Prugno, DO, and Katie Toft, MD.

Heavy or abnormal menstrual bleeding is one of the most common reasons women schedule a gynecology visit—yet many live with it for years, assuming it’s normal or something they just have to manage.

If your period feels heavy, unpredictable, or disruptive, your body may be signaling that something isn’t quite right. The good news is that abnormal bleeding is often very treatable, especially when addressed early.

What Is Considered Heavy or Abnormal Menstrual Bleeding?

While every woman’s cycle is different, certain bleeding patterns are considered outside the typical range. You should consider talking with your Premier Women’s Health provider if you experience:

• Periods lasting longer than 7 days

• Bleeding that requires changing a pad or tampon every 1–2 hours

• Passing large blood clots

• Bleeding between periods or after sex

• Periods that suddenly become heavier or more frequent

• Menstrual bleeding that interferes with daily activities, sleep, or work

If you find yourself planning your life around your period, that alone is reason to seek care.

Common Causes of Heavy or Irregular Periods

Abnormal uterine bleeding can occur at many stages of life and may have different causes depending on age, health history, and hormonal changes. Common causes include:

• Hormonal imbalances, including perimenopause

• Uterine fibroids or polyps

• Thyroid disorders

• Bleeding or clotting conditions

• Birth control–related changes

• Stress or significant weight changes

• Pregnancy-related complications

For women in their 40s and early 50s, hormonal shifts can cause periods to become heavier or less predictable—but symptoms should still be evaluated rather than dismissed.

Why Heavy Bleeding Shouldn’t Be Ignored

Heavy menstrual bleeding is more than a quality-of-life issue. Over time, it can contribute to:

• Iron deficiency or anemia

• Fatigue and low energy

• Brain fog or difficulty concentrating

• Shortness of breath or dizziness

• Increased stress and anxiety

Identifying the cause can help prevent these downstream effects and restore a sense of control over your health.

How Heavy or Abnormal Bleeding Is Evaluated

Many women delay care because they worry about what evaluation or treatment might involve. In reality, assessment often begins with simple steps, such as:

• A detailed conversation about your menstrual and medical history

• A physical exam

• Blood work or imaging, if needed

Treatment depends on the cause and your personal goals and may include medication, birth control adjustments, or minimally invasive procedures. Many women improve with conservative, non-surgical options.

When to See Your OBGYN for Heavy Periods

A helpful rule of thumb: If you’ve ever asked yourself, “Is this normal?”—it’s worth asking your provider.

Heavy or abnormal bleeding is common, manageable, and one of the most effective concerns to address with gynecologic care.

Women’s Health Care That Meets You Where You Are

At Premier Women’s Health, our providers care for women through every life stage—from adolescence through menopause. If heavy or irregular bleeding has become part of your routine, we’re here to help you understand what’s happening and explore treatment options that fit your life.

You don’t have to live around your period. To schedule an appointment, visit premierwomenshealthmn.com

The holiday season can be joyful — and demanding. Between social events, family expectations, disrupted routines, financial stress, rich foods, and colder, darker days, many women notice their bodies feel “off” this time of year. And there’s a medical reason: the holidays can influence hormones at every age and stage, from PMS to menopause. Here’s what’s happening — and how to feel more balanced this season.

Why the Holidays Affect Hormones

Several seasonal shifts happen at the same time in November and December:

• Rich holiday foods and alcohol → can trigger inflammation, hot flashes, and bloating.

• More stress → increases cortisol, which interferes with estrogen and progesterone balance

• Travel and schedule changes → throw off sleep and cortisol-melatonin cycles

• Shorter daylight hours → reduce serotonin and vitamin D, affecting mood and energy

In other words: it’s not you. Your body is responding to a perfect storm of hormonal influences.

How Hormone Run Amok Show Up in Different Life Stages

If You Experience PMS or PMDD

Stress and sleep loss can intensify:

• Cramps and headaches

• Mood swings or irritability

• Breast tenderness

• Cravings and bloating

• Fatigue or tearfulness

Why: Cortisol competes with progesterone, making PMS symptoms more noticeable. Helpful supports:

• Keep caffeine + alcohol in check when close to your period

• Magnesium glycinate at bedtime may ease anxiety and cramps (talk to your provider)

• Aim for consistent sleep, even when traveling

If You’re Pregnant or Postpartum

Holiday changes can amplify:

• Nausea or reflux

• Swelling

• Fatigue

• Bladder sensitivity

• Emotional ups and downs

Why: Late-night events, salty foods, and travel strain a body already working overtime. Helpful supports:

• Prioritize hydration

• Light movement during travel (walk breaks, ankle circles)

• Have a “graceful exit plan” for gatherings if you need rest

If You’re in Perimenopause

You might notice:

• Hot flashes that feel worse in warm rooms

• Sleep disturbances

• Mood swings or anxiety

• Irregular periods

• Bloating or breast tenderness

Why: Hormones fluctuate even more when sleep and stress are disrupted. Helpful supports:

• Wear layers to parties so you can cool off

• Limit alcohol — a top hot flash trigger

• Keep sleep and meal timing as consistent as possible

If You’re in Menopause

Hot flashes, night sweats, bladder sensitivity, and mood shifts can flare.
Why: Holiday patterns (alcohol, sugar, stress, late nights) activate the nervous system, which can worsen vasomotor symptoms and sleep. Helpful supports:

• Aim for alcohol-free nights between events

• Cooling bedding or pajamas for sleep

• Deep-breathing exercises before bed to reduce nervous-system overdrive

A Season of Joy — and Permission to Rest

Women often carry the emotional and logistical load of the holidays. If your body needs:

• More rest

• More hydration

• Fewer commitments

• Earlier nights

• Lower expectations

That’s not weakness — that’s listening to your physiology.

When to Reach Out to Your OBGYN Provider

Check in with your Premier OBGYN or women’s health provider if you’re experiencing:

• PMS or period symptoms that feel unmanageable

• Irregular periods that last more than a few months

• Hot flashes or night sweats that disrupt sleep or daily life

• Bladder leakage or urgency that’s affecting your confidence

• Mood changes that feel heavier than usual

Hormonal changes are common this winter — but you don’t have to struggle through them. There are evidence-based treatments and lifestyle supports at every stage of a woman’s life.

A Final Word

If you’re feeling “off” this month, you’re not failing at the holidays — your hormones are responding to stress, daylight shifts, and seasonal rhythms. With rest, nourishment, and support, you can protect your peace and your health this winter.

By Dr. Hilary Frank, DO, and Dr. Jenny Zhang, MD
Bladder & Bowel Specialists, Premier Women’s Health of Minnesota

Your bladder and bowel play a bigger role in your overall wellness than you might realize. They influence your comfort, sleep, and even your confidence throughout the day. When they’re not working well, it can affect nearly every part of life—from running errands to socializing to intimacy. The good news? Small, everyday habits can make a big difference.

1. Stay Hydrated (But Smartly)

Aim for steady, moderate hydration throughout the day—your urine should be light yellow (like lemonade), not clear or dark.

Water is best, while caffeine, alcohol, and carbonated drinks can irritate your bladder. If you notice more urgency or discomfort after certain beverages, your body may be sending a signal to cut back.

2. Move Your Body

Exercise isn’t just for your heart and muscles—it supports your pelvic floor, digestion, and circulation. Staying active helps prevent constipation, maintains sexual function, and keeps the muscles that support your bladder and bowel strong.

3. Prevent Constipation

Constipation and bladder health are closely linked. When your bowels are backed up, they can press against your bladder and make it harder to control urine flow. Keep things moving by drinking enough water, eating high-fiber foods (like fruits, vegetables, and whole grains), and staying physically active.

4. Take Regular “Bio Breaks”

Don’t hold it too long! Empty your bladder every 2–4 hours during the day. Over time, consistently “holding it” weakens your bladder muscles.

When you go, take your time—sit fully on the toilet and relax to avoid straining. This same principle applies to bowel movements; rushing or pushing can lead to long-term issues.

5. Practice Healthy Hygiene Habits

• Wipe from front to back to prevent bacteria from the rectum entering the urethra.

• Urinate after sexual intercourse to help flush out bacteria.

• Consider urinating before sex, too—especially if you’re prone to infections.

These small steps go a long way in preventing urinary tract infections.

6. Train Your Bladder

If you’re urinating very frequently or waking often at night, bladder training can help reset your system.

Keep a simple diary for a few days to track how often you go, and try gradually extending the time between trips to the bathroom by about 15 minutes.

Kegel exercises and mindful distractions can help delay the urge and strengthen control. Connect with one of our OBGYN physical therapists to leave how to perform Kegels correctly.

7. Maintain a Healthy Weight

Extra weight puts more pressure on the pelvic floor, which can lead to leaking and bladder strain. Maintaining a healthy weight helps your bladder work more efficiently and lowers your risk for incontinence and prolapse.

8. Don’t Smoke

Tobacco irritates the bladder and increases inflammation. Chronic coughing from smoking also adds downward pressure on your pelvic organs—raising your risk for bladder control issues and even pelvic organ prolapse. Plus, tobacco use increases your risk of bladder cancer.

When to See Your Provider or a Bladder Specialist

Contact your provider if you notice:

• Leaking urine

• Burning or pain when urinating

• Difficulty emptying your bladder

• A feeling of pressure or a bulge in your vaginal area

These can be signs of infection, prolapse, or other treatable conditions.

