Category: Conditions

If you have been diagnosed with PCOS or suspect you have PMOS, you might have seen the news this week. On 12 May 2026, a landmark paper published in The Lancet officially renamed polycystic ovary syndrome (PCOS) to polyendocrine metabolic ovarian syndrome, or PMOS. It’s one letter different in the acronym. But the reasoning behind it, and what it means for diagnosis, treatment and the millions of people living with this condition, is significant. Here’s everything you need to know. Why has PCOS been renamed? The short answer: because the old name was wrong and that had real consequences. “Polycystic ovary syndrome” implies the condition is defined by cysts on the ovaries. In reality, those are not actually pathological ovarian cysts. What is visible on ultrasound are small antral follicles – immature follicles that haven’t developed properly, not cysts in the clinical sense. Describing the condition by a feature it doesn’t actually have has caused confusion among patients and clinicians alike for decades. More importantly, the old name obscured what PCOS actually is: a complex, whole-body hormonal and metabolic condition that affects far more than the ovaries. The new name recognises that the condition is not  primarily a gynaecological disorder, but instead a complex, multisystem condition involving endocrine, metabolic, reproductive, dermatological and psychological health. The name PCOS is misleading – it focuses on ‘cysts’ and the ovaries, when the condition is much more complex than that. This has led to missed diagnoses and people not getting the right treatment. For an estimated 1 in 8 women worldwide – over 170 million people – that’s not a semantic issue, it’s a healthcare one. What does PMOS stand for and what does it mean? PMOS: Polyendocrine Metabolic Ovarian Syndrome Each word in the new name is deliberate: Polyendocrine – reflects that this is fundamentally a hormonal condition, involving multiple endocrine disruptions. People with PMOS have a disturbance in the endocrine (or chemical messenger) system of the body, which can lead to widespread impacts. This includes abnormalities in androgen production, insulin signalling, ovarian hormone regulation and neuroendocrine function. Metabolic – acknowledges the significant metabolic dimension of the condition, including insulin resistance, diabetes risk and cardiovascular risk. For many people with PMOS, the metabolic features are as impactful or more so than the reproductive ones. Ovarian – retained in the new name because the ovaries remain central to understanding the condition. Abnormalities in follicle development and ovulation are all key features of PMOS. The ovary is involved, it’s just not the only thing going on, and it’s not cysts that define it. Syndrome – correctly reflects that this is a cluster of features, not a single-cause disease. How did changing PCOS to PMOS happen? This wasn’t a quick decision. The name change followed more than a decade of vigorous debate and the most robust disease-renaming process in history. The process was led by Professor Helena Teede, Director of Monash University’s Monash Centre for Health Research & Implementation, alongside the International Androgen Excess and PCOS Society, 56 patient and professional organisations including Verity PCOS UK  and garnered more than 22,000 survey responses from patients and multidisciplinary health professionals across all world regions. The revised name was introduced in a paper published in The Lancet and presented at the European Congress of Endocrinology in Prague. “It is fantastic that the new name now leads with hormones and recognises the metabolic dimension of the condition.” – Rachel Morman, Chair of Verity PCOS UK How is PMOS diagnosed? Nothing about the diagnostic criteria has fundamentally changed. If you were diagnosed with PCOS, that diagnosis still stands. The condition is the same, the name is what’s changing. To receive a PMOS/ PCOS diagnosis, a person must meet at least two of the following three criteria: 1. Irregular or absent menstrual cycles. Irregular cycles indicate that ovulation is not occurring regularly, a key feature of PMOS/ PCOS. According to the 2023 International Evidence-Based PCOS Guidelines, irregular cycles are defined as fewer than eight cycles per year, or cycle intervals outside the 21–35 day range, in women who are at least three years post-menarche (which is your first period). 2. Clinical or biochemical signs of high androgens (hyperandrogenism). This means either physical symptoms associated with elevated androgens such as excess facial or body hair (hirsutism), acne, scalp hair thinning or elevated androgen levels on a blood test – typically testosterone.  3. Polycystic ovarian morphology (PCOM). This refers to the appearance of the ovaries on an ultrasound scan, specifically a high number of small antral follicles (the immature follicles that house eggs) in one or both ovaries, or an increased ovarian volume. Alternatively, a high AMH (anti-Müllerian hormone) level on a blood test can be used as a marker of PCOM when an ultrasound isn’t available or appropriate. Crucially, “60% of women with the condition only need those first two – they don’t need the ovaries assessed in any way,” says Professor Teede. “For the other 30–40%, they can either have a blood test or an ultrasound, and arguably, a blood test is actually cheaper and much more convenient than an internal ultrasound.” The conversation about your condition should broaden For too long, people with PCOS were told it was “just about your periods” or “just a fertility issue.” The new name makes explicit that PMOS involves the endocrine system, metabolism, skin, mental health and cardiovascular health, not just the ovaries and reproductive function. “Language matters in medicine. The previous name often led to misconceptions and stigma, particularly around fertility. This change helps shift the conversation toward overall health rather than a single aspect of the condition.” – Dr Melanie Cree What actually causes PMOS and what does it affect? The name change is an opportunity to understand PMOS more completely. It’s not a condition that starts and ends with your cycle. Hormonal disruption (the “polyendocrine” part) PMOS involves elevated androgens like testosterone which can disrupt ovulation, cause acne, trigger unwanted hair growth (hirsutism) and contribute to hair thinning. The androgen […]

Research shows that on average, it takes two years and visits to three different doctors for someone to get a diagnosis of polycystic ovary syndrome (PCOS), even though it’s one of the most common hormonal conditions in the UK, affecting around 1 in 10 women. Part of the problem is that PCOS presents differently in different people. There’s no single symptom that confirms it, no single test that catches every case, and whilst the  diagnostic criteria is  clinically sound, it requires ruling out other conditions before it can be applied. Add  that to the reality that many GPs have limited time and variable knowledge of reproductive hormones,  it’s not difficult to understand why so many people spend years being told their symptoms are normal, or being tested for the wrong things. This guide walks through exactly how PCOS is diagnosed: the criteria clinicians use, the tests involved, what the process typically looks like, and what you can do if you’re struggling to get answers. Quick Facts How is PCOS diagnosed? PCOS is most commonly diagnosed using what’s known as the Rotterdam criteria, established by an international consensus in 2003 and last updated in 2023. To receive a PCOS diagnosis, a person must meet at least two of the following three criteria: 1. Irregular or absent menstrual cycles. This means cycles that are consistently shorter than 21 days, longer than 35 days, or absent altogether. Irregular cycles indicate that ovulation is not occurring regularly, a key feature of PCOS. According to the 2023 International Evidence-Based PCOS Guidelines, irregular cycles are defined as fewer than eight cycles per year, or cycle intervals outside the 21–35 day range, in women who are at least three years post-menarche (which is your first period). 2. Clinical or biochemical signs of high androgens (hyperandrogenism). This means either physical symptoms associated with elevated androgens such as excess facial or body hair (hirsutism), acne, or scalp hair thinning or elevated androgen levels on a blood test – typically testosterone. Importantly, you don’t need both signs of hyperangrogenism – physical signs alone, or blood results alone, can satisfy this criterion. 3. Polycystic ovarian morphology (PCOM). This refers to the appearance of the ovaries on an ultrasound scan, specifically a high number of small antral follicles (the immature follicles that house eggs) in one or both ovaries, or an increased ovarian volume. Alternatively, a high AMH (anti-Müllerian hormone) level on a blood test can be used as a marker of PCOM when an ultrasound isn’t available or appropriate. Two out of three. That’s the threshold. Which means you can have PCOS without polycystic-looking ovaries on a scan. You can have PCOS without acne or excess hair growth. You can have PCOS with a relatively regular period. This variability is one reason why the diagnosis of PCOS is frequently missed or delayed – there’s no single presentation that fits everyone. What tests might I need to do to get a PCOS diagnosis? A PCOS diagnosis is built from a combination of clinical assessments, blood tests, and often an ultrasound. Here’s what each one involves. Blood tests for PCOS diagnosis Blood tests are central to PCOS diagnosis, both for assessing hormone levels and for ruling out other conditions that can mimic PCOS. The following are typically included in a diagnostic workup: LH and FSH Luteinising hormone (LH) and follicle-stimulating hormone (FSH) are both made by the pituitary gland and work together to regulate the menstrual cycle. In PCOS, LH is often elevated relative to FSH, producing a raised LH:FSH ratio (typically greater than 2:1). This is one of the hormonal patterns clinicians look for in the early follicular phase, ideally tested around day 2–5 of the cycle. Oestradiol Oestradiol (the primary form of oestrogen) is tested alongside FSH to interpret the hormonal picture correctly. High oestradiol can suppress FSH artificially, which is why these two should always be read together. Testosterone and other androgens Testosterone and DHEAS (dehydroepiandrosterone sulphate) are tested to assess androgen levels. Elevated androgens support the hyperandrogenism criterion and help explain symptoms like excess body or facial hair and acne.  