Category: Conditions

Uterine fibroids are benign, non-cancerous growths that develop in and around the uterus. They are incredibly common, with approximately two in three women developing a fibroid at some point in their lifetime. While many fibroids cause no issues, they are a major cause of debilitating heavy periods and pelvic pain. Understanding what drives their growth – primarily the female sex hormones – is the key to diagnosis and effective symptom management. This article outlines everything you need to know about Fibroid. We’ll also explain how our Advanced At-Home Hormone and Fertility Test can uncover the root causes of your symptoms and step towards a quicker diagnosis.  Quick Facts: What are Fibroids and Where Do They Grow? Fibroids can vary dramatically in size, from as small as a pea to as large as a melon, and you may have one or multiple growths. Their classification depends on their location within the uterine wall: Most people who develop fibroids are completely asymptomatic. However, about one in three will experience noticeable symptoms that impact their quality of life. The Main Symptoms of Fibroids The most common symptoms are related to the fibroid interfering with the uterus’s function or simply taking up space: 💡 Think you have one or more of these symptoms? Don’t ignore them!  Heavy periods can lead to anaemia and severe fatigue. If you are regularly soaking through a period product every 1–2 hours, it’s time to investigate the cause. Take our Advanced At-Home Hormone and Fertility Test to investigate your symptoms and the underlying hormonal factors. Hormonal Causes and Risk Factors The exact trigger for fibroid development is unknown, but they are highly sensitive to reproductive hormones, making it clear that they are a hormonally driven condition. Oestrogen and Progesterone Dependence Fibroids are known to grow in response to both oestrogen and progesterone throughout the reproductive years. The crucial link here is that the growth of fibroids is directly related to the hormonal environment of your body. Risk Factors and Ethnicity Certain risk factors increase the likelihood of developing fibroids: Diagnosis and Management If you are suffering from heavy or painful periods, or any of the above symptoms, it is essential to seek medical advice. Diagnosis A definitive diagnosis relies on two steps: Hormone Testing’s Role Testing a full panel of personalised hormones provides essential diagnostic data needed to find the root cause, tailored to your symptoms and concerns. Treatment Options Treatment depends entirely on the size, location, and severity of your symptoms, as well as your family-forming goals (NHS, 2022). If you are struggling with your symptoms, you deserve a personalised care plan that explores all available options. 💡 Find out what your hormones are telling you Don’t suffer through heavy or painful periods. Take our Advanced At-Home Hormone and Fertility Test to investigate the underlying hormonal factors and screen for complications like anaemia. References

Endometriosis is a chronic reproductive health condition that affects an estimated 1 in 10 women in the UK. It’s characterised by painful, heavy periods and a host of other debilitating symptoms that severely impact quality of life. Despite its high prevalence, many people live with endometriosis and diagnosis times are on average over 8 years. This delay is frequently due to a lack of awareness and the dismissal of women’s pain. Understanding the true nature of this condition is the first crucial step towards getting the expert care you deserve. This article outlines everything you need to know about Endometriosis. We’ll also explain how our Advanced At-Home Hormone and Fertility Test can uncover the root causes of your symptoms and step towards a quicker diagnosis.  What is Endometriosis? Endometriosis occurs when cells similar to those lining the uterus (endometrium) grow in other parts of the body, outside of the uterus (Endometriosis UK, 2024). These endometrial-like lesions are most commonly found in the ovaries and fallopian tubes, but can also grow on the vagina, cervix, bowel, bladder, and other pelvic organs. Rarely, they may appear in other parts of the body. Just like the lining of the uterus, these ectopic cells build up and eventually shed in response to your hormones. But unlike a period, this blood and tissue has nowhere to go. This internal bleeding leads to inflammation, crippling pain, and a build-up of scar tissue and adhesions (tissue that can bind organs together). Endometriosis can affect women of any age. The Main Symptoms of Endometriosis Endometriosis is a systemic, whole-body disease. Not everyone