Healthy Habits = Lifelong Wellness

Bladder and bowel health are not just about comfort—they’re about quality of life.
By staying hydrated, active, and mindful of your body’s signals, you can support your pelvic health for years to come.

If you have ongoing concerns, don’t hesitate to reach out to your Premier Women’s Health provider. We’re here to help you stay well, confident, and comfortable—every day.

Sexual wellness is an important part of overall health and wellbeing, yet it’s often overlooked or left unspoken—especially for people over 40. While your body and hormones change with age, your sexual health and satisfaction can remain vibrant, fulfilling, and deeply connected to your overall quality of life.

Here are some key things to know about sexual wellness after 40.

1. Hormonal Shifts and Desire

As estrogen, progesterone, and testosterone levels fluctuate in your 40s, you may notice changes in libido, arousal, and sexual comfort. Perimenopause and menopause can bring vaginal dryness, less elasticity, or discomfort during intercourse. These are common—and treatable. Options like vaginal moisturizers, lubricants, or hormone therapy can restore comfort and support intimacy. Talk to your provider about these options.

2. The Role of Mental Health and Stress

Life in your 40s often includes busy careers, caregiving responsibilities, and stress that can impact desire. Anxiety, depression, or simply exhaustion can dull your sexual spark. Prioritizing sleep, stress management, and open communication with your partner can help. Sometimes, professional support—whether from a therapist or a women’s health provider—makes all the difference.

3. Body Confidence and Self-Image

Your relationship with your body evolves as you age. Embracing body confidence, exploring what makes you feel attractive, and remembering that sexuality is about pleasure, connection, and joy—not perfection—are key. Movement, self-care, and positive self-talk all contribute to feeling at home in your body.

4. Expanding the Definition of Intimacy

Sexual wellness isn’t just about intercourse. It’s about emotional closeness, physical affection, and exploring new ways of being intimate with your partner—or yourself. Conversations about preferences, needs, and boundaries often deepen with age, leading to richer, more satisfying connections.

5. When to Seek Support

If pain, lack of desire, or other concerns are affecting your quality of life, you’re not alone. Talking with your Premier Women’s Health provider can open the door to options you may not have considered—from pelvic floor therapy to non-hormonal and hormonal treatments. Sexual wellness is healthcare, and our team is here to help

For many women, birth control conversations start in their teens or 20s—but decisions made about birth control in your 30s and 40s can be just as important. Fertility declines with age, but it doesn’t disappear until menopause, meaning unplanned pregnancies remain a real possibility well into your 40s. At the same time, many women in midlife are juggling career, family and health changes, which can shift birth control needs for preventing pregnancy to helping to manage hormonal changes that come with perimenopause.

The good news? There are safe, effective options tailored to all of these stages of your life.

Why Contraception Still Matters in Your 30s and 40s

In your 30s, you may be spacing pregnancies, delaying having children, or finalizing decisions about family size. As you move into your 40s, pregnancy is less common but still possible—and carries higher risks for mom and baby. Reliable birth control works hard at this age: it can prevent surprises while also supporting hormone, menstrual and bone health. Yay!

Birth Control Options to Consider

1. Long-Acting Reversible Contraception (LARC)

• IUDs (hormonal or copper): More than 99% effective, lasting 3–12 years depending on type. Hormonal IUDs can also reduce heavy bleeding associated with perimenopause.

• Implants: Inserted under the skin of the arm, effective for up to 3 years.

These options are “set it and forget it,” making them ideal for busy women. See our April blog, where we explore long-acting, reversible contraception in depth.

2. Hormonal Methods

• Pills, patches, and vaginal rings are familiar choices that regulate cycles and ease cramps.

• For women in their 40s, these options may also help control perimenopause symptoms like hot flashes and irregular or heavy bleeding.

• Some health risks (like smoking, high blood pressure, or migraines with aura) may limit use—your OBGYN provider can help weigh risks vs. benefits.

3. Barrier Methods

• Condoms and diaphragms provide pregnancy prevention and add protection against sexually transmitted infections (STIs), which are still common. Think HPV, genital herpes and chlamydia, which are still common today.

• While less effective on their own, condoms are a great choice when combined with another method.

4. Permanent Options

• Tubal ligation, also known as salpingectomy or getting your “tubes tied”, is a surgical procedure for women who are certain they don’t want future pregnancies.

• Vasectomy is an equally effective option for male partners and usually involves an easier recovery.

Special Considerations in Your 40s

• Heavy bleeding or irregular cycles? A hormonal IUD may ease symptoms while providing reliable protection.

• Perimenopause changes? Hormonal contraceptives can help balance fluctuating hormones and maintain bone health.

