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

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. […]

Over the last five years in the UK alone, 1 in 5 employees undergoing fertility treatment left their jobs due to insufficient support from their employers—and a further 1 million women left their workplaces because of debilitating menopausal symptoms. These are just a couple of the stats that highlight the growing importance of workplace reproductive health benefits as an integral part of employee wellbeing.  As the adage goes, knowledge is power and one of the best places to start is ensuring your employees have ample access to educational resources surrounding their reproductive health.  Awareness days offer purposeful opportunities to provide employees with education and celebration over a range of important issues. This can in turn foster your organisation’s culture whilst making your employees feel seen and supported.  This 2024, why not build some of the following key female reproductive health-focused awareness days into your internal events calendar?  2024 Calendar of Reproductive Health Awareness Days 1. International Women’s Day When: March 8th 2024 What: A globally recognised campaign that celebrates women’s achievements social, economic and political achievements whilst raising awareness for gender equality.  2. National Endometriosis Action Month When: March 2024 What: A globally recognised month of action for the 1 in 10 people assigned female at birth who suffer from the reproductive health condition endometriosis.  3. National Infertility Awareness Week  When: April 21st – 27th 2024 What: A UK-focused awareness week highlighting the challenges, mental and physical, faced by those struggling with infertility. 4. Black Maternal Health Week When: April 11th – 17th 2024 What: A globally recognised week to amplify Black female voices and raise awareness for the historically higher maternal mortality rates in Black women.  5. Maternal Mental Health Awareness Week When: 29th – 5th May 2024 What: A global weeklong campaign dedicated to awareness around mental health struggles before, during and after pregnancy.  6. National Women’s Health Week When: May 12th – 15th 2024 What: A UK-focused weeklong campaign encouraging women and girls to make their health, physical and social wellbeing a priority. 7. Fibroids Awareness Month When: July 2024 What: A globally recognised month to raise awareness about uterine fibroids that affect around 2 in 3 women.   8. Ovarian Cancer Awareness Month  When: September 2024 What: A globally recognised month to support those who’ve been diagnosed with or indirectly affected by ovarian cancer.  9. Polycystic Ovary Syndrome (PCOS) Month When: September 2024 What: A globally recognised month of action for the 1 in 10 people assigned female at birth who suffer from the reproductive health condition PCOS.  10. Menopause Awareness Month When: October 2024 What: A globally recognised awareness month focused on breaking the stigma surrounding menopause, including World Menopause Day on the 18th of October. 11. Baby Loss Awareness Week When: October 9th – 15th  What: A UK-focused week-long event dedicated to supporting those who have suffered pregnancy or infant loss.  12. National Fertility Awareness Week When: October 30th – 5th November What: A UK-focused weeklong campaign initiated to raise awareness about fertility issues, treatments and reproductive health education.  What next? Embedding reproductive health awareness into an organisation’s event calendar is an imperative step toward fostering a supportive and inclusive workplace culture. The alarming statistics revealing the impact of insufficient support on employee retention underline the urgency of addressing these issues.  By incorporating key awareness days and campaigns, such as International Women’s Day, National Endometriosis Action Month, and Menopause Awareness Month, employers can provide educational resources and celebrate the diverse aspects of female reproductive health. This not only promotes a sense of acknowledgement and support for employees but also contributes to a workplace environment that values the holistic well-being of its people.  At Hertility, we’re shaping the future of the workplace by supporting companies to become Reproductively ResponsibleTM. One way that we do this is through a range of CPD-accredited educational workshops that focus on female fertility and reproductive health. Ultimately, our aim is to change attitudes around reproductive health, both for individuals and in the workplace, and to encourage everyone to be proactive by tracking their reproductive health. We’re calling this the Reproductive Revolution! If you’d like to take proactive steps in this direction in 2024, get in touch – benefits@hertilityhealth.com. 

Polycystic Ovary Syndrome (PCOS) is a very common reproductive health condition estimated to affect 1 in 10 in the UK. In this article, we’ll cover exactly what PCOS is, its causes and symptoms, common FAQs about PCOS and some tips for those living with the condition. Quick facts: What is PCOS? Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders. PCOS is characterised by an imbalance of sex hormones which can cause a whole host of symptoms – including missed periods, acne, excessive hair growth and even fertility issues.  Despite how common it is, many people don’t get a proper diagnosis until they’re having difficulties trying to get pregnant. Research has shown that it can take on average 2 years and visiting more than 3 doctors to get a PCOS diagnosis. What are the symptoms of PCOS? We are all unique, so every person affected by PCOS will experience symptoms differently but some common symptoms include the following. Menstrual cycle-related symptoms PCOS can impact ovulation by either causing irregular ovulation or no ovulation at all (anovulation). This is because people with PCOS tend to have imbalances in hormones that regulate the menstrual cycle – particularly luteinising hormone (LH).  As these hormones are key for regulating ovulation, an imbalance can cause ovulation to happen less frequently or stop it altogether. Irregular ovulation will often result in irregular periods (oligomenorrhea). This is when your cycle is less than 21 days, or more than 35 days apart. People with PCOS tend to have very long cycles (i.e. more than 35 days) or no periods at all (amenorrhea). They have also reported experiencing heavier-than-normal periods. Skin and hair-related symptoms This can include excessive hair growth (hirsutism), especially on the upper lip, chin, neck, sideburn area, chest, upper or lower abdomen, upper arm and inner thigh. Loss of hair or thinning of the scalp hair (alopecia) can also be experienced as well as thick dark patches of skin in your armpit or around your groin or neck (acanthosis nigricans) and skin tags. Acne is also a common symptom. Skin and hair-related symptoms are caused by having too many androgens (such as testosterone) in your body, which is a common trait in people with PCOS. Weight gain or difficulty losing weight Weight gain is particularly seen around the abdomen area (known as central adiposity), which is caused by PCOS affecting your metabolism. Difficulty conceiving This is due to the hormone imbalances in PCOS causing irregular ovulation. PCOS can cause ovulation to become less frequent and unpredictable, which may make it more tricky to conceive. If ovulation doesn’t occur, there’s no egg awaiting fertilisation. Mental health-related symptoms People with PCOS are more likely to experience mental health-related symptoms including depression and anxiety as a result of the negative impact their symptoms can have on their day-to-day life. What causes PCOS? Although the exact cause of PCOS is unknown, research suggests that a combination of genetic, lifestyle and environmental factors are at play. Here are some of the main factors thought to be responsible for PCOS symptoms. High levels of Androgens Androgens are a group of hormones, the most common being testosterone. They are made mostly by the ovaries and are important for muscle growth and getting your libido going.  People with PCOS have been found to have higher than normal androgen levels, a condition called ‘“hyperandrogenism”. This can result in characteristic PCOS symptoms such as excessive body and facial hair growth, hair loss from the scalp, oily skin and acne. Don’t be fooled by its name, polycystic ovaries do not mean cysts in the ovaries. This imbalance of androgen hormones does not allow follicles (little sacs that house your eggs) in the ovaries to mature properly.  As a result, there are a large number of immature follicles which get stuck in different stages of maturation. These can appear like cysts during a pelvic ultrasound scan but are very different to cysts. High levels of insulin Some people with PCOS also experience a condition called insulin resistance. Insulin is a hormone that controls blood glucose levels (basically your blood sugar). When blood glucose levels rise (after eating for example), insulin helps the cells to absorb it so it can be used by the body for energy. Insulin resistance is when the body doesn’t respond to normal insulin levels. The body starts making excess levels of insulin to compensate for this, leading to misregulation of blood sugar levels and knock-on effects on the proper functioning of the ovaries and ovulation.  Insulin resistance can also lead to problems with metabolism, causing further symptoms such as weight gain, difficulty losing weight and higher risks of conditions like type 2 diabetes.  