Category: Reproductive Health Issues & Conditions

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

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 […]

September is PCOS Awareness Month, and if you’re trying to conceive with polycystic ovary syndrome (PCOS), you may have already discovered how much misinformation exists online.  PCOS affects around 1 in 10 women in the UK, yet many don’t receive a diagnosis until they start facing fertility challenges. If you’ve been told (or read online) that “PCOS means you can’t get pregnant,” let’s stop right there. PCOS can feel like a roadblock, but the truth is many people with PCOS go on to have healthy pregnancies, sometimes naturally, sometimes with a little help. But understanding how PCOS impacts fertility is the first step to taking back control.  In this guide, we’ll break down what PCOS actually means for your fertility, natural ways to improve your chances of conception, the most effective medical treatments, and when to seek extra support. We’ll also cover the emotional side of trying to conceive with PCOS, because it’s about much more than just biology. TL;DR (Trying to Conceive with PCOS – Quick Summary) PCOS affects around 1 in 10 women in the UK, and while it can make ovulation irregular, pregnancy is still possible. Many people with PCOS conceive naturally, though it may take longer due to unpredictable cycles. Lifestyle changes like balanced nutrition, exercise, supplements, and stress management can improve the regularity of your cycles, PCOS symptoms and fertility outcomes. Medical treatments from ovulation induction (Clomid/Letrozole/Gonadotrophin injections) to in-vitro fertilization (IVF) may be needed to address PCOS-related fertility issues. Getting support early, through fertility testing, nutrition and lifestyle management and tailored care, can make a big difference. You are not alone, PCOS is one of the leading causes of fertility issues, but with the right support, pregnancy is absolutely possible. What is PCOS and How Does It Affect Fertility? Polycystic Ovary Syndrome, better known as PCOS  is one of those conditions that most of us have heard of, but few of us really understand. It’s often framed as a fertility roadblock, but the reality is more nuanced. Around 1 in 10 women in the UK are thought to live with PCOS, though many don’t even know they have it until they start thinking about pregnancy. That’s often when the questions start: Why are my periods so irregular? Why does ovulation feel impossible to track? Is getting pregnant even an option for me? In PCOS, a delicate hormonal relay between the brain and the ovaries gets disrupted. Instead of one egg maturing and being released each month, multiple small follicles often develop but don’t quite make it to the finish line. In some cases, the ovaries can end up looking ‘polycystic’ on an ultrasound, but they are not cysts, they are lots of tiny immature follicles. At the same time, higher levels of androgens (so-called “male hormones”) and insulin resistance can throw the whole system off balance. The result? Ovulation might become unpredictable or stop altogether. That said, difficult does not mean impossible, ovulation can still occur in PCOS, sometimes unpredictably, and with the right intervention, it can be regulated. What Are My Chances of Getting Pregnant with PCOS? If you’ve Googled “Can you get pregnant naturally with PCOS?“, ” How to get pregnant with PCOS quickly” ? You’ve probably come across some pretty gloomy takes, headlines about infertility, scary statistics, forums filled with worst-case scenarios. It’s no wonder that so many people with PCOS assume pregnancy is out of reach.The truth? Yes, you absolutely can get pregnant naturally with PCOS. It just might not follow the textbook cycle you read about in biology class. Why Getting Pregnant Naturally Can Be Harder with PCOS Natural conception relies on timing, you need to ovulate, sperm needs to be there at the right moment, and fertilisation has to line up. With PCOS, ovulation is often the unpredictable piece of the puzzle. Some people with PCOS ovulate only a few times a year. Others might ovulate irregularly, one cycle at 35 days, the next at 60. That makes it harder to know when you’re ovulating, and harder to plan sex around your fertile window. But harder doesn’t mean impossible. Studies suggest that while it may take longer, many people with PCOS conceive without medical treatment. For some, it happens once they start making small lifestyle shifts (like balancing blood sugar, exercising regularly, or addressing stress). For others, they might need medical support. So rather than thinking of PCOS as shutting the door on pregnancy, it’s more accurate to see it as a condition that may require a different key.  Hertili-tip: If you’ve been trying for 12 months (under 35) or 6 months (over 35) or you have irregular cycles, book a Hertility Advanced at-home hormone and fertility test to get ahead. Step-by-Step: How to Boost Your Chances of Conceiving with PCOS Trying to conceive with PCOS can feel overwhelming, but breaking it down into clear steps makes the journey more manageable. Think of this as a roadmap, not a rigid schedule, but a sequence of strategies that build on each other. Pay attention to the preconception phase, the preconception phase is defined as the three months before you conceive. Why? Well, a few lifestyle changes before actively trying can make all the difference to your chances, according to the NHS. They recommend eating a healthy, balanced diet, drinking less alcohol, and exercising regularly to help prepare your body for getting pregnant.  Step 1: Get Clear on What’s Happening in Your Body The first step is clarity. Not every woman with irregular cycles has PCOS, and not everyone with PCOS experiences it in the same way. Getting a confirmed diagnosis through hormone blood tests and an ultrasound scan is important, because it helps rule out other conditions that can mimic PCOS.  Once you have that clarity, the next part is understanding how your cycles work. Most cycle tracking apps assume a neat 28 – 30 day cycle, where ovulation happens like clockwork around day 14. With PCOS, ovulation may happen on day 20, day 40, or not at […]

Polyendocrine metabolic ovarian syndrome (PMOS) is the condition you may still know as polycystic ovary syndrome (PCOS). It’s one of the most common hormonal conditions, affecting around 1 in 8 women. But despite the old name, it has never been just about the ovaries. PMOS can affect your periods, ovulation, skin, hair, metabolism, fertility, sleep and mental health. It can also look completely different from one person to another. One person may have very irregular periods and excess facial hair, while another has acne, fairly regular cycles and no obvious symptoms until they start trying to conceive. That variation is one of the reasons PMOS can be difficult to recognise and why diagnosis is sometimes delayed. Whether you have recently been diagnosed, think your symptoms could be linked to PMOS, or have been living with the condition for years, this guide covers PCOS symptoms, diagnosis, fertility, treatment, nutrition and long-term health. Quick facts:  If you are wondering whether your symptoms could be linked to PCOS, Hertility’s Advanced Hormone and Fertility Test can help build a clearer picture of your hormones, cycle and symptoms to help you understand what’s going on. Why was PCOS renamed PMOS? On 12 May 2026, the international PCOS community officially adopted the name polyendocrine metabolic ovarian syndrome, or PMOS. The previous name, polycystic ovary syndrome, could be misleading for several reasons. Firstly, the “cysts” associated with PCOS are not typical ovarian cysts. They are usually small ovarian follicles containing immature eggs. Secondly, you can have the condition without having polycystic-looking ovaries at all. Most importantly, the old name placed the emphasis on the ovaries when the condition can affect much more than reproductive health, including metabolism, hormones, mental wellbeing and long-term health. The new name was developed through an international process involving healthcare professionals, researchers and people living with the condition. If you already have a PCOS diagnosis, you do not need to be diagnosed again. Your diagnosis has not changed. You will also continue to see the term PCOS in medical records, research and online searches, which is why we use both PCOS and PMOS throughout this guide. Read more: PCOS has been renamed PMOS — here’s what that means for you. How common is PCOS? The World Health Organization estimates that PMOS affects up to 13% of women of reproductive age, making it one of the most common hormonal conditions worldwide, and that up to 70% of those affected may not know they have it. In the UK, the NHS estimates it affects about 1 in every 10 women. Part of the problem is that there’s no single way it presents. Diagnosis can also take time. In one international study, over a third of people with PCOS waited more than two years for a diagnosis, and almost half saw three or more health professionals before getting one. What are the common symptoms of PCOS? PCOS symptoms can affect your menstrual cycle, skin, hair, metabolism, sleep, mood and fertility. You do not need to have every symptom to have the condition. Menstrual cycle-related symptoms One of the most common features is irregular ovulation. which can make periods longer, unpredictable or absent for months, sometimes with heavier or prolonged bleeding after a long gap.  You may ovulate later, less often, or not at all in some cycles (an anovulatory cycle). In adults more than three years past their first period, cycles shorter than 21 days, longer than 35 days, or fewer than eight a year are considered irregular. Having regular periods don’t completely rule out PCOS, though more on that below.  If you want to understand your own cycle, see our guide Menstrual Cycle 101: Your Complete Guide to How Your Cycle Works Skin and hair-related symptoms Higher androgen activity (androgens include hormones like testosterone) can contribute to acne, oily skin, excess facial or body hair (known as hirsutism), often on the chin, upper lip, chest, abdomen or back, and scalp hair thinning, often noticed as a widening parting.  Hair-growth patterns vary a lot between individuals and ethnic groups, which matters when symptoms are assessed. Some people also develop acanthosis nigricans, darker, thicker, velvety-looking skin around the neck or underarms, which can be linked to insulin resistance. To find out more about how hormones affect your skin, read our guide to skin and hair changes. Weight gain or difficulty losing weight Some people experience weight gain or find weight harder to manage, but you don’t need to be overweight to have PCOS. It affects people across all body sizes, and insulin resistance can occur in people who aren’t overweight. Fatigue and sleep problems Significant tiredness is common, although fatigue has many causes and shouldn’t automatically be blamed on hormones. Obstructive sleep apnoea is more common in PMOS, even after taking BMI into account. So if you snore, wake up unrefreshed or feel tired all day, it’s worth talking to a healthcare professional. Mental health-related symptoms PCOS isn’t only physical. Depression and anxiety are more common, and symptoms like acne, unwanted hair growth, fertility difficulties, body-image concerns and weight stigma can all affect quality of life. Current guidance recommends that psychological wellbeing forms part of PMOS care, including screening and support for depression, anxiety and eating disorders. Difficulty conceiving PCOS is a leading cause of irregular ovulation and anovulatory infertility. If ovulation happens less often, there are fewer chances for egg and sperm to meet. But that’s very different from saying everyone with PCOS is infertile; many conceive naturally, and effective treatments exist when ovulation needs support. What causes PCOS? There is no single known cause of PCOS. Instead, it appears to develop through a combination of genetics, hormone signalling, ovarian function, metabolism and environmental factors. Two factors that are particularly important are androgens and insulin. High levels of Androgens Androgens are a group of hormones, the most common being testosterone. They are produced mainly by the ovaries and adrenal glands and have roles in reproductive health, bone and muscle health, sexual function and wider physiology. […]

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:  

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

Check your fertility The results revealed that between fertility preservation methods: egg, embryo or ovarian tissue freezing, there was no significant difference between these methods for women to have live births after pregnancies. At Hertility we are so proud to not only offer new and different care pathways for women but also to be home to so many amazing researchers. So we thought in this article we would take you through the research, and the findings and explain them to you. After all – knowledge is power! First up, let’s recap on fertility preservation…. We’ve already published an article that covers all the different types of fertility preservation for people with ovaries but here is a brief sum up: There are both medical and social reasons to undergo fertility preservation.  Medical fertility preservation means preserving parts of your fertility in people who might lose their ability to reproduce due to upcoming medical treatment, for example, cancer patients about to undergo chemotherapy/radiotherapy or people undergoing gender reassignment surgery, or for some who have an autoimmune condition that want to protect their fertility. Whereas, social fertility preservation is when you are opting to freeze your eggs because of social and age-related factors. There are several different fertility preservation methods, some of which include: Egg freezing – This is what it says on the tin: collecting your egg cells and putting them on ice for later use. Embryo freezing – This process involves fertilising your collected egg with IVF using either donor’s or your partner’s sperm and then the resulting embryo is frozen until you are ready to use it. Ovarian tissue cryopreservation – This method is created mostly for younger patients who have not yet gone through puberty and are therefore not able to fully mature their egg cells. Tissue containing immature eggs is cut from their ovaries and is preserved in a tissue bank until the tissue can be re-implanted and used at a later stage, however, this is not routinely used for the general population. There are more fertility preservation options but in this study, researchers only included cancer patients who had undergone oocyte, embryo or ovarian tissue cryopreservation (freezing) What did this study do? Researchers followed cancer patients that had both fertility preservation and then had fertility-damaging cancer treatment (gonadotoxic therapy) who were now looking to start a family using their cryopreserved oocyte, embryo or ovarian tissue. The main outcomes this research looked at were if there were clinical pregnancies (clinical signs of the foetus can be either seen or heard), miscarriages (pregnancy loss) and live birth (completed pregnancies that result in a live birth). What were the results? This study found that between fertility preservation methods: egg, embryo or ovarian tissue freezing, there was no significant difference between these methods for women to have live births after pregnancies. (In science it’s all about whether a difference is significant or not!).  Also high clinical pregnancy rates and live birth rates were observed in all techniques. They also found that freezing ovarian tissue results in significantly less miscarriages than embryo freezing, which is interesting and is something to further investigate! What do these results mean? Like anything in science, there are limitations in the study and this research does report some limitations since it was an early analysis. However, this is a really important and interesting starting point in this area of research and for cancer-related fertility preservation.Researchers hope that this study helps to establish better reporting of outcomes in cancer patients and will encourage clinicians to use appropriate statistics and information to counsel women who find themselves facing a cancer diagnosis on their chances of biological motherhood. If you fancy having a read of the article yourself, have a look here! At Hertility, we are dedicated to revolutionising women’s healthcare, whether that be through improving care pathways, helping women receive answers about their bodies through our at-home tests or contributing to the Women’s Health research. It’s all part of our mission for a #ReproductiveRevolution. Recent research conducted by some of our Hertility Team, led by one of our co-founders Dr Natalie Getreu, has been published in the Fertility and Sterility Journal. Fertility can be affected by cancer and cancer treatment to such an extent that women may have reduced family planning options once they’ve completed their treatment. Although, records of the success of fertility preservation methods in cancer patients are not routinely collected by hospitals, fertility clinics or researchers. Instead, when it comes to egg and embryo freezing, clinicians routinely use success rates from patients that have undergone fertility preservation for social reasons as opposed to medical reasons. Therefore, our research team aimed to look into pregnancy outcomes in cancer survivors who had used their frozen tissues to provide more up-to-date and relevant information for these patients. Check your fertility The results revealed that between fertility preservation methods: egg, embryo or ovarian tissue freezing, there was no significant difference between these methods for women to have live births after pregnancies. At Hertility we are so proud to not only offer new and different care pathways for women but also to be home to so many amazing researchers. So we thought in this article we would take you through the research, and the findings and explain them to you. After all – knowledge is power! First up, let’s recap on fertility preservation…. We’ve already published an article that covers all the different types of fertility preservation for people with ovaries but here is a brief sum up: There are both medical and social reasons to undergo fertility preservation.  Medical fertility preservation means preserving parts of your fertility in people who might lose their ability to reproduce due to upcoming medical treatment, for example, cancer patients about to undergo chemotherapy/radiotherapy or people undergoing gender reassignment surgery, or for some who have an autoimmune condition that want to protect their fertility. Whereas, social fertility preservation is when you are opting to freeze your eggs because of social and age-related factors. There are […]

Absenteeism, presenteeism, and stigma in the workplace. The profound impact of menstruation on workplace productivity and attendance is often overlooked, but period, PMS and symptoms associated can be extremely debilitating. Every day, millions of people show up to work and perform at the highest level while silently navigating the complexities of reproductive health. Many might try to manage it with home remedies and over the counter medication; for up to 1 in 10 women, it can cause severe debilitating chronic pain, impacting their daily routine due to a condition called endometriosis. “I never did say to work, that I was off because of period pain because I worked for years in a very male dominated banking environment…I felt there was an issue of stigma with saying I was off…I would have to invent reasons month after month, soldier on, dose yourself up and try and get through the days best you could. Then collapse when you go home.” – (Gender Health Gap Report, 2024) The Data: How can employers support this? 1. Help people understand the basics of their reproductive health. A supportive workplace can improve employee productivity and loyalty, reduce absenteeism and improve DE&I. Here are a few recommendations on how you can support your employees better through inclusive healthcare. Many women grew up believing period pain was a normal part of life. Social and cultural taboos combined with a lack of education on menstrual health could explain why someone might not discuss their period-related symptoms or ignore them altogether. Employers can help break this cycle of misinformation by referring employees to resources to understand their reproductive health better. Additionally, organising lunch & learns and workshops can be a stepping stone to open dialogue and normalise conversations around period pain in the workplace. 2. Establish support in the workplace. Experiencing pain in the workplace is challenging for employees. Providing flexible working hours, rotas and arrangements such as a quiet room, period products, heat packs, or modified workstations can support employees with the time they might need to prioritise their health. Research on menstrual workplace policies from Monash University found that flexible policies based on the individual employee’s needs were more effective than a blanket period leave. Beyond policies, ensuring that managers are well-trained to talk about reproductive health and support employees through their struggles will also help create a supportive environment at work. 3. Find the right partner to support reproductive health policies. Taking the first steps in making the workplace more period-friendly is a big task, which is why it is important to find a reputable expert provider who can support employers in educating their workforce, instating progressive policies and providing solutions to employees’ worries around their reproductive health. Hertility Health is shaping the future of reproductive health by giving women the ability to understand and manage their hormone health from menstruation to menopause. We believe in a proactive approach to reproductive health – by detecting issues early, helps prevent issues later down the line. We deliver our world-class reproductive health benefits to many leading companies and improve access to reproductive healthcare and education. We provide in personalised plans – for you and your employees – and offer a range of corporate plans and coverage options to suit your needs, from educational workshops, to female health assessments and consultations with in-house experts. For early adopters that have existing fertility treatment benefits for employees, we help you protect your budget – our proactive hormone tests are a fraction of the clinic price and by identifying issues early we can prevent costly treatment. Where treatment is required, our blood tests are accepted by partner clinics and reduce time to treatment. We provide DE&I impact reports, so you can see the tangible impact on your workforce and your bottom line. To learn more about our Reproductive Health Education and Benefits for Employers, reach out to benefits@hertilityhealth.com or visit our website https://hertilityhealth.com/workplace