• Chronic conditions? High blood pressure, diabetes, migraines, or clotting history may affect which methods are safest.

Common Birth Control Myths in Your 30s and 40s

Myth 1: “Birth control is only about preventing pregnancy.”
Fact: Many women in their 40s use birth control to manage irregular cycles, reduce heavy bleeding, protect bone health, and ease perimenopausal symptoms.

Myth 2: “I don’t need birth control anymore.”
Fact: While fertility does decline in your 40s, pregnancy is still possible until you’ve gone 12 consecutive months without a period (menopause). Unplanned pregnancies can still happen.

Myth 3: “Birth control is unsafe at my age.”
Fact: Many safe options exist for women in their 40s. Your health history (like blood pressure, smoking status, or migraines) matters more than age alone. Non-hormonal methods and lower-dose hormonal options may be a fit.

Myth 4: “I can’t use hormonal birth control if I’m over 40.”
Fact: Hormonal methods—including IUDs, implants, and certain pills—can be safe and effective for many women in their 40s. In fact, some can also help with heavy periods, hot flashes, and perimenopause symptoms.

Myth 5: “Sterilization is my only permanent option.”
Fact: While tubal ligation is one choice, long-acting reversible contraceptives (like IUDs and implants) are highly effective and can last for years—without being permanent.

The Bottom Line

Birth control in your 30s and 40s is about more than avoiding pregnancy—it’s about supporting your health, managing symptoms, and giving you peace of mind. Whether you want a long-term option, symptom relief, or a permanent solution, your provider can help you find the best fit for your body and your goals.

Schedule an appointment to talk through your options—because the right choice at this stage of life can make a big difference in your life for years to come.

Let’s face it—bladder issues can be frustrating, embarrassing, and too often dismissed as “just part of getting older.” But here’s the truth: the science, technology, and care options for bladder and bowel health have advanced dramatically. From new medications and minimally invasive procedures to smarter diagnostics and stronger support systems, women now have more paths to relief than ever before.

At Premier Women’s Health, our bladder specialists are here to help you navigate those options with expertise and empathy. Whether you're dealing with leaks, urgency, or discomfort, there is something that can work for you—and we’re breaking it all down in this blog.

Want to learn more? Check out our free bladder webinar, starting in August. Find a date that is convenient for you. Visit premierwomenshealthmn.com/urogynecology

1. Better Understanding of the Pelvic Floor

Recent research has deepened our understanding of how the pelvic floor muscles function—and don’t function. We now know how childbirth, hormonal changes, aging, and even certain exercises can impact bladder and bowel control. This knowledge allows our bladder team to better assess root causes and personalize treatment strategies.

What's new:

• Advanced imaging (like pelvic MRI and 3D ultrasound) gives a clearer picture of what's going on.

• Expanded pelvic floor physical therapy target specific muscle groups for better results.

2. Improved Medications

Medications for overactive bladder and bowel urgency have evolved, offering better control with fewer side effects.

For bladder concerns:

• Beta-3 agonists relax the bladder muscle without drying side effects of other anticholinergic medications.

• Combining therapies, such as medications, physical therapy, and lifestyle changes allow for more personal treatment.

3. Non-Surgical Devices

Technology is reshaping how we treat bladder and bowel concerns.

Notable innovations:

• Percutaneous tibial nerve stimulation (PTNS) and eCoin: These are non-invasive treatments that use gentle electrical pulses near the ankle to calm bladder nerves.

4. Minimally Invasive Surgical Advances

Surgery isn’t the first line of treatment, but for some women, it’s necessary—and today’s procedures are safer and more effective than ever.

Options include:

• Bladder sling procedures with improved materials and techniques to reduce complications.

• Sacral neuromodulation (like Axonics): A small implant that helps regulate bladder or bowel control by stimulating nerves.

• Vaginal bulking agents for stress incontinence—an outpatient procedure that adds support around the urethra to prevent leaking.

5. Multidisciplinary Care

Our clinics are increasingly taking a team-based approach to pelvic health, combining urogynecology, physical therapy, dietitians, and lifestyle health are often part of successful treatment plans.

6. More Conversations, Less Stigma

Perhaps the biggest change? More women are talking about it. National campaigns, social media advocacy, and women's health events are helping to break the silence.

At Premier Women’s Health of Minnesota, we’re proud to offer advanced care for bladder and bowel health—because every woman deserves to feel confident and in control.

If you’re dealing with bladder or bowel symptoms, don’t wait. Reach out to our team and start the conversation.

Summer is a season of sunshine, spontaneity, and schedules that don’t always stick to the usual routine. Whether you’re jet-setting across time zones, heading to the lake for the weekend, or simply soaking up more social time, it’s easy for birth control to become an afterthought. But staying consistent with your contraception is just as important in July as it is in January.

Here’s how to keep your birth control on track during the summer months — no matter where your plans take you.

1. Time Zone Changes: Timing Still Matters

If you’re on a birth control pill — especially a progestin-only pill (mini pill) — timing is key. These pills must be taken at the same time every day, with only a 3-hour window for effectiveness.

What to do when traveling:

• Adjust your pill schedule to your destination’s time zone before you go.

• Set reminders or alarms in your phone to keep consistency across time zones.

• Bring a small travel clock or use your phone in airplane mode to track your original time zone, if needed.

2. Weekend Getaways & Camping Trips: Pack Smart

Spontaneous summer escapes can throw off your routine — and birth control might not be the first thing on your packing list. But forgetting pills or leaving your patch behind can lead to gaps in protection.

Tips for staying covered:

• Pack enough birth control for your full trip — plus a few extra days in case of delays.

• Bring a backup method, like condoms, especially if you're using pills, the patch, or the ring.

• If you're going somewhere remote (like camping), consider methods that don’t require daily or weekly attention, like the IUD or implant. Our team can help you find something that is a fit for you.

3. Social Life & Alcohol: The Myths and Truths

Summer tends to bring more social events, patio drinks, and late nights. While alcohol doesn’t cancel out your birth control, it can affect your consistency and your decision-making.

What to know:

• Missing a pill due to drinking or forgetting it after a late night can reduce effectiveness.

• Vomiting within 2 hours of taking your pill (from illness or drinking) can also interfere with absorption — treat it like a missed pill.

• Always have condoms on hand, especially if you think your regular method could be compromised.

4. Heat and Storage Concerns

Extreme heat — like a car parked in the sun — can affect the effectiveness of pill packs, rings, and patches. Medications stored in high temperatures for prolonged periods may break down.

Protect your birth control:

• Keep it in a cool, dry place. Avoid glove compartments or beach bags that sit in the sun.

• Use an insulated bag or pack it with toiletries in your carry-on when flying.

5. Thinking Ahead: Changing Birth Control for the Season

If you’re planning a big summer trip, wedding, or back-to-back adventures, this could be a good time to talk to your provider at Premier Women’s Health about low-maintenance options like:

• The IUD (hormonal or copper)

• The implant (Nexplanon)

• The shot (Depo-Provera)

• The vaginal ring (NuvaRing or Annovera), which you can keep in for 3–4 weeks depending on the type

These methods don’t require daily tracking and are great for summer freedom.

When Things Don’t Go As Planned

If you miss the birth control window, what happens depends on the type of birth control you’re using — particularly for pills. We encourage you to talk with your provider but here's a quick breakdown:

1. Combination Pills (estrogen + progestin)

• 1 missed pill (less than 24 hours late):
  Take it as soon as you remember. You're still protected.

• 2 or more missed pills in a row:
  Take the most recent pill as soon as possible, even if it means taking two in one day. Use a backup method (like condoms) for the next 7 days.

• If you missed pills during the first week of your pack and had unprotected sex:
  Emergency contraception may be recommended. Call our clinic to talk with your provider.

2. Progestin-Only Pills (Mini Pill)

• More than 3 hours late: You’re at risk of pregnancy. Take the missed pill as soon as you remember and use backup contraception (like condoms) for the next 48 hours.

Progestin-only pills are very time-sensitive — consistency is critical.

3. Other Methods

• Patch: If it’s off for more than 48 hours, apply a new patch and use backup for 7 days.

• Ring: If out for more than 3 hours (NuvaRing) or more than 2 hours (Annovera), rinse, reinsert, and use backup for 7 days.

• Shot (Depo): Delayed more than 15 weeks? Use backup and talk to your provider about next steps.

• IUD or Implant: No risk of missing; continuous protection.

When in Doubt

If you miss your window or aren't sure what to do, use emergency contraception as a precaution and contact your provider for personalized advice.

Bottom Line

Summer should be carefree — but your birth control should never be. With a little planning, you can enjoy every trip, concert, and lakeside bonfire knowing you're protected. If you're considering a different method or have questions about managing your birth control this season, schedule a visit with your Premier Women’s Health provider.

Wishing you a safe and sunny summer — and peace of mind wherever it takes you.

Reviewed by Dr. Hilary Frank, Oakdale OBGYN – Premier Women’s Health 6.17.25

As a parent, you want to support your daughter’s health—physically, emotionally, and mentally—through every stage of her development. One of the milestones that may raise questions is when to schedule her first OBGYN visit. Is it based on age? A specific concern? What if she’s nervous or reluctant?

Here’s what you need to know about when and why to introduce your teen to gynecologic care—and how to make the experience a positive one.

