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Expert Q&A

	By Craig Sweet, M.D. Reproductive Endocrinologist

I am thinking about having another child. My youngest is 6. I am 35 years old. By today's standards, that doesn't seem to terribly old, but I have noticed changes in my menstrual cycles (heavy flow, shorter cycles, sometimes serious cramps), and I seem to be having some hormonal issues -- mood swings, break outs and other skin problems. My husband seems to think that these are all signs that I am too old to be considering pregnancy again. Am I?

My humble experience is that your husband is probably not wanting to have another child. A heart-to-heart discussion is in order. I may be wrong, but an open discussion is certainly suggested.

I hear similar GYN complaints from my patients as they age. One of the most common confounders, however, is not age but weight. Sometimes weight throws the sensitive balance required for regular ovulation off also inducing numerous other symptoms. Additionally, women seem to collect GYN problems as they age, including endometrial polyps, fibroids and a host of other GYN disorders. A discussion with your general physician or with your OB/GYN may be useful.

The risk for delivering a child with Down syndrome at the age of 36 is quite small, around 1 in 275 to 1 in 290. While certainly increased compared to when you were in your 20s, the risks actual incidence is rare. I have found these statistics never delay a truly driven couple from attempting pregnancy. Blood testing, genetic ultrasounds and genetic amniocentesis may be used to evaluate the fetus before birth should concerns remain.

I see women in their 50s who want to have children, although we cut off at age 55. The important point is that you are healthy, no matter what your age.

By the way, I also think 35 is still quite young ...

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