Hormone Changes and Women’s Wellness

Hormone changes can affect energy, sleep, mood, weight, mental clarity, and sexual wellness, especially during perimenopause and menopause. When symptoms begin to interfere with daily life, it may be time to look closer at hormone balance.

Dr. Joseph Leveno, OBGYN at Medical City Plano in Plano, Texas, helps women better understand their symptoms and whether bioidentical hormone therapy or another treatment option may be appropriate.

What Is Bioidentical Hormone Therapy?

Bioidentical hormone therapy, often called BHT, uses hormones that are chemically similar to hormones the body naturally produces. These may include estrogen, progesterone, or testosterone, depending on the patient’s symptoms, health history, and treatment goals.

The goal is not to “erase” aging or chase perfect hormone numbers. The goal is to understand whether hormone imbalance may be contributing to symptoms and whether treatment could help improve quality of life.

Common symptoms that may lead women to ask about BHT include:

• Fatigue, low energy, or brain fog
• Hot flashes, night sweats, or sleep problems
• Mood changes, anxiety, or irritability
• Low libido, sexual discomfort, or vaginal dryness
• Unexplained weight changes

These symptoms can also overlap with thyroid issues, stress, anemia, vitamin deficiencies, medication side effects, and other health concerns. That is why testing, discussion, and a full medical history matter before starting any type of hormone therapy.

Why Do Hormone Levels Change With Age?

Hormone levels change with age because the ovaries gradually produce less estrogen and progesterone over time. This usually happens in stages, not all at once, which is why some women notice changes years before menopause.

Several changes may happen during this transition:

• Estrogen and progesterone levels gradually decline
• Ovulation may become less regular
• Hormone levels may fluctuate before menopause
• Menopause begins once menstrual cycles have stopped
• Lower hormone levels can affect sleep, mood, metabolism, and sexual wellness

Because this process can feel different for every woman, symptoms are not always easy to connect. Some changes may be mild, while others may interfere with daily comfort, energy, or quality of life.

For women in Plano and those traveling from Frisco and McKinney, having access to an experienced OBGYN can make these conversations easier. Instead of guessing whether symptoms are “just age,” patients can review their concerns, medical history, and possible treatment options in a more structured way.

Is Bioidentical Hormone Therapy Right for Every Woman?

Bioidentical hormone therapy is not right for every woman. That is one of the most important things to understand.

Some patients may be good candidates for hormone therapy, while others may need a different approach based on personal risk factors, health history, or the type of symptoms they are experiencing. A history of certain cancers, blood clots, heart disease, liver disease, abnormal bleeding, or other medical concerns may affect whether hormone therapy is appropriate.

This is also why self-treating with online hormone products, supplements, or unmonitored compounded hormones can be risky. Hormone therapy should be guided by a medical professional, such as Dr. Leveno, who can review the full picture and monitor how the body responds.

A thoughtful hormone evaluation may include:

• Symptom review

  Health history

  Menstrual or menopause status

  Lab testing when appropriate

  Medication and supplement review

  Follow-up after treatment begins 

Bioidentical does not automatically mean safer, stronger, or better for every patient. The right treatment depends on the individual. For some women, hormone therapy may help relieve symptoms. For others, lifestyle changes, non-hormonal treatments, sleep support, nutrition guidance, or additional testing may be more appropriate.

A Clearer Path to Hormone Balance

Hormone symptoms can affect sleep, energy, mood, weight, and sexual wellness at the same time, which can make it hard to know where to start. A thorough evaluation helps connect the dots and determine whether BHT or another treatment option may be appropriate.

Dr. Leveno can help patients review their symptoms, health history, and goals so the conversation is safer, clearer, and based on their full health picture. If hormone changes are affecting your quality of life, contact us to schedule an appointment with Dr. Leveno in Plano to discuss your options.

Published by Dr. Joseph Leveno, OBGYN | Medical City Plano | Serving Collin County, TX | (972) 596-5821

Educational purposes only. Not medical advice.

