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 […]

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. […]

For women or those assigned female-at-birth, society ensures that as we age, we’re hyper-aware of our declining fertility. Jokes about our ticking ‘biological clocks’, extended family constantly asking when we’re going to ‘settle down’ and even trying to navigate company maternity policies—it can feel really overwhelming. There are many different pathways to parenthood and for a lot of people, either for medical or social reasons, their fertility timeline just doesn’t line up with where they are at in their personal or professional lives. Luckily, advances in reproductive science are enabling many people to access fertility treatments, like egg freezing, to preserve their fertility.  We spoke to five people, all with different circumstances, who have undergone egg freezing. We hope these accounts can help you to understand a little bit more about the egg freezing experience. Recap: What is egg freezing? The egg freezing process (known medically as ‘oocyte cryopreservation’) is a fertility preservation method and medical procedure that involves having your unfertilised eggs surgically removed from your ovaries, frozen and stored in a lab until you’re ready to use them.  You may choose to freeze your eggs if you want to have children in the future, but aren’t ready to yet. As you age, the quantity and quality of your eggs decline, which means your chance of getting pregnant does too. Freezing your eggs will preserve their quality, as they are now, for if and when you become ready to use them. There are two types of egg freezing: The egg freezing process An egg-freezing cycle involves several different stages including preliminary tests, ovarian stimulation, egg retrieval, storage and then subsequently thawing once you’re ready to use them. Egg-freezing can be incredibly empowering—allowing you to control your family planning timeline and focus on your personal and professional life, or any medical treatment, without having to worry about your fertility decline.  However, it can be an intensely emotional journey full of ups and downs, with financial strain, daily injections, and hormonal changes that can affect your mental and physical health.  Remember—if you’re going through this process, Hertility’s fertility counsellors can support you through these challenges. While the procedure is generally safe, there is a small risk of Ovarian Hyperstimulation Syndrome (OHSS), which is a condition that can happen in response to fertility medication. For more information, read our egg-freezing guide. Natalie Getreu’s egg freezing journey Ovarian biologist and one of our very own co-founders, Dr Natalie, had a unique egg freezing experience after having been both a fertility practitioner and patient.  “I thought I knew everything about egg freezing, at least from a scientific standpoint. I’d supervised procedures, sat in on consultations, educated women and delivered lectures on treatments.  But when it came to undergoing the process myself, as a patient, it was a completely different experience.  I definitely didn’t fully appreciate the physical toll it would take, how draining it would be emotionally, or how much I would have to relinquish control to the process and just let my body do what it needed to do in response to the treatment.  Probably the biggest thing I came to appreciate was how much I needed to slow down. As a founder, there is an enormous pressure to be available 24/7, and as a woman, for everything to be done perfectly. There often doesn’t feel like we are afforded the space to slow down, but I realise now how important that is. The whole process made me have a much deeper appreciation of the lack of education and awareness out there about alternative routes to parenthood. If you’re thinking about undergoing treatment, get as much info as possible. Support is out there no matter what your circumstance is’.” Asher’s egg freezing journey “I discovered the importance of [egg freezing] the same day that I was diagnosed with gender dysphoria and recommended for Testosterone HRT. Luckily, this is when I was introduced to Hertility – finally some humane guidance, clarity and crucially being seen and understood as a trans person. The whole process became much clearer and felt more manageable, and honestly I started to feel inspired by the gift of being able to do this. The actual process wasn’t nearly as bad as I imagined, especially in relation to triggering my dysphoria.