Knowledge Centre

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

We’re all sold the ideal of flawless skin and perfect hair, but sometimes the cause of persistent breakouts or unexplained thinning is more than skin deep. Your complexion and scalp are often the first, most visible external indicators of your internal hormone balance. When hormones that regulate your sebaceous glands and hair follicles shift out of their optimal range, the results – from cystic acne to a widening hair parting – can be frustratingly visible. Quick Facts: Hormonal acne and hair thinning are primarily caused by fluctuations or imbalances in androgen hormones (like testosterone) and thyroid hormones. Oestradiol supports skin health and increases a key protein that controls active androgen levels. These symptoms are common in conditions like PCOS and during hormonal transitions like perimenopause. Find out what your hormones are telling you 💡  Don’t guess what’s causing your skin and hair changes. Take our Advanced At-Home Hormone and Fertility Test to uncover the root causes and get a personalised care plan. Take the Test → What are Hormonal Skin and Hair Changes? These symptoms are related to the pilosebaceous unit – the complex structure comprising the hair follicle and the sebaceous (oil) gland. Hormonal Acne: Breakouts related to hormonal imbalance or fluctuation, typically found on the lower face, cheeks, jawline, chest, neck, and back. Hormonal Hair Changes: This includes both hair thinning or loss on the scalp (androgenic alopecia) and excessive dark, thick hair growth on the face or body (hirsutism). The Hormonal Culprits Behind Your Skin and Hair Your sebaceous glands and hair follicles have receptors for several key hormones. Imbalances in these messengers directly influence how much oil is produced and how the hair growth cycle progresses. 1. Androgens: The Oil and Hair Drivers Androgens, such as testosterone and DHEAS, are the most significant modulators of your skin and hair health. Acne and Oily Skin: When your body produces excess androgens, there is more of the hormone binding to the sebaceous gland receptors. This stimulates excessive oil (sebum) production, resulting in oily skin hormones and clogged pores, which can cause inflammatory, cystic acne. Hirsutism: High androgen levels convert fine hair into thick, dark hair in androgen-sensitive areas (face, chest, back). Hair Thinning: Conversely, in scalp follicles, testosterone can be converted into dihydrotestosterone (DHT) which causes hair follicles to shrink, shorten the growth phase, and ultimately lead to hair thinning and female pattern hair loss (Glaser et al., 2012). A key marker for assessing true androgen activity is sex hormone-binding globulin (SHBG). SHBG is a protein that binds to and deactivates sex hormones. If your SHBG levels are low, more testosterone is left “free” and biologically active in your system, intensifying its impact on your skin and hair, even if your total testosterone level is within range. Clinical Link: High androgens, measured as testosterone or DHEA-S, are a defining feature of Polycystic Ovary Syndrome (PCOS) symptoms (Teede et al., 2018). This is why people with PCOS are significantly more likely to experience persistent hormonal acne and hair issues. 2. Thyroid Hormones: The Metabolic Regulators The thyroid gland acts as the body’s metabolic regulator, and its hormones (thyroid stimulating hormone (TSH) and free thyroxine) are essential for the natural cycle of the hair follicle (Schmidt et al., 1991). Hypothyroidism (underactive): When the thyroid is underactive (often seen with high TSH and low FT4), cell regeneration slows down. This commonly results in diffuse hair thinning across the entire scalp, hair that is dry and brittle, and dry, scaly skin. Hyperthyroidism (overactive): An overactive thyroid accelerates the hair cycle, causing hair to shed prematurely. This can also lead to noticeable thinning and frequently causes the skin to be warm and moist. Hair and skin changes can be some of the first signs of underlying thyroid dysfunction and require testing to confirm if the condition is metabolic or hormonal in origin. 3. Oestradiol, LH, FSH, and Prolactin: The Modulators These hormones work together to modulate androgen activity and support tissue health: Oestradiol (Oestrogen): Oestradiol supports the anagen (growth) phase of hair and promotes healthy skin by increasing collagen production, hydration, and wound healing. Critically, high oestradiol levels increase the production of SHBG in the liver, lowering the amount of active, acne-causing free testosterone. Conversely, low oestrogen (e.g. in perimenopause) can cause skin thinning, dryness, and sometimes acne. LH and FSH: As the pituitary signals that regulate the ovaries, an altered LH:FSH ratio combined with other markers (like high AMH and testosterone) helps diagnose conditions like PCOS, which are the source of most severe hormonal skin and hair symptoms. Prolactin: Elevated prolactin (hyperprolactinemia) can sometimes signal hormonal disruption that indirectly affects the balance of sex hormones, potentially contributing to symptoms like hirsutism (Tirgar-Tabari et al., 2016). When to Get Tested If you are treating your skin and hair symptoms with topical creams or cosmetics and seeing minimal, temporary, or no improvement, it’s a strong indication that the issue is systemic and hormonal. Consider testing your hormones if your symptoms include: Acne that is cystic, deep, or confined to the lower face and jawline. Noticeable, persistent thinning of the scalp hair, especially if your part line is widening. The new or increased growth of coarse body or facial hair (hirsutism). Skin or hair changes coupled with other systemic symptoms, such as irregular periods, chronic fatigue, or unexplained weight changes. What Your Personalised Results Can Tell You Hertility’s panel of personalised hormones provides the essential diagnostic data needed to find the root cause. This panel is tailored to your symptoms and what you are looking to achieve from your test. Pinpoint Androgen Activity: Your personalised results will clarify if the issue is high total androgens, high free testosterone (due to low SHBG), or high adrenal output (DHEAS), which directs the most effective therapeutic strategy (e.g. lifestyle, targeted supplements, or medication). Uncover Thyroid Issues: We can rule out or suggest thyroid dysfunction by measuring TSH and free T4, ensuring hair loss isn’t misdiagnosed as purely androgenic. Identify Underlying Conditions: The results provide the crucial diagnostic […]

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

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

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

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

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

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

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 […]

Hertility today announces the launch of GYN-AI™, a patent-pending, clinical-grade diagnostic tool set to redefine how fertility and gynaecological conditions are detected and diagnosed. A moment of justice for women’s health For decades, women have faced unacceptable delays in receiving diagnoses for gynaecological and fertility-related conditions, waiting years, sometimes decades, for answers that should take days.  Hertility’s GYN-AI™ changes that. Hertility was founded to deliver personalised, and expert healthcare across every stage of a woman’s hormonal lifespan using a preventative and data-first approach. Now, that mission reaches a breakthrough moment with the launch of GYN-AI™, a first-of-its-kind, patent-pending diagnostic tool that redefines how fertility and gynaecological conditions are detected and diagnosed. Developed by Hertility’s team of leading scientists, clinicians, and data engineers, GYN-AI™ combines years of research, clinical expertise, and advanced machine learning. Trained on Hertility’s uniquely comprehensive dataset,  including over one million Hertility Health Assessments and hundreds of thousands of blood results, the model achieves 98–99% diagnostic precision across 18 fertility-related and gynaecological conditions. When tested against clinicians, GYN-AI™ performs as well as or outperforms them in diagnostic accuracy, reducing diagnosis times for some conditions from nine years to just seven days. Closing the data gap and the gender health gap Until now, healthcare data has been dangerously incomplete. Women were largely excluded from clinical trials until the 1990s, meaning much of modern medicine, and the data used to train most AI systems, reflects a male default. This makes even the most advanced AI models, including tools like ChatGPT, unreliable and potentially unsafe for women’s health. GYN-AI™, by contrast, is built on Hertility’s own curated dataset: one of the largest and most clinically validated in women’s health, spanning over a million assessments and hundreds of thousands of blood test results linked to confirmed clinical outcomes. Built for women and from women’s data, it delivers a level of diagnostic precision and safety that is truly world-changing. End-to-end care, powered by data and compassion GYN-AI™ integrates seamlessly with Hertility’s full-service clinical pathway, offering end-to-end care from screening, diagnostic blood testing, and ultrasound scanning to telemedicine, prescriptions, IVF, and egg freezing. This means women can move from assessment to diagnosis to treatment without delay, closing the loop on women’s healthcare like never before. Dr Helen O’Neill, Founder and CEO of Hertility, said: “I see this as a movement; and perhaps a moment of justice for women’s health. For too long, women have been dismissed, misdiagnosed, and left waiting years for answers about their own bodies. With GYN-AI™, we are changing that forever. Every algorithm has been trained on the lived experiences, symptoms, and data of over a million women: women who deserved faster care, earlier intervention, and to be believed. This tool will help clinicians deliver answers in days, not years, giving women back their time, their control, and in some cases, their chance to create life. This marks the beginning of a new era, one where women’s health is finally powered by data, intelligence, and compassion.” Mr Srdjan Saso, Consultant Gynaecologist at Hertility, added: “As a clinician, I have seen the damage that diagnostic delays cause physically, emotionally, and financially. GYN-AI™ is truly revolutionary in medicine- it allows us to detect potential issues earlier and with greater precision than ever before, guiding women to the right care pathway faster. This technology does not replace doctors; it empowers them. It gives us a clinical tool built on real-world data that helps us treat women sooner, more accurately, and more holistically.” The beginning of a new clinical paradigm GYN-AI™ represents a seismic shift from reactive to proactive care, bridging science, compassion, and intelligence to transform how women are diagnosed and treated. Hertility’s mission is clear: to close the gender health gap by delivering faster, data-driven, and personalised diagnostic care that gives women the answers they deserve. We are not just advancing technology. We are transforming lives and creating them. To begin your own journey toward better understanding your hormones and reproductive health, start your Hertility Health Assessment today at www.hertilityhealth.com.