Happy Memorial Day from the Leveno Team!

We are forever grateful for the ultimate sacrifice of those who died for the United States of America. May their courage and dedication will never be forgotten.
Don't forget our office will be closed today in observance.

What Should a Blood Test Check for During Pregnancy?

Blood tests are an important part of prenatal care because they help your OBGYN monitor your health and your baby’s development. While ultrasounds and physical exams provide valuable information, blood work can reveal concerns that may not cause obvious symptoms.

During pregnancy, blood volume increases, hormones shift, nutrient needs rise, and your immune system adjusts. Routine prenatal blood tests may check for anemia, blood type, Rh factor, infections, immunity, thyroid concerns, gestational diabetes risk, and nutrient deficiencies.

Dr. Joseph Leveno, OBGYN at Medical City Plano, Texas, helps patients understand why certain labs are recommended at different stages of pregnancy. For patients in Plano and those traveling from Wylie and Garland, blood testing can help catch concerns early and guide safer prenatal care.

Blood Type and Rh Factor Testing

One of the first pregnancy blood tests checks your blood type and Rh factor. Your blood type may be A, B, AB, or O, and your Rh factor may be positive or negative. This matters because Rh incompatibility can happen when a pregnant patient is Rh negative and the baby is Rh positive.

If Rh incompatibility is possible, your provider may recommend Rh immunoglobulin during pregnancy or after delivery. This helps reduce the chance of your body forming antibodies that could affect the baby or future pregnancies.

Complete Blood Count During Pregnancy

A complete blood count, often called a CBC, looks at red blood cells, white blood cells, hemoglobin, hematocrit, and platelets. This test can help check for anemia, infection signs, and platelet concerns.

Anemia is common during pregnancy because the body needs more iron to support increased blood volume and the baby’s growth. Symptoms may include fatigue, weakness, dizziness, shortness of breath, or feeling more worn down than expected.

Dr. Leveno encourages patients to speak up if something feels off. “Pregnancy can make you tired, but you still know your body. If you are feeling unusually weak, dizzy, or worn down, blood work can help us understand what is going on and what we can do to support you.”

If anemia or another concern is found, your provider may recommend dietary changes, iron supplementation, follow-up labs, or additional evaluation.

Why Are Infection and Immunity Tests Important?

Infection and immunity testing is important because certain infections can affect pregnancy, delivery planning, or newborn care. Early screening allows your provider to identify risks and take appropriate steps when needed.

Common prenatal blood tests may screen for:

• HIV
• Hepatitis B
• Syphilis
• Rubella immunity
• Sometimes varicella immunity or other tests based on history

Rubella immunity is checked because rubella infection during pregnancy can be serious. If you are not immune, your provider can document that information, discuss ways to avoid exposure, and plan for postpartum vaccination if appropriate.

Gestational Diabetes Screening

Gestational diabetes screening is often done between 24 and 28 weeks of pregnancy, although some patients may be tested earlier if they have certain risk factors. This screening checks how your body processes sugar during pregnancy.

Gestational diabetes can happen even in patients who did not have diabetes before pregnancy. Pregnancy hormones can affect how insulin works, which may cause blood sugar levels to rise. If blood sugar stays too high, it can increase the risk of complications for both mother and baby.

Screening typically involves drinking a glucose solution and having blood drawn afterward. If the first screening is elevated, additional testing may be recommended. When gestational diabetes is diagnosed, many patients can manage blood sugar with nutrition changes, activity, monitoring, and regular prenatal care, while some may need medication.

Thyroid, Iron, and Vitamin Levels

Thyroid function may be checked during pregnancy, especially if a patient has symptoms, a history of thyroid disease, or certain risk factors. Thyroid hormones help support metabolism, energy, and baby’s brain development.

Iron and vitamin levels may also be checked when symptoms or health history suggest a possible deficiency. Low iron can contribute to anemia, while low vitamin D, B12, or other nutrients may affect overall wellness. Targeted testing can be helpful when there are dietary restrictions, prior deficiencies, or ongoing concerns.