will experience all symptoms, and the severity of pain doesn’t necessarily correlate with the stage of the disease. Pain and Menstruation Intense period and pelvic pain are often reported to be the most debilitating symptoms. This pain is frequently described as ‘a razor blade pain’. Heavy Bleeding Another common symptom is heavy periods (menorrhagia). Heavy periods are clinically defined as: Monthly heavy bleeding can lead to anaemia (iron deficiency), which results in secondary symptoms such as chronic fatigue, hair thinning, and constantly feeling cold. Bowel, Bladder, and Other Symptoms Endometrial lesions can cause symptoms that mimic other common conditions: 💡 Suspect endometriosis is the cause of your pain? Take our Advanced At-Home Hormone and Fertility Test to investigate the link between your cycle and inflammatory conditions like endometriosis. Endometriosis and Hormones: The Oestrogen Link Endometriosis is fundamentally an oestrogen-dependent condition. This is the main hormonal driver for the initiation, growth, and maintenance of the lesions. Getting to a Diagnosis Diagnosing endometriosis is challenging, as the symptoms overlap with many other conditions (NHS, 2024). A definitive diagnosis typically requires surgery (laparoscopic keyhole surgery). However, hormonal and blood marker testing can be a vital first step on the road to a specialist referral and diagnosis. Testing a full panel of personalised hormones provides essential diagnostic data needed to find the root cause, tailored to your symptoms and concerns. If you are experiencing any of the debilitating symptoms listed,you don’t have to suffer in silence. It’s important to seek expert medical advice to clarify the cause. 💡 Take the first step toward getting answers Our team of specialists, including Private Gynaecologists, can offer you a tailored care plan to manage your endometriosis symptoms and explore treatment options. Take our Advanced At-Home Hormone and Fertility Test today. References

Polycystic ovary syndrome (PCOS) is one of the most common hormonal and metabolic conditions, estimated to affect 1 in 10 women in the UK. Despite how common it is, the journey to a diagnosis can be challenging; research shows it can take, on average, two years and multiple doctor visits to get a confirmed diagnosis. PCOS is characterised by an imbalance of sex hormones, which can cause a host of symptoms – from irregular cycles and challenging skin issues to difficulty managing weight and long-term health risks. It’s a systemic condition, but with the right diagnosis and personalised management plan, its impact on your health and wellbeing can be controlled. This article outlines everything you need to know about PCOS. We’ll also explain how our Advanced At-Home Hormone and Fertility Test can uncover the root causes of your symptoms and step towards a quicker diagnosis.  What is Polycystic Ovary Syndrome (PCOS)? PCOS is a complex condition characterised by three main features, of which you need to be experiencing at least two to receive a diagnosis (known as the Rotterdam criteria) (Teede et al., 2018): It’s important to remember that ‘polycystic ovaries’ do not mean true cysts; they are actually immature follicles that haven’t developed correctly due to hormonal imbalances. 💡 Think you may have PCOS?  Take our Advanced At-Home Hormone and Fertility Test to screen for Polycystic Ovary Syndrome and uncover the specific hormonal imbalances driving your symptoms. Common Symptoms PCOS manifests differently in everyone, but the most common symptoms are driven by elevated levels of androgen hormones (like testosterone) and metabolic dysfunction. Cycle-Related Symptoms (Irregular Ovulation) PCOS often prevents the ovaries from regularly releasing an egg (a process called anovulation). This hormonal disruption leads to: Skin and Hair-Related Symptoms (Hyperandrogenism) These visible symptoms are direct consequences of high androgen activity in the skin and hair follicles: Metabolic and Weight Symptoms PCOS affects your metabolism, which can lead to weight issues: Mental Health and Fertility Living with the physical symptoms and systemic nature of PCOS can take a toll: Hormonal Causes and Diagnosis The symptoms of PCOS are primarily driven by two key hormonal issues: high androgens and insulin resistance. High Androgens: The Core Driver People with PCOS often have higher-than-normal levels of androgens, such as testosterone. This hormonal elevation, known as hyperandrogenism, is the direct cause of the skin, hair, and cycle issues. High androgen levels disrupt the delicate balance of hormones like LH and FSH, preventing follicles from maturing properly and causing a build-up of immature follicles in the ovaries – the ‘polycystic’ appearance seen on scans. Insulin Resistance: The Metabolic Link Many people with PCOS experience insulin resistance, meaning their body doesn’t respond properly to the hormone insulin. To compensate, the body produces excess insulin. These high levels then have a crucial negative effect on the ovaries: This interconnected hormonal loop is what drives the severity of PCOS symptoms. PCOS and Ethnicity PCOS affects people of all ethnic backgrounds, but research shows that those from ethnic minority communities, especially those who are Black or South Asian, are at a higher risk.  Interestingly, the symptoms can differ depending on your ethnicity (VanHise et al., 2023): women of South Asian and Middle Eastern descent are often more likely to experience excessive body and facial hair, while women of East Asian descent are more likely to experience irregular periods. Managing PCOS with Hertility There is no cure for PCOS, so management is focused on controlling symptoms and mitigating long-term health risks such as Type 2 diabetes, cardiovascular disease, and endometrial cancer. The first step is always diagnosis and a personalised plan, often involving a multidisciplinary team. When to Get Tested If you suspect you have PCOS based on a history of irregular periods, signs of hyperandrogenism (acne, hirsutism), and difficulty managing weight, testing is vital. Early diagnosis allows for a proactive approach to long-term health. Testing a full panel of personalised hormones provides essential diagnostic data needed to find the root cause, tailored to your symptoms and concerns. Managing Your Condition Effective management is often achieved through a combination of lifestyle changes and targeted medical support (NHS, 2022): If you are struggling with a recent diagnosis or symptoms, you don’t need to suffer in silence. 💡 Take control of your hormones today Take our Advanced At-Home Hormone and Fertility Test to screen for Polycystic Ovary Syndrome and uncover the specific hormonal imbalances driving your symptoms. References

Premenstrual symptoms are incredibly common, but the line between feeling a bit irritable and experiencing debilitating mental health distress is critical. Premenstrual Syndrome (PMS) and its severe counterpart, Premenstrual Dysphoric Disorder (PMDD), both occur during the luteal phase of your cycle. They are not psychological flaws; they are the result of a profound biological sensitivity to your cycling hormones. This article outlines the difference between PMS and PMDD. We’ll also explain how our Advanced At-Home Hormone and Fertility Test can uncover the root causes of your symptoms. If you need urgent help for your mental health, you can contact the Samaritans 24/7 helpline (116 123), or access Mind’s crisis resources. Quick facts: What is PMS and PMDD? Both PMS and PMDD are cyclical conditions linked entirely to the luteal phase of the menstrual cycle, the time between ovulation and your period. Premenstrual Syndrome (PMS) PMS is a cluster of physical and mental symptoms experienced in the week or two leading up to your period (NHS, 2024). It is super common, with up to 90% of women and people who menstruate experiencing it at some point. Common PMS symptoms include: Premenstrual Dysphoric Disorder (PMDD) PMDD is a severe, chronic form of premenstrual distress that has a significant impact on daily function, relationships, and work (NHS, 2024). Symptoms tend to be far more exaggerated, with emotional symptoms dominating the presentation, and they generally resolve entirely once the period begins. PMDD symptoms often include: The Hormonal Cause: A Sensitivity Disorder The exact cause of PMDD is not a hormonal deficiency or excess in the traditional sense, but a genetic and biological vulnerability to the normal hormonal changes that occur after ovulation. This makes it a disorder of sensitivity. Other Contributing Hormones While the oestrogen/progesterone axis is key, other hormones can modulate severity or flag underlying conditions: Possible Contributing Factors: Genetic variations (particularly on the oestrogen receptor alpha gene), trauma, stress, and smoking are also linked to increased sensitivity or worsening PMDD symptoms. Getting to the Root Cause If you suspect you are suffering from severe PMS or PMDD, the first step is always to speak to a professional. However, gaining hormonal clarity can be vital for diagnosis and treatment planning. 💡 Is your cycle secretly impacting your mood? Take our Advanced At-Home Hormone and Fertility Test to investigate the underlying hormonal patterns contributing to your mood shifts, including free oestradiol and androgen activity. Treatment Pathways The primary goal of treating PMDD is to dampen the body’s adverse reaction to the cyclical hormonal changes. What Your Personalised Results Can Tell You Testing a full panel of personalised hormones provides essential diagnostic data needed to find the root cause, tailored to your symptoms and concerns. 💡 Find clarity on your mental health If your emotional symptoms are severe and regularly affecting your wellbeing, don’t suffer in silence. Take our Advanced At-Home Hormone and Fertility Test to gain clarity and take control of your health. References  Thys-Jacobs, S, McMahon, D, Bilezikian, JP. (2008). Differences in Free Estradiol and Sex Hormone-Binding Globulin in Women with and without Premenstrual Dysphoric Disorder. The Journal of Clinical Endocrinology & Metabolism. 93(1):96–102, https://doi.org/10.1210/jc.2007-1726

Experiencing severe period pain that stops you in your tracks, or cycles that are unpredictable from month to month, is a clear sign that your body needs attention. Irregular periods and intense pain are not simply something you have to endure. They are powerful signals of a deeper issue, often stemming from hormonal imbalances or underlying reproductive health conditions. Understanding what constitutes a ‘normal’ cycle is the first step toward recognising when your body is sending up a red flag. The second is knowing that targeted testing can find the specific cause, getting you off the cycle of pain and uncertainty. This article outlines all of this. We’ll also explain how our Advanced At-Home Hormone and Fertility Test can uncover the root causes of your symptoms. Take the Test → The Menstrual Cycle: A Vital Sign Your menstrual cycle is far more than just your period; it is a vital sign of your overall health, carefully regulated by cycling hormones—namely oestradiol, progesterone, follicle-stimulating hormone (FSH), and luteinising hormone (LH). The cycle begins on the first day of your bleed and ends the day before your next bleed. It is broken down into two coordinated cycles: the ovarian cycle (managing egg release) and the uterine cycle (managing the womb lining). Follicular Phase: This first phase, beginning with your period, involves a rise in FSH to mature an egg, which in turn leads to rising oestradiol levels. Ovulation: The mid-cycle surge of LH triggers the release of the egg. Luteal Phase: After ovulation, progesterone rises to prepare the uterine lining for potential pregnancy. A drop in both oestradiol and progesterone, if no pregnancy occurs, triggers your next period, starting the cycle anew. Defining Normal vs. Irregular Cycles Understanding the precise timing of your cycle is essential for identifying potential issues. Normal Cycle Length: An average cycle lasts around 28 days, but a healthy range falls anywhere between 21 and 35 days. Having a one-off longer or shorter cycle is usually nothing to worry about. Irregular Cycle Definition: Your cycles are defined as irregular when they are consistently shorter than 21 days or longer than 35 days. An irregular cycle can also be diagnosed when the length varies by more than 7 days from your shortest cycle to your longest cycle.  Normal Period Duration (Bleeding): A period is normally classified as lasting anywhere between 2 and 7 days, with the heaviest bleeding usually during the first two days. Bleeding that is consistently prolonged or lasts longer than 8 days is often a sign of heavy periods or an underlying structural issue. An irregular cycle is one of the clearest signals of a hormonal imbalance, as the lack of regular ovulation breaks the hormonal rhythm needed for a predictable period. What Causes Painful and Heavy Periods? Severe pain (dysmenorrhea) and heavy periods (menorrhagia) are symptoms with deep hormonal and structural roots. Hormonal Mechanisms of Pain and Bleeding It’s often the imbalance between oestrogen and a lack of proper progesterone that causes cycle issues. If you fail to ovulate, the ovaries don’t produce enough progesterone. Oestrogen continues to build up the uterine lining (endometrium) without opposition. This leads to an excessively thick lining that is difficult to shed, resulting in heavy periods. Period pain itself is caused by the release of chemicals called prostaglandins, which trigger the uterine muscles to contract. Conditions that increase inflammation or tissue build-up in the pelvic region cause the body to release a higher volume of prostaglandins, leading to the kind of crippling pain described as ‘a razor blade pain’.  Finally, heavy, prolonged bleeding can deplete your body’s iron stores, leading to Iron Deficiency Anaemia. This is a common consequence of unmanaged heavy periods and causes secondary symptoms like fatigue, low energy, and hair thinning. Key Conditions Linked to Painful & Irregular Cycles Many complex reproductive health conditions manifest as pain and irregularity. Finding the root cause requires checking for these conditions, all of which Hertility is able to support the diagnosis of through our comprehensive testing and clinical pathways: Polycystic Ovary Syndrome (PCOS): This common hormonal condition is a major cause of infrequent or absent periods (oligomenorrhoea or amenorrhoea). This is driven by elevated testosterone (androgens) which may disrupt ovulation. Endometriosis, Adenomyosis: These are key causes of severe, debilitating pain, chronic pelvic pain, and heavy periods. The chronic inflammation and lesion growth are sensitive to oestrogen levels (Hoffman et al., 2021). Thyroid Conditions: Imbalances in TSH and free thyroxine (hypothyroidism or hyperthyroidism) directly disrupt the hormonal signals required for regular ovulation, often leading to irregularity, absence, or heavy bleeding. Early Menopause / Premature Ovarian Insufficiency (POI): As ovarian function diminishes, signalled by low AMH and high FSH and LH, cycles typically become shorter and more frequent before becoming irregular or absent. POI occurs before age 40, and early menopause occurs between 40 and 45. Uterine Fibroids and Polyps: These structural growths are a common cause of very heavy and prolonged bleeding, and their growth is sensitive to oestradiol levels (Hoffman et al., 2021). Hyperprolactinaemia: Excess prolactin can suppress the release of LH and FSH, inhibiting ovulation and leading to infrequent or absent periods. Hypothalamic Amenorrhoea: Chronic stress, under-eating, or excessive exercise that suppresses the brain’s signalling to the ovaries can cause irregular or absent periods. 💡 Think your symptoms may be signs of an underlying condition?  Take our Advanced At-Home Hormone and Fertility Test to investigate the cause of your painful or irregular cycles and get a personalised care plan. Take the Test When to Get Tested If you are experiencing pain that requires strong painkillers, or if your cycle falls outside the normal 21-35 day range, you should seek medical advice. Do not normalise crippling pain. You should consider testing your personalised hormones if: You regularly go longer than 35 days between periods. Your cycle length varies by more than 7 days each month. Your pain is severe enough to interfere with work, sleep, or daily activities (dysmenorrhea). You bleed heavily (soaking through a pad or tampon […]

Fluctuations in mood, unexpected bursts of anxiety, or persistent feelings of low mood are incredibly common. Many women and people with cycles dismiss these feelings, believing they are ‘just emotional’ or simply a consequence of a busy life. Yet, these psychological shifts are often indicators that your internal hormone balance is disrupted. Mood and mental health are intrinsically linked to the endocrine system. The very hormones that regulate your menstrual cycle and reproductive health – like oestradiol and testosterone – are also neuroactive steroids. This means they directly communicate with your brain, influencing key neurotransmitters like serotonin and GABA, which govern happiness, stability, and calm. This article outlines the complex interplay between your hormones and your brain. We’ll also explain how our Advanced At-Home Hormone and Fertility Test can uncover the root causes of your symptoms. What Causes Mood and Mental Health Changes? Whilst depression and anxiety can stem from genetics, life events, or chemical imbalances unrelated to hormones, there are distinct patterns of mood disruption that point directly toward hormonal drivers. Recognising Hormonal Triggers Hormonally driven mood changes often present with specific characteristics: How Hormones Affect Mood and Mental Health Hormones don’t just affect your reproductive organs; they are powerful modulators of your entire central nervous system (CNS). Imbalances or abrupt fluctuations in these critical messengers are a common cause of psychological distress. 1. The cycling hormones (oestradiol, LH, and FSH:  Oestradiol (the primary oestrogen), regulated by the brain’s signals LH and FSH, is a potent regulator of mood and anxiety. 💡 Is your cycle affecting your head? If your anxiety or mood shifts violently or predictably, it could be your hormones. Take our Advanced At-Home Hormone and Fertility Test to investigate the link between your sex hormones, LH, and FSH. 2. Androgens (Testosterone, DHEAS, and SHBG) Androgens are powerful neuroactive hormones that significantly influence energy, motivation, and psychological well-being. 