Tag: hormone levels

Research shows that on average, it takes two years and visits to three different doctors for someone to get a diagnosis of polycystic ovary syndrome (PCOS), even though it’s one of the most common hormonal conditions in the UK, affecting around 1 in 10 women. Part of the problem is that PCOS presents differently in different people. There’s no single symptom that confirms it, no single test that catches every case, and whilst the  diagnostic criteria is  clinically sound, it requires ruling out other conditions before it can be applied. Add  that to the reality that many GPs have limited time and variable knowledge of reproductive hormones,  it’s not difficult to understand why so many people spend years being told their symptoms are normal, or being tested for the wrong things. This guide walks through exactly how PCOS is diagnosed: the criteria clinicians use, the tests involved, what the process typically looks like, and what you can do if you’re struggling to get answers. Quick Facts How is PCOS diagnosed? PCOS is most commonly diagnosed using what’s known as the Rotterdam criteria, established by an international consensus in 2003 and last updated in 2023. To receive a PCOS diagnosis, a person must meet at least two of the following three criteria: 1. Irregular or absent menstrual cycles. This means cycles that are consistently shorter than 21 days, longer than 35 days, or absent altogether. Irregular cycles indicate that ovulation is not occurring regularly, a key feature of PCOS. According to the 2023 International Evidence-Based PCOS Guidelines, irregular cycles are defined as fewer than eight cycles per year, or cycle intervals outside the 21–35 day range, in women who are at least three years post-menarche (which is your first period). 2. Clinical or biochemical signs of high androgens (hyperandrogenism). This means either physical symptoms associated with elevated androgens such as excess facial or body hair (hirsutism), acne, or scalp hair thinning or elevated androgen levels on a blood test – typically testosterone. Importantly, you don’t need both signs of hyperangrogenism – physical signs alone, or blood results alone, can satisfy this criterion. 3. Polycystic ovarian morphology (PCOM). This refers to the appearance of the ovaries on an ultrasound scan, specifically a high number of small antral follicles (the immature follicles that house eggs) in one or both ovaries, or an increased ovarian volume. Alternatively, a high AMH (anti-Müllerian hormone) level on a blood test can be used as a marker of PCOM when an ultrasound isn’t available or appropriate. Two out of three. That’s the threshold. Which means you can have PCOS without polycystic-looking ovaries on a scan. You can have PCOS without acne or excess hair growth. You can have PCOS with a relatively regular period. This variability is one reason why the diagnosis of PCOS is frequently missed or delayed – there’s no single presentation that fits everyone. What tests might I need to do to get a PCOS diagnosis? A PCOS diagnosis is built from a combination of clinical assessments, blood tests, and often an ultrasound. Here’s what each one involves. Blood tests for PCOS diagnosis Blood tests are central to PCOS diagnosis, both for assessing hormone levels and for ruling out other conditions that can mimic PCOS. The following are typically included in a diagnostic workup: LH and FSH Luteinising hormone (LH) and follicle-stimulating hormone (FSH) are both made by the pituitary gland and work together to regulate the menstrual cycle. In PCOS, LH is often elevated relative to FSH, producing a raised LH:FSH ratio (typically greater than 2:1). This is one of the hormonal patterns clinicians look for in the early follicular phase, ideally tested around day 2–5 of the cycle. Oestradiol Oestradiol (the primary form of oestrogen) is tested alongside FSH to interpret the hormonal picture correctly. High oestradiol can suppress FSH artificially, which is why these two should always be read together. Testosterone and other androgens Testosterone and DHEAS (dehydroepiandrosterone sulphate) are tested to assess androgen levels. Elevated androgens support the hyperandrogenism criterion and help explain symptoms like excess body or facial hair and acne.  