Knowledge Centre

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

Still, a hushed and taboo topic – almost 1 in every 6 couples have fertility issues in the UK-that’s about 3.5 million. The global infertility rate is increasing as people choose to have children later in their lives, with the average age to have a first child now 30.7 years in the UK. This means that fertility treatment is becoming more and more common, so the need for fertility benefits as support is more important than ever. Infertility and the fertility treatment journey can be a roller coaster, both emotionally and physically. Almost 90% of people experience depression as a result of infertility. Over 40% do not disclose that they are undergoing fertility treatment to their employers fearing that it would negatively impact their career prospects. Here are a few recommendations on how you can support your employees undergoing fertility treatment and challenges better: 1. Help people understand the basics about their fertility. Up to 59% of respondents in a Fertility Network UK survey felt their employer would benefit from education about fertility and treatment options to help better understand and support the needs of someone undergoing treatment. Referring your employee to resources that may help them understand the basics of all things reproductive health will make them more confident in their reproductive journeys. 2. Help establish the feeling of a supportive environment. Educational workshops can be a stepping stone to understanding the concerns your employees might have surrounding their fertility. These can help build open dialogue and encourage them to discuss fertility issues without concerns of negative consequences. 88 % of employees who felt unsupported during IVF treatment have left or consider leaving their job. Partnering with organisations that provide fertility counselling can support your employees during this emotional turmoil. 3. Establish a fertility benefits policy in the workplace. Eligible employees in the UK have a statutory right to up to 52 weeks of maternity leave and 2 weeks paternity leave. On the other hand, preconception care is not a statutory right, which is why most employers do not have formal policies in place. With the number of NHS-funded cycles declining rapidly and extensive criteria couples, especially LGBTQ+ couples, have to fulfil before accessing a funded cycle, many people are opting for private treatment but few can afford it. The average cost per cycle in a private clinic is about £5,000+, but it can cost even more depending on the treatment options chosen and the clinic. Establishing fertility benefits policies – covering proactive fertility testing, fertility treatment or egg freezing costs or providing low-interest loans – can help align your interests with your employees, supporting their individual journeys to parenthood, facilitating equality, diversity and inclusion. 4. