Optimising Skin Health When Trying to Conceive: A Dermatologist’s Guide-image

Optimising Skin Health When Trying to Conceive: A Dermatologist’s Guide

When you’re planning to conceive, there’s a lot on your mind—from diet and lifestyle to managing stress and preparing your body for the changes ahead. But one area that often gets overlooked in this journey is your skin health. As a dermatologist, I frequently meet women who are trying to conceive, whether naturally or through assisted reproductive technologies like IVF, and they’re often unsure about which skincare products are safe to use or how to handle the skin changes that come with fluctuating hormone levels. Let’s explore how to optimise your skin health when trying to conceive, what to watch out for in your skincare routine, and why consulting a dermatologist might be a wise move during this time. Understanding Hormonal Changes and Skin Impact Hormones have a significant impact on skin health, and this becomes even more pronounced when you’re trying to conceive. The body undergoes various hormonal shifts even before pregnancy begins, which can lead to skin concerns such as acne, dryness, sensitivity, and pigmentation changes. When you stop hormonal contraception in preparation for pregnancy, your skin may react to the sudden shift in hormones. Research shows that oestrogen and progesterone levels, which help regulate the menstrual cycle and are key in pregnancy, can influence the skin’s oil production, hydration levels, and overall texture. Additionally, if you’re undergoing IVF or preparing for embryo transfer, the high doses of hormones involved can cause further changes. These hormones can stimulate oil glands, leading to an increase in acne, or exacerbate conditions like melasma (dark patches on the skin) due to increased melanin production. Common Skin Concerns When Trying to Conceive As you navigate the journey to conception, whether naturally or through IVF, you might notice changes in your skin. Here are some common skin concerns during this time: Oily skin, acne, and breakouts: Hormonal fluctuations often lead to increased sebum (oil) production, which can clog pores and cause acne. This can be particularly pronounced after stopping birth control or during fertility treatments when hormone levels are artificially manipulated. Increased sensitivity and redness: Hormonal changes can make the skin more sensitive and prone to redness, dryness, or irritation. This is especially true if you have a history of sensitive skin or conditions like rosacea or eczema. Pigmentation changes: An increase in melanocyte-stimulating hormones can cause dark patches or melasma in pregnancy. This can also be seen in women undergoing IVF due to the high levels of hormones used in the process. Dryness and dehydration: Hormonal shifts can also affect the skin’s ability to retain moisture, leading to dryness or flakiness. Keeping the skin well-hydrated and maintaining a strong skin barrier is essential during this time. Navigating Skincare Confusion: What’s Safe When Trying to Conceive? When you’re trying to conceive, whether naturally or through IVF, you might find yourself wondering which skincare products are safe to use. The skincare landscape can be confusing, with countless products on the market and mixed messages about what is safe during conception and pregnancy. Here’s a guide to help you navigate this tricky terrain: Avoid certain ingredients: Some skincare ingredients are best avoided during conception and pregnancy due to potential risks to the developing baby. Retinoids (often found in anti-ageing products), high concentrations of salicylic acid, and other exfoliating acids can fall into this category.  Emphasise hydration and skin barrier support: Ingredients that support hydration and the skin barrier are your best friends. Look for products containing hyaluronic acid to retain moisture, ceramides to strengthen the skin’s barrier, and niacinamide to soothe irritation and reduce sensitivity. Choose Safe Sun Protection: Protecting your skin from UV damage is always important, but it becomes even more crucial when trying to conceive, especially if you’re prone to pigmentation changes. Opt for high factor broad-spectrum sunscreen with blue light protection to reduce the risk of pigmentation. Consider mild active ingredients: Consider azelaic acid, which is both effective in managing acne and pigmentation and safe for use when trying to conceive. It is an anti-inflammatory rather than an exfoliating acid and can also help with redness. Preventative Acne Treatments: The Role of Laser For women prone to acne, especially those who experience breakouts after stopping hormonal contraception or undergoing fertility treatments, taking preventative measures can be highly beneficial. One innovative treatment to consider is a drug-free, non-invasive laser therapy that targets sebaceous glands to reduce oil production and prevent acne. It offers a preventative approach without the need for systemic medications, which may be restricted when trying to conceive or during pregnancy. By reducing oil production, the laser  can help maintain clearer skin during a time when treatment options are more limited due to safety concerns. It’s a great option to discuss with your consultant dermatologist, particularly if you’re seeking ways to manage acne without relying on potentially harmful medications. Adapting Skincare During IVF and Embryo Transfer If you’re undergoing IVF or preparing for an embryo transfer, your skin is likely to undergo additional changes due to the high levels of hormones administered during treatment. These hormones can exacerbate acne, increase pigmentation issues like melasma, and make your skin more sensitive or reactive. In such cases, a tailored skincare routine that addresses these specific concerns is essential. Working with a dermatologist can help you develop a plan that suits your skin’s needs while being mindful of the changes brought on by fertility treatments. They can recommend safe, effective products and treatments, such as laser treatment, to help manage skin concerns during this time. Supporting Skin Health Through Lifestyle Optimising skin health isn’t just about topical skincare—it’s also about making healthy lifestyle choices that support your body from within. Here are a few tips to help support your skin health while trying to conceive: Nutrition: Eating a balanced diet rich in vitamins, minerals, and antioxidants supports both your overall health and your skin. Focus on foods rich in omega-3 fatty acids, such as salmon and flaxseeds, which help maintain the skin barrier, and plenty of fruits and vegetables for antioxidants. Manage stress: Stress can trigger skin issues, particularly during the emotionally taxing […]

Menopause and Skin Health: Understanding the Changes and How to Manage Them-image

Menopause and Skin Health: Understanding the Changes and How to Manage Them

Menopause is a significant phase in a woman’s life, marked by a decline in oestrogen levels that leads to various changes in the skin. These hormonal shifts can cause several skin concerns, ranging from dryness and thinning to increased sensitivity and a heightened risk of developing both medical and cosmetic skin issues. Understanding these changes and learning how to manage them effectively is crucial for maintaining healthy, youthful skin during this transitional period. How Menopause Affects Your Skin During menopause, the body undergoes several hormonal changes, particularly a reduction in oestrogen and progesterone levels, which have profound effects on the skin: Loss of collagen and elasticity: Oestrogen is vital for maintaining collagen, the protein that provides structural support and elasticity to the skin. With menopause, collagen production decreases significantly—by up to 30% within the first five years—and continues to decline at a rate of about 2.1% per year thereafter. This reduction leads to thinner skin, loss of firmness, and decreased elasticity, resulting in sagging, fine lines, and deeper wrinkles.  Increased dryness and skin thinning: Oestrogen plays a key role in regulating the skin’s moisture levels by promoting sebum production. As oestrogen levels decline, the skin becomes drier and the moisture barrier weakens, leading to increased transepidermal water loss (TEWL) and a rough texture. Thinning skin is more fragile and prone to bruising and injury, and reduced thickness also makes blood vessels more visible, contributing to increased redness. Pigmentation changes: Hormonal fluctuations during menopause can lead to pigmentation issues such as age spots, melasma, and uneven skin tone. Prolonged exposure to UV radiation further exacerbates these changes, as the skin’s ability to repair sun damage diminishes with age. This results in more pronounced pigmentation and sunspots, especially on areas frequently exposed to the sun, like the face, hands, and chest. Altered skin texture: The reduction in collagen and elastin also affects the skin’s texture, leading to enlarged pores and a rougher surface. Decreased skin cell turnover can contribute to a dull complexion, making regular exfoliation and rejuvenation practices essential to maintain a smooth, glowing appearance. Increased sensitivity and pruritus (itchiness): Menopausal skin is often more sensitive due to a compromised barrier and decreased hydration. This increased sensitivity can lead to greater reactivity to skincare products and environmental factors. Pruritus, or itching, is also a common complaint among postmenopausal women, often associated with dry skin conditions like xerosis. Higher risk of medical and cosmetic skin issues: As skin ages and hormone levels change, there is an increased risk of developing both medical and cosmetic skin concerns. Women with outdoor hobbies, frequent sun exposure, or a history of sun damage are particularly vulnerable to skin cancers, including melanoma. Regular mole checks and skin screenings are crucial for early detection. Some laser treatments, such as Halo, not only improve the skin’s aesthetic appearance by reducing pigmentation and fine lines but can also help reduce the risk of skin cancer by targeting and treating precancerous lesions. The Role of Hormone Replacement Therapy (HRT) Hormone Replacement Therapy (HRT) can be effective in alleviating some of the skin changes associated with menopause by replenishing oestrogen levels. HRT has been shown to increase collagen production, enhance skin thickness, and improve elasticity, potentially restoring some of the skin’s youthful qualities. However, it is not without risks. While oestrogen in HRT can improve skin hydration and reduce signs of ageing, some women may experience side effects like acne, especially if their HRT regimen includes progesterone. Progesterone can increase sebum production, leading to clogged pores and breakouts. For women experiencing acne due to HRT, laser treatment designed to target sebaceous glands, may offer a solution. It works by reducing oil production, thereby minimising acne flare-ups without the need for long-term medications, providing a non-invasive option for managing hormone-induced acne. Effective Strategies for Managing Menopausal Skin To manage these changes effectively, a comprehensive approach involving skincare, medical treatments, and lifestyle adjustments is essential: Topical retinoids: Retinoids are highly effective in promoting collagen production and enhancing skin cell turnover. They help reduce the appearance of fine lines, improve skin texture, and increase elasticity. However, due to their potential to cause irritation, especially on thinning menopausal skin, retinoids should be used cautiously and under the supervision of a dermatologist. Hydrating moisturisers: Moisturisers that contain hyaluronic acid and ceramides are crucial for maintaining hydration and supporting the skin’s moisture barrier. Hyaluronic acid acts as a powerful humectant, attracting moisture to the skin, while ceramides help strengthen the barrier and prevent further dryness and irritation. Antioxidant serums: Antioxidants like vitamins C and E play a crucial role in protecting the skin from environmental damage and reducing pigmentation. These serums neutralise free radicals, molecules that accelerate skin ageing, and help improve overall skin tone and texture. Energy-Based Treatments: Lasers and ultrasound technologies are highly effective for stimulating collagen and elastin production, tightening, and lifting sagging skin. Treatments such as BroadBand Light (BBL) therapy, fractional laser resurfacing, and Sofwave can rejuvenate the skin and provide a firmer, more youthful appearance. Additionally, lasers like Halo can aesthetically enhance the skin while targeting and treating precancerous lesions, potentially reducing the risk of developing skin cancer. Injectable treatments – Polynucleotides and Profhilo: Polynucleotides and Profhilo are innovative injectables that promote skin regeneration and hydration. These treatments help improve skin elasticity and overall quality by providing deep hydration and stimulating collagen production, making them particularly effective for addressing thinning skin and volume loss. Microneedling with radiofrequency: This advanced treatment combines microneedling with radiofrequency energy to enhance collagen production and improve skin texture and firmness. It is particularly beneficial for menopausal skin, helping to reduce fine lines, improve skin tone, and provide a smoother appearance. Sun protection and lifestyle modifications: Protecting the skin from UV damage is critical during menopause. Using a broad-spectrum sunscreen with SPF 30 or higher, wearing protective clothing, and avoiding sun exposure during peak hours can help prevent further pigmentation and damage. Additionally, maintaining a healthy diet rich in antioxidants, staying hydrated, and managing stress can significantly impact […]