The Recommended Age for a First Visit

The American College of Obstetricians and Gynecologists (ACOG) recommends that girls have their first gynecologic visit between the ages of 13 and 15. This visit is usually focused on education, prevention, and building a trusted relationship with a women’s health provider. Pelvic exams are not recommended until age 21 unless there is a specific medical reason or symptoms.

For many teens, the first appointment is simply a conversation. It’s an opportunity to:

• Discuss normal development, periods, and what to expect during puberty

• Address concerns about irregular cycles, cramps, or heavy bleeding

• Talk about healthy habits, like hygiene, exercise, and emotional well-being

• Ask questions about sexuality, relationships, and birth control in a safe, confidential space

• Begin a relationship with a provider that specializes in women’s bodies. This could include doctors, nurse practitioners, physician assistants, or a nurse midwife.

When to Schedule Sooner

You don’t have to wait until age 15 if there’s a concern earlier. Schedule a visit if your daughter:

• Hasn’t started her period by age 15

• Has very painful, heavy, or irregular periods

• Experiences vaginal discomfort, itching, or unusual discharge

• Is sexually active or considering becoming sexually active

• Needs the HPV vaccine (recommended starting at age 11 or 12)

• Has questions or worries she might not feel comfortable discussing with a parent

Helping Her Feel Comfortable

It’s completely normal for a teen to feel anxious about this first appointment. Our team can ease the process by:

• Choosing a provider who works more often with teens

• Letting your daughter know she can ask questions and set boundaries

• Explaining that the visit doesn’t always involve an exam—most early visits are just a conversation

• Offering to be in the room (or wait outside) based on her comfort level

The goal is to help her feel supported, respected, and in control of her health.

Starting on the Path of Lifelong Wellness

The first OBGYN visit isn’t just a medical milestone—it’s a step toward lifelong body confidence and wellness. By encouraging open conversations about health and development, you’re giving your daughter the tools she needs to care for herself now and into the future.

Our team is your women’s health resource and we are here for you and your daughter.

Reviewed by physician assistant Becky Roverud, OBGYN West, and nurse practitioner Bethany Hjelle, Oakdale OBGYN.

May is more than flowers and fresh air—it’s a reminder to put yourself first. During National Women’s Health Week, we’re celebrating the power of preventive care, everyday wellness, positive mental health, and making space for your health journey.

Here are five ways to show up for your health this May:

1. Schedule Your Annual Well-Woman Exam

Your annual visit is a check-in for the whole you—from screenings and vaccinations to birth control options and menopause support. It’s preventive care with a personal touch.

2. Know What Screenings You Need

Depending on your age and health history, screenings for cervical cancer, breast cancer, and colorectal cancer could be on the list. Ask your provider what’s right for you and checkout this page.

3. Talk About What’s Been On Your Mind

Painful periods? Bladder leaking? Mood changes? Nothing is “too small” to bring up. Your provider is here to listen—and help. If you’re struggling with mental health, learn how we can help.

4. Move Your Body, Fuel Your Energy

Whether it’s walking with a friend, dancing in your kitchen, or joining a fitness event, May is a great time to find joy in movement. Consider joining our clinic Southdale OBGYN at the upcoming Women Run the Cities.

5. Bring a Friend Along

Encourage your sister, mom, or bestie to schedule their own wellness visit. Women supporting women—it’s powerful stuff.

This May, Choose You

You don’t have to do it all—but you can take one step. And then another. Our team is here to walk with you. Book online at premierwomenshealthmn.com with a clinic most convenient to you.

When it comes to birth control, convenience and effectiveness are top priorities for many women. Long-term birth control methods can offer a set-it-and-forget-it approach, providing reliable pregnancy prevention for months or even years. Whether you’re looking for a low-maintenance option or something hormone-free, there’s a long-term birth control method that might be right for you.

What is Long-Term Birth Control?

Long-term birth control, also known as long-acting reversible contraception (LARC), refers to methods that provide protection against pregnancy for an extended period without requiring daily or frequent action on your part. These options are designed to be highly effective and reversible, meaning you can stop using them whenever you’re ready to conceive, or simply don’t need it any more.

Benefits of Long-Term Birth Control

1. Highly Effective

LARC methods are more than 99% effective, significantly reducing the risk of an unintended pregnancy. Because they don’t rely on daily or monthly use, the chance of human error is minimized.

2. Convenience & Low Maintenance

Unlike birth control pills or condoms, LARC methods don’t require daily attention. Once inserted or administered, they work continuously until removed or replaced.

3. Long-Lasting Protection

Depending on the method, long-term birth control can last anywhere from 3 to 10 years, making it an ideal choice for those who aren’t planning to start a family anytime soon.