High insulin levels also decrease the production of sex hormone-binding-globulin (SHBG)—an important hormone that regulates testosterone levels—which therefore results in increased levels of testosterone and excess androgen-related symptoms. Genetic causes PCOS has been found to run in families, so having an immediate relative with PCOS can put you at a higher risk of developing it yourself. There have been several genes which have been identified as possible causes of PCOS, but as of yet, no conclusive links have been made. Recent research published by members of the Hertility research team shows that PCOS may be associated with genetic changes in the powerhouse of our cells called the mitochondria. Ethnicity PCOS affects people of all ethnic backgrounds, however, research has shown that those from ethnic minority communities, especially those who are Black or South Asian, are at a higher risk of developing PCOS.  Different ethnicities are also known to have different PCOS symptoms. For example, research has found that women of South Asian and Middle Eastern descent are more likely to experience excessive body and facial hair and women of East Asia are more likely to experience irregular periods. How can I be diagnosed with PCOS? Someone would need to be experiencing at least two of the following to be diagnosed with PCOS:  Is there a […]

If you have been diagnosed with Polycystic Ovary Syndrome (PCOS) and are feeling a bit clueless or overwhelmed, we’re here to help. In this article, we explain all of the possible treatments for PCOS and how to effectively manage your symptoms. Quick facts: What is PCOS? PCOS is an extremely common reproductive health condition that affects up to 1 in 10 people assigned-female-at-birth. It can affect how the ovaries work and can cause an array of different symptoms, which can range in severity from person to person.  The good news is, that even if you are feeling overwhelmed or anxious at the outcome of your recent diagnosis, PCOS symptoms can be treated and managed with lifestyle changes. Symptoms of PCOS As with most conditions, the symptoms of PCOS vary from person to person, as does the severity of the symptoms. Not everyone with PCOS will experience all of these symptoms, but you need to have at least two of the below to have been diagnosed.   Other symptoms can include: What causes PCOS? Currently, the exact cause of PCOS is unknown but it often runs in families and can be related to abnormal hormone levels in the body, including high insulin.  Higher insulin levels also induce your ovaries to produce androgen hormones such as testosterone. An increase in androgen hormones can cause symptoms like excess hair growth (hirsutism) acne and alopecia.  High levels of insulin can also eventually cause insulin resistance. Because insulin metabolises carbohydrates in your body, those with insulin resistance are therefore unable to respond to glucose properly.  This can then lead to being overweight as your body is not able to absorb the sugars from your food into your liver and convert it into energy—so it is stored as fat instead. How to manage your PCOS symptoms The current treatment options for PCOS are symptomatic, as there is currently no cure. This means treatment is focused on treating and mitigating symptoms with lifestyle changes and certain medications.  Your treatment will follow patient-centred care, meaning you will have a say in your treatment and your doctors should respond by providing you with care that is responsive to your preference and needs. The first line of treatment they will recommend will be to make changes to your lifestyle. These include changing your diet, exercising, losing weight and taking part in activities to maintain healthy mental health.  Don’t underestimate the power of lifestyle changes. Making healthy choices and bringing positive changes to your lifestyle can create a major difference in your symptoms, allowing you to control them and improve your quality of life. With the right, tailored care plan, many people find that their PCOS symptoms can be controlled and that they don’t present any further problems for them. Let’s take a look at some of the lifestyle changes involved in PCOS symptom management. PCOS diet and nutrition Some research suggests that following a healthy balanced diet is a significant way to manage your PCOS—it can regulate your period and ovulation and reduce the presence of symptoms like acne and hirsutism. High GI carbs Vs low GI and weight loss If you are currently overweight, losing weight and maintaining a healthy weight is crucial for managing PCOS.  