Category: Gynaecological health

Getting diagnosed with PMOS (PCOS), should not take years. Yet many people are dismissed, told their symptoms are normal, or given the pill without being told what is driving their irregular periods, acne, excess hair growth or fertility concerns. PMOS is diagnosed using the Rotterdam criteria. This means you need to meet at least 2 out of 3 criteria: irregular or absent periods, signs of high androgens, and/or polycystic ovarian morphology on ultrasound or AMH testing. Other conditions, such as thyroid disorders and raised prolactin, should also be ruled out. This guide explains the tests used to diagnose PMOS, what the criteria mean, whether you need an ultrasound, and what to do if you are not getting clear answers. Quick facts: What tests are used to diagnose PMOS (PCOS)? There is no single test that can diagnose polyendocrine metabolic ovarian syndrome, or PMOS. Instead, diagnosis is usually based on a combination of your symptoms, menstrual cycle pattern, hormone levels, metabolic health markers and, in some cases, an ultrasound scan. Your doctor may recommend a combination of the following assessments. Medical history and symptom assessment The first step is usually a detailed conversation about your symptoms and health history. This may include questions about: This helps build a clearer picture of whether your symptoms fit with PMOS and whether other conditions need to be ruled out. Physical examination A clinician may also look for physical signs that can be associated with PMOS. These may include acne, excess facial or body hair, scalp hair thinning, skin tags or darker velvety patches of skin, which can sometimes be linked to insulin resistance. This helps identify patterns that may guide further testing. Blood tests for PMOS (PCOS) Blood tests are often used to check hormone levels, assess metabolic health and rule out other conditions that can cause similar symptoms. These may include: These tests help identify whether PMOS is likely, how it may be affecting your body, and what kind of support may be most appropriate. Pelvic ultrasound scan for PMOS (PCOS) A pelvic ultrasound may be recommended to look at the ovaries and uterus. This can help assess whether the ovaries have a polycystic appearance, meaning they contain a higher number of small follicles. A transvaginal ultrasound is often used because it provides a clearer view of the ovaries. This involves placing a slim ultrasound probe into the vagina, which uses sound waves to create images on a screen. However, having polycystic-looking ovaries alone is not enough to diagnose PMOS. Some people have polycystic ovaries without symptoms, and some people with PMOS may not have obvious changes on ultrasound. Pelvic examination In some cases, a pelvic examination may be offered to check for abnormalities or signs of other reproductive health conditions. This is not always needed for a PMOS diagnosis, but it may be useful if you have symptoms such as pelvic pain, abnormal bleeding or pain during sex. Testing does more than confirm a diagnosis. It can help rule out other causes of irregular periods, acne, excess hair growth or difficulty conceiving, and it can identify whether PMOS is affecting ovulation, hormone balance or metabolic health. That means your care can be tailored to what is actually happening in your body, whether that involves cycle support, fertility planning, skin and hair treatment, metabolic health support or longer-term monitoring. How is PMOS/PCOS diagnosed? PMOS is diagnosed using the Rotterdam criteria, the internationally recognised diagnostic framework, most recently updated in the 2023 International Evidence-Based PCOS Guidelines. To receive a diagnosis, you must meet at least 2 of the following 3 criteria. You do not need all three. Criterion 1: Irregular or absent menstrual cycles This criterion reflects the disruption to ovulation that is central to PMOS. When elevated androgens interfere with follicle development, ovulation doesn’t happen reliably, and without ovulation, the regular hormonal cycle that produces a period is disrupted. What counts as irregular?  A single late or missing period doesn’t meet this criterion, it needs to be a consistent pattern, not an occasional variation. Criterion 2: Clinical or biochemical hyperandrogenism (elevated androgens) This criterion reflects the androgen excess that is the hormonal driver of many PMOS symptoms. It can be met in two ways, through physical symptoms, or through blood test results, either is sufficient. Clinical hyperandrogenism means physical signs of elevated androgen activity: Biochemical hyperandrogenism means elevated androgens on a blood test including high testosterone and DHEAS. SHBG is a protein that binds to testosterone and reduces its biological activity. In PMOS, SHBG is often low, meaning more testosterone is free and active. This is why a PMOS-focused blood panel should always include SHBG alongside testosterone, not testosterone in isolation. Hormonal contraception can raise SHBG significantly, which suppresses testosterone and can mask androgen excess entirely. If you’re on or have recently stopped the pill, your androgen levels may not reflect your true baseline for several months. Ideally, androgens should be tested at least 3 full cycles after stopping hormonal contraception for the most accurate picture. Criterion 3: Polycystic ovarian morphology (PCOM) This criterion refers to evidence of the characteristic ovarian appearance associated with PMOS, a high number of follicles that haven’t been able to progress to ovulation. It can now be assessed in two ways: Transvaginal ultrasound (TVUS) A pelvic ultrasound scan counts the number of follicles visible in each ovary. The scan should ideally be performed in the early follicular phase, days 1-7 of the menstrual cycle, when follicles are at their most clearly countable.  AMH blood test This is the significant change introduced in the updated 2023 guidelines. AMH (anti-Müllerian hormone) is a hormone made by the follicles themselves. In PMOS, AMH is typically elevated, reflecting the high number of small arrested follicles. AMH is now formally accepted as an alternative to ultrasound for assessing polycystic ovarian morphology. This means that for many people, a blood test alone can support this third criterion, without the need for an internal transvaginal scan. Can AMH diagnose PMOS (PCOS)? AMH can help […]

If you’ve recently heard the term PMOS and wondered what it means, or if you’ve had a PCOS diagnosis for years and want to understand what’s changed, this is your complete guide. PMOS stands for polyendocrine metabolic ovarian syndrome. It’s the new name for what was previously called polycystic ovary syndrome (PCOS). The name has changed, but the condition hasn’t, and understanding it properly has never mattered more. PMOS affects an estimated 1 in 8 women and people with ovaries worldwide, more than 3.1 million in the UK alone. Despite being one of the most common hormonal conditions, it remains widely misdiagnosed, misunderstood, and undertreated. On average, it takes two years and multiple doctor visits to get a diagnosis. You deserve better than that. This guide covers everything: what PMOS actually is, what causes it, what it feels like, how it’s diagnosed, and what you can do about it. Quick facts: What is PMOS? P – PolyendocrineM – MetabolicO – OvarianS – Syndrome Let’s break that down: Polyendocrine means more than one hormone system may be involved. PMOS can affect reproductive hormones such as testosterone, LH and FSH, but it may also affect insulin, thyroid hormones, cortisol and other metabolic pathways. Metabolic refers to the way your body processes energy, sugar and insulin. Many people with PCOS/PMOS have some degree of insulin resistance, where the body has to produce more insulin to keep blood sugar stable. Ovarian reflects the fact that the ovaries may be affected, particularly ovulation. However, despite the old name “polycystic ovary syndrome”, you do not need to have cysts on your ovaries to have the condition. Syndrome means it is a collection of features that can look different from person to person. PMOS is the most common cause of irregular periods and ovulatory infertility in people with ovaries. It is also linked to an increased risk of developing insulin resistance and longer-term health risks including type 2 diabetes, cardiovascular disease, endometrial cancer, anxiety and depression. Is PMOS the same as PCOS? PMOS is just the newer name being used for PCOS. For years, the condition was called polycystic ovary syndrome (PCOS), but that name has always been a bit misleading. Not everyone with PCOS has polycystic-looking ovaries, and not everyone with polycystic-looking ovaries has PCOS. The condition also affects far more than the ovaries. The shift towards PMOS aims to better reflect the full-body nature of the condition, including its links with insulin resistance, androgen excess, metabolic health, cardiovascular risk, mental health and fertility. That said, PCOS is still the most widely recognised search term, and most NHS, NICE and clinical guidance currently still uses PCOS. So, for now, you may see both terms used: PCOS = the older, widely used namePMOS = the newer, more accurate name You can read more about why PCOS was renamed PMOS here. What causes PMOS? The exact cause of PMOS isn’t fully understood, but research points to a combination of genetic, hormonal and metabolic factors. It tends to run in families, and if your mother, sister or aunt has PMOS, you might be at a higher risk. At its core, PMOS involves a dysfunction in the way the body produces and responds to hormones, particularly androgens and insulin. Androgen excess – the ovaries (and in some cases the adrenal glands) produce higher levels of androgens than normal. Androgens are often called “male hormones,” but they play important roles in everyone’s body. In PMOS, elevated androgens disrupt the normal development of follicles in the ovaries, preventing regular ovulation. Insulin resistance – the majority of people with PMOS have some degree of insulin resistance, meaning their cells don’t respond efficiently to insulin. This causes the pancreas to produce more insulin to compensate, and elevated insulin in turn stimulates the ovaries to produce more androgens, creating a self-reinforcing cycle. Disrupted pituitary signalling – the hormonal signals from the brain to the ovaries are altered in PMOS. LH (luteinising hormone) is often disproportionately elevated relative to FSH (follicle-stimulating hormone), which further disrupts follicle development and ovulation. Genetic factors – PMOS can run in families, suggesting genes play an important role. Researchers are trying to identify which genes are involved, but because it’s a complex condition, it’s not surprising that it’s not a single gene, but that many genes are involved. What are the symptoms of PMOS? PMOS presents differently  from person to person. Some people have many symptoms; others have very few. Some symptoms are visible; others are internal. This variability is one of the reasons it takes so long to diagnose. Irregular or absent periods Irregular menstrual cycles are one of the hallmark features of PMOS. Because elevated androgens interfere with regular ovulation, periods can arrive unpredictably, sometimes weeks late, sometimes skipped altogether. Some people experience very long cycles (35 days or more); others may go several months without a period. What counts as irregular? Cycles shorter than 21 days or longer than 35 days, fewer than 8 periods per year, or periods that have no predictable pattern. If your periods have always been irregular  or if they became irregular after stopping the pill, PMOS is one of the first things worth looking into. Hormonal acne Hormonal acne is one of the most common and most distressing symptoms of PMOS. PMOS-related acne typically appears along the jawline, chin and lower cheeks. It may flare around the time of a period, or it may be persistent and seemingly random. It tends to involve deeper, more inflamed spots rather than surface-level break out, and it often doesn’t respond well to standard skincare. If you’ve tried everything on your skin and still can’t get it under control, your hormones are worth investigating. Unwanted hair growth (hirsutism) Elevated testosterone stimulates hair growth in areas where most women don’t typically grow coarse hair, the upper lip, chin, jaw, chest, stomach and inner thighs. This is called hirsutism, and it affects a significant proportion of people with PMOS. It can range from fine, barely noticeable hair to […]

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

This January as part of Cervical Cancer Awareness Month, we explore how to improve your cervical health to prevent cervical cancer, enhance your fertility and improve your overall reproductive health. Quick facts: Understanding cervical health Cervical health refers to the health and functioning of the cervix, the lower part of the uterus that connects to the vagina. To check your cervical health, you need to attend regular cervical screenings, (known as the smear test), and ensure you have your HPV vaccination. Your cervical fluid changes throughout your menstrual cycle and understanding these changes can give you insight into your fertility. Knowing what your cervical fluid looks and feels like throughout your menstrual cycle can help you identify your optimal fertile window (when you’re most likely to get pregnant). Usually, it becomes more slippery, slimy like egg white around ovulation, to help the sperm swim up towards the cervix. Cervical cancer Every year, more than 3,200 people are affected by cervical cancer in the UK. Two women lose their lives to cervical cancer every week and nine more receive a life-changing diagnosis. Despite this, 1 in 3 people don’t attend their smear test. Yet, if it’s caught early, cervical cancer can be treated. Some countries, like Sweden, predict that they will have eliminated cervical cancer by 2030, while the UK aims to eliminate it by 2040. Ensuring that you have your HPV vaccination and also attending your Cervical Screening when you’re invited is the best way to protect against cervical cancer. With the NHS, you should be invited to a smear test every 3 years between the age of 25-49, and every 5 years after that until to turn 64. The frequency may increase depending on if you have any abnormal results. These cervical screenings check the health of your cervix. It’s not a test for cancer, but it’s a test to help prevent cancer. They are crucial in spotting any changes in the cervical cell which could be signs of an infection or cervical cancer.  Cervical cancer often remains undetected because not everyone will always experience symptoms so ensuring your cervical screening is up to date is an important preventative measure.Symptoms like a change in your vaginal discharge, bleeding between periods, or during or after sex, unexplained pain in your lower back or pelvis, or pain and discomfort during sex can all indicate cervical infection or cervical cancer. Cervical cancer awareness month Cervical Cancer Awareness Month aims to encourage more people to attend their cervical screening appointment and take their HPV vaccinations, (in case they haven’t already got it) to prevent cervical cancer as well as raise awareness about common signs and symptoms. You know your body better than anyone. Becoming attuned to it will empower you and help you spot anything out of the ordinary.If you notice anything that doesn’t feel normal (symptoms like bleeding between periods, or unusual vaginal discharge, for example) when it comes to your reproductive health, especially if you’re trying to conceive or plan to have a baby in the future, speaking to a healthcare professional and getting the necessary tests early in the process is key. The connection between cervical health and fertility First, let’s talk about the cervix and how it’s related to your fertility.  Your cervix is a narrow, cylinder-shaped passage, this is where all the uterine lining will pass through during your period. It is the mouth of the uterus and connects it to your vagina. When in labour, the cervix is also the part that dilates, so the baby can be delivered, but it’s more than just a passageway. The cervix plays a key role in conception. When you ovulate, your cervical fluid (sometimes called cervical mucus) becomes watery to help transport the sperm from the vagina towards the cervix and to the egg to become fertilised (the first step of conception). Your cervical health can affect your fertility in various ways. Infections, cervical cancer and structural abnormalities can lead to your cervix not functioning properly. Without the cervical fluid that helps to transport the sperm, and the protective barrier your cervical fluid creates during pregnancy, a poorly functioning cervix could have led to complications. After ovulation, your cervical fluid becomes sticky and thick, acting like a barrier to the sperm. If this happens around the time of ovulation, it could inhibit sperm from reaching the egg, preventing fertilisation and conception. If you do become pregnant, poor cervical health can cause miscarriage or preterm labour. Infections of the cervix, such as sexually transmitted infections (STIs) can negatively impact fertility. Infections cause inflammation and scarring of the cervix, which can affect its normal function and increase the risk of infertility. Common cervical health issues affecting fertility Cervical infections can affect fertility Infections of the cervix, such as sexually transmitted infections (STIs) can negatively impact fertility. Infections cause inflammation and scarring of the cervix, which can affect its normal function and increase the risk of infertility. Cervical polyps can affect fertility Cervical polyps are growths that can develop on the cervix. Polyps are usually (benign) harmless and do not often cause any symptoms, but they can sometimes cause fertility issues, or increase the risk of miscarriage.  Once found, the treatment is usually to remove them. The process of removal depends on the size, type, location, visibility and number of polyps. Cervical dysplasia can affect fertility Cervical dysplasia is a cervical condition in which abnormal cells grow on the surface of your cervix. Cervical dysplasia (also known as cervical intraepithelial neoplasia or CIN) is not cancer but if left untreated, it can develop into cervical cancer and affect fertility. Early detection and treatment is key. Cervical dysplasia is often termed “precancerous”, which can sound scary, but if you get timely treatment, most people who get it do not get cancer. If you have abnormal cells from your screening test, you may be invited to have a colposcopy test to look closer at your cervix. The treatment you need for abnormal cervical cell changes […]

On Wednesday, the 15th of February, we hosted our first community event to launch our Black Women’s Health Initiative. It was a privilege to have brought together so many people who were actively engaged in the topic.  The event provided us with such insightful information and has helped us not only hone our commitments to change but also acted as the first step in our journey as a company. We are still learning and growing as a young seed-stage start-up, but that doesn’t stop us from having big aspirations, and we hope to build on these year after year. We are so thankful to everyone who attended the event. We really appreciate the time, energy and support each person gave.  It was an incredibly proud moment to be able to share the findings from our recent research looking into the role that ethnicity played in access to fertility testing and reproductive healthcare. A roundtable discussion followed, moderated by Hertility’s CEO and founder Dr Helen O’Neill, where we heard from clinical gynaecology experts, community leaders, and patient advocates Dr Christine Ekechi, Dr Stephanie Kuku, Noni Martins and Sophia Ukor. In case you missed it, here’s a rundown of what was covered: The changes to Black women’s reproductive healthcare over the years All the panellists agreed that they are seeing a positive trend, with more conversations being had around women’s health in general, and increased awareness and advocacy from colleagues within the healthcare system and doctors for their patients. We heard about positive interactions with healthcare providers  or seeing positive changes in healthcare delivery in the last five years.  “I feel there is a change with the language, culture and even the way they listen to you. They listen and you feel understood. I felt seen, I did not feel alone. The language, the care and the attention is evident.” – Sophia Ufy Ukor, Founder & CEO of Violet Simon We heard from Dr Christine Ekechi that not only is there an increased awareness of conditions that are more prevalent in Black women, but they are more cognisant of their experiences.  We briefly touched on the current state of the healthcare system and what needs to be done to support healthcare professionals further to provide compassionate care. As the healthcare system becomes more stretched and there is continuous pressure to shorten GP appointments, there will be limitations on the capacity of doctors. It is no surprise that the average GP appointment in the UK lasts just 9.2 minutes, with an average of 2.5 health concerns being discussed (1), and there is not enough time to allow for a  comprehensive discussion about someone’s reproductive health or pregnancy history. Women whose first language is not English and/or who have had a negative experience with a healthcare practitioner are at more of a disadvantage.  “We all swear on the Hippocratic oath to do no harm, but if the system works such that the resources and the human capacity are lacking, there is a dearth of compassion. As a result, unfortunately, I think that, as with everything in life, some people are going to suffer more than others, and the human reflexes are that when you have no capacity, you are less likely to treat people the same” –  Dr Stephanie Kuku Advisor, Consultant and Health Technology Executive (MBCHB MRCOG MD) However, Dr Christine Ekechi also highlighted that the majority of UK-based doctors are willing to learn to improve the care of Black women and there is room for positive impact.  Looking to the future, we heard from both the event and post-event feedback about the importance of framing positive conversations around Black women’s reproductive health to stop the further victimisation of Black women and ethnic minority groups and to empower them so that we can help give women strength and power in healthcare situations, instead of reinforcing currently accepted narratives. The power of knowledge and tips on advocacy Throughout the discussion, a salient theme that shone through was the value and power of having the right information in a healthcare setting, especially when it comes to advocating for ourselves. Noni Martins emphasised the importance of going into GP appointments with symptom diaries and the knowledge about what is going on with your body, as no one knows your body better than you. Dr Christine Ekechi also highlighted that everyone deserves a right to a second opinion if they feel they do not understand or agree with the outcome of their appointment.   “One thing about doctors, particularly doctors now, is that we are cognisant about working in partnership with you…Of course, you’re not going to go into a consultation and understand everything about gynaecology, but you should leave with an understanding of what the concerns are and what the approach is going to be. For me the key is if you come away thinking I have no idea what they said, then you ask for a repeat explanation or ask for a second opinion” – Dr Christine Ekechi Consultant Obstetrician & Gynaecologist and Co-Chair, Race Equality Taskforce, Royal College of Obstetricians & Gynaecologists. We briefly spoke about the prevalence of myths in reproductive health, fertility and women’s health more generally. We know from the Women’s Health Strategy that many women get their information from the NHS website (2), so as Dr Christine Ekechi said, “it’s about going to the trusted sources and addressing those gaps by filling it in with the correct information”. “I think my biggest concern when we have these kinds of discussions is for people who don’t have that voice. I worry about the people who, in their homes and in their communities, cannot speak out about the fact that they have been trying to conceive and it is not working out. I’m always thinking about how we can get to those people, I don’t have the answers. I hope that by being someone who looks like them and talking about it, we can draw them out. Even if you are having a […]

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

COVID-19 and the shift to remote working has catalysed the demand for mental health benefits – it is now a “must have” for employers in 2021. In fact, in a recent survey, 91% of respondents stated that a company’s culture should support mental health. It is no coincidence that mental well-being is included in how reproductive health is defined by the World Health Organisation, stating that “Reproductive health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes”. These two elements of well-being are interconnected. As a result, it is impossible to provide comprehensive mental health benefits without considering the impact that reproductive health conditions can have and figuring out how employees dealing with those can be supported. How do reproductive health conditions affect mental health? InfertilityTake infertility, which affects 1 in 6 couples in the UK. Despite its prevalence, it is often met with confusion and denial.. This can seriously impact mental well-being – feelings of anxiety, depression and loss are all common. Besides, treatment can be time-consuming, stressful and a significant financial burden for individuals. Leading employers in the benefits space are recognising the impact that infertility may have on mental health and offering “fertility leave” as well as compassionate leave after miscarriage. EndometriosisReproductive health conditions such as endometriosis are associated with difficulty conceiving and chronic pain, both of which impact quality of life. Alongside having increased sick leave and loss of productivity, women with endometriosis feel their career goals were impacted negatively. Premenstrual syndrome (PMS)PMS describes the array of physical and emotional changes that occur as part of the monthly cycle. Approximately 90% of people who menstruate experience PMS. In some cases, this can be debilitating, a condition known as premenstrual dysphoric disorder (PMDD). PMDD can be so severe that suicidal thoughts are common in these women. Undiagnosed health issuesUnfortunately, it is not just the physical manifestations of the conditions alone that may impact employees’ mental health. Stigma and shame on reproductive health conditions from society and inadequate support from healthcare with symptom dismissal and months or years required to get to a diagnosis can be a significant cause of anxiety or depression for people suffering from a reproductive health condition. Many things in this journey even after getting the answers are outside of employees’ control. There are no guarantees that fertility treatments will succeed; failed attempts can seriously affect mental health, especially in those cases where little can be done to change the outcome. How can you support your employees on their reproductive health journey?There are several things that you can do to help alleviate the burden reproductive health conditions can place on mental health. Destigmatise reproductive health conditions by encouraging education and learning. This is a great way to challenge the current attitude to reproductive health conditions in the workplace and facilitates supportive conversations. Joining schemes provided by charitable bodies such as the Endometriosis Friendly Employer scheme can help you to make those first steps. Create a supportive workplace environment through flexible working hours for those who need to attend multiple appointments, inclusive leave policies and offering free menstrual products in bathrooms. Provide comprehensive reproductive health benefits by partnering with companies like Hertility to connect your employees to expert care and help them make informed decisions with regards to their reproductive health. These can include things such as proactive testing opportunities with actionable insights, fertility counselling, referrals to trusted clinics and specialist care with experts in the field. About Hertility HealthHertility Health is shaping the future of Reproductive Health by giving women the ability to understand and manage their fertility and hormone health from menstruation to menopause. 1 in 3 women suffer from a reproductive health issue, yet conversations around fertility, menopause and menstrual symptoms are still stigmatised in the workplace. As employees suffer in silence – up to £4k is lost per year per employee due to reduced productivity, absenteeism and presenteeism. Hertility reduces the need for unnecessary appointments and delay in diagnosis time through an online health assessment and at home test. To learn more about our Reproductive Health Education and Benefits for Employers, reach out to benefits@hertilityhealth.com or visit our website.

Endometriosis is a common reproductive health condition that affects 1 in 10 in the UK. It’s characterised by painful, heavy periods as well as other, often debilitating symptoms. Here we go through each of the main symptoms in detail, so you know what to look out for and when to get checked.  Quick facts: Endometriosis in the UK In the UK, endometriosis affects around 1.5 million women and people assigned female-at-birth (AFAB). That’s 1 in 10 who are currently living with the condition, regardless of race or ethnicity (1). People with endometriosis often experience very painful periods as well as a host of other symptoms. Many people live with endometriosis for a long time before getting diagnosed. Sometimes up to 7 years or more.  This is often the result of a general lack of awareness about the condition, dismissal of women’s pain and symptoms having a lot of crossover with other conditions. So what are the main symptoms of endometriosis? Here’s what to look out for if you suspect you, or someone close to you, may have the condition. What is endometriosis? Endometriosis is a chronic reproductive health condition where cells similar to those lining the uterus grow in other parts of the body. Endometrial tissues and lesions are found in the ovaries and Fallopian tubes.  They can sometimes also grow in the vagina, cervix, vulva, bowel, bladder and rectum. Rarely, do they appear in other parts of the body, like the lungs, brain, and skin (2). Just like the lining of the uterus, these cells build up and eventually shed. But unlike your period which drains through the vagina, this blood and tissue has nowhere to go. This can cause inflammation, crippling pain and a long list of other symptoms. Endometriosis can affect women of any age, including teenagers. What are the main symptoms of endometriosis? Here are the most common symptoms of endometriosis (3):  Severe period pain  Severe period and pelvic pain are often reported to be the most debilitating symptoms of endometriosis. This pain is often described as ‘a razor blade pain’.  During your menstrual cycle, the lining of your uterus (endometrium) is built up to support a potential pregnancy. If its baby-making dreams are not fulfilled, your body releases chemicals called prostaglandins.  Prostaglandins cause the uterus to contract and your endometrium sheds. Cue, your period. These contractions are what cause period pain. With endometriosis, the endometrial-like cells that have grown outside of the uterus also build up and shed. This internal bleeding leads to inflammation, intense pain and a buildup of scar tissue and adhesions (a type of tissue that can bind your organs together).  Usually, the first or second day of your period is the most painful. But in cases of endometriosis, the crippling pain usually kicks in a few days before your period’s arrival. It can also make an unwelcome return during ovulation or even throughout the month.  People can also experience chronic pain, increased lower back and pain around their legs which increases around their periods. “Endo belly” is a common term used to refer to the uncomfortable abdominal symptoms associated with endometriosis. Heavy periods Another common endometriosis symptom is heavy periods. Heavy periods are defined as: If your periods are painful or heavy it’s important to seek medical advice. Monthly heavy bleeding can increase the risk of anaemia (iron deficiency) which can result in symptoms of fatigue, feeling cold often and hair thinning. Pain during or after sex Another common symptom of endometriosis is pain during or after vaginal penetration. This can be caused by endometrial lesions growing in the pelvic region and becoming inflamed during or after sex. This pain is called dyspareunia. It has been reported to feel like a stabbing shooting pain, usually felt deep inside the pelvis. Any unwanted pain during sex is not normal. If you experience any pain during or after sex or any bleeding, get it checked out. There is also mental health support available if you feel your intimacy is being affected by pain during sex. Bowel and urination pain Endometrial lesions can sometimes find their way to the surface of the bowel or even penetrate its wall. This can cause uncomfortable symptoms such as pain when urinating or passing bowel movements or noticing blood in your urine or poo. Pain during urination can sometimes be misdiagnosed as a UTI. If you’re in pain when passing urine or poo or if you notice any blood in either, get it checked out to understand what might be the cause. Bloating and gastrointestinal issues People with endometriosis can also experience bloating and gastrointestinal issues. These symptoms are similar to those of irritable bowel syndrome (IBS). Including diarrhoea, constipation and bloating. These symptoms are often affected by your cycle and can worsen in the days before your period. Fertility problems Unfortunately, endometriosis can affect your fertility. Infertility affects about 30-50% of those with endometriosis, but there are no definitive answers (yet) as to why—only theories.   However, this does not mean that if you have endometriosis you can’t conceive. Even in cases of severe endometriosis, natural conception is possible.  Mental health impacts Living with a chronic condition can be tough and often isolating. Endometriosis can affect various aspects of life from personal to professional relationships, which can impact your mental health.  If you feel like endometriosis is impacting your mental health, there are online support communities like Endometriosis UK. You can also talk to our Fertility Counsellors for any mental health concerns relating to your fertility.  Getting to the bottom of symptoms Just like any reproductive health condition, endometriosis varies from person to person. Not everyone with endometriosis will experience all of these symptoms to the same severity. Some people may not experience any of these symptoms at all.  Having severe pain or very heavy periods is not necessarily a sign of more severe endometriosis. It’s also important to remember that each of these symptoms can also be caused by other conditions.  If you’re experiencing any of the […]

Have you been diagnosed with endometriosis? Discover our top tips for managing endometriosis pain and the treatment options available to you. From painkillers to surgery.  Quick facts: Living with endometriosis If you live with endometriosis, you probably know that one of the biggest symptoms of endometriosis is pain… a lot of it. Experiencing chronic pain amongst other, often equally debilitating symptoms, can have big physical and emotional consequences.  Sadly, there is currently no cure for endometriosis. And with limited research and understanding of the condition, it can be difficult for both doctors and endo warriors to get a handle on managing endometriosis symptoms.   But you don’t have to put up with pain. There are several treatments available to manage symptoms and help improve your quality of life. Lots of people report huge improvements with these treatments—it’s just about finding what works for you. Medication for managing symptoms The first step in managing pain is usually exploring the use of painkillers. Your doctor may recommend taking nonsteroidal anti-inflammatory drugs (NSAIDs) (aspirin, ibuprofen) or paracetamol as a first line of treatment to manage any pain.  