Tag: hormone imbalance

From PMDD symptoms and AMH levels to managing PMOS without contraception, Hertility’s clinical team answers your most pressing cycle and hormone questions.

Anti-Müllerian Hormone (AMH) is one of the most talked-about fertility hormones, but also one of the most misunderstood. Because AMH is closely linked to your eggs, testing it can offer valuable insight into your ovarian reserve (the number of eggs you have left). But it’s not a fertility “yes or no” test. In this guide, we break down exactly what AMH testing can and can’t tell you about your reproductive health.  Quick facts: What is AMH and why is it so important? Anti-müllerian hormone (AMH) is made by small fluid-filled sacs in the ovaries called follicles, each of which houses an immature egg. Because AMH is made by these follicles, your AMH level gives an indication of how many eggs you may have remaining at a given time. However, this is only one piece of the fertility puzzle. There are a few myths out there about what exactly AMH testing can tell us. In this article, we cover the main things an AMH test can and can’t tell you. Let’s get into it. What can AMH testing tell me? Whether your ovarian reserve is a normal for your age AMH testing will give you insights into whether your ovarian or egg reserve is what is expected with other healthy people in your age group. It helps you understand whether your egg reserve is higher, average, or lower than expected for your age. If you are not using any hormonal contraception, testing other hormones, like follicle-stimulating hormone (FSH) and oestradiol alongside AMH can also help to build a more complete picture of egg reserve. Generally, people with low egg reserves are known to have higher levels of FSH and lower levels of oestradiol. Whether you have polycystic ovaries or polycystic ovary syndrome AMH testing can also be used as an indicator of whether you could have polycystic ovaries (PCO). PCO is a common reproductive health condition affecting around 30% of reproductive-aged people assigned female-at-birth. PCO is benign and does not affect fertility, but it can cause other unwanted symptoms.  People with PCO have a higher-than-expected number of immature follicles in their ovaries. More follicles mean a higher level of AMH in the blood.  Some people with PCO also have the syndrome that can be associated with it polycystic ovary syndrome (PCOS), which often presents as symptoms like irregular periods, acne, hair thinning or loss and high testosterone levels. According to updated guidelines, AMH can now be used as an indicator for polycystic ovaries in place of doing an ultrasound scan for the diagnosis of PCOS. However, at Hertility, we would always recommend getting a pelvic ultrasound scan to further assess your ovarian reserve. During this scan, your ovaries are assessed to determine your antral follicle count (the number of eggs sacs seen within your ovaries) and to confirm the diagnosis. Whether IVF or egg freezing could be right for you In fertility treatment settings, AMH plays an important role in guiding decisions around interventions such as IVF and egg freezing . It is commonly used to estimate how the ovaries may respond to stimulation and to guide medication dosing.  Lower AMH levels are generally associated with retrieving fewer eggs during IVF, while higher levels may indicate a stronger response but also carry a risk of developing a rare but potentially life threatening condition called OHSS (ovarian hyperstimulation syndrome). This makes AMH a valuable tool for planning treatment safely and effectively. Many NHS-funded and private IVF clinics therefore require a minimum AMH level for you to be eligible for a free IVF treatment cycle. The minimum level on the NHS will depend on where in the UK you are currently residing. Whether you may be perimenopausal or menopausal or have POI Menopause marks the point at which your periods stop permanently, typically between the ages of 45 and 55, with the average age for menopause in the UK being 51. After menopause, natural conception is no longer possible. It is associated with a very low, or completely depleted, ovarian reserve. Clinically, menopause is usually diagnosed retrospectively, after 12 consecutive months without a period in someone not using hormonal contraception. In individuals under the age of 45, follicle-stimulating hormone (FSH) is more commonly used as a diagnostic marker, as levels tend to rise when ovarian function declines. While AMH is not currently recommended as a standalone test to diagnose menopause, it is well established that AMH levels fall to very low levels as ovarian reserve diminishes. This makes AMH a useful indicator of overall ovarian activity. Declining or very low AMH levels can suggest that you are approaching menopause, although it cannot predict the exact timing. In younger individuals, particularly those under 40, significantly low AMH levels may raise suspicion of premature ovarian insufficiency (POI), a condition in which the ovaries stop functioning earlier than expected. What can’t AMH testing tell me? While AMH testing is a useful tool for understanding your ovarian reserve, it only represents one part of your overall fertility picture. There are several important limitations to be aware of, and understanding these can help you interpret your results more accurately and avoid common misconceptions. It can’t determine your egg quality One of the biggest limitations is that AMH cannot tell you anything about your egg quality. Although AMH reflects the number of eggs you may have remaining, it does not provide any insight into how healthy those eggs are. Egg quality is one of the most important factors influencing fertility and pregnancy outcomes, and it is largely driven by age and genetics. At present, there is no reliable test to measure egg quality directly, except through assessing embryos during IVF treatment. It can’t determine your exact egg quantity AMH also cannot determine your exact number of eggs. While it gives an indication of the size of your ovarian reserve, it is not a precise measurement. This is because AMH is made by ovarian follicles, and each follicle can release different amounts of the hormone depending on its size and […]