3. Thyroid Hormones: TSH and Free Thyroxine (FT4) The thyroid axis is central to CNS function, as thyroid hormones regulate cell metabolism throughout the body, including the brain. Measuring TSH (from the pituitary) and Free Thyroxine (FT4) (the active thyroid hormone) provides a clear picture. When to Get Tested If your feelings of hormonal low mood or hormonal anxiety are persistent, cyclical, or do not respond fully to standard treatments, exploring your hormone health is a vital step. Mood disorders often represent a neuro-biological effect of an underlying hormone imbalance. You should consider comprehensive testing if you experience: What Your Results Can Tell You Testing a full panel of personalised hormones – which can include Testosterone, SHBG, DHEAS, TSH, Free T4, Oestradiol, LH, FSH, AMH, and Prolactin – provides the essential diagnostic data needed to find the root cause: 💡 Take control of your hormones today Uncover the biological drivers of your anxiety and low mood. Take our Advanced At-Home Hormone and Fertility Test for clarity and a personalised care plan. References  Zhu, H., Sun, Y., Guo, S., Zhou, Q., Jiang, Y., Shen, Y., Zhou, Z., Du, Z., & Zhou, H. (2023). Causal relationship between sex hormone-binding globulin and major depression: A Mendelian randomization study. Acta psychiatrica Scandinavica, 148(5), 426–436. https://doi.org/10.1111/acps.13614

Experiencing persistent fatigue or low energy that just won’t shift, no matter how much you sleep or how many coffees you have? You’re not alone. Many women and people with cycles dismiss chronic tiredness as a normal part of a busy life, yet it can be a sign that something is going on. When fatigue becomes persistent, heavy, and impacts your daily life, it’s time to look beyond just needing more rest. Fatigue is a feeling of constant tiredness or weakness, and it can be physical, mental, or both.  Low energy describes a lack of vigour or motivation.  Whilst lifestyle factors – like a poor night’s sleep, stress, or a less-than-ideal diet – can certainly cause temporary dips, when these symptoms become chronic, it’s often a signal from your body that your delicate hormonal balance might be disrupted. This article will explore the common, and often overlooked, hormonal drivers behind feeling tired all the time and outline how taking our Advanced At-Home Hormone and Fertility Test can uncover the root causes of your symptoms. Take the Test → What Causes Fatigue and Low Energy? The causes of fatigue are diverse, ranging from simple lifestyle factors to underlying medical conditions. However, many of the most persistent and hard-to-diagnose cases in women often circle back to hormone health. Common Lifestyle and Medical Causes Before diving into the hormonal links, it’s important to rule out the most common causes of low energy: Sleep Deprivation: Lack of quantity or quality sleep. Sleep disorders like sleep apnoea are common culprits. Nutrient Deficiencies: Low levels of iron (leading to anaemia), Vitamin B12, and Vitamin D are strongly associated with fatigue. Stress and Mental Health: Chronic stress, anxiety, or depression can deplete both physical and mental reserves. Other Medical Conditions: Fatigue is a key symptom of conditions such as coeliac disease, chronic fatigue syndrome (ME/CFS), and heart disease. The Hormonal Connection: A Deeper Dive For many, general medical checks come back clear, yet the profound tiredness persists. This is where hormones often step in as the missing piece of the puzzle. Hormones act as chemical messengers throughout the body, regulating metabolism, sleep cycles, stress response, and reproductive health – all of which are intrinsically linked to your energy levels. How Hormones Affect Fatigue and Low Energy Several key hormones play critical roles in regulating your energy, and imbalances in any of them can lead to that heavy, constant feeling of being drained. 1. Cycling Hormones (Oestrogen, Progesterone, LH & FSH) The menstrual cycle is an intricately regulated process driven by the hypothalamic-pituitary-ovarian (HPO) axis. The fluctuation of key hormones – oestrogen (specifically estradiol), progesterone, luteinising hormone (LH) and follicle-stimulating hormone (FSH) – has a significant influence on central nervous system function, affecting energy metabolism, sleep architecture, and neuropsychiatric stability (Li et al., 2020).  