Book a Prenatal Care Appointment

Prenatal blood testing is one part of a bigger care plan. It can help identify concerns early, confirm that your body is getting the support it needs, and guide safer decisions throughout pregnancy.

If you are pregnant, planning to conceive, or due for prenatal testing, schedule a woman's wellness or prenatal appointment with Dr. Leveno at Medical City Plano.

Published by Dr. Joseph Leveno, OBGYN | Medical City Plano | Serving Collin County, TX | (972) 596-5821

Educational purposes only. Not medical advice.

Why Do Prenatal Vitamins Matter During Pregnancy?

Prenatal vitamins help support both maternal health and a baby’s development during pregnancy. While a balanced diet is important, pregnancy increases the need for certain nutrients that can be difficult to get through food alone. A prenatal vitamin can help fill nutritional gaps and provide steady support during early development, growth, and ongoing prenatal wellness.

Dr. Joseph Leveno, OBGYN at Medical City Plano, helps patients make informed decisions about prenatal vitamins, nutrition, and pregnancy wellness. For patients in Plano and those traveling from Celina and Fairview, prenatal visits are a helpful time to review supplements, discuss dietary needs, and talk through symptoms such as nausea, digestion changes, or food restrictions.

Prenatal vitamins are not meant to replace healthy eating. They are designed to work alongside a nutrient-rich diet that includes fruits, vegetables, lean proteins, whole grains, healthy fats, and plenty of water. Food provides fiber, energy, antioxidants, and other nutrients that supplements cannot fully replace.

Key Nutrients in Prenatal Vitamins

A quality prenatal vitamin usually includes several nutrients that support pregnancy health. Each nutrient plays a different role, which is why choosing a vitamin specifically formulated for pregnancy is important.

Important nutrients often include:

• Folic acid: Supports early brain and spinal cord development and helps reduce the risk of neural tube defects
• Iron: Supports healthy blood volume and may reduce the risk of iron-deficiency anemia
• Calcium: Supports bone and teeth development while helping protect maternal bone health
• Vitamin D: Works with calcium to support bones, immune health, and overall wellness
• Iodine: Supports thyroid function and baby’s brain development
• Omega-3 DHA: Supports brain and eye development

Some prenatal vitamins include DHA, while others may require a separate supplement. This is one reason it can be helpful to bring your vitamin bottle or supplement list to an appointment. Your provider can review what you are taking and help identify whether your current option fits your needs.

How Do You Choose the Right Prenatal Vitamin?

Choosing the right prenatal vitamin starts with selecting one made specifically for pregnancy. Standard multivitamins may not contain the right amounts of folic acid, iron, iodine, vitamin D, or other pregnancy-supportive nutrients. Prenatal formulas are designed with pregnancy needs in mind.

It is also important to consider your health history, diet, and tolerance. Some patients may need additional iron, extra vitamin D, methylated folate, DHA, or a specific formulation based on lab results, dietary habits, nausea, digestive comfort, or medical conditions.

Dr. Leveno often reminds patients that prenatal care should be personal, not one-size-fits-all. “I want patients to feel comfortable asking about what they are taking, because vitamins, nutrition, and pregnancy symptoms are all connected. The goal is to support the pregnancy in a way that makes sense for mom.”

When choosing a prenatal vitamin, consider:

• Whether it is specifically labeled for pregnancy
• Whether it includes folic acid, iron, iodine, vitamin D, and calcium
• Whether DHA is included or needs to be added separately
• Whether the pill size, taste, or form is realistic for daily use
• Whether you have allergies, dietary restrictions, or sensitivities

Gummy prenatal vitamins may be easier for some patients to tolerate, but they may not contain iron. Capsules or tablets may offer more complete nutrition, but they can be harder to take during morning sickness. The best option is one you can take consistently and safely.