PCOS and Acne: What You Need to Know and Why It Matters-image

PCOS and Acne: What You Need to Know and Why It Matters

As a consultant dermatologist, I’ve seen many women come through my clinic doors frustrated by stubborn acne that doesn’t seem to respond to any treatment. If this sounds familiar, you’re not alone. Acne can be a visible and sometimes painful marker of an underlying condition called polycystic ovary syndrome (PCOS). Understanding the connection between acne and PCOS is crucial, not just for the health of your skin but for your overall well being Why Should You Consider PCOS if You Have Acne? Acne is often thought of as a teenage problem, something that magically disappears with age. But for many people, particularly those with PCOS, acne can persist into adulthood and become a significant concern. PCOS is a hormonal condition that affects up to 10% of women and people assigned female at birth and is often characterised by elevated levels of androgens like testosterone– hormones that can lead to increased oil production in the skin, causing clogged pores and, subsequently, acne. But it’s not just any acne we’re talking about. Women with PCOS often experience more persistent and inflammatory acne that tends to appear along the lower third of the face, jawline, and upper neck. This is because of the hormonal imbalance that’s driving excess oil production. So, if you find yourself struggling with acne in these areas and have tried countless treatments without success, it might be time to think beyond the skincare aisle and look a little deeper. What Are the Signs That PCOS Could Be Affecting Your Skin? When we talk about PCOS and acne, it’s essential to consider the bigger picture. PCOS is not just about your skin; it can impact various aspects of your health. So, when should you start thinking about getting screened for PCOS? Here are a few signs that might suggest PCOS could be contributing to your acne: If you’re noticing any of these symptoms alongside your acne, it’s worth discussing them with your doctor. Why Early Diagnosis and Treatment is Key If you’ve been diagnosed with PCOS, it can feel like a lot to take in. But remember, getting an early diagnosis is a positive step. Why? Because it allows you to take control of your health and manage the condition effectively. PCOS doesn’t just affect your skin; it’s a systemic condition that can have long-term health implications, including an increased risk of developing type 2 diabetes, high blood pressure, mental health issues and other metabolic issues. It can also impact fertility and increase the risk of complications during pregnancy. By diagnosing PCOS early, you can work with your healthcare provider to develop a management plan tailored to your needs. This might include lifestyle changes, like a balanced diet and regular exercise, which are crucial in managing weight and improving insulin sensitivity – both key factors in PCOS. Medications may also be prescribed to help regulate your menstrual cycle, manage acne, or reduce excess hair growth. Treating Acne in PCOS: What Works? When it comes to managing acne in the context of PCOS, it’s not just about what you put on your skin – it’s also about addressing the hormonal imbalance driving it. Here are some treatment options that might be recommended: Lifestyle Changes: Small Steps, Big Impact Don’t underestimate the power of lifestyle changes when managing PCOS and its symptoms. Maintaining a healthy weight through a balanced diet and regular physical activity can significantly impact hormone levels and insulin sensitivity, improving both your skin and overall health. Focus on whole foods, such as fruits, vegetables, lean proteins, and whole grains, and try to reduce your intake of sugar and processed foods. Staying hydrated and getting plenty of sleep can also make a difference. In addition to lifestyle changes, a consistent and gentle skincare routine can help manage acne. Opt for non-comedogenic (non-pore-clogging) products and avoid harsh scrubs or overly drying treatments that can irritate the skin further. Take Charge of Your Health Remember, PCOS is a manageable condition. With the right care and support, you can control its impact on your life. Getting screened is the first step towards understanding your body better and finding a treatment plan that works for you.PCOS and acne don’t have to define you. With early screening and proper management, you can take control of your skin and health and feel more confident in your body. The journey might seem daunting, but with the right information and a proactive approach, you can find a way forward that brings clarity and comfort to both your skin and your overall well being Inspiring skin confidence with Hertility and Self London Hertility and Self London are collaborating to give you absolute clarity into what’s going on inside your body and inspire skin confidence. We’re working with patients to uncover how hormones impact not only our reproductive health but also our skin’s natural glow.Discover the partnership

How to manage your PCOS with exercise-image

How to manage your PCOS with exercise

PCOS is one of the most common reproductive health conditions. Some of the most common symptoms people struggle with are physical symptoms such as issues with weight; skin and hair related issues such as acne or excessive hair growth and irregular periods. These are mainly driven through disrupted hormones. Androgens are a group of hormones, including testosterone,  that are made in the ovaries and are often found at much higher levels in women with PCOS, called “hyperandrogenism”. Insulin is also found to be at much higher levels, due to insulin resistance. Normally, Insulin helps manage blood sugar levels, helping cells absorb glucose. Insulin resistance is when the body no longer responds to normal levels of insulin. This can result in excess amounts of insulin being produced, misregulated blood sugar levels and metabolism issues like weight gain and type 2 diabetes. Women are also 3 times more likely to experience mental health related symptoms like anxiety, depression or body image issues. Unfortunately there is currently no cure for PCOS, however, there are  treatment options  aimed to manage symptoms.  Think you might have PCOS? Check your hormones Benefits of regular exercise Regular exercise can be an extremely effective way to help manage PCOS symptoms. Some experts suggest exercise as a first port of call for PCOS management but can also work alongside medications like metformin for increased effects, particularly for improving cycle related issues (1). Exercise can have positive effects on physical, hormonal and mental health related issues including: How much exercise is recommended? For a healthy lifestyle, preventing weight gain and maintaining health: Adults should do a minimum of 150 minutes a week of moderate-intensity physical activity or 75 minutes per week of vigorous activity or a combination of both and include muscle-strengthening activities Young women should do 60 minutes or more of moderate to vigorous activity per day including those that strengthen muscle at least three times a week Activity can be done in 10-minute bursts or around 1000 steps, aiming to do at least 30 minutes on most days. For those who have a goal to lose weight, prevent weight regain or achieve greater health benefits more exercise is needed: A minimum of 250 minutes a week of moderate-intensity activity or 150 minutes a week of vigorous activity or a combination of both Muscle-strengthening activity on 2 non-consecutive days of the week. Overall, aim for around 30 minutes per day. Of this, 90 minutes per week should be more active or aerobic activities (running, biking, fast pace walking etc.) at a moderate to high intensity to optimise clinical outcomes (see table below for suggested activities). Remember physical activity includes walking, activity at work, household chores, sports and planned exercise. Choose an exercise you like and if possible exercise with friends or others to increase your motivation. Mixing up exercise will also help with motivation. Benefits for your body What are the benefits of exercise on PCOS? PCOS can affect the body’s metabolism making it harder to lose weight and also affect where fat is stored. Visceral fat (fat in the abdomen and around your organs) tends to be increased in those with PCOS. Alongside this, there is an increased risk of long-term health issues including obesity, cardiovascular disease and high blood pressure. Regular physical activity can help improve body composition and is extremely beneficial for reducing these risks.  In general aerobic exercise (or cardio), like running, swimming or cycling, is great for reducing blood pressure and improving heart health. Increasing your daily energy expenditure (the amount of energy you burn in a day) can help with losing weight by creating a calorie deficit (burning more calories than you consume). Women with PCOS who had greater vigorous activity levels were found to have less visceral fat (2). A 6 month study introducing an exercise regime of 30 mins aerobic exercise 3 times a week saw a reduction in waist circumference (as a measure of visceral fat), and improvements in menstrual cycle patterns (3).  What type of exercise is best? There is a lack of evidence supporting any one type and intensity of exercise being better than another for metabolic, hormonal, reproductive or psychological outcomes. The International guidelines and majority of studies have focused on aerobic exercise routines, however, resistance training (exercise designed to improve muscle strength or endurance) such as weight lifting, has big benefits too. Resistance training has a positive effect on body composition by increasing muscle mass, which can contribute to increasing your energy expenditure. In studies focusing on resistance training for women with PCOS, a reduction in visceral fat and an increase in lean muscle mass was seen (4). It is also important to know that exercise without weight loss or only moderate weight loss can still lead to a reduction in visceral fat and improve insulin sensitivity. Think of being active as often as you can through the day, for example take stairs instead of lifts, park further away from shops etc. Can exercise improve chances of conceiving? Improvements in reproduction have been seen in women with minimal weight loss – so the scales are not the be all and end all! The NHS states as little as 5% reduction bodyweight can help improve symptoms (5). Other important lifestyle factors to consider, particularly for managing weight, are issues with appetite regulation – if this is something you are struggling with you can speak to one of our Fertility Nutrition Consultation. Benefits for your hormones  Insulin resistance is common among those with PCOS and can contribute to many of the symptoms like dark skin patches, fatigue and weight issues. This goes hand in hand with visceral fat and general inflammation throughout the body.  This is believed to be associated with greater levels of visceral fat and amount of visceral fat Women who had greater levels of physical activity, had better chances of normal insulin responses (6)  and reduced chances of inflammation (7).  Excess insulin can increase the production of androgens in the ovaries, contributing to hyperandrogenism. […]

5 Things AMH Testing Can Tell You About Your Fertility-image

5 Things AMH Testing Can Tell You About Your Fertility

Anti-Müllerian Hormone (AMH) is a really important hormone for your fertility because of how closely it is linked to your eggs, AMH testing can help you understand your fertility and give you insights into your overall reproductive health. Here’s what testing can and can’t tell you. Quick facts: What is AMH and why is it so important? Anti-müllerian hormone (AMH) is a super important hormone for fertility. AMH is made by the small sacs, called follicles, in your ovaries. These follicles house your eggs.  Because of its close relationship to your eggs, testing your AMH levels can help indicate how many eggs you have left at the time of testing.  There are a few myths out there about what exactly AMH testing can tell us. So in this article, we cover the main things an AMH test can and can’t tell you. Let’s get into it… What can AMH testing tell me? Whether your ovarian reserve is a normal for your age AMH testing will give you insights into whether your ovarian reserve is in line with other healthy people in your age group. If you are not using any hormonal contraception, testing other hormones, like follicle-stimulating hormone (FSH) and oestradiol alongside AMH can also help to build a full picture of egg reserve. Generally, people with low egg reserves are known to have higher levels of FSH and lower levels of oestradiol. Whether you have polycystic ovaries or polycystic ovary syndrome AMH testing can also indicate whether you could have polycystic ovaries (PCO). PCO is a common reproductive health condition affecting around 30% of reproductive-aged people assigned female-at-birth. PCO is benign and does not affect fertility, but it can cause other unwanted symptoms.  People with PCO have a higher-than-expected number of immature follicles in their ovaries. More follicles mean a higher level of AMH in the blood.  Some people with PCO also have the syndrome that can be associated with it—polycystic ovary syndrome (PCOS), which often presents as symptoms like irregular periods and high testosterone levels.  According to updated guidelines, AMH testing can be used as a marker for polycystic ovaries, which is one of the criteria for a  PCOS diagnosis. However, we would always recommend getting a scan of your ovaries) to confirm the diagnosis. Whether IVF or egg freezing could be right for you AMH testing and understanding your ovarian reserve can also help to determine if certain fertility treatments like IVF or egg freezing could be suitable for you. During these fertility treatments, AMH levels are often tested to help determine the doses of medication needed and used to predict the outcomes of the egg collection process. People with lower AMH levels are known to have less successful IVF treatment cycles, whereas someone with high AMH might be at increased risk of developing a rare but potentially life threatening condition called OHSS (ovarian hyperstimulation syndrome).  Many NHS-funded and private IVF clinics therefore require a minimum AMH level for you to be eligible for a free IVF treatment cycle. The minimum level on the NHS will depend on where in the UK you are currently residing. Whether you may be perimenopausal or menopausal or have POI Menopause refers to the period of your life, usually post 45-50, where you no longer have menstrual cycles and are therefore no longer able to conceive naturally. Menopause is associated with having an extremely low, or completely diminished, ovarian reserve.  It is usually diagnosed retrospectively—when women are over 45 years old and have not had a period in 12 months (and are not using hormonal contraception).  For people who are younger, FSH levels are useful for diagnosing menopause, as FSH levels are known to increase for people with low egg reserves. Although AMH levels are not recommended to help diagnose menopause, it is known that AMH levels reduce to very low levels at the time of menopause. There is also evidence that people with very low AMH levels (who are not going through menopause) will undergo menopause much sooner than those with AMH levels that are within range. When the ovaries stop working before the age of 40, this is known as premature ovarian insufficiency (POI), which AMH levels have also been shown to provide a good indicator of. If you have a higher risk of miscarriage or recurrent pregnancy loss It is estimated that approximately 1 in 5 pregnancies end in miscarriage. Miscarriages occur most frequently in the first 12 weeks of pregnancy and can be associated with lots of different risk factors. Some of the most common are your and your partner or sperm donors’ age, pre-existing conditions and ethnicity. Recent evidence has shown that people with diminished ovarian reserve, and therefore very low AMH levels, are more likely to have a miscarriage or recurrent miscarriage (two or three consecutive pregnancy losses).  However, more research needs to be done to understand the links between AMH levels and miscarriage, including its risk factors. What can’t AMH testing tell me? Unfortunately, AMH testing and ovarian reserve forms only one part of the fertility picture and there are some things that AMH testing may not be able to tell you. Let’s take a look… It can’t determine your egg quality Although AMH levels can give insight into your egg quantity, it does not provide any insight into the quality of those eggs. Despite poor egg quality being one of the most common causes of female infertility, there is currently no test that can definitely determine egg quality (unless testing embryos in IVF treatment). It can’t determine your exact egg quantity Your AMH result can give an indication of the size of your ovarian reserve.  This is because it is released by the follicles which contain our eggs, meaning that the more follicles we have, the higher the AMH that will be produced. However, it can’t tell you your exact number of eggs because each follicle may produce a different amount of AMH depending on its size.  In order to estimate the number […]