The more overweight you are the more complications you will face with PCOS as well as having a higher risk of developing other long term health conditions. There are many different PCOS diets that people recommend, but a healthy and sustainable option is a low glycaemic index (G.I) diet. This involves substituting high GI carbs with low GI carbs which can help PCOS sufferers lose weight efficiently. Low GI carbs increase blood glucose levels very slowly, whereas high GI foods are digested rapidly, which can cause spikes in your glucose and insulin levels.  A great book that explains the G.I diet very well is ‘ The Low GL Diet Bible’ by Patrick Holford, it contains a list of foods that you can substitute your daily carbs with. Here are some great examples of Low GI carbs that you could incorporate into your diet: Following a low GI carbs diet is generally the key piece of advice that clinicians and dieticians will advise in the case of any PCOS diagnosis and will likely form the basis of a PCOS specific nutritional care plan.  However, there are other foods and simple switches that you can incorporate into your diet which may help to further reduce your symptoms too. A PCOS friendly food list may contain: If you’d like help with anything regarding PCOS specific nutrition, you can book a consultation with one of our Fertility Nutritionists who will be able to help you with a nutritional care plan. Reducing fat and salt As well as managing and decreasing your carbohydrate intake, you should also manage your fat and salt intake and make sure you’re taking in all the necessary vitamins and minerals. Try to keep your salt intake to a maximum of 2,300 mg per day.Also, increasing the intake of whole foods aids weight loss and helps to maintain a healthy balanced diet.  Although losing weight isn’t so easy for PCOS sufferers, it is totally worth it—just a decrease in 5% of overall body weight can significantly improve symptoms. PCOS and exercise benefits Like losing weight, exercise increases metabolism and may help to improve many of your symptoms. When exercising, the main goal is to lose weight in the abdomen and reduce fat around the organs.  This will help to support your endocrine system, which secretes and regulates your hormones, including your insulin and testosterone levels.  If you’re new to regularly exercising, it’s best to start slowly, steadily increasing your workouts as well as the time spent working out. In the long run, this will be much easier to maintain.  Cardio is great for heart health, with things like swimming, hiking and running great for getting a sweat on. But there is a misconception that you will only lose weight with cardio, it’s a total myth!  […]

For many, the journey to parenthood can be a challenging process, both physically and emotionally. We’re here to help you understand the different causes of infertility, and the options available for those who need support. Quick facts: What is infertility? Infertility is defined as not being able to conceive after one year (or longer) of trying. This could be despite having regular unprotected sex with a partner, or trying using methods like artificial insemination (IUI).  There are 2 types of infertility: In the UK, as many as 1 in 7 heterosexual couples experience infertility, yet the causes are sometimes preventative, or treatable.  Causes of infertility  There can be many different reasons why you might struggle to conceive. This can include structural fertility issues, ovulation problems, underlying health conditions and hormonal imbalances. Let’s take a look at each. Ovulation issues  Anovulation, also known as the inability to ovulate, is the most common cause of infertility. Ovulation is when a mature egg is released from one of your ovaries, each month, during your menstrual cycle. The egg travels into the Fallopian tube, where it prepares to be fertilised by a sperm, before then travelling down the tube to the uterus.  When trying to conceive, ovulation is a crucial event, with the 5 days before ovulation and ovulation day itself often referred to as your ‘fertile window’.This is the time of the month when you’ll be most likely to get pregnant.  Research suggests that as many as 25% of infertility cases are caused by anovulation. Anovulation can be caused by: Another possible explanation is a problem with the egg maturation process. This means that an “immature” egg may be released from your ovaries when it is not quite ready and unable to fertilise. Underlying health conditions Polycystic ovary syndrome (PCOS) PCOS is the most common underlying condition affecting fertility. PCOS affects as many as 1 in 10 people with ovaries.  People with PCOS produce higher levels of androgen hormones, like testosterone. This can disrupt your menstrual cycle, ovulation, and balance of cycling hormones—like oestrogen, follicle-stimulating hormone and luteinising hormone (LH). As PCOS is still under-researched and misunderstood, many people are left undiagnosed and are unaware they have it until they are actively trying to conceive. This is why it’s a good idea to check in on your hormones before you start your conception journey.  Primary ovarian insufficiency (POI)  POI is when the ovaries stop working properly before the age of 40. POI is far less common than PCOS, affecting only 1 in 100 women younger than 40. Your ovaries produce oestrogen and progesterone—two cycling hormones responsible for the regulation of your menstrual cycle. When their function is disrupted, ovulation can also become disrupted or stop completely.  People with POI also have a lower ovarian reserve, meaning fewer eggs for their age. Without a sufficient amount of eggs and the correct level of hormones needed to regulate your cycle, the possibility of conceiving is reduced considerably. According to the National Infertility Association, POI can be caused by genetics, autoimmune factors, induced by chemo or radiotherapy, or it can have an unknown cause. Uterine fibroids Uterine fibroids are noncancerous tumours that affect as many as 25% of people with a uterus. They can cause symptoms such as heavy periods, intermenstrual bleeding, and pelvic pain. In some cases, depending on the location in which they grow, and whether they affect the shape of the uterus or cervix, fibroids can also cause infertility.  This is because they can block the fallopian tubes, stopping eggs from meeting sperm, or reaching the uterus for implantation. They can also get in the way of implantation if they are near the inner lining of the womb.  Despite being less common than other causes of infertility, around 5-10% of infertile women and those assigned female-at-birth are found to have uterine fibroids, with their instance being much more common in Black women.  Endometriosis Endometriosis is a common reproductive health condition that affects around 1 in 10 women and people assigned female-at-birth. With endometriosis, tissue similar to the tissue that makes up the lining of the womb starts to grow in other places, such as the ovaries and the fallopian tubes, causing lesions and scarring.   This can cause several life-altering symptoms, such as painful and heavy periods, pain during or after intercourse and pelvic pain. It is also another common cause of infertility, with research suggesting it is present in around 20-50% of infertility cases. The exact link between endometriosis and infertility is unknown. However, some theories suggest that lesions and scarring can cause structural problems with the reproductive organs and chemical changes in the lining of the uterus. Structural infertility  Structural infertility is a problem with the anatomical structure of the reproductive organs. This can include blockages, structural damage or abnormal growth in the fallopian tubes, uterus or ovaries.  Structural issues with the ovaries or fallopian tubes can prevent eggs from being released from the ovaries or stop them from moving through the fallopian tubes to reach a sperm for fertilisation.   Additionally, if the structure of your uterus is abnormal or damaged, it may prevent eggs from implanting into the endometrium (uterus lining). This is needed to create a healthy embryo and pregnancy.  Structural infertility problems can also be caused by scarring from surgery, infections, injuries, or endometriosis.  Also, the growth of noncancerous tissues such as uterine polyps on the lining of the uterus, can cause blockages. Polyps occur when additional tissue grows on your uterus. However, sometimes tissue grows elsewhere in your reproductive system potentially blocking your fallopian tubes and preventing pregnancy.  Implantation failure Other possible explanations of implantation failure are: Infections and auto-immune disorders  Untreated sexually transmitted infections (STIs) may have serious consequences for your fertility. STIs like chlamydia or gonorrhoea can cause scarring and blocking of your Fallopian tubes.  Additionally, if syphilis is left to develop, it can cause stillbirth. There are also other forms of infections of the cervix with human papillomavirus (HPV) that could cause infertility. It’s […]