Prenatal Vitamins and Healthy Eating

Prenatal vitamins are helpful, but food still matters every day. A balanced diet can support energy, digestion, blood sugar stability, healthy weight gain, and overall pregnancy wellness.

A pregnancy-supportive diet may include:

• Fruits and vegetables for vitamins, minerals, and fiber
• Lean proteins such as eggs, poultry, fish, beans, or yogurt
• Whole grains for steady energy and digestion
• Healthy fats from foods like avocado, nuts, seeds, and appropriate fish options
• Water to support hydration and circulation

Some patients struggle with nausea, food aversions, heartburn, or fatigue, especially during the first trimester. In those cases, nutrition may not feel perfect every day. Prenatal vitamins can help provide consistency when eating patterns are limited, but ongoing symptoms should still be discussed during prenatal care.

If a prenatal vitamin causes nausea, constipation, or stomach discomfort, do not stop taking it without talking with your provider. A different brand, time of day, formulation, or supplement plan may be easier to tolerate.

When to Start Prenatal Vitamins

Ideally, prenatal vitamins should begin before pregnancy when someone is trying to conceive. Folic acid is especially important early in pregnancy, often before a person knows they are pregnant. However, if you are already pregnant and have not started a prenatal vitamin yet, it is still worth discussing the best option with your provider.

Consistency is important. Taking a prenatal vitamin daily helps maintain steady nutrient support throughout pregnancy. Some patients find it easier to take it with food, before bed, or at the same time each day.

Prenatal vitamins are only one part of prenatal care, but they are an important one. Regular appointments, lab work when needed, nutrition guidance, safe activity, and open communication all work together to support a healthier pregnancy.

Dr. Joseph Leveno provides prenatal and women's care at Medical City Plano and helps patients make informed decisions about vitamins, nutrition, and pregnancy wellness. If you are pregnant, planning to conceive, or unsure which prenatal vitamin is right for you, schedule an appointment to discuss the best next step for you.

Published by Dr. Joseph Leveno, OBGYN | Medical City Plano | Serving Collin County, TX | (972) 596-5821

Educational purposes only. Not medical advice.

Pregnancy Activities to Avoid for Safer Prenatal Wellness

Pregnancy can be exciting, emotional, and full of questions, especially when it comes to what is safe for your body and your growing baby. Staying active during pregnancy is often encouraged, but not every activity is a good fit during this season of life. As your body changes, your balance, joints, circulation, energy levels, and comfort can change too.

Dr. Joseph Leveno, OBGYN at Medical City in Plano, Texas, helps patients understand how to stay active while making thoughtful choices about safety. The goal is not to stop moving altogether. The goal is to choose activities that support strength, circulation, flexibility, and overall wellness without adding unnecessary risk.

For patients in Plano, Allen, and Richardson, prenatal care provides a helpful opportunity to talk through exercise routines, work demands, travel plans, and hobbies that may need to be adjusted during pregnancy.

Why Should Some Activities Be Avoided During Pregnancy?

Certain activities become riskier during pregnancy because the body is working harder and adapting quickly. Hormonal changes can loosen ligaments, which may make joints more vulnerable to injury. A growing belly can shift your center of gravity, making balance more difficult. Blood pressure, hydration needs, and heat tolerance may also change.

Some activities increase the risk of falls, direct abdominal impact, overheating, oxygen changes, or physical strain. These risks may affect the mother, the baby, or both. Even if an activity felt easy before pregnancy, it may not feel the same now.

Dr. Leveno often encourages patients to think about movement in a practical way. “Pregnancy is not about proving what your body can push through. It's about listening carefully, staying safe, and making choices that support both you and your baby.”

Activities that may need to be avoided or modified include:

• High-impact sports such as skiing, horseback riding, or contact sports
• Heavy lifting or activities that require straining
• Hot tubs, saunas, or intense heat exposure
• Scuba diving or activities with oxygen-related concerns
• Rock climbing, trampolines, rollercoasters, or anything with a high fall risk

These recommendations are not meant to create fear. They are meant to help patients make safer choices and avoid preventable complications.