SHBG blood test measures the level of a protein called sex hormone binding globulin (SHBG) in your blood. SHBG attaches to sex hormones such as testosterone and estrogen and helps control how much of these hormones are active  in the tissues of your body and to understand how testosterone and oestrogen are working in the body. AMH (anti-Müllerian hormone) AMH is made by the antral follicles in the ovaries (early stage follicles that haven’t been selected for ovulation yet) and reflects the size of your egg reserve. In PCOS, AMH is often significantly elevated becausethere is a high number of small follicles stuck at different stages of development. A high AMH can serve as a marker of polycystic ovarian morphology in clinical settings, particularly when an ultrasound is unavailable. AMH doesn’t fluctuate dramatically across the cycle but is ideally tested on day 3 of the cycle for consistency. Thyroid function tests (TSH and free T4) Both an underactive and overactive thyroid can cause irregular cycles, weight changes, and fatigue that closely resemble PCOS symptoms. Ruling out thyroid issues is a standard part of the diagnostic process. Prolactin Elevated prolactin (hyperprolactinaemia) can also disrupt the menstrual cycle and cause irregular or absent periods. Testing prolactin helps exclude this as an alternative explanation for cycle irregularity. Glucose and insulin / HbA1c Because insulin resistance affects a lot of people with PCOS and significantly impacts its management, assessing metabolic markers such as fasting glucose or HbA1c is an important part of a thorough diagnostic workup. These tests are ideally taken in the early follicular phase, between days 2–5 of the menstrual cycle, when cycling hormones like LH, FSH, and oestradiol are at their baseline. If your cycles are very irregular, your doctor may advise testing at a specific point or to simply proceed whenever possible. Hertility’s Advanced At-home Hormone & Fertility Test checks for these markers including LH, FSH, oestradiol, testosterone, […]

New data reveals we may be moving backwards on endometriosis diagnosis and care. Here’s what the 2026 report shows—and why women are still being dismissed. The wait is over, but for millions, the wait continues. The 2026 Endometriosis UK Report has officially been released, and the findings are a sobering wake-up call for healthcare providers and policymakers alike. At a time when medical technology is advancing faster than ever, the reality of living with endometriosis in the UK is becoming increasingly difficult. Instead of closing the gap, the data shows we are drifting further away from timely care. Why This Report Matters Endometriosis UK’s 2026 State of Endometriosis Care in the UK report offers an invaluable look at the lived experience using the data from 3,075 respondents who had received a diagnosis of endometriosis from a healthcare practitioner in the UK since 2015. It provides one of the most comprehensive insights into diagnosis times, standards of care, and real-world patient outcomes ever recorded. As the UK’s leading charity for the condition, Endometriosis UK serves as the primary advocate for the “1 in 10.” They provide vital support services, reliable information, and a community for those suffering, while campaigning relentlessly for government policy changes and better NHS clinical standards. Their goal is simple but ambitious: to ensure that everyone with endometriosis has the right to a timely diagnosis and high-quality treatment. The Numbers: A Downward Spiral The most startling takeaway from the 2025-2026 data is the “Trend Line of Delay.” We are no longer just stagnant; we are moving in the wrong direction. The Diagnosis Gap The average time from the first GP visit to an endometriosis diagnosis in the UK overall has climbed to 9 years and 4 months. To put that in perspective: This isn’t just a statistic; it represents nearly a decade of someone’s life spent in limbo. For ethnically diverse communities, the situation is even more dire, with an average diagnosis time of 11 years – nearly two years longer than the national average. The Postcode Lottery Where you live in the UK significantly impacts how quickly you receive an endometriosis treatment plan. What Does Endometriosis Feel Like? Endometriosis is a chronic, often debilitating condition affecting 1 in 10 women (1.5 million in the UK and 176 million worldwide). It occurs when tissue similar to the lining of the womb grows elsewhere. 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. Common symptoms of endometriosis include: Chronic pelvic pain and severe menstrual cramps, heavy periods, deep pain during or after sex, pain when urinating or defecating and infertility. And secondary symptoms like bloating (often called “endo belly”), severe fatigue and mental health struggles (98% of patients report an impact on their mental wellbeing). It can also sometimes cause complications with fertility. It is frequently accompanied by adenomyosis, where this tissue grows into the muscular uterine wall. The 2026 report found that 32% of respondents had been diagnosed with both. Up to 40% of those with endometriosis are estimated to also have adenomyosis. If doctors only treat one, symptoms of endometriosis like pelvic pain and heavy periods often persist. The Culture of Dismissal ” GP told me pain was normal for women. I was told it was all in my head. I was told I was too young to have health problems. I was told it was psychosomatic and there was nothing there.” Perhaps the most heartbreaking stat is that 83% of patients were told by healthcare professionals that they were “making a fuss about nothing” or that their symptoms were “normal.” 50% went to A&E only to be sent home. 80% were put on the contraceptive pill before any investigation, effectively masking the signs of endometriosis and delaying surgical diagnosis. “I felt over the moon that I finally had a diagnosis so that teachers, family, and just anyone would actually take me seriously now.” For many, the dismissals were gendered or only corrected when a man was present: “Doctors only really took my pain seriously when I mentioned it having an impact on my male partner’s life… they only really listened when I started bringing him along to appointments.” The impact on living with endometriosis is not just physical; 98% say their mental health has suffered. One 21-year-old respondent shared: “My mental health was genuinely so bad, the only way out I thought was suicide… if my mum hadn’t paid privately, I don’t know if I’d have been able to live like this anymore.” The Gynaecology Waiting List: A Systemic Bottleneck Even if you clear the first hurdle of being taken seriously by a GP, the path to endometriosis treatment remains blocked by a massive, systemic backlog. For many, the “referral” is just the start of a new, years-long wait. “I was referred in April 2024 with a 67-week wait. By November 2025, I was still waiting, and the average wait had risen to 114 weeks.” — Patient Quote At the start of 2026, roughly 750,000 women are waiting for gynaecology care in England. Gynaecology has now become the largest specialty for those on waiting lists aged 18–64. The statistics are a stark reminder of the “secondary wait”: 32% of patients are waiting over a year after being referred to secondary care. 9% are waiting over two years after their referral. Despite the 10-Year Women’s Health Strategy, the reality on the ground hasn’t shifted. The NICE Guideline on Endometriosis (updated in 2024) and the Quality Standard (2018) were designed to ensure all healthcare practitioners suspect endometriosis immediately upon presentation. However, these standards have not been fully implemented in any UK nation. Without mandatory enforcement or a clear audit process, these guidelines remain “suggestions” rather than the rule. This lack of accountability is a primary driver of the worsening 9-year diagnosis time. This means that even with a supportive GP, […]

Can GLP-1s like Ozempic or Mounjaro help with PCOS? Our experts explain how they work, safety rules before pregnancy, and what to know about long-term use. Thank you to everyone who joined our recent webinar, “GLP-1 RAs: The PCOS Game Changer?”with Dr. Helen O’Neill and Dr. Paul Hardiman. The overwhelming response (over 600 attendees) confirmed the critical need for transparent, evidence-based information regarding these new therapies and their role in managing Polycystic Ovary Syndrome. We know the session generated significant interest and, crucially, many complex questions about everything from long-term safety and fertility planning to navigating the NHS and finding effective alternatives. This document serves as our expert-synthesised FAQ, acting as a crucial next step in your journey. It consolidates the questions we received into a concise, actionable resource. This FAQ will help you understand: By providing these clinically-vetted answers, we aim to empower you to have confident, informed conversations with your own healthcare providers, ensuring your PCOS management pathway is truly personalised and effective. Understanding PCOS and How GLP-1 Medications Fit In What does an irregular period mean in PCOS? According to the 2023 International Evidence-Based Guidelines (Teede et al., 2023), for women 3 years post-menarche up to the perimenopause stage, irregular menstrual cycles are defined as: OR Does everyone with PCOS have insulin resistance, even if my test results (such as glucose) have always been negative? No, not everyone with PCOS has insulin resistance (IR), but it is a critical part of the syndrome’s pathogenesis, documented in approximately 75% of women with PCOS (Cleveland Clinic, 2024).It is important to know that in the early stages of IR, standard tests like fasting glucose or HbA1c may appear normal because the pancreas is compensating by overproducing insulin (hyperinsulinemia). Therefore, monitoring glucose levels alone will not reliably detect the onset of IR. If my BMI is within the normal range (lean PCOS), would GLP-1 RAs still help with my symptoms (like skin, mood, or central adiposity)? Yes, GLP-1 RAs primarily target insulin sensitivity, which is thought to be a core driver of the syndrome, not just weight loss. Preclinical studies indicate that GLP-1 RAs can directly improve reproductive endocrinopathy by reversing high Luteinising Hormone (LH) levels and reducing serum testosterone and the Free Androgen Index (FAI) (Bednarz et al., 2022). These hormonal improvements offer a potential treatment strategy to manage hyperandrogenism-related symptoms regardless of BMI. What are the non-pill treatment options for managing acne and irregular periods in women with lean PCOS? For women with a normal BMI who wish to avoid the contraceptive pill, management focuses on lifestyle and targeted therapies: Ensure you consult a doctor or sexual health specialist before taking any supplements, vitamins or starting new treatments.  . At Hertility, we provide diagnostic testing with clinical grade results into your hormonal health. Get actionable insights into your reproductive health and egg count, and screen for up to 18 conditions such as PCOS. Receive in-depth insights, a comprehensive Doctor-written report, a clinically recommended Care Plan, and a complimentary Clinical Result Review Call. My GP is reluctant to diagnose or treat me for PCOS; what steps can I take to get appropriate care? PCOS diagnosis in the UK is guided by International Evidence-based Guidelines, typically using the Rotterdam Criteria (2 out of 3 features: irregular periods, hyperandrogenism, or polycystic ovarian morphology) (NICE, 2025; Teede et al., 2023). If you are struggling to get a diagnosis, ensure you have documented evidence of your symptoms (irregular periods, clinical signs like acne or hirsutism, and any relevant blood test or ultrasound reports). The Hertility Advanced Hormone & Fertility Test is a diagnostic test with clinical grade results into your hormonal health. Get actionable insights into your reproductive health and egg count, and screen for up to 18 conditions such as PCOS. Receive in-depth insights, a comprehensive Doctor-written report, a clinically recommended Care Plan, and a complimentary Clinical Result Review Call. We also provide fast referrals to leading UK private fertility clinics and treatment centres for comprehensive onward care. GLP-1 for PCOS: Safety, Effectiveness and Long-Term Use If I achieve my weight and symptom goals on a GLP-1 RA, will I regain the weight and symptoms if I stop taking it? Is this medication necessary long-term? GLP-1 RAs should generally be viewed as a long-term management strategy for a chronic metabolic condition. Clinical data does indicate a considerable likelihood of weight regain upon cessation, with weight often returning toward the pre-treatment baseline within about a year (Budini et al., 2025). However, the outlook is not universally negative; some evidence suggests that more than half of patients are able to maintain the achieved weight loss one year after discontinuing the medication (Szczesnowicz et al., 2023). Are there any known long-term health risks associated with taking GLP-1 RAs? While GLP-1 RAs are generally well-tolerated, rare but serious adverse events can occur, including acute pancreatitis and gallbladder issues (Szczesnowicz et al., 2023). Furthermore, long-term safety, particularly regarding combination therapy (e.g. with Metformin) in women with PCOS is an area that requires further research. It is crucial to obtain these prescriptions only from a doctor and fill them at a pharmacy, as unapproved or compounded versions have not been reviewed for safety or quality. If hair loss or fatigue occurs while taking a GLP-1 RA, what steps or supplements can help manage these side effects? Hair thinning or increased shedding (telogen effluvium) reported while on GLP-1 RAs is typically considered temporary and is usually attributed to the physiological stress of rapid weight loss or significant dietary changes, rather than the drug itself (Healthline, 2025). Management involves consulting your healthcare provider to assess your overall health and ensuring adequate nutritional intake, as inadequate consumption of key vitamins and minerals can impede the hair growth cycle. Vitamin D, iron and zinc are common deficiencies that can cause hair loss, but ensure you contact your doctor before taking any vitamins or supplements.  Through targeted dietary and lifestyle advice, Hertility works alongside you to help manage your symptoms of PCOS or help you […]

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: 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