Oestrogen’s Role: Oestrogen generally acts as a boost; it can be linked to improved muscle function, mood, and sleep quality. When oestrogen peaks in the late follicular phase (leading up to ovulation), many women report feeling their most energetic. A notable dip in oestrogen – such as during the early follicular phase (the start of the cycle/period) or during perimenopause – is often associated with low mood and brain fog. Progesterone’s Role: Often called the calming hormone, progesterone rises sharply after ovulation (in the luteal phase). Progesterone has a sedative effect, primarily by enhancing the activity of GABA, the brain’s main inhibitory neurotransmitter. While this is great for promoting sleep, high progesterone during the pre-menstrual (PMS) week can be a key driver of that characteristic fatigue or sluggishness. Poor sleep quality due to a fall in progesterone just before a period can also lead to day-time exhaustion (Ennour-Idrisi et al., 2015). LH & FSH: These hormones, released by the pituitary gland, regulate the production of oestrogen and progesterone. While they don’t directly cause fatigue, measuring their levels is crucial for diagnosing reproductive health conditions (like PCOS) or age-related shifts (like perimenopause/menopause), which have fatigue as a key symptom. 2. Androgens (Testosterone, DHEAS & SHBG) Androgens are essential for vitality in women and people with menstrual cycles. Testosterone and its precursor, DHEAS, are powerful hormones linked to motivation, muscle mass, bone density, and energy metabolism. Testosterone’s Impact: A drop in testosterone can lead to decreased muscle mass, lower bone density, reduced libido, and a general sense of low energy (Bolour & Braunstein, 2005). Low testosterone levels often naturally occur with age or can be caused by certain hormonal contraceptives. Sex Hormone-Binding Globulin (SHBG): This protein acts as a transport mechanism, binding to sex hormones like testosterone and making them biologically inactive. If your SHBG levels are too high (often seen in high-oestrogen states or with certain medications), it can ‘hoover up’ your biologically active testosterone, leading to low energy and other symptoms, even if your total testosterone level is within the normal range (Szybiak-Skora et al., 2025). 💡 Find out what your hormones are telling you Take our Advanced At-Home Hormone and Fertility Test to uncover the root causes of your symptoms, including persistent fatigue and low energy. Take the Test → 3. Cortisol (The Stress Hormone) Cortisol is released by the adrenal glands and is part of the body’s natural “fight or flight” stress response. While essential in short bursts, chronic stress leads to chronically elevated cortisol, which eventually impacts energy regulation (Kumari et al., 2009). Chronic Stress and Adrenal Fatigue (Exhaustion): While “adrenal fatigue” isn’t a recognised medical diagnosis, prolonged high stress can lead to dysregulation of the HPA (Hypothalamic-Pituitary-Adrenal) axis, which manages cortisol. This dysregulation is linked to the symptoms of tired all the time and low energy women. Initial high cortisol can disrupt sleep, and later dysregulation can leave you feeling depleted and unable to manage stress. 4. Insulin Insulin regulates blood sugar, which is your body’s primary fuel source. When insulin is dysregulated (known as insulin resistance), your cells struggle to absorb glucose, leaving your body and brain starved of the energy they need. This common issue is a […]

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!  […]

A common symptom of endometriosis is fertility issues. Up to 50% of people with endometriosis will struggle to conceive, with the causes still relatively unknown. Here take a deep dive into what you need to know about your fertility if you have diagnosed or suspected endometriosis. Quick facts: What is endometriosis? Endometriosis is a reproductive health condition where tissue similar to the lining of the womb grows in other places. This is called endometrial tissue. This tissue can grow in the ovaries and fallopian tubes and can cause painful symptoms.  It’s one of the most common reproductive health conditions. 1 in 10 women and those assigned female-at-birth (AFAB) will develop endometriosis, yet its definitive cause is still unknown.  As a long-term condition, endometriosis can significantly impact some people’s lives. One of the most common concerns is how does endometriosis affect fertility? Will endometriosis affect my fertility? In short, it might. Fertility problems are common in those with endometriosis, with 30-50% experiencing fertility problems (1). But having endometriosis does not automatically mean you will have fertility problems—every case is different. It will depend on the severity of your symptoms and any structural or hormonal issues you may have.  