SHBG blood test measures the level of a protein called sex hormone binding globulin (SHBG) in your blood. SHBG attaches to sex hormones such as testosterone and estrogen and helps control how much of these hormones are active  in the tissues of your body and to understand how testosterone and oestrogen are working in the body. AMH (anti-Müllerian hormone) AMH is made by the antral follicles in the ovaries (early stage follicles that haven’t been selected for ovulation yet) and reflects the size of your egg reserve. In PCOS, AMH is often significantly elevated becausethere is a high number of small follicles stuck at different stages of development. A high AMH can serve as a marker of polycystic ovarian morphology in clinical settings, particularly when an ultrasound is unavailable. AMH doesn’t fluctuate dramatically across the cycle but is ideally tested on day 3 of the cycle for consistency. Thyroid function tests (TSH and free T4) Both an underactive and overactive thyroid can cause irregular cycles, weight changes, and fatigue that closely resemble PCOS symptoms. Ruling out thyroid issues is a standard part of the diagnostic process. Prolactin Elevated prolactin (hyperprolactinaemia) can also disrupt the menstrual cycle and cause irregular or absent periods. Testing prolactin helps exclude this as an alternative explanation for cycle irregularity. Glucose and insulin / HbA1c Because insulin resistance affects a lot of people with PCOS and significantly impacts its management, assessing metabolic markers such as fasting glucose or HbA1c is an important part of a thorough diagnostic workup. These tests are ideally taken in the early follicular phase, between days 2–5 of the menstrual cycle, when cycling hormones like LH, FSH, and oestradiol are at their baseline. If your cycles are very irregular, your doctor may advise testing at a specific point or to simply proceed whenever possible. Hertility’s Advanced At-home Hormone & Fertility Test checks for these markers including LH, FSH, oestradiol, testosterone, […]

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

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

PCOS is one of the most common reproductive health conditions. Some of the most common symptoms people struggle with are physical symptoms such as issues with weight; skin and hair related issues such as acne or excessive hair growth and irregular periods. These are mainly driven through disrupted hormones. Androgens are a group of hormones, including testosterone,  that are made in the ovaries and are often found at much higher levels in women with PCOS, called “hyperandrogenism”. Insulin is also found to be at much higher levels, due to insulin resistance. Normally, Insulin helps manage blood sugar levels, helping cells absorb glucose. Insulin resistance is when the body no longer responds to normal levels of insulin. This can result in excess amounts of insulin being produced, misregulated blood sugar levels and metabolism issues like weight gain and type 2 diabetes. Women are also 3 times more likely to experience mental health related symptoms like anxiety, depression or body image issues. Unfortunately there is currently no cure for PCOS, however, there are  treatment options  aimed to manage symptoms.  Think you might have PCOS? Check your hormones Benefits of regular exercise Regular exercise can be an extremely effective way to help manage PCOS symptoms. Some experts suggest exercise as a first port of call for PCOS management but can also work alongside medications like metformin for increased effects, particularly for improving cycle related issues (1). Exercise can have positive effects on physical, hormonal and mental health related issues including: How much exercise is recommended? For a healthy lifestyle, preventing weight gain and maintaining health: Adults should do a minimum of 150 minutes a week of moderate-intensity physical activity or 75 minutes per week of vigorous activity or a combination of both and include muscle-strengthening activities Young women should do 60 minutes or more of moderate to vigorous activity per day including those that strengthen muscle at least three times a week Activity can be done in 10-minute bursts or around 1000 steps, aiming to do at least 30 minutes on most days. For those who have a goal to lose weight, prevent weight regain or achieve greater health benefits more exercise is needed: A minimum of 250 minutes a week of moderate-intensity activity or 150 minutes a week of vigorous activity or a combination of both Muscle-strengthening activity on 2 non-consecutive days of the week. Overall, aim for around 30 minutes per day. Of this, 90 minutes per week should be more active or aerobic activities (running, biking, fast pace walking etc.) at a moderate to high intensity to optimise clinical outcomes (see table below for suggested activities). Remember physical activity includes walking, activity at work, household chores, sports and planned exercise. Choose an exercise you like and if possible exercise with friends or others to increase your motivation. Mixing up exercise will also help with motivation. Benefits for your body What are the benefits of exercise on PCOS? PCOS can affect the body’s metabolism making it harder to lose weight and also affect where fat is stored. Visceral fat (fat in the abdomen and around your organs) tends to be increased in those with PCOS. Alongside this, there is an increased risk of long-term health issues including obesity, cardiovascular disease and high blood pressure. Regular physical activity can help improve body composition and is extremely beneficial for reducing these risks.  In general aerobic exercise (or cardio), like running, swimming or cycling, is great for reducing blood pressure and improving heart health. Increasing your daily energy expenditure (the amount of energy you burn in a day) can help with losing weight by creating a calorie deficit (burning more calories than you consume). Women with PCOS who had greater vigorous activity levels were found to have less visceral fat (2). A 6 month study introducing an exercise regime of 30 mins aerobic exercise 3 times a week saw a reduction in waist circumference (as a measure of visceral fat), and improvements in menstrual cycle patterns (3).  What type of exercise is best? There is a lack of evidence supporting any one type and intensity of exercise being better than another for metabolic, hormonal, reproductive or psychological outcomes. The International guidelines and majority of studies have focused on aerobic exercise routines, however, resistance training (exercise designed to improve muscle strength or endurance) such as weight lifting, has big benefits too. Resistance training has a positive effect on body composition by increasing muscle mass, which can contribute to increasing your energy expenditure. In studies focusing on resistance training for women with PCOS, a reduction in visceral fat and an increase in lean muscle mass was seen (4). It is also important to know that exercise without weight loss or only moderate weight loss can still lead to a reduction in visceral fat and improve insulin sensitivity. Think of being active as often as you can through the day, for example take stairs instead of lifts, park further away from shops etc. Can exercise improve chances of conceiving? Improvements in reproduction have been seen in women with minimal weight loss – so the scales are not the be all and end all! The NHS states as little as 5% reduction bodyweight can help improve symptoms (5). Other important lifestyle factors to consider, particularly for managing weight, are issues with appetite regulation – if this is something you are struggling with you can speak to one of our Fertility Nutrition Consultation. Benefits for your hormones  Insulin resistance is common among those with PCOS and can contribute to many of the symptoms like dark skin patches, fatigue and weight issues. This goes hand in hand with visceral fat and general inflammation throughout the body.  This is believed to be associated with greater levels of visceral fat and amount of visceral fat Women who had greater levels of physical activity, had better chances of normal insulin responses (6)  and reduced chances of inflammation (7).  Excess insulin can increase the production of androgens in the ovaries, contributing to hyperandrogenism. […]

Whilst it might be tempting to want to predict the age you may experience menopause, calculators and predictions are generally not thought to be medically accurate. But there are a few things you can do to prepare for menopause. Read on to find out.  Quick facts: Can you predict menopause? It’s normal to be curious about the age at which you’ll reach menopause. We get it—you want to feel prepared and plan ahead for big life changes. Despite advances in technology and science, there’s no definitive menopause age calculator or test that can predict the age you’ll reach menopause with any certainty.  While there’s more research being carried out into predicting the age of menopause, there’s simply no one-size-fits-all approach as menopause is so dependent on your individual hormonal make-up. Since multiple factors contribute to the onset of menopause, a menopause age calculator won’t be accurate. There are, however, some factors that can affect when in life you may reach menopause—like your genetics, lifestyle choices and medical history. If you’re experiencing symptoms that may be related to menopause or perimenopause, then book an appointment to speak to one of our Menopause Specialists who can provide advice, and guidance as well as HRT prescriptions. What is menopause? You reach menopause once you have not experienced a period for more than 12 months.  It’s a natural biological process that marks the end of your reproductive years.  Biologically, your hormones are shifting, and most notably, there’s a massive dip in oestrogen —the hormone that plays a key role in regulating your menstrual cycle and supporting your reproductive health. This hormonal change can bring on physical and emotional symptoms such as hot flashes, vaginal dryness, mood changes, problems sleeping and irregular periods.  These changes can start happening years before you even reach menopause. This phase is called perimenopause. There are ways you can offset and support your perimenopause symptoms. During perimenopause, your body is adjusting to the hormonal changes and you will gradually stop producing the hormones that control and bring about your periods, causing your periods to eventually stop altogether.Once your hormones rebalance post-menopause, many report feeling like they’ve got a new lease of life. This is why menopause is often nicknamed “the second spring”—a chance for new beginnings, which is often welcome after a time of massive change in the perimenopause. The myth of menopause prediction Just like each one of us is unique, the age we reach menopause is too.  Limited research in this area means that not even the experts can determine the age you’ll reach menopause. It’s easier to want to turn to a definitive answer, but more often than not, this oversimplified prediction isn’t backed up with scientific evidence. There are too many individual variations for them to be reliable. Menopause age calculators also don’t take into consideration any external factors that are difficult to measure, for example, exposure to pollutants and other environmental factors, or exposure to stress. Ultimately, any factors that can impact your hormones can impact the onset of menopause. Average age for menopause The average age for the onset of menopause in the UK is 51, with most people reaching menopause between the ages of 45-55. A small percentage experience early menopause or premature menopause (premature ovarian insufficiency) before the age of 40. Factors that influence menopause timing Three key areas may indicate when you start menopause: your genetics, your medical history, and your lifestyle. Genetic influences Research suggests that you can roughly predict the age you’ll reach menopause according to when other females in your family like your mother or sister reached theirs.  Studies suggest there may be a familial pattern and even certain genetic markers that indicate the age of menopause onset. However, while genetics play a crucial role, other factors, such as your medical history and lifestyle factors come into play too. For example, you may have a different upbringing from other female relations in terms of where you live, whether you have any underlying health conditions and what you’ve consumed in your diet and lifestyle over the years. Lifestyle and medical history  Lifestyle choices, such as whether you are overweight or underweight (or have a low or high BMI) from nutrition and exercise patterns, or whether you smoke or drink alcohol impact the age you reach menopause. This is because poor lifestyle choices can negatively affect your reproductive and overall health. They can impact your ovarian reserve and hormones and bring on menopause sooner. Biological factors can impact your menopausal age including: The wide variation of genetics, lifestyle and medical history amongst individuals makes it difficult to predict the age you’ll reach menopause. Understanding your body’s signals Becoming attuned to your body’s signals can help you predict when you’re approaching menopause. A key factor, often coined “the fifth vital sign”, is your menstrual cycle. Your menstrual cycle is considered regular if your cycle lasts roughly the same amount of days, e.g. between 21 and 35 days each cycle.  Irregular periods are one of the first signs of perimenopause you might notice, along with things like hot flashes, trouble sleeping, lowered sex drive and vaginal dryness. To find out what’s going on inside, you could take a advanced hormone and fertility test. This will give you a report indicating your hormone levels, and you can speak with a Menopause Specialist to make sense of your results and discuss your next steps. If you have questions about the age of your menopause, it’s best to speak with a healthcare professional for the most reliable information. They can advise you on your individual menopause experience with as much support as possible instead of focusing on predicting the age you’ll get there. Preparing for menopause Maintaining health and well-being is crucial for navigating menopause with ease. Adopt a healthy lifestyle with balanced nutrition and regular exercise to improve your mood, maintain a healthy weight and support your vitality. Limit alcohol and smoking, manage stress and make sure you’re getting enough sleep to balance your […]

In this article we will walk you through what happens if your Hertility at-home hormone testing kit comes back with a haemolysed blood sample, what happens during lab tests affected by hemolysis and our top tips for taking and sending off your samples to ensure your hormone blood test results don’t come back haemolysed. Quick facts: What does it mean when a blood sample is haemolysed? A haemolysed blood sample is when the red blood cells in the sample you provided have burst or broken down.  This process is called haemolysis—the red blood cells rupture and spill their contents, mainly haemoglobin (a protein that carries oxygen around your body) into their surrounding serum or plasma.  