“ Georgia Habboo’s egg freezing journey “The reason I did this was that I had not had a period since coming off the pill (it had been 3.5 years) and I literally was getting no answers from doctors after 10,000 tests. I did the hormone testing kit which I’m SO grateful for. My AMH, which is an indicator of your egg reserve (ovarian reserve), was really low – within the range of a 55-65-year-old, so they recommended that I freeze my eggs straight away”. Daniella Abraham’s egg freezing journey “At age 30, I wasn’t anywhere near ready to have a baby. Although I wanted the option to have kids in the future, I didn’t want to feel pressured into trying sooner than I might have done just because of my ‘biological clock’. Honestly, the hardest part was deciding if the process was right for me, but in the end, I’m so glad I chose to do it. “Freezing my eggs has given me reassurance that I didn’t need to rush into making any major life decisions and given me peace of mind that I will have the option to start a family in the future when I’m ready to.” Mish’s egg freezing journey “As I approached 35, I knew I wanted to freeze my eggs. I didn’t want to feel pressured to have a baby just because of my biology. But I had no idea if I would be able to  – I knew you can only get screened on the NHS if you’re trying, so I assumed I would just have to wait until then. “That’s when I found Hertility. I took a Hertility test which allowed me to see if I had any issues in advance of starting […]

Stress is bad news, period. It can affect the menstrual cycle, and just about every other bodily process. In this article we’ll cover exactly what stress is, the science behind it, how it can impact our periods, and some top tips for managing it. Quick facts: What is stress? Stress is defined as a state of worry caused by a difficult situation. It’s always been a part of human life and is a fundamental element for our survival.  Stress is a natural part of life and impacts us almost daily. Whilst a small amount of stress can actually be good for us (believe it or not), chronic stress and burnout can end up negatively impacting almost all of our body’s processes—including our menstrual cycles. The bodily changes you feel when you’re stressed are akin to what your ancestors felt when they were running away from life-threatening predators. Except, nowadays, predators take on the shapes of boardrooms, bosses and bills. Stress is classed as a state of ‘disharmony’, disrupting the carefully coordinated balance that your body is consistently fine-tuning. Usually, your body’s reaction to stress is temporary and it’s able to revert to its previous state.   However, it’s increasingly common to be exposed to prolonged periods of stress or several different, unresolved stressors, which cannot be adapted to—resulting in chronic stress. This can feel never-ending and all-encompassing, impacting both our mental and physical health.  This is the type of stress linked to depression, fertility issues and other health problems. The science behind stress The body’s reaction to stress is coordinated by something called the hypothalamic-pituitary-adrenal axis (HPA axis). The hypothalamus, in the brain, helps encourage the production of hormones like cortisol aka stress hormone (1). These kickstart the body’s stress response and divert the brain’s attention away from other processes, like coordinating your reproductive system. When we are chronically stressed, our cortisol remains constantly high. This can put us in a constant state of ‘fight or flight’, leading to the body being unable to adequately support other bodily functions. What is a ‘normal’ period? To understand how stress may affect your menstrual cycle, it’s important to understand what a ‘normal’ or average cycle looks like. A ‘normal cycle’ can last anywhere from 21 to 35 days, depending on the individual.   A one-off longer or shorter cycle is still considered normal, but if yours are consistently irregular, it’s worth getting checked out as they could be caused by an underlying health condition, such as PCOS. Can stress affect your period? Stress can affect your period in many different ways. This is because your menstrual cycle and your body’s response to stress are both coordinated by the same part of the brain—the hypothalamus. If you have high cortisol it can disrupt the hypothalamus, disrupting the production of gonadotropin-releasing hormone (GnRH).  GnRH controls the production and regulation of follicle-stimulating hormone (FSH) and luteinising hormone (LH), two hormones incredibly important for the regulation of the menstrual cycle.  If FSH and LH become disrupted, you’re likely to experience disruptions to ovulation and menstrual cycle regularity. This can also disrupt sexual desire and arousal. One study found that women experiencing high levels of stress showed lower levels of sexual desire, linked to elevated cortisol levels. Can stress delay your period? Elevated cortisol levels as a result of stress can effectively delay ovulation by blocking the release of LH. Without a surge in LH, you won’t ovulate. This can make your cycles longer and potentially heavier. On the flip side, high levels of stress are also associated with shorter cycles. Can stress stop your period? In situations of chronic stress, ovulation can be prevented for long periods of time (known as chronic anovulation), stopping your period altogether. This can be due to psychological stress but also periods of intense exercise or eating disorders. Missing periods due to stress is called functional hypothalamic amenorrhoea. How do I know if stress is the cause of my menstrual cycle changes? Without the analysis of a medical professional or hormone test, it’s not possible to know for certain that stress is the cause of your menstrual cycle changes.  Lifestyle factors often work in tandem. Changes to your cycle may be because of a handful of interacting factors. That being said, there are steps you can take to get a better idea of whether stress could be behind your period irregularities.  Tracking your periods and symptoms, either with a period tracking app or just using a calendar or diary can help you understand if stress is linked to your cycle. Make a note of how irregular or regular your periods are and any symptoms like pain, acne and how you’re feeling emotionally, including stress.  You can also take our Online Health Assessment. Our assessment analyses your biometrics, medical history, periods and lifestyle factors, to calculate your risk profile and help determine the cause of your symptoms. By looking at the pattern between your menstrual cycle and stress levels, you should be able to spot if there’s any obvious link. Even if they aren’t linked, just being able to rule out stress as the cause of your period troubles is helpful—you’ll then at least know to direct your attention elsewhere. If you are under stress consistently, it may be difficult to pinpoint that this is what’s causing your irregular cycles. The best way to establish what is going on with your cycles is to look at your hormone health – you can do this using our tailored at-home Hormone and Fertility Test. By looking at hormones such as testosterone and thyroid-stimulating hormone, we can eliminate other things which can affect your cycle, such as PCOS or abnormal thyroid function. How can we manage stress? Although experiencing stress might not feel great in the moment, it does serve an important purpose and actually, in small doses, it’s a powerful motivator, helping us to work harder and achieve our goals.  Although our modern-day stressors might not be as dangerous as the threats facing our ancestors, they do still present […]

Can smoking cause hormonal imbalances? Just like the negative consequences to heart and lung health, smoking can also negatively impact our reproductive health. Read on to find out.  Quick facts: How smoking affects the body It’s a well-known fact that smoking can have a negative impact on health, with both active and passive smoking being associated with multiple forms of cancer, diabetes and heart disease. Despite this, in the UK, as of 2019, 28% of men and 22% of women aged between 25 and 34 years are current smokers, according to published health data in England (1)—and a whopping 175 million people assigned-female-at-birth (AFAB) smoke worldwide. But whilst smoking’s effects on the heart and lungs are fairly common knowledge, fewer people are aware that it can also influence the body’s hormones. But how exactly are hormones and smoking linked? In this article we’ll look at: Does smoking affect hormones? Despite the lack of public awareness, there is plenty of research that shows how smoking can impact and even wreak havoc on our hormonal health. The chemical components of cigarette and cigar smoke can disrupt the normal functioning of our bodily systems, including the endocrine system. The endocrine system is a network of glands which influence the production, secretion and regulation of hormones throughout the body, such as the hypothalamus, thyroid, adrenal gland, and even the ovaries.  This disruption might lead to lasting effects on all kinds of hormonally regulated processes, including sexual function and reproductive potential, our metabolism and even our sleep.  As mentioned, both active and passive smoking (also known as second-hand smoking) can cause these nasty effects, with some research even indicating that prolonged exposure and inhalation of cigarette smoke can even affect the onset of menopause (3). There are over 4,000 substances in cigarettes that display reproductive toxicity. How does smoking affect different hormones? Smoking has been linked to abnormal changes and fluctuations in various hormone levels, including: Let’s take a look at each of these in detail. Smoking and testosterone Studies have consistently shown that smoking increases testosterone in AFAB individuals. Those who smoke have been found to have higher serum testosterone levels in their blood than those who don’t (4).  This is because smoking is inherently pro-androgenic, meaning it has a positive effect on androgen hormones like testosterone. Increased testosterone levels can bring on side effects such as excess body hair growth (hirsutism), acne, greasy hair and skin, irregular periods and low libido. The main reason for smoking’s pro-androgenic effects lies with nicotine. As tobacco is metabolised, the nicotine within it produces a compound known as cotinine, which inhibits testosterone breakdown (17). However, it’s interesting to note that similar studies performed on ageing men have indicated that, over a long enough timespan, smoking can reduce testosterone levels in those assigned-male-at-birth (AMAB) (16). Smoking and oestrogen As well as being pro-androgenic, smoking is also anti-oestrogenic, which means it has a negative effect on oestrogen levels. Studies have shown that women who smoke have  lower progesterone and oestrogen levels in both their blood and follicular fluid (the fluid which surrounds the developing egg, important for egg growth) (2,5).  Smoking even affects the conversion of androstenedione to oestradiol by cells within the eggs (2). This switch is mainly driven by the effects smoking has on the production of these hormones.  As well as negatively affecting oestrogen production and metabolism by your liver, smoking increases the levels of a hormone called sex hormone-binding globulin (SHBG) which binds to oestrogen—preventing it from performing its essential functions around the body. Symptoms of low oestrogen can include low libido, fatigue, and negative mood changes. Smoking and gonadotropins Follicle-stimulating hormone (FSH) and luteinising hormone (LH) are both gonadotropin hormones. These are hormones released from the hypothalamus (a part of the brain) to regulate the menstrual cycle and induce ovulation.  Unsurprisingly, smoking has been found to affect gonadotropin levels as well. Studies have shown that habitual smokers tend to have higher levels of FSH and LH in the first half of their cycle and during their periods, than non-smokers (6,7).  Disrupted FSH and LH levels can lead to problems with both fertility and menopause. Smoking and Anti-müllerian hormone Anti-müllerian hormone (AMH) is produced by granulosa cells within the ovarian follicles. It’s used as an indicator of ovarian reserve, sometimes referred to as egg count. Research has shown that smokers generally have lower AMH levels. One study in particular found that current smokers have  44% lower AMH levels than non-smokers (8), indicating that smoking can be directly toxic to the eggs within the ovaries. Another study showed that, in smokers, the fluid produced by the granulosa cells (known as follicular fluid) also contains increased levels of harmful nicotine toxins (9). Chemicals derived from cigarettes and smoking have even been detected in the cervical mucus (10). Smoking and thyroid hormones Cigarette smoke has been found to have both inhibitory and stimulatory effects on thyroid hormones. Both active and passive smoking have been linked to decreased levels of thyroid-stimulating hormone (TSH) and increased levels of free thyroxine (T4) and triiodothyronine (T3) (11,12).  Because the thyroid gland plays an important role in the regulation of many different bodily functions such as growth and development, disruption in thyroid level can have huge knock on effects all around the body. The thyroid can also affect fertility.Smoking is consequently a known risk factor for thyroid-related disorders, especially Grave’s disease and Goitres (13,14). Smoking and prolactin Prolactin is produced by the pituitary gland in the brain and is most commonly associated with milk production and altering breast physiology, but it also has a number of different roles throughout the body.  Chronic long-term smoking has been found to be associated with decreased prolactin levels (14), which can cause irregular menstrual cycles, difficulty breastfeeding and negative mood changes. Smoking and cortisol Smoking has also been linked to increased cortisol levels in the blood. It also affects hormones involved in the production of cortisol (2), which can disrupt the regulation of its levels. Cortisol […]

Hertility partners with Pearl & Dean for the launch of #MeToo film, ‘She Said’, to rally women in the UK for the next women’s rights movement, the Reproductive Revolution.   Women’s health company Hertility’s award-winning film, ‘Ooh Someone’s Hormonal,’ spotlighted the lack of research on women’s bodies and called out society for using women’s hormones against them. Now, they’re teaming up with Pearl & Dean, the UK’s best-known cinema advertising contractor, to take the “Mother of all movements” to the next level in a bid to urge millions of women across the UK to get to know their bodies. For 5 weeks from November 25th, ‘Ooh Someone’s Hormonal,’ created by female-founded creative content agency Be The Fox, will be shown before every screening of ‘She Said’ in Pearl and Dean cinemas nationwide, the film starring Carey Mulligan and directed by Maria Schrader telling the story of the #MeToo movement.  