Your feelings about having kids might be not right now or far in the future or not ever. Or maybe you absolutely know you want to get pregnant—and soon. Either way, it’s important to know the signs of infertility, because can often indicate a larger problem that can affect your overall health, whether kids are your goal or not. “If you think there’s something wrong, listen to your body. Talk to your doctor whether you want to get pregnant or not,” advises Meike Uhler, MD, a fertility specialist with the Fertility Centers of Illinois.
We’ve compiled a list that’s by no means exhaustive—for more information, you should always talk to your doctor in person—but it does hit on some of the biggest signs that should perk up your ears and let you know it’s time to make an appointment.
Your Periods are Unusually Painful
Just so you know, you shouldn’t have to clear your calendar when your period’s coming because you know you’ll be in bed in agony. In fact, it may be a sign of endometriosis, says Dr. Uhler. And we’re not talking a little cramping here and there, but “enough pain that it affects your lifestyle. You can’t go to work or do the things you normally do,” she says. The condition, which happens when the lining of your uterus (endometrial tissue) grows outside of it, affects up to half of infertile women, according to the American Society for Reproductive Medicine. Hormonal birth control pills are one treatment. Talk to your doctor if period pain is messing with your ability to live comfortably—it doesn’t have to be your normal.
Your Hands and Feet are Always Cold
If your extremities are constantly icy, the answer isn’t to wear gloves and fuzzy socks. Get your thyroid hormone levels checked ASAP. Cold feet and hands are one sign of hypothyroidism (or an underactive thyroid gland), says Dr. Uhler. That can lead to irregular ovulation and affect your menstrual cycle. A blood test will tell your doctor if your levels are normal. Other signs: constipation, forgetfulness, dry skin, and being unusually tired.
Your Period is MIA—or Constant
While you might feel lucky to skip a period (or five), that can be a sign of what docs call “ovulatory dysfunction.” Your ovary has to release an egg in order to be fertilized, and if you’re not ovulating at all, you won’t get your period, explains Dr. Uhler. If you have cycles that are longer than every 35 days, you should get checked out, as well as if your period is MIA altogether. Also, keep a heads up if you get your period too frequently—that’s every 21 days or less—because it may be another sign of an ovulation problem.
Your Nipples are Leaking
If you’re not pregnant or breastfeeding, nada should be coming out of your nipples. If they are leaking fluid, it may be a sign of a condition called hyperprolactinemia, which means that you’re body is producing too much of the breastfeeding hormone prolactin. Causes can range from thyroid problems to medications to a (normally) benign tumor on your pituitary gland. When prolactin levels are high, it affects your hormonal balance and may tell your ovaries to go on hiatus. Don’t be shy about mentioning any weird symptom to your gynecologist—trust us, they’ve heard it all. A simple blood test can ID this problem, and medications can treat most cases.
You’re Very Overweight
If your BMI is 30 to 40, you qualify as obese, which can compromise fertility, according to the American Society for Reproductive Medicine. They note that obesity is the cause of six percent of infertility. Reproductive hormones can be stored in body fat and mess with the area of your brain that tells your ovaries it’s go-time, so if you’re trying for a baby or know you will be in the next several years, talk to your doc if you’re concerned that your weight could lower your odds of conceiving.
You’re Sprouting Facial Hair
Hair growing profusely in places you wouldn’t expect (like your face), or losing it in surprising places (like your head) are hallmark symptoms of PCOS, or polycystic ovary syndrome (it’s also marked by acne and screwy periods). The condition means your reproductive hormones are out of whack, which can impair your ovaries’ ability to make or release an egg. “PCOS is one of the most common, but treatable causes of infertility in women,” according to Womenshealth.gov. Meds like birth control can help manage the condition, as can reaching a healthy weight.
You Have a History of Gonorrhea
The common sexually transmitted disease can come with a few symptoms: burning while you pee, an abnormal amount of vaginal discharge, and bleeding mid-cycle. But, unfortunately, according to the CDC, most women don’t have symptoms. The STD can lead to pelvic pain, infertility, and cause scar tissue that blocks fallopian tubes, which prevents the egg and sperm from meeting in the first place. If your OB doesn’t mention screening for gonorrhea during your annual appointment, and you’re worried you might be at risk, be sure to ask to be tested.