Oestrogen 101: What it is, What it Does and How it Changes-image

Oestrogen 101: What it is, What it Does and How it Changes

Oestrogen—the matriarch of female sex hormones. But what exactly does it do in the body, what’s its role in the menstrual cycle and what are the symptoms to look for if your oestrogen has become imbalanced? Read on to find out.  Quick facts: What is oestrogen? Oestrogen is an important reproductive hormone in people of all sexes. It’s generally known as the ‘female’ sex hormone, because of its role in the development of the female reproductive system and regulation of the menstrual cycle.  Oestrogen works to enable ovulation and produce female sex characteristics. When we have healthy levels of oestrogen, it can help us to feel feisty, frisky and fabulous. Whilst it’s true that oestrogen plays a bigger role in those assigned-female-at-birth, everybody produces oestrogen, regardless of sex. In those assigned-female-at-birth, oestrogen is produced mainly in ovaries and depends on other reproductive hormones including follicle stimulating hormone (FSH), luteinising hormone (LH) and testosterone for both its production and regulation. Like all of our hormones, our oestrogen levels can sometimes become off-balanced—with many different lifestyle and genetic factors impacting its production and regulation throughout the body. Types of oestrogen? There are three different types of oestrogen, also sometimes spelt estrogen (the American spelling). What does oestrogen do? Oestrogen wears many hats—it helps to regulate our menstrual cycles, triggers the development of secondary sex characteristics like breasts and pubic hair and helps to maintain things like our skin’s moisture, our mood and even our bone and heart health. Let’s take a look at these in more detail: What is oestrogen’s role in the menstrual cycle? Like all of our menstrual cycle hormones, our oestrogen levels during the menstrual cycle fluctuate.  During the first part of our menstrual cycles, the follicular phase, which lasts from day 1 of our periods until ovulation (when we release a mature egg), our oestrogen levels start off low but steadily increase. In this phase, our eggs are maturing in preparation for ovulation.  Our eggs mature in our ovaries, in little sacs called follicles. These follicles make oestrogen, so whilst your eggs are maturing, your follicles steadily release this oestrogen—and it rises until it reaches a peak, just before we ovulate. Because of oestrogen’s feel-good factors, just before and during ovulation is the time of the month when we’ll be killing it, feeling our most fierce and fabulous. This is the time to book that big presentation at work, go on that first date or really push it in your gym session. This peak in oestrogen causes a surge in LH, which triggers the release of a mature egg from one of our ovaries during ovulation. After ovulation, oestrogen levels gradually drop and despite a small second wind around a week later, they continue to level off throughout the second stage of our menstrual cycles—the luteal phase. At the end of our cycles, if the ovulated egg has not met a sperm and been fertilised, all of our menstrual cycle hormones, including oestrogen, drop off to their baseline levels—triggering our periods. If our oestrogen levels get off balance, it can disrupt the balance of our other menstrual cycle hormones—potentially impacting ovulation. No ovulation = no pregnancy. So if you’re trying to get pregnant, testing your hormone levels is really important for understanding your ovulation and general menstrual cycle health. What affects oestrogen levels? As well as fluctuating naturally month to month, lots of other lifestyle, genetic and medical conditions can affect our oestrogen levels, including: Does oestrogen decline with age? Thanks to our wonderful ‘biological clocks’, as we age, our oestrogen levels gradually decline. This is because our number of egg cells decreases as we age and as a result, our follicles stop growing and producing as much oestradiol (E2). After menopause (when our periods stop completely), our E2 levels completely drop off, which is what causes the common low oestrogen menopausal symptoms like hot flushes, dry skin and mood swings. During perimenopause (the lead up to menopause), E2 levels fluctuate up and down which can also cause menopausal symptoms. Declining oestrogen levels has whole-body knock-on effects, but luckily these days hormone replacement therapy (HRT) can be a great option to relieve symptoms for many people during perimenopause and postmenopause. How do I know if my oestrogen levels are normal? Because our oestrogen levels fluctuate during our cycles, as we age, and are dependent on whether we’re taking hormonal birth control or not, our ‘normal’ level is constantly changing.  Like all of our hormones, our oestrogen is super sensitive and can easily get off balance. Oestrogen imbalances can cause a whole host of symptoms and can be caused by both lifestyle and genetic factors. Symptoms of high oestrogen levels Oestrogen dominance is a phrase that has been used to describe a phenomenon when oestrogen levels are too high in relation to the other sex hormones in your body.  Although it’s not a clinically recognised term, being more sensitive or having excess oestrogen is known to cause symptoms like irregular periods, abnormal vaginal bleeding, bloating, swollen or tender breasts and weight gain. Some causes of high oestrogen levels include underlying health conditions, genetic factors, dietary and lifestyle factors and environmental pollutants. Symptoms of low oestrogen levels On the flip side, when oestrogen levels are too low we can experience irregular periods, fertility difficulties, reduced bone density, vaginal dryness, hot flashes and dry skin—to name a few. Having very low oestrogen levels can be caused by your ovaries not working properly, which occurs in menopause or primary ovarian insufficiency (POI). However, underlying health conditions like pituitary gland disorders, as well as having very low levels of body fat, a high caffeine intake, smoking and excessive exercise can also result in lower oestrogen levels. Luckily, testing our E2 levels with a hormone test can help us to decipher if our oestrogen levels are within the normal range for us. Oestrogen FAQs Where can I get an oestrogen blood test? You’ve landed in the right place. With a Hertility Hormone and Fertility test […]

Luteinising Hormone: What do Your LH Levels Mean?-image

Luteinising Hormone: What do Your LH Levels Mean?

Luteinising hormone is an important cycling hormone, involved in the regulation of the menstrual cycle and ovulation. But what happens when our levels get a little off balance? In this article, we’ll explain exactly what luteinising hormone is, how it works, and take a deep dive into its importance for female fertility. We’ll also take a look at LH levels and why they’re important, as well as how to recognise the symptoms of low or high LH. Quick facts: What is Luteinising Hormone (LH)?  Luteinising hormone (LH) plays a huge role when it comes to fertility and ovulation, despite it being one of the lesser-known cycling hormones. Luteinising hormone (LH) is what’s known as a gonadotropin hormone. There are only two types of this hormone, LH and its partner in crime, follicle-stimulating hormone (FSH). Gonadotropins are hormones that are released from the pituitary gland in the brain, into the bloodstream where they are transported to the gonads—or ovaries in those assigned female-at-birth and the testes in those assigned male-at-birth. LH has 3 main functions in those assigned-female-at-birth:  Oestrogen production LH works in tandem with FSH to stimulate the ovaries and surrounding cells to produce oestrogen. First, LH stimulates what’s known as theca cells in the ovaries, which then produce testosterone. Once testosterone is abundant, nearby granulosa cells are then stimulated by FSH to produce an enzyme called aromatase, which converts the testosterone into a type of oestrogen, oestradiol, or E2. Without the correct functioning of LH or FSH, testosterone and oestrogen production can become impacted. Ovulation LH is also crucial for successful ovulation. First, FSH stimulates the growth of follicles (small sacs that contain your eggs) in your ovaries. A number of eggs mature during the first half of your cycle, but only one gets released during ovulation—usually the ‘most mature’ follicle. In the days leading up to ovulation, this follicle increases its sensitivity to LH. It gradually produces more and more E2 and when this reaches a certain level, the pituitary gland releases a surge of LH. This LH surge is what causes the follicle to rupture and release the mature egg into the fallopian tube—triggering ovulation. Progesterone production After ovulation has occurred, LH stimulates the now empty follicle to start producing progesterone throughout the second half of the menstrual cycle—also known as the luteal phase. Both progesterone and E2 released by the empty follicle are intended to support conception, implantation and the early stages of pregnancy. However, if the egg is not fertilised and no embryo implants into the uterus, the empty follicle stops producing these hormones and eventually wastes away at the end of the menstrual cycle. What are normal LH levels in women? LH levels in women, or those assigned-female-at-birth, fluctuate during the menstrual cycle—so their levels will vary depending on where you are in your monthly cycle. LH levels can also vary depending on an individual’s age and whether they’re pregnant. Normal LH levels for women before menopause are around 5-25 IU/L, depending on the stage of the menstrual cycle. After menopause, normal LH levels range from around 14-52 IU/L. LH levels during the menstrual cycle Let’s take a closer look at how LH fluctuates during the menstrual cycle. As we mentioned earlier, a dramatic surge in LH around the middle of the cycle triggers ovulation. But after ovulation, LH production is dulled by rising levels of progesterone. If no pregnancy occurs and progesterone levels fall, LH production will start again anew at the beginning of the next cycle. LH levels during pregnancy During early pregnancy, LH levels remain low—blocked by continued progesterone production. High levels of human chorionic gonadotropin (hCG) released throughout pregnancy also ensure that they stay low throughout pregnancy, so no further ovulation is triggered. LH levels in menopause During menopause, LH levels become elevated, although this can vary from person to person. This increase in LH levels happen as a result of the general decline in hormone production by the ovaries. When the ovaries stop producing as much oestrogen and progesterone, the pituitary responds by increasing the production of FSH and LH, in an attempt to stimulate the ovaries. However, the ovaries become less responsive and, instead, LH levels rise. This rise in LH levels is associated with a lot of the typical symptoms of menopause, including hot flashes and night sweats. After menopause, LH levels can decline by around 30-40%. High LH levels High LH levels in females outside of normal menstrual cycle fluctuations can cause fertility problems, irregular periods and early puberty. High LH levels are often seen in people with primary ovarian insufficiency and in those with polycystic ovary syndrome (PCOS) often have elevated LH compared to their FSH. This unusual imbalance can lead to irregular periods and the overproduction of testosterone, both key symptoms of PCOS. Sometimes LH levels can become elevated due to dietary and lifestyle factors, including: Symptoms of high LH levels Symptoms of high LH levels in females are more related to the underlying cause than the LH itself. However, some of the most common symptoms associated with the causes of high LH levels include: How to lower LH levels If your LH levels are elevated and you are a regular smoker or drinker, consider taking steps to reduce these habits. If you’re trying to conceive, consider cutting alcohol and cigarettes completely as this will improve your chances of conception and prevent harmful effects to the baby during pregnancy. Low LH levels There are also a number of reasons why low LH levels might occur. Meningitis infections that have occurred in the last 12 months have been linked to low LH levels and so have eating disorders. Sometimes, LH levels can be decreased due to dietary and lifestyle factors as well as certain medications including: Low LH levels in females can lead to problems with ovulation. This includes anovulation, which is not ovulating at all. This can also lead to problems with menstruation, such as irregular, missing, or complete cessation of periods. Symptoms […]

What Do Your SHBG Levels Mean?-image

What Do Your SHBG Levels Mean?

Sex hormone-binding globulin (SHBG) is an important protein involved in the regulation of our sex hormones and in turn our ability to conceive. So what is a good, or ‘normal’ range for our SHBG levels? And how do we know when ours might be too high or too low? We’ve broken down all you need to know about SHBG levels, including what they mean, why they matter and what to do if you suspect yours might be out of range. Quick facts: What is SHBG? SHBG is an important protein that regulates the amount of testosterone and oestrogen available in the body by ‘binding’ to these hormones—which makes them inactive. This is because to bring about an effect in the body, hormones need to be unbound or free so they can enter cells and bring about their effect. The vast majority of testosterone and oestrogen in our bodies is bound to SHBG and other proteins. SHBG also controls the balance between testosterone and oestrogen, which is also important for the healthy functioning of our menstrual cycles. Why do SHBG levels matter? Because SHBG levels regulate the amount of testosterone and oestrogen available to be used by the body, if our SHBG levels are too high or low, this will have a knock on effect on our levels of both of these sex hormones.  If our SHBG levels are higher, we’ll have less free testosterone or oestrogen available. If our SHBG levels are lower, we’ll have more testosterone and oestrogen available.  Both of these sex hormones have important roles in the regulation of the menstrual cycle, ovulation, libido, energy levels and our mental health. Low SHBG When our SHBG levels are low, our levels of free unbound testosterone and oestrogen can become high. Let’s take a look at some of the symptoms, causes and what can be done to help. Symptoms of low SHBG These symptoms can often mirror those of excess testosterone including: Or excess oestrogen: Causes of low SHBG There is no single cause for abnormal SHBG levels, although increases in insulin, prolactin and androgens have been found to block SHBG production which could be a factor for those with low SHBG levels.  Low SHBG can also be caused by a number of lifestyle factors, certain medical conditions and genetics. Here are several conditions, as well as other factors, that low SHBG has been found to be associated with: How to raise low SHBG If you have low SHBG there are a number of lifestyle changes that may help to increase your levels. These include: High SHBG  On the flip side, when our SHBG levels are too high, our unbound testosterone and oestrogen can become abnormally low. Here are some symptoms, causes and what can be done to reduce high levels of SHBG. Symptoms of high SHBG These symptoms can often mirror those of low testosterone including:  Or low oestrogen: Causes of high SHBG Again, there is no single cause for abnormal SHBG levels, although as we mentioned previously, increases in oestrogen and thyroxine (T4) have been found to increase SHBG production, which could be a factor for those with high SHBG levels. There are also a number of conditions associated with high SHBG which include: How to lower SHBG Dietary changes are the most effective way to lower SHBG levels. Decreasing alcohol consumption, gaining weight if you have a low BHM and following a high-fat, low fibre diet may help decrease levels of SHBG. One study involving 48 premenopausal women showed that maintaining a high-fat, low diet decreased SHBG. However, more clinical studies are required to confirm this association. If the levels are elevated due to contraception use, this will usually return to normal levels once you stop using that contraception. Other possible causes such as type 1 diabetes and an overactive thyroid will need further investigation and will require medication specific to these conditions. SHBG tests Ultimately, if you suspect you may have abnormal levels of SHBG, the only way to definitively get a diagnosis is via a blood test. Because symptoms of abnormal SHBG levels can mimic those of high or low oestrogen and testosterone, your SHBG levels should be tested in tandem these hormones. You can test all of these hormones and more, with a Hertility at-home Hormone and Fertility Test. Resources:

Follicle-Stimulating Hormone: What Do Your FSH Levels Mean?-image

Follicle-Stimulating Hormone: What Do Your FSH Levels Mean?

Follicle-stimulating hormone (FSH) is really important for our reproductive health. In this article, find out how to know what normal FSH levels look like, what the symptoms of high and low FSH levels are and how to balance your FSH levels. Quick facts: What is FSH?  FSH stands for Follicle-Stimulating Hormone and is one of the main hormones involved in the regulation of your menstrual cycle and ovulation—making it an important hormone not only for your health but your fertility too. FSH is what’s known as a gonadotropin hormone. It’s released by the pituitary gland in the brain and then acts on the ovaries.There is only one other gonadotropin hormone in the body—luteinising hormone (LH). True partners in crime, there’s no FSH without LH, and they act in tandem to bring about changes which essentially regulate ovulation. Normal FSH levels in women Because our FSH levels are intricately linked to our ovarian reserve, what’s considered a ‘normal’ FSH level changes as we age. This is because our ovarian reserve declines as we age which makes our FSH levels increase.  Gonadotropic hormones are hormones released from the pituitary gland in the brain and released into the bloodstream. Gonadotropins then go on to act on the ovaries. There are two types of gonadotropins, follicle-stimulating hormone (FSH) and luteinizing hormone (LH).  The pituitary gland produces FSH which acts on the ovaries to stimulate the growth of follicles containing your eggs. As well as growing the ovarian follicles, FSH stimulates the granulosa cells that surround the follicle to produce oestrogen from testosterone, an essential hormone for regulating the menstrual cycle (1). You can read more about oestrogen here.  What does FSH do? FSH has two primary functions:  Follicular development FSH does pretty much exactly what it says on the tin—it stimulates the growth of follicles which contain your eggs.  You’re born with ‘immature’ eggs. So each month, a number of them start maturing before one is released during ovulation. Your eggs are housed in tiny follicles inside your ovaries, and it’s these follicles that FSH signals to prepare your eggs for ovulation (2). Oestrogen production FSH also stimulates the cells that surround the follicles to make an enzyme called aromatse, which converts testosterone into oestrogen, another essential hormone for regulating the menstrual cycle and reproductive health (1). The relationship between FSH and LH When your eggs are fully mature and ready to be released during ovulation, LH steps in. A surge of LH is released, again by the pituitary gland in the brain, causing the most mature follicle to rupture—releasing an egg into your Fallopian tube. This is ovulation.  Despite FSH causing numerous follicles, and therefore numerous eggs, to mature each cycle, only one follicle will release an egg each month. This is because FSH and LH are both involved in negative feedback loops, controlled by E2. But what does negative feedback loop mean? Increasing FSH levels in the early stages of your menstrual cycle leads to more oestrogen being made, but this ha, a negative feedback effect on FSH levels. In other words, when you have lots of oestrogen, it feeds back to the brain that it needs to stop making more FSH. Similarly, with LH, oestrogen levels keep increasing through the cycle and once they reach a peak around the middle of the cycle, it causes a sudden surge in LH that promotes ovulation. After ovulation, the empty follicle that once contained the egg makes another hormone, progesterone, to support conception, implantation and the early stages of pregnancy. High levels of progesterone tell the brain to stop making more FSH. Now if a pregnancy doesn’t happen, there is a drop in oestrogen and progesterone which triggers your period. It also tells the brain it needs to start making FSH to start the whole process all over again in the next menstrual cycle (5). High FSH levels Okay, but what happens when we have high FSH levels? Let’s take a look at the causes and symptoms of high FSH levels. What causes high FSH levels? The most common reason for high FSH levels is a low ovarian reserve (egg count), or ovaries that aren’t functioning properly. When we have a low ovarian reserve, this essentially means we have a smaller number of immature follicles available in our ovaries and our bodies will produce less oestrogen.  Because oestrogen controls how much FSH we produce (remember that negative feedback loop), when we have less oestrogen, our FSH levels may go up.  High FSH levels can therefore indicate that our ovaries aren’t functioning properly, be an indicator of low ovarian reserve or an indicator of the onset of menopause. Other reasons for high FSH levels can be ovarian cancer (although this is very rare) (9) and Premature Ovarian Insufficiency (POI) which is the loss of ovarian function before the age of 40 (6,7). In some cases, dietary and lifestyle factors can moderately raise FSH levels. Symptoms of high FSH levels Symptoms of high FSH levels usually mimic symptoms of menopause and are related to low oestradiol levels —which is why it’s so important to test a range of your reproductive hormones to get to the bottom of symptoms. Symptoms can include: How to lower FSH levels? It is important to understand that if high FSH levels have been caused by menopause or a low egg reserve, modifications to your diet or lifestyle will not be able to reverse this. However, there are some dietary lifestyle factors associated with a higher FSH, such as smoking and high alcohol consumption.  If you’re trying to conceive, consider cutting alcohol and cigarettes completely as this will improve your chances of conception and prevent harmful effects to the baby during pregnancy (17). For advice on how to quit smoking, see the full list of NHS quit smoking services here. Nutrition can be a really powerful tool in balancing hormones and helping to alleviate symptoms. You can book a nutritional health consultation with one of our registered nutritionists via your health hub. […]

Fibroids 101: Signs, Symptoms and Treatments-image

Fibroids 101: Signs, Symptoms and Treatments

Around 2 in 3 people assigned female-at-birth will develop a fibroid at some point in their lifetime. But what are fibroids, how do we look out for symptoms and what are the treatments if we’re diagnosed? Read on to find out.  Quick facts: What are fibroids? Uterine fibroids are benign or non-cancerous growths in and around the uterus, or womb. They are made up of fibrous muscle tissue and are extremely common. Around 2 in 3 people assigned female-at-birth will develop a fibroid at some point in their lifetime (1). Your risk of developing a fibroid increases with age and if you: Where do fibroids grow? Fibroids can vary in size and you may have one or multiple fibroids. They can develop as singular fibroids or as clusters. There are three different types of fibroid, depending on where in the body they grow: Signs and symptoms of fibroids Not all people who develop fibroids experience symptoms. Most are actually asymptomatic and have no symptoms at all. Only approximately 1 in 3 people with fibroids will experience symptoms. The symptoms of fibroids can include: What causes fibroids?  Unfortunately, like many reproductive health conditions, the exact cause of fibroids is unknown. What we do know though, is they’re affected by oestrogen and progesterone—two hormones important for regulating the menstrual cycle. After menopause, when oestrogen and progesterone levels drop, fibroids tend to shrink (3). How are fibroids diagnosed? To diagnose fibroids you’ll need a pelvic ultrasound scan. Usually, your doctor will discuss any symptoms you’ve been experiencing with you first. Then they’ll carry out an abdominal examination to look for any areas of tenderness or masses in your abdomen, before referring you for a scan.  The ultrasound will look at your reproductive organs including your uterus, Fallopian tubes, ovaries and general pelvic area. This can be done either transvaginally (through the vagina) or transabdominally (looking at your uterus through your abdomen). A scan is the only way to definitively diagnose fibroids and to determine their size and location. You may also be offered a blood test to screen for iron deficiency anaemia, which is a condition that can occur as a result of heavy bleeding.  Because lots of people with fibroids don’t experience symptoms, often fibroids are found coincidentally. This could be during an ultrasound for a pregnancy or another suspected condition. Black women have an increased risk of developing fibroids Black women are three times more likely to develop fibroids than white women. They’re also more likely to be diagnosed with fibroids at a younger age, have a longer duration of symptoms and have larger, more rapidly growing fibroids. Although the increased risk of fibroids in Black women is known, there’s been little research conducted to understand why this is. Some research suggests genetics, such as Vitamin D deficiency in Black women (4) could be a link. Other research has suggested certain environmental factors could be linked. These include exposure to chemical relaxers, used for afro-textured hair, which have been linked to a higher risk of developing fibroids (5). Will fibroids affect my fertility? Some fibroids can cause problems with fertility (6). This largely depends on their size and where they are located.  Fibroids can affect the structure of the uterus and its surrounding organs. Meaning they can prevent sperm from fertilising an egg or prevent an embryo from implanting. However, lots of people with fibroids do not have any difficulties getting pregnant. How are fibroids treated?  Treatment for fibroids depends on:  If you have fibroids that are not causing symptoms and aren’t likely to affect your fertility, then generally no treatment is required. But if you begin to experience any new symptoms, it is really important to go back to the doctor to have a check-up.  The treatment methods for fibroids can be broken down into non-surgical and surgical methods. Non-surgical methods If you commonly experience heavy periods as a result of your fibroids, you may be given medications such as tranexamic acid. This is a medication which breaks down blood clots in the womb. You may also be given anti-inflammatory medications, like ibuprofen or an oral medication called Ryeqo. The combined oral contraceptive pill and hormonal IUD can also be prescribed to help you have lighter, less painful periods.  As well as treating heavy periods directly, you may also be given a gonadotrophin-releasing hormone (GnRH) analogue. This is to try and shrink your fibroids and is also commonly prescribed before any surgical treatment.  GnRH analogues work by reducing your levels of oestrogen. Low levels of oestrogen can lead to several other long-term complications, so this method can only be used for a short period.If you have larger fibroids, you may be offered a procedure called Uterine Artery Embolisation. This is used to block the arteries which supply blood to the fibroids. If you have smaller fibroids, you may also be offered a procedure which removes the lining of the womb called Endometrial Ablation. Surgical methods There are various surgical techniques which can be used to treat fibroids. Surgery can be explored if medical treatments don’t work for you or aren’t suitable in the long term.  You may be offered one of the following surgical treatments for fibroids:  What type of procedure is most suitable for you depends on the location, size and number of your fibroids. Each varies in terms of invasiveness, risks and its potential effect on fertility. Some people’s fibroids may grow back after surgery, known as ‘recurrence’.  Suspect you may have fibroids? As the symptoms mentioned above are commonly experienced in various types of pelvic issues, they may be linked to other causes apart from fibroids.  If you’re suffering from painful periods or any of the above symptoms, it’s important to get your hormones tested, to rule out a hormonal cause. This, alongside a pelvic ultrasound scan, can help you get to the bottom of symptoms and get a recommended care plan based on your biology.  If you’ve been diagnosed with fibroids, you can also talk to our team of […]