Is it possible to get pregnant with endometriosis? Yes, it’s possible to get pregnant with endometriosis. However, you may experience difficulty getting pregnant. Those with endometriosis have a lower chance of getting pregnant with each monthly cycle (2). This can result in it taking longer for people with endometriosis to conceive (3).  Infertility is also common in those with endometriosis, and in subfertile (failure to conceive after one year of trying) women the prevalence seems to be considerably higher, ranging from 20% to 50%, but it varies with time and age (1). How does endometriosis affect fertility? Again, not necessarily. But those with endometriosis are at an increased risk of miscarriage, ectopic pregnancy and other obstetric complications compared to those without (4). How does endometriosis affect fertility? Exactly why and how endometriosis affects fertility is still unknown. But here are the latest theories of possible links and causes.  Structural issues One of the ways endometriosis is likely to affect fertility is by distorting the position of reproductive organs. Growth of endometrial tissue and adhesions around the uterus and Fallopian tubes can cause this distortion. In turn, this may block mature eggs from reaching the uterus to be fertilised. The risk of blocked Fallopian tubes, in particular, increases in the more advanced stages of endometriosis.  Endometriomas The presence of cysts on your ovaries, called endometriomas, could also affect fertility and ovulation. Endometriomas can damage ovarian tissue and the precious ovarian follicles which house immature eggs.  Immune reaction Another theory is an immune reaction to endometrial tissue growing outside the uterus. This is because this tissue is recognised as ‘foreign’ to these parts of the body. The immune system responds by attacking it, causing inflammation. Inflammation leads to harmful toxins which may affect Fallopian tube function, sperm function and egg quality (5). Womb reciprocity There is also debate about whether endometriosis affects the receptivity of the womb to a fertilised egg. However, there is currently no conclusive evidence to prove this theory.  Painful sex Painful sex is one of the symptoms associated with endometriosis. Pain during or after intercourse can negatively impact your sex life and make the trying-to-conceive process difficult. Can treating endometriosis improve fertility? Various treatments for endometriosis that aim to improve fertility. The right ones for you will depend on the location and severity of your endometriosis and what your symptoms are.  One treatment that aims to improve fertility is laparoscopic surgery. This is surgery to remove the endometrial tissue deposits and adhesions. It aims to free the pelvic organs of any structural issues or blockages and reduce inflammation.  For people with endometrioma, laparoscopic ovarian cystectomy can remove the endometriosis-related cysts on the ovaries (6). This has been shown to lower the recurrence rate of both cysts and pain symptoms.  However, there are risks associated with any surgery. For example, ovarian cystectomy can also negatively affect ovarian reserve by the removal of healthy tissue.  It’s important to discuss the potential for surgery with a specialist. And to explore the individual risks. How can I improve my chances of conceiving with endometriosis? If you’re trying to conceive with endometriosis, there are options to improve your chances. These include expectant management and assisted reproductive techniques (ARTs).  Expectant management  This is for heterosexual people who are trying to conceive naturally and:  To improve your chances of conceiving with every menstrual cycle, it is recommended to have sex every 2-3 days so there is a good chance of catching your fertile window.   Assisted reproductive techniques (ARTs) ART options include ovarian stimulation (COS), intrauterine insemination (IUI), and in-vitro fertilisation (IVF).  Depending on your age, ART is recommended if: IUI is usually offered to couples with minimal or mild endometriosis if their partner has normal semen quality and is typically not offered to those with moderate/severe endometriosis, because of a probable effect on the Fallopian tubes. IVF can be offered to those with moderate or severe endometriosis. It can also help those with a very low egg reserve. IVF has been found to be less successful in people with endometriosis compared to those without endometriosis. However, lots of factors influence IVF success, like age, whether you’ve been pregnant before, if you’ve had treatment before body mass index, underlying health conditions, lifestyle and your partner’s sperm quality.  Resources: