Tag: hormone imbalance

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 […]

When you’re planning to conceive, there’s a lot on your mind—from diet and lifestyle to managing stress and preparing your body for the changes ahead. But one area that often gets overlooked in this journey is your skin health. As a dermatologist, I frequently meet women who are trying to conceive, whether naturally or through assisted reproductive technologies like IVF, and they’re often unsure about which skincare products are safe to use or how to handle the skin changes that come with fluctuating hormone levels. Let’s explore how to optimise your skin health when trying to conceive, what to watch out for in your skincare routine, and why consulting a dermatologist might be a wise move during this time. Understanding Hormonal Changes and Skin Impact Hormones have a significant impact on skin health, and this becomes even more pronounced when you’re trying to conceive. The body undergoes various hormonal shifts even before pregnancy begins, which can lead to skin concerns such as acne, dryness, sensitivity, and pigmentation changes. When you stop hormonal contraception in preparation for pregnancy, your skin may react to the sudden shift in hormones. Research shows that oestrogen and progesterone levels, which help regulate the menstrual cycle and are key in pregnancy, can influence the skin’s oil production, hydration levels, and overall texture. Additionally, if you’re undergoing IVF or preparing for embryo transfer, the high doses of hormones involved can cause further changes. These hormones can stimulate oil glands, leading to an increase in acne, or exacerbate conditions like melasma (dark patches on the skin) due to increased melanin production. Common Skin Concerns When Trying to Conceive As you navigate the journey to conception, whether naturally or through IVF, you might notice changes in your skin. Here are some common skin concerns during this time: Oily skin, acne, and breakouts: Hormonal fluctuations often lead to increased sebum (oil) production, which can clog pores and cause acne. This can be particularly pronounced after stopping birth control or during fertility treatments when hormone levels are artificially manipulated. Increased sensitivity and redness: Hormonal changes can make the skin more sensitive and prone to redness, dryness, or irritation. This is especially true if you have a history of sensitive skin or conditions like rosacea or eczema. Pigmentation changes: An increase in melanocyte-stimulating hormones can cause dark patches or melasma in pregnancy. This can also be seen in women undergoing IVF due to the high levels of hormones used in the process. Dryness and dehydration: Hormonal shifts can also affect the skin’s ability to retain moisture, leading to dryness or flakiness. Keeping the skin well-hydrated and maintaining a strong skin barrier is essential during this time. Navigating Skincare Confusion: What’s Safe When Trying to Conceive? When you’re trying to conceive, whether naturally or through IVF, you might find yourself wondering which skincare products are safe to use. The skincare landscape can be confusing, with countless products on the market and mixed messages about what is safe during conception and pregnancy. Here’s a guide to help you navigate this tricky terrain: Avoid certain ingredients: Some skincare ingredients are best avoided during conception and pregnancy due to potential risks to the developing baby. Retinoids (often found in anti-ageing products), high concentrations of salicylic acid, and other exfoliating acids can fall into this category.  Emphasise hydration and skin barrier support: Ingredients that support hydration and the skin barrier are your best friends. Look for products containing hyaluronic acid to retain moisture, ceramides to strengthen the skin’s barrier, and niacinamide to soothe irritation and reduce sensitivity. Choose Safe Sun Protection: Protecting your skin from UV damage is always important, but it becomes even more crucial when trying to conceive, especially if you’re prone to pigmentation changes. Opt for high factor broad-spectrum sunscreen with blue light protection to reduce the risk of pigmentation. Consider mild active ingredients: Consider azelaic acid, which is both effective in managing acne and pigmentation and safe for use when trying to conceive. It is an anti-inflammatory rather than an exfoliating acid and can also help with redness. Preventative Acne Treatments: The Role of Laser For women prone to acne, especially those who experience breakouts after stopping hormonal contraception or undergoing fertility treatments, taking preventative measures can be highly beneficial. One innovative treatment to consider is a drug-free, non-invasive laser therapy that targets sebaceous glands to reduce oil production and prevent acne. It offers a preventative approach without the need for systemic medications, which may be restricted when trying to conceive or during pregnancy. By reducing oil production, the laser  can help maintain clearer skin during a time when treatment options are more limited due to safety concerns. It’s a great option to discuss with your consultant dermatologist, particularly if you’re seeking ways to manage acne without relying on potentially harmful medications. Adapting Skincare During IVF and Embryo Transfer If you’re undergoing IVF or preparing for an embryo transfer, your skin is likely to undergo additional changes due to the high levels of hormones administered during treatment. These hormones can exacerbate acne, increase pigmentation issues like melasma, and make your skin more sensitive or reactive. In such cases, a tailored skincare routine that addresses these specific concerns is essential. Working with a dermatologist can help you develop a plan that suits your skin’s needs while being mindful of the changes brought on by fertility treatments. They can recommend safe, effective products and treatments, such as laser treatment, to help manage skin concerns during this time. Supporting Skin Health Through Lifestyle Optimising skin health isn’t just about topical skincare—it’s also about making healthy lifestyle choices that support your body from within. Here are a few tips to help support your skin health while trying to conceive: Nutrition: Eating a balanced diet rich in vitamins, minerals, and antioxidants supports both your overall health and your skin. Focus on foods rich in omega-3 fatty acids, such as salmon and flaxseeds, which help maintain the skin barrier, and plenty of fruits and vegetables for antioxidants. Manage stress: Stress can trigger skin issues, particularly during the emotionally taxing […]

Menopause is a significant phase in a woman’s life, marked by a decline in oestrogen levels that leads to various changes in the skin. These hormonal shifts can cause several skin concerns, ranging from dryness and thinning to increased sensitivity and a heightened risk of developing both medical and cosmetic skin issues. Understanding these changes and learning how to manage them effectively is crucial for maintaining healthy, youthful skin during this transitional period. How Menopause Affects Your Skin During menopause, the body undergoes several hormonal changes, particularly a reduction in oestrogen and progesterone levels, which have profound effects on the skin: Loss of collagen and elasticity: Oestrogen is vital for maintaining collagen, the protein that provides structural support and elasticity to the skin. With menopause, collagen production decreases significantly—by up to 30% within the first five years—and continues to decline at a rate of about 2.1% per year thereafter. This reduction leads to thinner skin, loss of firmness, and decreased elasticity, resulting in sagging, fine lines, and deeper wrinkles.  Increased dryness and skin thinning: Oestrogen plays a key role in regulating the skin’s moisture levels by promoting sebum production. As oestrogen levels decline, the skin becomes drier and the moisture barrier weakens, leading to increased transepidermal water loss (TEWL) and a rough texture. Thinning skin is more fragile and prone to bruising and injury, and reduced thickness also makes blood vessels more visible, contributing to increased redness. Pigmentation changes: Hormonal fluctuations during menopause can lead to pigmentation issues such as age spots, melasma, and uneven skin tone. Prolonged exposure to UV radiation further exacerbates these changes, as the skin’s ability to repair sun damage diminishes with age. This results in more pronounced pigmentation and sunspots, especially on areas frequently exposed to the sun, like the face, hands, and chest. Altered skin texture: The reduction in collagen and elastin also affects the skin’s texture, leading to enlarged pores and a rougher surface. Decreased skin cell turnover can contribute to a dull complexion, making regular exfoliation and rejuvenation practices essential to maintain a smooth, glowing appearance. Increased sensitivity and pruritus (itchiness): Menopausal skin is often more sensitive due to a compromised barrier and decreased hydration. This increased sensitivity can lead to greater reactivity to skincare products and environmental factors. Pruritus, or itching, is also a common complaint among postmenopausal women, often associated with dry skin conditions like xerosis. Higher risk of medical and cosmetic skin issues: As skin ages and hormone levels change, there is an increased risk of developing both medical and cosmetic skin concerns. Women with outdoor hobbies, frequent sun exposure, or a history of sun damage are particularly vulnerable to skin cancers, including melanoma. Regular mole checks and skin screenings are crucial for early detection. Some laser treatments, such as Halo, not only improve the skin’s aesthetic appearance by reducing pigmentation and fine lines but can also help reduce the risk of skin cancer by targeting and treating precancerous lesions. The Role of Hormone Replacement Therapy (HRT) Hormone Replacement Therapy (HRT) can be effective in alleviating some of the skin changes associated with menopause by replenishing oestrogen levels. HRT has been shown to increase collagen production, enhance skin thickness, and improve elasticity, potentially restoring some of the skin’s youthful qualities. However, it is not without risks. While oestrogen in HRT can improve skin hydration and reduce signs of ageing, some women may experience side effects like acne, especially if their HRT regimen includes progesterone. Progesterone can increase sebum production, leading to clogged pores and breakouts. For women experiencing acne due to HRT, laser treatment designed to target sebaceous glands, may offer a solution. It works by reducing oil production, thereby minimising acne flare-ups without the need for long-term medications, providing a non-invasive option for managing hormone-induced acne. Effective Strategies for Managing Menopausal Skin To manage these changes effectively, a comprehensive approach involving skincare, medical treatments, and lifestyle adjustments is essential: Topical retinoids: Retinoids are highly effective in promoting collagen production and enhancing skin cell turnover. They help reduce the appearance of fine lines, improve skin texture, and increase elasticity. However, due to their potential to cause irritation, especially on thinning menopausal skin, retinoids should be used cautiously and under the supervision of a dermatologist. Hydrating moisturisers: Moisturisers that contain hyaluronic acid and ceramides are crucial for maintaining hydration and supporting the skin’s moisture barrier. Hyaluronic acid acts as a powerful humectant, attracting moisture to the skin, while ceramides help strengthen the barrier and prevent further dryness and irritation. Antioxidant serums: Antioxidants like vitamins C and E play a crucial role in protecting the skin from environmental damage and reducing pigmentation. These serums neutralise free radicals, molecules that accelerate skin ageing, and help improve overall skin tone and texture. Energy-Based Treatments: Lasers and ultrasound technologies are highly effective for stimulating collagen and elastin production, tightening, and lifting sagging skin. Treatments such as BroadBand Light (BBL) therapy, fractional laser resurfacing, and Sofwave can rejuvenate the skin and provide a firmer, more youthful appearance. Additionally, lasers like Halo can aesthetically enhance the skin while targeting and treating precancerous lesions, potentially reducing the risk of developing skin cancer. Injectable treatments – Polynucleotides and Profhilo: Polynucleotides and Profhilo are innovative injectables that promote skin regeneration and hydration. These treatments help improve skin elasticity and overall quality by providing deep hydration and stimulating collagen production, making them particularly effective for addressing thinning skin and volume loss. Microneedling with radiofrequency: This advanced treatment combines microneedling with radiofrequency energy to enhance collagen production and improve skin texture and firmness. It is particularly beneficial for menopausal skin, helping to reduce fine lines, improve skin tone, and provide a smoother appearance. Sun protection and lifestyle modifications: Protecting the skin from UV damage is critical during menopause. Using a broad-spectrum sunscreen with SPF 30 or higher, wearing protective clothing, and avoiding sun exposure during peak hours can help prevent further pigmentation and damage. Additionally, maintaining a healthy diet rich in antioxidants, staying hydrated, and managing stress can significantly impact […]

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

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 […]

Luteinising hormone (LH) is one of the key hormones involved in the regulation of the menstrual cycle and ovulation. But what happens when our levels get a little off balance? In this article, we’ll explain exactly what luteinising hormone is, how it works, and take a deep dive into its importance for female fertility. We’ll also take a look at LH levels and why they’re important, as well as how to recognise the symptoms of low or high LH. Quick facts: What is Luteinising Hormone (LH)?  Luteinising hormone is a hormone made by the pituitary gland in the brain. It forms part of a communication system between your brain and reproductive organs known as the hypothalamic-pituitary-gonadal axis (HPG axis). The hypothalamus (also in the brain) makes gonadotrophin-releasing hormone (GnRH), which tells the pituitary gland to make two key reproductive hormones: luteinising hormone (LH) and  LH and, follicle-stimulating hormone (FSH). These two hormones work closely together. FSH helps the follicles (the small sacs in your ovaries containing immature eggs) develop during the first half of the menstrual cycle. LH then becomes particularly important around the middle of the cycle, when a sharp rise in LH helps trigger ovulation, the release of a mature egg from the ovary. What does luteinising hormone do during the menstrual cycle? Luteinising hormone (LH) works alongside FSH and oestradiol to coordinate the menstrual cycle and regulate ovulation. At the beginning of the cycle, LH levels are relatively low. During this follicular phase, FSH helps several follicles (the sacs with the immature eggs) begin developing. As one follicle becomes dominant, it produces increasing amounts of oestradiol. The rise in oestradiol tells your pituitary gland to stop making FSH and to start making more LH. This is known as the LH surge. The LH surge helps the egg complete its final maturation and triggers the dominant follicle to rupture, releasing the egg from the ovary. This process is called ovulation. After ovulation, LH levels fall as the cycle enters the luteal phase. LH helps the emptied follicle develop into the corpus luteum, which produces progesterone alongside oestradiol. These hormones help prepare and maintain the uterine lining in case pregnancy occurs. If pregnancy doesn’t occur, the corpus luteum eventually breaks down. Progesterone and oestradiol levels fall, your period begins and the cycle starts again. You can read more about how all of these hormones work together in our Menstrual Cycle 101 guide. What is the LH surge? The LH surge is a rapid rise in luteinising hormone that happens shortly before ovulation. This is exactly what at home ovulation predictor kits, or OPKs, are designed to detect. Urinary LH tests can identify the mid-cycle surge that generally occurs around 24-36 hours before ovulation, which is why they can be useful for identifying when your fertile window may be approaching. But an LH surge predicts that ovulation may happen. It doesn’t prove that an egg was actually released. How does luteinising hormone affect fertility? LH is essential for fertility because it helps coordinate ovulation. Without appropriate LH signalling, the final stages of follicle maturation and egg release may not happen. But this doesn’t mean a single LH result can tell you whether you are fertile. Fertility depends on many factors, including your age, whether you’re ovulating, ovarian reserve, fallopian-tube and uterus health, sperm health and whether underlying health conditions such as endometriosis or PMOS are present. LH is therefore usually interpreted as one part of the fertility picture. Current NICE guidance recommends measuring FSH and LH in people with irregular menstrual cycles who are undergoing fertility investigation, helping doctors understand whether disrupted ovulation may be part of the problem. If you’re tracking ovulation at home, LH can also help identify when your fertile window may be approaching, although, again, it can’t confirm ovulation by itself. Why do I need an LH test? An LH test can be useful for several different reasons. One of the most common is investigating irregular or absent periods. Because LH is involved in ovulation, looking at it alongside hormones such as FSH and oestradiol can give clues about how the communication between your brain and ovaries is working. LH may also be measured if you’re having difficulty conceiving, particularly if your cycles are irregular or there is reason to think you might not be ovulating consistently. It can also form part of the investigation of conditions such as PMOS, hypothalamic amenorrhoea, primary ovarian insufficiency or pituitary disorders, although LH cannot diagnose any of these conditions on its own. For example, lower LH and FSH alongside low oestradiol can point towards reduced signalling from the hypothalamus or pituitary gland, while raised gonadotrophins alongside low ovarian hormone levels can suggest reduced ovarian function. LH testing is therefore most useful when it is interpreted alongside your symptoms, menstrual-cycle pattern and other hormone results. How can I find out my LH level? LH can be measured through a blood test or, for ovulation tracking, through a urine test. A blood test measures the amount of LH circulating in your bloodstream. This is usually the more useful approach when LH is being investigated as part of a wider hormone assessment. Urinary ovulation tests have a different purpose. They’re designed specifically to detect the rise in LH that happens shortly before ovulation. Standard OPKs generally show a positive or negative result once LH passes a particular threshold, while some digital or quantitative monitors show more information about changing urinary LH levels. Can an LH test tell you if you’re ovulating? An LH blood test can measure how much LH is circulating at one moment in time. An ovulation predictor kit measures LH in urine and looks for the surge that usually happens before ovulation. A positive ovulation test therefore suggests that ovulation may be approaching. But LH testing doesn’t directly confirm that an egg was released. For clinical confirmation of ovulation, mid-luteal progesterone is generally more useful. If you have PMOS and are using LH strips, interpretation can be trickier […]

Sex hormone-binding globulin (SHBG) is an important protein involved in the regulation of our sex hormones and in turn our ability to conceive. So what is a good, or ‘normal’ range for our SHBG levels? And how do we know when ours might be too high or too low? We’ve broken down all you need to know about SHBG levels, including what they mean, why they matter and what to do if you suspect yours might be out of range. Quick facts: What is SHBG? SHBG is an important protein that regulates the amount of testosterone and oestrogen available in the body by ‘binding’ to these hormones—which makes them inactive. This is because to bring about an effect in the body, hormones need to be unbound or free so they can enter cells and bring about their effect. The vast majority of testosterone and oestrogen in our bodies is bound to SHBG and other proteins. SHBG also controls the balance between testosterone and oestrogen, which is also important for the healthy functioning of our menstrual cycles. Why do SHBG levels matter? Because SHBG levels regulate the amount of testosterone and oestrogen available to be used by the body, if our SHBG levels are too high or low, this will have a knock on effect on our levels of both of these sex hormones.  If our SHBG levels are higher, we’ll have less free testosterone or oestrogen available. If our SHBG levels are lower, we’ll have more testosterone and oestrogen available.  Both of these sex hormones have important roles in the regulation of the menstrual cycle, ovulation, libido, energy levels and our mental health. Low SHBG When our SHBG levels are low, our levels of free unbound testosterone and oestrogen can become high. Let’s take a look at some of the symptoms, causes and what can be done to help. Symptoms of low SHBG These symptoms can often mirror those of excess testosterone including: Or excess oestrogen: Causes of low SHBG There is no single cause for abnormal SHBG levels, although increases in insulin, prolactin and androgens have been found to block SHBG production which could be a factor for those with low SHBG levels.  Low SHBG can also be caused by a number of lifestyle factors, certain medical conditions and genetics. Here are several conditions, as well as other factors, that low SHBG has been found to be associated with: How to raise low SHBG If you have low SHBG there are a number of lifestyle changes that may help to increase your levels. These include: High SHBG  On the flip side, when our SHBG levels are too high, our unbound testosterone and oestrogen can become abnormally low. Here are some symptoms, causes and what can be done to reduce high levels of SHBG. Symptoms of high SHBG These symptoms can often mirror those of low testosterone including:  Or low oestrogen: Causes of high SHBG Again, there is no single cause for abnormal SHBG levels, although as we mentioned previously, increases in oestrogen and thyroxine (T4) have been found to increase SHBG production, which could be a factor for those with high SHBG levels. There are also a number of conditions associated with high SHBG which include: How to lower SHBG Dietary changes are the most effective way to lower SHBG levels. Decreasing alcohol consumption, gaining weight if you have a low BHM and following a high-fat, low fibre diet may help decrease levels of SHBG. One study involving 48 premenopausal women showed that maintaining a high-fat, low diet decreased SHBG. However, more clinical studies are required to confirm this association. If the levels are elevated due to contraception use, this will usually return to normal levels once you stop using that contraception. Other possible causes such as type 1 diabetes and an overactive thyroid will need further investigation and will require medication specific to these conditions. SHBG tests Ultimately, if you suspect you may have abnormal levels of SHBG, the only way to definitively get a diagnosis is via a blood test. Because symptoms of abnormal SHBG levels can mimic those of high or low oestrogen and testosterone, your SHBG levels should be tested in tandem these hormones. You can test all of these hormones and more, with a Hertility at-home Hormone and Fertility Test. Resources:

Follicle-stimulating hormone (FSH) is really important for our reproductive health. In this article, find out how to know what normal FSH levels look like, what the symptoms of high and low FSH levels are and how to balance your FSH levels. Quick facts: What is FSH?  FSH stands for Follicle-Stimulating Hormone and is one of the main hormones involved in the regulation of your menstrual cycle and ovulation—making it an important hormone not only for your health but your fertility too. FSH is what’s known as a gonadotropin hormone. It’s released by the pituitary gland in the brain and then acts on the ovaries.There is only one other gonadotropin hormone in the body—luteinising hormone (LH). True partners in crime, there’s no FSH without LH, and they act in tandem to bring about changes which essentially regulate ovulation. Normal FSH levels in women Because our FSH levels are intricately linked to our ovarian reserve, what’s considered a ‘normal’ FSH level changes as we age. This is because our ovarian reserve declines as we age which makes our FSH levels increase.  Gonadotropic hormones are hormones released from the pituitary gland in the brain and released into the bloodstream. Gonadotropins then go on to act on the ovaries. There are two types of gonadotropins, follicle-stimulating hormone (FSH) and luteinizing hormone (LH).  The pituitary gland produces FSH which acts on the ovaries to stimulate the growth of follicles containing your eggs. As well as growing the ovarian follicles, FSH stimulates the granulosa cells that surround the follicle to produce oestrogen from testosterone, an essential hormone for regulating the menstrual cycle (1). You can read more about oestrogen here.  What does FSH do? FSH has two primary functions:  Follicular development FSH does pretty much exactly what it says on the tin—it stimulates the growth of follicles which contain your eggs.  You’re born with ‘immature’ eggs. So each month, a number of them start maturing before one is released during ovulation. Your eggs are housed in tiny follicles inside your ovaries, and it’s these follicles that FSH signals to prepare your eggs for ovulation (2). Oestrogen production FSH also stimulates the cells that surround the follicles to make an enzyme called aromatse, which converts testosterone into oestrogen, another essential hormone for regulating the menstrual cycle and reproductive health (1). The relationship between FSH and LH When your eggs are fully mature and ready to be released during ovulation, LH steps in. A surge of LH is released, again by the pituitary gland in the brain, causing the most mature follicle to rupture—releasing an egg into your Fallopian tube. This is ovulation.  Despite FSH causing numerous follicles, and therefore numerous eggs, to mature each cycle, only one follicle will release an egg each month. This is because FSH and LH are both involved in negative feedback loops, controlled by E2. But what does negative feedback loop mean? Increasing FSH levels in the early stages of your menstrual cycle leads to more oestrogen being made, but this ha, a negative feedback effect on FSH levels. In other words, when you have lots of oestrogen, it feeds back to the brain that it needs to stop making more FSH. Similarly, with LH, oestrogen levels keep increasing through the cycle and once they reach a peak around the middle of the cycle, it causes a sudden surge in LH that promotes ovulation. After ovulation, the empty follicle that once contained the egg makes another hormone, progesterone, to support conception, implantation and the early stages of pregnancy. High levels of progesterone tell the brain to stop making more FSH. Now if a pregnancy doesn’t happen, there is a drop in oestrogen and progesterone which triggers your period. It also tells the brain it needs to start making FSH to start the whole process all over again in the next menstrual cycle (5). High FSH levels Okay, but what happens when we have high FSH levels? Let’s take a look at the causes and symptoms of high FSH levels. What causes high FSH levels? The most common reason for high FSH levels is a low ovarian reserve (egg count), or ovaries that aren’t functioning properly. When we have a low ovarian reserve, this essentially means we have a smaller number of immature follicles available in our ovaries and our bodies will produce less oestrogen.  Because oestrogen controls how much FSH we produce (remember that negative feedback loop), when we have less oestrogen, our FSH levels may go up.  High FSH levels can therefore indicate that our ovaries aren’t functioning properly, be an indicator of low ovarian reserve or an indicator of the onset of menopause. Other reasons for high FSH levels can be ovarian cancer (although this is very rare) (9) and Premature Ovarian Insufficiency (POI) which is the loss of ovarian function before the age of 40 (6,7). In some cases, dietary and lifestyle factors can moderately raise FSH levels. Symptoms of high FSH levels Symptoms of high FSH levels usually mimic symptoms of menopause and are related to low oestradiol levels —which is why it’s so important to test a range of your reproductive hormones to get to the bottom of symptoms. Symptoms can include: How to lower FSH levels? It is important to understand that if high FSH levels have been caused by menopause or a low egg reserve, modifications to your diet or lifestyle will not be able to reverse this. However, there are some dietary lifestyle factors associated with a higher FSH, such as smoking and high alcohol consumption.  If you’re trying to conceive, consider cutting alcohol and cigarettes completely as this will improve your chances of conception and prevent harmful effects to the baby during pregnancy (17). For advice on how to quit smoking, see the full list of NHS quit smoking services here. Nutrition can be a really powerful tool in balancing hormones and helping to alleviate symptoms. You can book a nutritional health consultation with one of our registered nutritionists via your health hub. […]

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

Hormones help to regulate almost all of the body’s processes, including reproductive health and fertility. Testing your hormones regularly can give you insights into your overall health and help you track changes in your menstrual cycle and fertility over time. Here we’ve broken down which hormones you should test and why.  Quick facts: What are hormones? Put simply, hormones are small chemical messengers that travel through the blood to different parts of your body. They help control many different functions from growth and development to metabolism, the menstrual cycles, fertility and mood, just to name a few. Hormones are made by special cells in the endocrine system. Some of the major endocrine glands are: Why are sex hormones important? Sex hormones are a group of hormones that help to regulate the female and male reproductive organs and fertility. They are important not only for reproductive health but for overall health too—often having multiple functions within the body.  The main hormones involved in the female reproductive system are:  Thyroid hormones can also impact your levels of reproductive hormones. Why do you need to test your hormones? Hormones are often involved in complex feedback loops with one another. This means if one hormone gets off balance, it can often disrupt the whole system and bring about multiple, often overlapping symptoms.  Our hormones are also changing constantly, as we age and in response to things like lifestyle factors, medications or external stresses. A change in your hormone levels could be the reason you’re feeling sluggish or slightly emotional, explain your irregular periods or why you’re struggling to get pregnant. Our hormone levels can give us insight into both our overall reproductive health, show our risk factors for certain conditions, explain any unwanted symptoms, or indicate the health of our ovarian reserve and fertility.  Which hormones should I test? Which hormones you need to test and monitor will depend on your individual medical history, symptoms, biometrics and fertility goals. Luckily, our Online Health Assessment is built on a proprietary algorithm that does the leg work for you, recommending you hormone panel personalised to you.  Let’s take a look at each of the main female sex hormones and what testing them could tell you.  Follicle-stimulating hormone One of the main hormones that regulate the menstrual cycle and fertility is follicle-stimulating hormone (FSH). Its main job is to stimulate your ovaries each month to mature a set of follicles (the sacs that house the immature eggs) into mature eggs.  If FSH gets out of balance, ovulation can be affected, negatively impacting fertility and causing irregular cycles.  FSH levels increase with age. High FSH is usually an indication that ovarian reserver is declining and more FSH is needed to encourage your eggs to grow. This is why monitoring FSH can help you understand the health of your ovaries.  FSH levels will slowly increase with age as your ovarian reserve declines. When your ovarian reserve is finally depleted (and menopause occurs), FSH levels become substantially elevated. This is why FSH is used as an indicator of menopause.  Persistently high FSH levels in someone younger than 40, along with irregular periods and vasomotor symptoms, could indicate premature ovarian insufficiency (POI). This is when someone experiences menopause before the age of 40. FSH levels are usually not recommended as an indicator of menopause beyond the age of 45. Oestrogen (Oestradiol) Oestrogen is an important hormone for the growth and maturation of eggs and the thickening of the uterus lining each cycle. It’s also incredibly important for overall health, regulating bone, heart, skin and hair health, as well as mood.  Oestrogen is made by the ovaries, so monitoring oestrogen levels gives a good indication of how well your ovaries, and menstrual cycle in general, are functioning. Oestrogen levels will fluctuate and eventually significantly drop when your ovarian reserve becomes depleted and menopause occurs. Low oestrogen levels are therefore linked with many symptoms of menopause, such as dry skin and hair, vaginal dryness, hot flushes, brain fog, night sweats, difficulty falling asleep and fatigue.  Luteinising hormone (LH) LH is the hormone responsible for triggering ovulation, which is the release of the mature egg from an ovary each month.  If your LH levels are too low or too high, it can interfere with ovulation. High LH levels are often seen in those with Polyendocrine Metabolic Ovary Syndrome (PMOS, formerly known as PCOS), which can cause irregular ovulation and issues with periods and fertility. Anti-Müllerian hormone (AMH) Anti-Müllerian Hormone (AMH)  is a super important hormone for fertility and overall reproductive health. AMH is made by the small sacs, called follicles, in your ovaries. These follicles house your eggs.  Since AMH is made by the follicles, your AMH levels can therefore give you an insight into your ovarian reserve, or how many eggs you have at the time of testing.  We were all born with all of the eggs we’ll ever have, and as we age, both our egg quality and quantity decline. Generally, our AMH levels will decline with age as our egg count diminishes, unless we have an underlying condition or lifestyle factor which is affecting our AMH levels (like PMOS).  High AMH levels can be an indicator of polycystic ovaries and can be used to diagnose PMOS based on recently updated clinical guidelines. On the other hand, low AMH along with high FSH and low oestrogen is usually an indicator of low ovarian reserve.  AMH is often also used to predict someone’s chances of success during fertility treatment, such as egg freezing and IVF. However, it’s important to remember that AMH can only tell you about the quantity, and not the quality, of your eggs. Testosterone Testosterone can be converted to produce the wonder hormone oestrogen and is also associated with libido, maintaining muscle mass, vaginal health, breast health and bone health.  High levels of testosterone can cause symptoms such as excess body and facial hair, acne, and irregular or absent periods. These symptoms are often seen in women with PMOS […]