However, there are lots of different types of painkillers and your doctor can help you to find ones that work for you and your pain level.  Depending on the severity of your endometriosis pain, you may try a course of painkillers for a few months until you assess whether or not they are working for you.  But if you’re finding that these aren’t making the cut and you’re unable to go to work, uni, school, work or other plans, don’t suffer in silence! This is just the first option for managing endometriosis, so push your doctor for alternatives. Tips for endometriosis pain management Endometriosis UK suggests some extra tips for pain management: Heat and comfort Hot water bottles, heated wheat bags or special heat pads can really help to soothe pain, cramping and inflammation.  Remember to never put them directly onto the skin and always have a layer in between. Partnered with your comfies, hopefully, this can help you to feel more comfortable. Physiotherapy Physiotherapists can develop a programme of exercise and relaxation techniques designed to help strengthen pelvic floor muscles, reduce pain, and manage stress and anxiety. TENS machines Transcutaneous Electrical Nerve Stimulator (TENS) machines are small devices with electrodes that send electrical pulses into the body. This can block the pain messages as they travel through your nerves. Pain clinics Your doctor can refer you to your nearest pain clinic to see chronic pain specialists. Push for your doctor to get you the expert advice you deserve to manage your endometriosis pain. Hormone treatment for endometriosis When you’re diagnosed with endometriosis, hormone treatment is another common avenue to explore. You should discuss hormone treatment with your doctor or specialist to decide if it’s right for you. For those with endometriosis, similar cells to those lining the womb exist outside of the womb (usually in the abdomen).  These cells also respond to your sex hormones, particularly oestrogen and progesterone, in the same way as your womb lining. They thicken, break down and bleed during your period. This bleeding causes inflammation and scarring, leading to chronic pain.  Hormone treatment is commonly used to reduce the growth of this endometrial tissue.  How does hormone treatment help endometriosis? Hormone treatment aims to maintain low levels of oestrogen in the body, as oestrogen has been found to encourage the growth of endometrial tissue. Hormone therapy can help reduce heavy flow or even stop periods and therefore improve symptoms.  Whilst most endo warriors find that hormonal treatment reduces their symptoms, it is not a permanent fix to manage endometriosis. Types of hormonal treatment used to manage endometriosis? There are lots of different types of hormone treatment available. Some of the most common are also used as contraceptive methods including: Unfortunately, not everyone gets on with hormonal contraception and side effects can be common. It’s important to consider which hormone treatment is right for you. Surgery for endometriosis A last resort if the above treatments aren’t keeping your symptoms at bay, is endometriosis surgery. This aims to remove or destroy areas of endometrial tissue.  This can include laparoscopic surgery or a hysterectomy. The kind of surgery you have will depend on where the endometriosis is and how much of it there is. Laparoscopic surgery for endometriosis Initial surgery will almost always involve gynaecological laparoscopy for both diagnosis and excision. In laparoscopic surgery, also known as keyhole surgery, your surgeon inserts a small tube with a light source and a camera, through a small incision near your belly button.  They use this to be able to look inside your tummy or pelvis and then use fine tools to remove endometrial tissue (excision) or use intense heat to destroy the tissues (ablation). They can also remove any scar tissue that has built up in the area.  This form of surgery can be difficult, as many of the lesions are below the surface and not visible, so a highly skilled practitioner is required to remove them.  It might be the most long-lasting treatment, and people do notice relief in symptoms, but many who undergo surgery find their endometriosis grows back over time. This is why endo warriors may have to undergo surgeries multiple times. Hormone treatment might be used after surgery to help get better, longer-lasting results. Hysterectomy for endometriosis Sometimes healthcare professionals will also suggest undergoing a hysterectomy, a surgery where the womb is removed. This can be a very big decision as post-surgery, you will no longer be able to become pregnant or carry a pregnancy.  If you want children, you can discuss egg freezing before this procedure with your doctor. This means that you will then have the option of trying to have a baby using fertility treatments such as in vitro fertilisation (IVF) with the help of a surrogate. In some cases, someone might still experience symptoms after getting a hysterectomy done as a form of endometriosis management. If the ovaries […]