Annie Coleridge, CEO of Alva Health, shares her story of getting a PCOS and dermoid cyst diagnosis. Erratic periods I’ve always had a feeling something wasn’t quite right with my hormones. Nothing major, but something a little skew-whiff.  Since I was a teenager I’ve had erratic periods. They’re on the light side, making me one of the lucky ones, but sometimes they won’t come for months.  Once, just after my final exams at university, my period didn’t come for about 9 months. I’ve always been a normal weight and was eating ok (albeit a bit stressed about exams) but 9 months seemed excessive…  So did the endless doctor’s appointments checking that I wasn’t pregnant or having a flare of an autoimmune condition I had previously. That was my early 20s. My mid-twenties passed with little change to that pattern, to be honest. Months and months without a period, then they’d just restart again.  I tried to track my periods, but I didn’t have the monthly reminders to help me remember. So I just put up with a mild, low-level, background kind of anxiety about my reproductive health.  Weirdly, although I understand contraception pretty well, it made me reluctant to go on any hormonal birth control. I just didn’t want to mess with these hormones which seemed in such fine balance. And anyway, it didn’t bother me that much. Testing my hormones Then I started working at a health tech company, which really highlighted to me that knowledge is power when it comes to your body. Finally, it clicked – I really should check if my hormones are balanced.  I knew that wouldn’t hold all the answers to my period woes… but it seemed like a very interesting place to start.  When I got my first test back I had high testosterone and low oestrogen – which was not what I expected… I knew that raised testosterone suggested PCOS but I also knew I didn’t have the typical symptoms. Beyond the messed up periods and the raised testosterone, I just didn’t have much else that was typical for PCOS. Or at least I thought I didn’t.  What I knew about PCOS was that it usually causes heavy periods, excessive hair growth, insulin sensitivity and weight gain. I didn’t struggle with those. I had light, irregular periods and bad mood swings. But that was it.  So… I ignored my first few sets of results, for about a year. I’d had abnormally high cortisol results at the same time, so as ever I just sort of put it all down to stress. Maybe my periods were just super super super sensitive to stress. A sudden change Then my periods suddenly got incredibly heavy. I thought it might be a sign of something really serious so I went to a doctor. I don’t hate the doctors at all, but I do find the process often quite inconvenient. It just doesn’t fit in with my life. Despite having recent blood tests, the doctors made me take another test and told me I had PCOS. That was it. A single phone call. Just the test results and a simple conclusion. Nothing else on the matter,  no follow-up information.  Doctor Google and my mum (an actual doctor) helped me learn that there are loads of different types of PCOS. Turns out whilst some people get the more ‘classic’ PCOS symptoms it’s actually a hugely varied condition. PCOS diagnosis – what else? But this new diagnosis didn’t explain the sudden changes in my periods. Or at least I didn’t think it did. I was pretty confused to be honest. So I went back to my GP and they said I could have an ultrasound.  The process of finding out I had a dermoid cyst involved an initially inconclusive scan – where the sonographer simply told me that I had ‘some sort of mass.  Four weeks later, another scan followed. This time they told me that the mass was probably a ‘ benign cyst’. The probably in that sentence didn’t fill me with confidence. So I went to my GP to ask what next? What next was a very long wait to see an NHS gynaecologist.  Now, let me say that although I felt pretty horrific after my various appointments I am staunchly pro the NHS. They gave me a certain first diagnosis – PCOS – and a probable second one – a benign cyst.  I did feel a little lost though. Suddenly my fertility (not something I’d thought about being 28 years old at the time and in a very new relationship) felt uncertain. I’m not even sure I want kids but that feeling was very unsettling. Knowledge is power To get a quicker second diagnosis I went and got a private scan. I’m very lucky they could confirm it was a dermoid cyst that was not cancer.  They could also see the characteristic ‘string of pearls’ appearance around my ovaries that suggested PCOS. It was a relief to be able to see what was going on in my ovaries, although they didn’t look in the best shape I must say.  I feel so fortunate to have been able to quickly access answers but it took me years to take control of my reproductive health. Even though it’s not perfect – nothing ever is and it’s much better to know Written by Annie Coleridge, CEO Alva Health If like Annie, you’re experiencing irregular and erratic periods, it could be a sign of a hormonal imbalance. Our at-home hormone tests can help you get to the root of your period problems. Our team of experts include PCOS specialists that can help you to manage your PCOS symptoms.