Founded by women and powered by an (all female) research team, Hertility is setting a new standard of scientific rigour in female health by empowering women with information about exactly what’s going on under their skin using at-home diagnostic testing, telemedicine and treatment. By joining forces with cinema ad sales firm Pearl & Dean, the partnership aims to fuse science and art in the fight for equality. ‘The #MeToo movement was such a huge step forwards in women’s rights but from a reproductive perspective, women are still second-class citizens. We want to inspire women watching ‘She Said’ to join us in our fight in the next revolution – the Reproductive Revolution – by getting to know their bodies and taking control of their life choices. For themselves and for all women worldwide.’ – Dr Helen O’Neill, CEO and Founder of Hertility Carey Mulligan, has spoken openly about the lack of support for women in the film industry but as a middle finger to the male-dominated Harvey Weinstein era, ‘Ooh Someone’s Hormonal’, produced by female-led production company, Be The Fox, shows Hollywood how it’s done. Echoing the equality seen in the production of ‘She Said’, the female-powered cast and crew of ‘Ooh Someone’s Hormonal’ worked to the soundtrack of female artist Rebecca Taylor of Self-Esteem, complete with childcare on set, changing the outdated landscape and showing what’s possible when women, fully supported, come together. Diana Ellis Hill, Co-Founder, Be The Fox comments: “Empowering women and having true representation is an important cause that’s close to our hearts. We gathered an 80% female team to make the film from DOP and Director to Editor and Colourist as we wanted it to be real and authentic. We are immensely proud of what’s been produced and to see our film on screens at cinemas nationwide ahead of She Said.” Kathryn Jacob OBE, CEO at Pearl & Dean, said: “Cinema is a unique advertising medium in the sense that it is both a personal and shared experience. Cinema has the power to truly reach an individual, and to speak to them one on one, as well as spark a conversation. We are honoured to be working with Hertility to launch its first ever cinema campaign and to be a part of helping to better articulate an important issue that is often hidden or ignored by wider society.” Watch the cinema advert ‘Ooh Someone’s Hormonal’ More information on ‘She Said’

Anti-Müllerian Hormone (AMH) is a really important hormone for fertility. It can give insight into your ovarian reserve and how many eggs you have left. But what is a good AMH level for your age? Here’s everything you need to know about AMH levels.  Quick facts: What is AMH? Anti-Müllerian Hormone (AMH) is an incredibly important hormone when it comes to fertility and overall reproductive health.  AMH is made by the small sacs, called follicles, in your ovaries. These follicles house your eggs. Because of this close relationship with your eggs, testing 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 are all born with all of the eggs we’ll ever have. As we age, both our egg quality and quantity declines. This is due to both the natural ageing process and eggs being lost with each menstrual cycle. This happens right up until menopause when all your eggs are gone. As our egg count diminishes, generally so do our AMH levels, unless we have an underlying condition or lifestyle factor which is affecting our AMH levels (like PCOS).  What is a normal AMH level for my age? AMH levels will steadily decrease year after year from your mid-20s onwards. This occurs in tandem with your ovarian reserve declining.  After your mid-30s, AMH decline becomes much more rapid. It completely drops off as you near menopause (usually between 45 and 55 years old).  Although the overall levels of AMH by age is a general downward trend, each person has an individual rate of decline depending on genetics, lifestyle, medication and underlying conditions. What is a good AMH level? The higher your AMH the better, right? Well… not exactly. Like all of our hormones, too much or too little can indicate problems.  High AMH levels In general, higher AMH levels indicate a larger number of ovarian follicles and therefore a larger ovarian reserve.  However, some underlying reproductive health conditions like polycystic ovarian syndrome PCOS are associated with high AMH levels too. PCOS can cause hormonal imbalances which can negatively impact your fertility. Symptoms of high AMH levels Generally, high AMH levels don’t have any specific symptoms. But if you’re experiencing any symptoms that indicate a possible problem with your cycle you should test your hormones including AMH levels to investigate the possibility of PCOS. These symptoms could be things like irregular or no periods, or any other PCOS symptoms like acne, excessive body or facial hair, hair thinning or loss.  