4. Reversible

All long-term options are reversible, meaning fertility typically returns soon after discontinuing use.

5. Cost-Effective

While some options have a higher upfront cost, they often save money over time compared to monthly prescriptions for birth control, or frequent contraceptive purchases.

6. Potential Health Benefits

Some hormonal LARC options can reduce heavy periods, menstrual cramps, and symptoms of endometriosis, while others, like the copper IUD, offer hormone-free birth control.

Long-Term Birth Control Options

1. Intrauterine Devices (IUDs)

IUDs are small, T-shaped devices inserted into the uterus by a health care provider. There are two main types:

+ Hormonal IUDs (e.g., Mirena, Kyleena, Skyla, Liletta)

• Lasts 3 to 8 years, depending on the type

• Releases a hormone to prevent pregnancy

• May reduce or eliminate periods over time

+ Non-Hormonal Copper IUD (Paragard)

• Lasts up to 10 years

• Uses copper to create an environment that prevents sperm from fertilizing an egg

• Hormone-free option, but may cause heavier periods initially

2. Birth Control Implant (Nexplanon)

• A small, flexible rod inserted by our team under the skin of the upper arm

• Releases progestin and lasts up to 3 to 5 years

• Highly effective and discreet

• May cause irregular periods initially

3. Birth Control Shot (Depo-Provera)

• An injection of progestin that prevents ovulation

• Given every three months

• Can lead to lighter or no periods

• Requires commitment to getting injections on schedule

For those who are certain they don’t want children, permanent birth control (sterilization) is an option:

+ Bilateral Salpingectomy (“Getting Your Tubes Tied”)

• A surgical procedure that blocks or cuts the fallopian tubes

• Highly effective and permanent

• Interesting note: An up-to-date practice is to remove the fallopian tubes, which decreases risk for ovarian cancer

+ Vasectomy (for male partners)

• A quick outpatient procedure that cuts or seals the vas deferens

• Does not affect sexual function but is considered permanent

Choosing the Right Long-term Birth Control

The best method for you depends on factors like your general health, medical history, lifestyle, desire for hormonal vs. non-hormonal options, and long-term family planning goals. Consulting with our team can help you weigh the pros and cons of each method based on your individual needs.

Choosing Long-term Birth Control

Long-term birth control methods provide peace of mind, allowing you to focus on your life without the daily worry of contraception. Whether you choose an IUD, an implant, or another method, these options offer highly effective, low-maintenance solutions to prevent pregnancy while keeping future choices open.

Our team is here to answer your questions and help you make a decision about a LARC that is a fit for you.

To learn more about Premier Women’s Health of MN, visit www.premierwomenshealthmn.com

Reviewed and approved: Drs. Taryn McEvoy and Jenny Zhang, Premier Women’s Health – Oakdale OBGYN, March 2025.

Colorectal cancer (CRC) is often thought of as a health concern primarily affecting men, but did you know it is the third most common cancer in women? Despite this, many women are unaware of their risks and the importance of early detection. That’s where our team steps in.

Advocate for Yourself: Get screened if 45 years and older

Our team, along with leading OBGYN and cancer organizations, recommends routine screenings starting at age 45, or earlier for those with a family history of CRC. Ask us about getting screened – we can help open the door to a screening option that’s best for you. And there are lots, including the “gold standard”, a colonoscopy, and a stool test for women with no risk factors. These simple tests are effective screening methods to help detect precancerous polyps before they turn into cancer. Put this on your list of questions to ask your provider at your annual even.

What is Your Risk?

Women face unique risk factors when it comes to colorectal cancer. Age, family history, and lifestyle choices such as diet and physical activity all play a role. And, conditions like inflammatory bowel disease (IBD) and a history of ovarian, uterine, or breast cancer can increase the likelihood of developing CRC.

Be Alert for Symptoms

Colorectal cancer often develops silently, which is why a regular screening is critical. However, some symptoms include:

• Persistent changes in bowel habits (diarrhea or constipation)

• Blood in the stool

• Unexplained weight loss

• Abdominal pain or cramping

• Fatigue and weakness

Proactive Prevention: It’s Cool

You can reduce your risk by:

• Eating a fiber-rich diet with plenty of fruits, vegetables, and whole grains

• Maintaining a healthy weight

• Exercising regularly

• Limiting alcohol intake and avoiding smoking

• Managing conditions like diabetes and high blood pressure

Your health is in your hands. Stay informed, get screened, and encourage the women in your life to do the same.

Reviewed by OBGYN Drs. Katie Toft, OBGYN West, and Cassie Albertin, MetroPartners OBGYN.

More Than Just “Baby Blues”

Postpartum depression (PPD) is a significant mental health concern affecting one in 7 new moms. More than just the “baby blues”, symptoms can include persistent sadness, anxiety, crying episodes, feeling distant from baby, withdrawing from family and friends, and irritability.