In our recent webinar, we unpacked the science behind fertility, explaining how hormones regulate ovulation, why timing matters, and how ovarian reserve naturally changes with age. We explored evidence-based ways to optimise egg and sperm health through nutrition, sleep, stress management, and reducing exposure to endocrine disruptors. But as always, the most important part of the session was your questions. Many of them couldn’t be answered fully in the time we had live. So we’re starting something new. Welcome to the Hertility Expert Q&A series,  a new post-webinar blog series where our clinical and research team answer your most pressing women’s health questions in depth. This edition covers the questions submitted during our fertility science webinar, including: This edition’s questions were answered by Emily Moreton, Clinical Services Manager at Hertility, fertility nurse, and registered nutritionist specialising in reproductive health. Emily holds a Master’s degree in Clinical Nutrition and Public Health from UCL and is a trained nutrition counsellor. Her work focuses on health-promoting behaviours, empowering individuals to improve their relationship with food, movement, and their body without restrictive dieting. ​​Her clinical expertise supports individuals in optimising fertility, managing PCOS and hormonal symptoms, maintaining a healthy pregnancy, and navigating menopause with confidence. We’ve rounded up every answer here so nothing gets lost in your inbox. Folic acid vs methylfolate: what’s the difference and which should you take? If you’re trying to conceive, you’ve likely been told that folic acid is non-negotiable. But then you see supplements advertising “methylfolate” or “5-MTHF” and suddenly the choice feels far less straightforward. Here’s what you actually need to know. The basics first. Folate is the natural form of vitamin B9 found in food. Folic acid is the synthetic version used in most prenatal supplements and fortified foods. Methylfolate, also known as 5-methyltetrahydrofolate (5-MTHF)  is the biologically active form your body ultimately uses. When you take folic acid, your body converts it into methylfolate through a series of enzymatic steps. For most people, this happens efficiently. The official recommendation is . 400mcg of folic acid for all women from three months before conception through the first 12 weeks of pregnancy to reduce the risk of neural tube defects (NTDs) like spinal bifida. This recommendation is backed by major health bodies including the NHS and CDC, and is supported by decades of large-scale clinical trial data. Folic acid is currently the only form of folate clinically proven in human trials to significantly reduce NTD risk. So why does methylfolate exist as an alternative? Some people carry variations in a gene called MTHFR, which can reduce how effectively the body converts folic acid into its active form. For those individuals, methylfolate may raise blood folate levels more efficiently because it bypasses this conversion step entirely. The catch is that methylfolate has not been put through the same rigorous, large-scale trials as folic acid for NTD prevention and at this point, it would be unethical to design such a trial, because it would require withholding a known protective intervention from pregnant women.  Which is better absorbed: Folic Acid or Methylfolate? Folic acid is actually very well absorbed, and crucially it is the form used in the large clinical trials that proved it prevents neural tube defects like spina bifida. That is why public health bodies, including the NHS, recommend 400 micrograms of folic acid daily before conception and during the first trimester. However, this dose needs to be increased to 5 milligrams daily (prescription-only in the UK) in certain higher-risk situations. When is a higher 5mg dose of Folic Acid recommended? A higher 5mg dose (prescription-only in the UK) may be recommended if you: When might methylfolate be worth considering?  It may be appropriate in cases of known MTHFR variants, recurrent pregnancy loss, recurrent implantation failure, or where a previous pregnancy was affected by a neural tube defect despite folic acid supplementation. Hertility’s in-house clinical team or registered nutritionists and dieticians if you’d like some advice but ultimately it should be up to the individual to make an informed decision. A large number of fertility supplements now use methylfolate rather than folic acid and that shift isn’t without reason. The reality is that experts are divided. Folic acid remains the gold standard in public health guidelines because it’s backed by decades of clinical trial data. Methylfolate is a promising and increasingly popular alternative, but it doesn’t yet carry the same evidence base for preventing neural tube defects in large-scale trials.  Which foods are richest in folate? Supplementation is important, but dietary sources matter too. Good sources include spinach, kale, Brussels sprouts, broccoli, beans and lentils, eggs, oranges, fortified breakfast cereals, nuts and seeds, and wholegrains. Because folate is water-soluble and lost during cooking, steaming or microwaving vegetables rather than boiling helps preserve it. The bottom line: for most women, folic acid remains the evidence-backed standard. If you have reason to believe methylfolate may be more appropriate for you, whether due to a genetic variant or a history of pregnancy complications, speak with your GP or Hertility’s clinical team before switching. What is the best nutrition approach for PCOS and improving ovulation? PCOS is one of the most common hormonal conditions affecting women of reproductive age and one of the most common causes of irregular ovulation. Search online for the “best diet for PCOS fertility”  or “how to improve ovulation naturally with PCOS,”  and you’ll be met with extremes: cut carbs, go keto, eliminate gluten, try fasting. The evidence doesn’t support most of it. There is no single recommended PCOS diet. The goal of nutrition in PCOS is not restriction, it’s choosing foods that stabilise blood sugar and reduce inflammation, consistently, over time. Understanding the link between PCOS and insulin. At its core, PCOS is often linked to insulin resistance. When insulin levels stay elevated, the ovaries produce more androgens such as testosterone, which can interfere with follicle development and regular ovulation. Managing insulin through diet is therefore one of the most evidence-based nutritional targets in PCOS. A Mediterranean-style […]

If you’ve ever been told to get bloods done on day 3 and wondered why that specific day matters, or felt frustrated trying to time a test around an unpredictable cycle, this guide is for you. We’re going to explain not just when to test, but why the timing matters at a biological level, what each hormone is actually measuring, and what to do when life doesn’t cooperate with your cycle. First: What does “day 3 of your cycle” mean? Day 1 of your cycle is the first day of your period, this means full menstrual flow, not spotting. If you see light spotting on Monday and Tuesday but don’t experience a proper flow until Wednesday, Wednesday is your day 1. Count forward from there: day 3 is the third day of your period (in this scenario that would be Friday). If your period is less than 3 days, day 3 is the third day after your period starts.  This matters because starting the count from spotting rather than full flow is one of the most common reasons people test at the wrong time. How does the menstrual cycle affect hormone levels? To understand why day 3 matters, it helps to have a basic picture of what’s happening in your body across the menstrual cycle. Your menstrual cycle is divided into two main phases separated by ovulation. The follicular phase always begins on day 1 of the menstrual cycle and ends with ovulation. In a 28-day cycle, the follicular phase extends from day 1 to approximately day 14. The luteal phase then follows ovulation and typically lasts 14 days, ending when your next period begins. The follicular phase is a period of rapid hormonal change, making it significant for hormone testing. When the previous menstrual cycle completes, levels of oestrogen and progesterone decrease. This triggers the release of follicle-stimulating hormone (FSH) into circulation.  Therefore, the days right around day 3 are when your body’s hormone system essentially resets and returns to its baseline. This is precisely why it’s the ideal time to take a snapshot of your reproductive hormones. Which hormones can be tested on day 3, and what does each one tell us? At Hertility, we test a broader panel than many providers. Here’s a detailed breakdown of each hormone in our Advanced At-Home Hormone and Fertility Test and why its timing matters. The Cycling Hormones These are tested on day 3 as mentioned earlier because they are at their ‘baseline’ around the first few days of your cycle. FSH (follicle-stimulating hormone) FSH is made by the pituitary gland in the brain and is the primary driver of egg development. FSH stimulates the production of oestradiol and eggs (oocytes) during the first half of the menstrual cycle.  Your FSH on day 3 might tell us whether the body is working as we would expect, or a little bit harder to induce follicular growth which may indicate reduced ovarian reserve, suggesting the egg supply could be beginning to decline.  Oestradiol (E2) Oestradiol is the primary form of oestrogen produced by the ovaries, and it plays a complex, interconnected role with FSH. Oestradiol serves as the brakes for the brain’s production of FSH. It travels from the ovaries to the brain and signals it to dial down FSH levels.  This is why FSH and oestradiol are always measured together. Not only their results, but their interpretation relative to each other is important for our clinicians to determine whether there is anything going on.  LH (luteinising hormone) LH is best known as the hormone that surges dramatically at mid-cycle to trigger ovulation. But measuring it at baseline on day 3 also tells us something important. If LH is too high on day 3, it may signal a condition like polycystic ovary syndrome (PCOS). An elevated LH:FSH ratio in the early follicular phase is one of the hormonal patterns clinicians look for when investigating PCOS and irregular ovulation. AMH (anti-Müllerian hormone) AMH is one of the most valuable markers for assessing ovarian reserve, and it works quite differently from the cycling hormones.  Historically, it has been thought that AMH doesn’t fluctuate dramatically across the cycle in the same way, so could be measured at any point during the menstrual cycle. However, research does suggest there may be some variation, which is why at Hertility, we standardise AMH testing to the days 2-5 window. This allows us to negate any potential fluctuation and ensure our results are consistent and comparable over time. AMH tells us about egg quantity (how many follicles are available) but it’s important to note it doesn’t directly measure egg quality. It should always be interpreted alongside your other results and your clinical history. Thyroid hormones (TSH and free T4) Thyroid hormones don’t fluctuate with the menstrual cycle, so strictly speaking they don’t need to be tested on day 3. We include them in the same panel because thyroid dysfunction, both overactive and underactive thyroid can significantly disrupt ovulation, cycle regularity, and fertility outcomes. Testing them alongside your reproductive hormones gives a more complete picture of your overall hormonal health in a single sample. Androgens (including testosterone) Androgens like testosterone are relatively stable across the menstrual cycle, making cycle timing less critical for these markers. That said, testing during the early follicular phase, when oestrogen is at its lowest means androgens aren’t being masked or influenced by rising oestrogen levels. For women investigating conditions such as PCOS, elevated androgens are an important part of the diagnostic picture. Prolactin Prolactin can technically be tested on any day. What does affect prolactin is the time of day and lifestyle factors. Prolactin naturally rises during sleep and can remain elevated for some hours after waking. Stress, physical activity, and even eating can temporarily raise levels. This is why Hertility asks you to take your sample first thing in the morning, before eating or exercise, to capture the most stable reading. The science behind day 3 testing: what does the research actually say? Day […]

For years, women have been told to wait. Wait until the symptoms get worse.Wait for an appointment.Wait until it’s “clinically significant.” And so women wait, often with fatigue, irregular cycles, unexplained anxiety, weight changes, brain fog, pain, or the quiet, persistent feeling that something isn’t quite right. Not urgent enough for A&E. Not specific enough for a specialist referral. But not nothing either. This gap is where modern women’s healthcare loudly fails. And it’s exactly the space Hertility is trying to rebuild. So, we’re introducing Women’s Health GP Consultations to close that gap. Helping you bring your symptoms, test results and medical history into one joined-up consultation. It’s a space designed to give you clarity, not just reassurance, and a plan you can actually act on. We’re bringing you a consultation with a GMC Registered GP trained women’s hormonal and reproductive health. It’s medical care, informed by your test results, so you don’t have to start again. A Women’s Health GP will be there to: It’s general practice redesigned around women’s bodies and your lived experience. Because these days, getting an appointment isn’t always the same as getting help On paper, the NHS has never been busier. In August 2025 alone, there were over 27 million GP appointments in England, an increase of 11% per working day compared to pre-pandemic levels*. The demand is there. The doors are technically open. But access doesn’t always equal care. With short appointments and fragmented follow-ups make it hard to unpick complex hormonal symptoms. Many conditions don’t show up clearly in one blood test. Patterns take time and context matters.  This isn’t a failure of clinicians. It’s a failure of design, shaped by decades of neglect in women’s health. We can see women are falling through the cracks (it’s a tale as old as time) In a Hertility survey of nearly 1,000 users.  Crucially, these were not stories of advanced disease or specialist-level cases. They were stories of everyday medical uncertainty: These are conditions and symptoms woven into daily life, not medical outliers. They sit firmly within the scope of good general practice when time, expertise, and continuity are available. There’s a serious diagnosis to treatment gap Even when women do receive a diagnosis, care often stalls. Among Hertility users with known conditions such as PCOS, thyroid disorders, fibroids, or anaemia: This is not a failure of specialist medicine. It is the absence of ownership in the middle. Someone to say: this matters. This can be treated. Or this can safely be monitored. And while NHS diagnostic and treatment backlogs continue, with 24% of patients waiting over six weeks for diagnostic tests* and referral-to-treatment targets unmet since 2016, many women are left in limbo. Unsure whether to push, pause, or escalate. How Hertility is building women’s healthcare differently We founded Hertility because we’d seen first-hand how often women’s health concerns are dismissed, delayed, or oversimplified. Too often, symptoms are looked at in isolation. Too often, women are told everything is “normal” without anyone taking the time to explain what that actually means for them. By combining diagnostics, hormone-literate clinicians, and now, ongoing GP care, we’re creating a more reliable path from results to action. It’s the difference between being told “everything looks normal” and being helped to understand what normal means for you. What Women Actually Want From Care (It’s Simpler Than You Think) For many women, we hear the most powerful part of healthcare isn’t always the diagnosis or even the treatment. It’s being believed, understood, and guided toward the right next steps. We know that the future of women’s health won’t be built on apps alone, or tests alone, or even specialists alone. It will be built in the spaces between. Where insight becomes action. Where long-ignored conditions finally meet real medical solutions. Our new Women’s Health GP service isn’t about replacing what exists. It’s about rebuilding care in a way that finally works for women. In a world capable of extraordinary scientific progress, it shouldn’t be radical to expect clear pathways for conditions that affect 51% of the population.  We’re tired of waiting, so we’re building the future ourselves. From Deirdre O’Neill, Dr Helen O’Neill and Dr Natalie Getreu x Resources: https://researchbriefings.files.parliament.uk/documents/CBP-7281/CBP-7281.pdf

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 […]

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 […]