Low AMH levels On the flip side, low AMH levels can indicate lower numbers of remaining follicles and therefore, a smaller ovarian reserve.  Very low AMH levels are often seen in premature ovarian insufficiency (POI), which is a condition where menopause occurs before the age of 40 or even when you are going to experience menopause. Ovarian surgery can also carry a risk of low AMH levels afterwards. Some lifestyle factors have also been linked to low AMH levels – smoking, obesity, and poor diet and nutrition—specifically insufficient Vitamin D levels.  How to increase AMH levels? Unfortunately, you can’t stop your AMH from declining with age. That being said, there are some lifestyle and diet changes that can improve your fertility.  Monitoring your AMH levels with an at-home blood test if you have low AMH levels and are actively trying to conceive, or wanting to do so soon is a good idea to understand your rate of decline. Additionally, if you’re worried about your future fertility but not ready to have kids yet, you may want to consider egg freezing. Or, if you have low AMH levels and are struggling with conceiving, IVF treatment could be a good option for you.  If you’re concerned about your AMH levels, you can speak to our Private Gynaecologists at any time. Our Doctors can help you with a care plan that’s right for you and your body.  Do AMH levels fluctuate? Unlike your menstrual hormones which are cyclical, meaning their levels fluctuate throughout the month, your AMH levels stay relatively stable throughout your menstrual cycle. How do I know if I have normal AMH levels?  Testing your hormones is the only way to definitively know if your AMH levels are within the normal range for your age.  Doing an AMH blood test can give you an accurate insight into your current AMH levels, and give you an insight into your reproductive health because it is reflective of your ovarian reserve (egg count). Your AMH levels can also be used as an indication of whether you have polycystic ovaries, however, it can not currently be used to diagnose PCOS based on current guidelines. Understanding your AMH levels and ovarian reserve can also help to determine if you would be suitable for certain fertility treatments like IVF or egg freezing.  During fertility treatment, AMH levels are often tested to help determine the doses of medication and to predict the outcomes of the egg collection process.  Investigation of AMH levels is often done in combination with an Antral follicle count (AFC), which is an internal ultrasound scan where the number of small follicles seen on the ovary is counted. What is a good AMH level to get pregnant or to have IVF? Successfully getting pregnant is not entirely dependent on your AMH levels and ovarian reserve. Other factors can affect fertility such as: There is, therefore, no evidence of a good AMH level to increase the likelihood of pregnancy.  The success of IVF treatment is also dependent on many different factors. However, there is evidence that an AMH level lower than 5.4 pmol/L may have a poorer response to fertility medications. This is why some NHS IVF clinics will not accept patients who have an AMH level lower than this threshold.   Resources:

If you’re looking to conceive soon, nutrition can have a big impact on your fertility and reproductive health—both positive and negative. Get to know which foods are natural fertility boosters and valuable lifestyle changes that can improve your journey to conception. Quick facts: Why are diet and nutrition important for fertility? As the saying goes, we really are what we eat. Our diets and nutrition impact almost all of our body’s processes—all the way from our metabolism to our mental health. But one often overlooked area is how food can impact our fertility. When trying to conceive, you’ll need a high-nutritional diet. This can increase your chances of conceiving and help to create a healthy home for your baby during their vital first 9 months. Even making small changes to your lifestyle and nutrition choices can go a long way. Here are 16 evidence-backed tips from our Registered Nurse and Associate Nutritionist, Emily Moreton to help prepare your body for pregnancy. You can also book an appointment with a Hertility Nutritionist for a personalised plan. 1. Follow a Mediterranean-style diet Whilst there are no specific guidelines for a recommended fertility diet, the Mediterranean diet, is associated with improved fertility in both women and men. Known for its abundance of fruits, vegetables, nuts, whole grains, fish and healthy fats, the Mediterranean diet is rich in antioxidants. These have been shown to protect sperm and eggs from DNA damage and oxidative stress. A study involving 15,396 participants, which looked at how different diets affect fertility, showed that sticking to the Mediterranean diet improved birth and pregnancy rates significantly, with a 91% higher chance of success. This diet is also high in fibre and rich in vitamins and minerals that support fertility and pregnancy. Think lots of veg, whole grains, nuts, seeds, beans, pulses, olive oils, avocados and oily fish. 2. Eats foods high in antioxidants Eating a diet rich in a variety of colourful fruits and vegetables can provide a wide range of antioxidants that support fertility and overall health. Think making a rainbow on your plate. Foods high in antioxidants include fruits (such as berries, apples, and citrus fruits), vegetables (such as broccoli, spinach, kale, and carrots), nuts, seeds, and whole grains. 