So it’s good news that the Food and Drug Administration (FDA) recently approved the first oral medication specifically designed to treat PPD. This new 14-day medication is prescribed by your OBGYN doctor or midwife.

How Does Zurzuvae® Work?

During pregnancy, levels of naturally-occurring hormones rise significantly and then drop sharply after giving birth. Research suggests this rise and fall may contribute to PPD in some people. This medication helps to regulate the hormone’s impact on mood and behavior, reducing PPD symptoms.

Benefits of Zurzuvae for New Moms

There are a number of benefits. They include:

Fast acting: clinical trials show that Zurzuvae can lead to significant improvements in symptoms within just three days, offering faster relief compared to traditional antidepressants, which may take several weeks to work. 

Short treatment duration: the medication is administered once daily for 14 days, providing an easy and convenient treatment for new moms busy with baby. 

Easier access: Zurzuvae is an oral medication that can be taken at home, usually before bedtime.

Considerations and Side Effects

Common side effects reported during clinical trials include drowsiness, dizziness, and fatigue. Due to the sedative effects, it is recommended to take the medication in the evening. Additionally, while preliminary data suggest low transmission of Zurzuvae through breast milk, moms should discuss the benefits and risks of breastfeeding while on medication with their OBGYN provider.

The approval of Zurzuvae marks a significant advancement in the treatment of postpartum depression, offering a rapid and convenient option for new mothers struggling with this condition. As with any medication, it is essential for new moms to consult with their OBGYN provider to determine the most appropriate treatment plan tailored to individual needs.

Given that January is Cervical Health Awareness Month, it’s the perfect time to learn more about this vital part of the female anatomy. The cervix plays a crucial role in women’s health, yet it often doesn’t get the attention it deserves. So, what exactly is the cervix, and why is its health so important?

To start, the cervix is a remarkable structure with several essential functions. Anatomically, you can think of it as a narrow, inch-long tunnel that connects the vagina to the uterus. If the uterus were shaped like an upside-down pear, the cervix would be the slender neck at the bottom, serving as both a gateway and a protector.

Let’s explore facts about the cervix and highlight why maintaining good cervical health is vital for overall well-being.

A Key Player in Pregnancy

The cervix plays a vital role in pregnancy and fertility. First, it produces cervical mucus, which changes in texture and composition throughout the menstrual cycle. These changes create a sperm-friendly environment during ovulation, enhancing the chances of getting pregnant. Once fertilization occurs, this same mucus helps guide sperm from the vagina into the uterus to meet the egg. During pregnancy, the cervix steps up as a protector, forming a mucus plug to shield the developing baby from infection. When it’s time for your baby to be born, the cervix softens and widens, allowing the baby to pass through the birth canal for delivery.

A Natural Defense System

Cervical mucus isn’t just about fertility—it also helps maintain vaginal health by keeping the area clean and balanced. Too, the cervix acts as a barrier against infections, including sexually transmitted infections (STIs), helping to safeguard the reproductive system. Last, it even prevents foreign objects, such as tampons, from entering the uterus, serving as a natural gatekeeper.

Caring for Your Cervix

As essential as the cervix is, it can be vulnerable to infections and certain cancers. One common issue is cervicitis, an inflammation of the cervix caused by skin irritation, allergic reactions, or sexually transmitted infections (STIs). Another concern is cervical dysplasia, which involves abnormal cell growth often linked to the human papillomavirus (HPV). If left untreated, cervical dysplasia can sometimes progress to cervical cancer.

Many cervical conditions develop without noticeable symptoms. When symptoms do appear, they may include unusual vaginal discharge, heavy or irregular bleeding, or pain when you pee. That’s why prioritizing prevention and early detection is so important.

Steps to Protect Your Cervical Health

• Schedule Regular Screenings: Routine Pap smears and HPV testing, based on your age and medical history, can help detect abnormalities early.

• Consider HPV Vaccination: If you’re sexually active, the HPV vaccine offers protection against high-risk HPV strains responsible for most cervical cancers. The HPV vaccine is FDA approved up to age 45.  Ask your provider about it at your annual.  Note: HPV vaccine is also recommended for boys and men, aged 9-45.

• Practice Safe Sex: Use condoms and consider regular STI testing to lower your risk of infections.

• Quit Smoking: Smoking weakens your immune system, increasing susceptibility to cervical cancer.

• Adopt a Healthy Lifestyle: Eating a balanced diet, exercising regularly, adequate sleep, and maintaining good hygiene all support a strong immune system and overall wellness.

By taking proactive measures, you can safeguard your cervical health and ensure early detection of potential issues, giving you peace of mind and long-term protection.