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8 Signs of Infertility: Symptoms to Watch for in Women & Men


“Chemotherapy or pelvic radiation can cause rapid loss of eggs and some women may have an earlier menopause,” says Westphal. She recommends speaking with a fertility specialist prior to cancer treatment in order to discuss your fertility preservation options. (Some of these options include IVM, ovarian transposition, and ovarian tissue cryopreservation.)

Signs of Infertility in Men

Infertility in men can be more difficult to pinpoint due to a lack of obvious symptoms. However, according to Westphal, infertility in men accounts for roughly a third of all cases (another third are related to the female partner, with the final third pointing to both), and is just as important to diagnose and potentially treat.

Swelling or Pain In the Testicular Area

One of the easiest symptoms of infertility to diagnose is swelling or pain in the testicular area. There are a number of reasons for this (including infections, fluid buildup, trauma, and cancer), but not all necessarily indicate infertility.

Another cause, however, is varicoceles—an enlargement of the veins in the scrotum. “This can cause overheating of the testicles and lead to lower sperm production,” says Westphal. “About 15% of men have varicoceles, but most will have not had fertility problems.” If it is associated with infertility, surgery can likely correct it, she adds.

Ejaculatory Dysfunction

Men who experience ejaculatory dysfunction of any kind (such as premature ejaculation, delayed ejaculation, retrograde ejaculation, and anejaculation) may struggle with infertility.

Take retrograde ejaculation, which is when the sperm can stream into the bladder instead of out the penis. “Health problems like diabetes or a spinal cord injury can cause this, or previous surgery on the bladder, prostate, or urethra,” Westphal says. Medications can sometimes help, she explains, as well as finding other ways to retrieve the sperm to use for IVF.

As far as premature ejaculation, a study in Reproductive Medicine and Biology found it usually doesn’t affect fertility, but often co-occurs with fertility struggles. (Retrograde ejaculation and anejaculation are more likely to actually cause infertility.)

Low Sperm Count

Issues with semen and sperm count are sometimes related to ejaculatory dysfunction issues. Other times, low sperm counts are due to infections (like epididymitis, orchitis, and certain STDs).“Some infections can affect sperm production or cause scarring that could block the passage of sperm,” says Westphal. She also mentions that certain medications, like ones to treat high blood pressure, depression, arthritis, and cancer can affect both sperm production and/or delivery. “Testosterone replacement or medication to treat prostate enlargement (BPH) can reduce sperm, too. When possible, stopping or switching to another medication may help improve sperm,” she adds. Always talk to your doctor before making any changes in medication.

Additional causes include anti-sperm antibodies, hormone imbalances, chromosome defects, tumors, celiac disease, certain medications, and previous surgeries.

Fortunately, many of these causes of low sperm count and infertility are treatable. Infections (like gonorrhea) can be treated with antibiotics. Hormone treatments can be offered, surgeries can be performed to correct certain issues, and medications can be prescribed for others. Additionally, assisted reproductive technology can be used to obtain or extract sperm for IVF.

Unhealthy Lifestyle

Just like in women, taking lifestyle choices that negatively affect personal health can often cause issues that affect fertility in men. “Tobacco smoking, marijuana use, and alcohol use can decrease sperm production,” says Westphal.

Tobacco is well-known to negatively impact fertility, sometimes causing abnormal sperm morphology among other things. Alcohol also has deleterious effects on male fertility, including reducing testosterone levels and affecting other hormones. And studies have also shown that cannabis use can reduce sperm count and concentration, among other things. Additionally, obesity has been linked to hormone issues that can cause infertility, though these seem to be reversible. Overall, it’s advised to reduce or eliminate use of substances such as the ones noted, and actively make health-conscious lifestyle choices (such as exercising and reducing stress) in order to improve fertility.

Experiences of infertility always have one thing in common: uncertainty. The countless visits to doctors, the months (or years) of planning, the tens of thousands of dollars, never add up to a guarantee. Even under the best of circumstances, there’s only so much about a pregnancy you can plan, and in the midst of a global pandemic, the idea of planning anything seems foolish. For National Infertility Awareness Week, we’re exploring the uncertainty—and the hope.



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10 Breast Cancer Symptoms (Besides Lumps) That Everyone Should Know About


Lumps get all the attention. As they should: A new lump or mass is the most common symptom of breast cancer. But there are other explanations for lumpy breasts—and other breast cancer symptoms you should know about.

Many women have lumpy or uneven breasts. And even if yours are as uniform as Hostess cupcakes, they can change over time for a bunch of reasons. Your breasts may feel more swollen or tender before or during your period. If you’re pregnant, the glands that produce milk may multiply and become larger. Before menopause, hormonal changes may make your breasts lumpier. Weight loss, weight gain, and certain medications can also affect your breasts.

The bottom line: Breast changes are very common, and they’re not usually cancer. In fact, the two most common causes of breast lumps are fibrosis, or the formation of fibrous tissue, and small fluid-filled cysts.

With that said, if you notice a new lump in your breast or armpit—breast tissue can extend into your underarm area—you should see your doctor right away. A lump that’s painless and uneven is more likely to be breast cancer, but breast cancers can also be tender and symmetrical. They can be soft or rubbery. Unless your breasts are small and the lump is very large, you probably won’t be able to see it.

Other reasons besides a lump to make a doctor’s appointment ASAP? If you notice any of the following symptoms:

  • thickening or swelling of part of the breast, even without a
    noticeable lump

  • dimpled or irritated breast skin that can look like an orange peel

  • red, flaky, scaly, dry, or thick skin around your breast or nipple

  • a change in the direction of your nipple (it may turn inward, pull to
    one side, or point in a different direction)

  • pain around the nipple

  • an ulcer on the breast or nipple

  • nipple discharge (other than breast milk), including blood

  • swollen lymph nodes (sometimes breast cancer spreads to the lymph
    nodes under your arms or around your collarbone and can cause a lump
    there before you can feel one in your breast)

  • pain in any part of the breast

  • any change in the size or shape of your breast

While mammograms are important, they don’t find every breast cancer. Most breast cancers are found by women while they’re soaping up in the shower, putting on deodorant, and doing other daily activities that bring them into close contact with their breasts. So get familiar with yours—there are some good guidelines here—and know your risk factors. And if you anything seems amiss, get yourself to a healthcare provider stat.

Additional resources: CDC, National Cancer Institute, American Cancer Society, MD Anderson Cancer Center, Moffit Cancer Center



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This Is What It’s Like to Live With Paranoid Schizophrenia Symptoms


Many people break their lives into before and after. A major loss, a medical procedure, an event so radically disruptive that it splits your life into two distinct chapters. I’m no different. the timeline of my life is punctuated by the first time I started showing schizophrenia symptoms.

Before I suffered my first episode of psychosis at twenty-seven, I was a college graduate, working as a professional social worker, a homeowner, and going through the process of divorce from my first husband. I was outgoing, I laughed easily, I had a good sense of humor, I went to parties, I made friends quickly, I was fiercely independent and capable. I took flights by myself to South America, the Middle East, and many countries in Europe to meet up with my parents who had been working overseas since my junior year in high school.

My first break from reality crept into my life slowly, seemingly banal at first—I cried a lot and was experiencing symptoms of major depression. I started isolating myself from other people. But then I started to believe that a therapist I once worked with was plotting with a well-known judge and other county and city officials to set me up. I became painfully paranoid. Delusional.

By the time my mom and aunt tried to get me admitted to a hospital, I had been actively psychotic for three weeks. I was unable to sit still, pacing around the rooms I was in. I barricaded my mom into a bedroom because I thought people were after us, and I was attempting to jump out a second-story window to run away. My mind was racing in circles trying to make sense of the distorted experiences.

It is difficult to get someone admitted to a hospital involuntarily. If the person isn’t showing signs of being a danger to themselves or others, they have to willingly sign themselves in for treatment. As a social worker, I knew the system. I was aware of the laws regarding commitment, so when I was asked, “Are you thinking of harming yourself?” I would reply, “No.”

That was true, but it didn’t mean that I was okay. The paranoia I was experiencing was so significant and overwhelming that I was convinced that once I went into the hospital, I would be drugged, tortured and forced to testify that people I knew were criminals. My mind went around and around in circles playing out these terrifying scenarios.

After several days of going from one hospital to another with my mom and aunt, I finally agreed to sign myself in. It wasn’t that I was less paranoid but I had resigned myself to the fact that whatever and whoever was out to get me was too powerful—I might as well give up. I resigned myself to the idea that I’d have to undergo whatever terrible things they had planned for me just hoped I could survive.

In the locked unit of the hospital, the nurses conducted drug tests and blood work. I was clean, so drug-induced psychosis was ruled out. But that meant there had to be some other cause. For the first five days of treatment, I was kept away from other residents. In my paranoia, I stripped the bedsheets off of my bed in an effort to calm my fears. I was convinced I was being poisoned through the cloth. My non-compliant behavior meant I couldn’t be trusted around the other patients. I’d never felt so alone.

After a week in the hospital, the medication flooding through my system finally reached a therapeutic level in my blood—the paranoia and delusions started to recede rapidly. I started to regain traction with reality, but after everything I’d been through, “reality” wasn’t the same as It was before my episode. In my new reality, I had to accept that fact that I was living with a severe mental illness and a mind that could seriously, and at any time, betray me.



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