3. Increase intake of plant-based proteins In general, you should focus on lowering your intake of red and processed animal meats and focus on adding plant-based protein sources into your diet.  This can include fertility-friendly and micronutrient-rich beans, lentils, peas, soya beans, and chickpeas. Plant-based protein sources help to support healthy ovulation and are high in antioxidants and nutrients, such as iron and fibre, which are really important during pregnancy.  Low iron levels can add to your tiredness or even could cause iron deficiency anaemia. Iron deficiency during pregnancy can increase the risk of pregnancy complications. It is also important to keep your iron uptake up postpartum too, to replace any iron lost at birth.  You’ll also find some protein in whole grains such as quinoa. If you are opting for plant-based meat alternatives (‘fake meats’), choose a brand that is not ultra-processed and low in additives. 4. Cut down on sugar Cutting down on sugar can be beneficial for fertility. This is because too much sugar can lead to insulin sensitivity, disrupting certain reproductive hormones and causing inflammation. Insulin spikes have been associated with poor egg quality and sperm production and could affect implantation. A study published in the American Journal of Clinical Nutrition in 2018 found that women who consumed two or more servings of sugary drinks per day had a 50% higher risk of ovulatory infertility compared to those who consumed less than one serving per month. Reducing sugar intake and opting for a balanced, low-glycemic index diet can help improve insulin sensitivity and overall reproductive health. Limit sugary foods and high glycemic index foods such as cakes, biscuits, fizzy drinks, energy drinks, sweets, white rice and white bread. Check the labels for high sugar content. 5. Take pregnancy supplements Folic acid Folic acid is an important supplement during pregnancy because it decreases a risk called neural tube defects. This is a defect that can occur during the development of the baby’s brain and spine.  If you are currently trying to become pregnant, it is advised to take at least 400 mcg of folic acid supplement every day for 12 weeks before conception and for at least three months after conceiving. Some people are at an increased risk of their baby having a neural tube defect and so it is advisable to speak with your doctor as they may recommend and prescribe you a higher dose.  Prenatal vitamins Prenatal vitamins typically contain a combination of various vitamins and minerals that are important for both maternal and foetal health. While folic acid is a main component of prenatal vitamins, these vitamins usually contain a range of other nutrients as well.  These include iron, calcium, vitamin D and other essential vitamins and minerals needed to support maternal health and the baby’s development during pregnancy. Tip: More often than not, doctors will suggest taking prenatal vitamins instead of just folic acid supplements because they cover a wider range of needs for both mum and baby’s health. However, it’s essential to consult with your doctor to determine the most appropriate approach for your unique needs.  6. Take Vitamin D for pregnancy  A previous study has shown that both men’s and women’s vitamin D levels impact fertility and IVF results. It showed that Vitamin D supplements reduce risks for mums and babies, might prevent bone problems, and play a role in foetal development.  How much Vitamin D should I take? It’s recommended that all adults at all stages of life should supplement with 10 micrograms a day of Vitamin D, in the UK. This is particularly true if you are trying to conceive, or you are pregnant—so be sure to supplement right through from the preconception period to breastfeeding.  Prenatal vitamins often contain vitamin D, but the amount can vary […]

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 polycystic ovary syndrome (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 PCOS).  High AMH levels can be an indicator of polycystic ovaries and can be used to diagnose PCOS 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 PCOS which can cause high testosterone. […]