With any type of blood collection, haemolysed blood samples can happen. They are very common—in fact, they are actually the number one cause of rejected samples by labs, second only to insufficient sample size (1). Haemolysed samples are unable to be tested and labs will reject and request new samples. This is because analytes that are tested for in the sample will potentially have become diluted by haemolysis and an accurate result will not be able to be obtained. We know it can be frustrating to hear that your sample couldn’t be analysed—especially if you’re someone who doesn’t like having blood taken.  What causes a haemolysed blood sample? Haemolysis can happen with any form of blood collection, whether it’s a finger prick sample like the one used in our at-home Hormone & Fertility Test or a traditional venous blood drawn by a nurse or doctor. It can also happen regardless of where the sample was taken.  Samples can become haemolysed for a number of different reasons, but here are some common ones we’ve found with our tests. Haemolysed blood could be caused by: Can my sample be analysed if it’s haemolysed? Unfortunately, no. Because the red blood cells have broken down, the hormones within the sample can’t be analysed.  We know this can be really disappointing and frustrating. So, if your sample has come back haemolysed, we will send you a second test kit, free of charge, for you to retake your sample.  All you need to do is log in to your health hub, navigate to your tests and click on the notification we’ve sent you. We will have already credited your account with a free test, so all you need to do is check out.  Top tips for taking your sample Sometimes haemolysis can happen because of the way your blood sample was collected or packaged. We’ve put together a few tips and tricks to help you get your sample to us safe and sound. Top tips for preventing hemolysis when taking your blood sample: 1. Slow it right down Take your time when taking your sample, don’t rush through or squeeze your finger really hard. Use gentle downward strokes to encourage blood flow. 2. Make sure your hands are warm Warm hands = more blood circulation. This means it will be easier to draw your sample. Submerge your hand in warm water for a couple of minutes before collecting your sample to get that blood pumping all the way to your fingers. 3. Use your ring finger This one usually works the best, giving the biggest drops. Make sure you prick the fleshy part. 4. Always wipe away the first droplet Use a tissue or sterilised wet wipe to wipe the first drop clean, before aiming the rest of your drops into your collection tube. 5. Pierce a second finger if the blood stops flowing on the first Don’t overdo it on the first finger, if the blood flow stops, start fresh on a new finger. 6. Use the cartwheel method Take your arm that is not being used for the sample (we don’t want an American psycho situation up the walls) and swing in a cartwheel motion for about a minute. Don’t ask why, but it works. 7. Get your blood pumping with some star jumps Bring back some P.E class nostalgia star jump it out for a minute or so before you take your sample. This will get your blood flowing and your fingers warm.  8. Make sure you’re hydrated Everyone is more dehydrated than usual when first waking up which can make circulation slower and collecting your sample more difficult. Stay hydrated the day before you’re due to collect your sample and drink a couple of glasses of water roughly half an hour beforehand.  Top tips for preventing hemolysis when packing your blood sample 1. Do not shake your tube after collecting your sample Place your tube carefully back into your kit box, into the space indicated. This will keep it wedged safely in place during transit. 2. Post your sample on the same day it was collected Ideally you’ll do your test first thing in the morning. Then, keep it at room temperature and post it to your nearest postbox as close to the collection time as you can. This will reduce the time it’s outside for, potentially getting hot in the sun or too cold. 3. Use a priority postbox if you can These are collected everyday, you can find your nearest one on the Royal Mail website.  4. Check our social channels for lab closures and postal service delays We regularly post or email reminders about upcoming lab closures, postal strikes and delays due to public holidays on our stories, make sure you’re following us and check our socials before doing your test. FAQs How will I know if my sample arrives haemolysed? Rest assured, we will always contact you directly if your sample arrives haemolysed. One of our customer service team will be in touch.  Will I get another test free of charge if my sample is haemolysed? Our labs will inform us, we will contact you to let you know and will offer a second kit free of charge to redo your test Do I have to wait until day 3 of my cycle before I can test again? Unless you’re on hormonal contraception, unfortunately yes, you will have to wait until […]