High-Impact Sports and Fall Risks

Activities that involve sudden stops, speed, impact, or unstable surfaces can become more concerning during pregnancy. Skiing, horseback riding, contact sports, gymnastics, rock climbing, and trampoline use can all raise the risk of falling or taking a blow to the abdomen.

Even experienced athletes may need to adjust. Pregnancy changes balance and reaction time, and a fall that might have been minor before pregnancy could carry more risk now. Rollercoasters and thrill rides are also generally avoided because of sudden jerking movements and forceful changes in direction.

For many patients, this does not mean giving up fitness. It means choosing safer alternatives during pregnancy and returning to higher-risk activities only after medical clearance postpartum.

Heavy Lifting and Physical Strain

Heavy lifting can place extra pressure on the back, pelvis, abdominal wall, and pelvic floor. For some patients, especially those with certain pregnancy complications, heavy lifting or straining may increase concern for pain, injury, contractions, or preterm labor risk.

This can matter at the gym, at work, and at home. Lifting heavy weights, moving furniture, carrying large loads, or pushing through intense physical labor may need to be modified.

Safer strategies may include:

• Using lighter weights with controlled movement
• Asking for help with heavy objects
• Avoiding breath-holding while lifting
• Taking breaks during physically demanding tasks
• Stopping activity if pain, pressure, dizziness, or contractions occur

A conversation with your OBGYN can help clarify what is safe based on your pregnancy, health history, fitness level, and symptoms.

How Can You Stay Active Safely While Pregnant?

Safe movement during pregnancy often focuses on low-impact exercise, steady breathing, hydration, and body awareness. Walking, swimming, prenatal yoga, gentle stretching, and low-impact strength training may help support energy, circulation, muscle tone, and mood.

Swimming can feel especially helpful because the water supports body weight and may reduce pressure on the back and joints. Walking is simple, flexible, and easy to adjust based on energy level. Prenatal yoga can support flexibility and breathing, as long as poses are pregnancy-safe and guided appropriately.

Good options may include:

• Walking at a comfortable pace
• Swimming or water-based exercise
• Prenatal yoga with modified poses
• Stationary cycling if balance feels stable
• Light strength training with proper form

The safest routine is one that fits your body, your pregnancy, and your provider’s guidance. If you were active before pregnancy, you may be able to continue many activities with modifications. Always talk with your healthcare provider before starting a new exercise routine, continuing intense workouts, or trying new activities during pregnancy.

Hot Environments and Overheating

Hot tubs, saunas, steam rooms, and intense heat exposure are commonly discouraged during pregnancy because overheating can be risky. Pregnancy already raises demands on the cardiovascular system, and high heat can increase the chance of dehydration, dizziness, or overheating.

This is especially important in Texas, where outdoor heat can become intense. You should be mindful of hydration, shade, clothing, and timing when exercising outdoors. Morning or indoor activity may be safer during hotter months.

Warning signs to take seriously include dizziness, headache, weakness, rapid heartbeat, shortness of breath, contractions, or feeling overheated. If these happen, stop the activity, cool down, hydrate, and contact your healthcare provider if symptoms continue.

Safer Choices for a Healthier Pregnancy

Pregnancy is a time to stay connected to your body, not disconnected from it. Movement can be healthy and helpful, but safety should always come first. The right activity plan can help you stay strong while lowering avoidable risks.

Dr. Joseph Leveno provides prenatal care at Medical City in Plano, Texas, helping patients make informed decisions about exercise, activity restrictions, and pregnancy wellness. If you are unsure whether an activity is safe, schedule an appointment to talk through your routine and get guidance that fits your pregnancy.

Published by Dr. Joseph Leveno, OBGYN | Medical City Plano | Serving Collin County, TX | (972) 596-5821

Educational purposes only. Not medical advice.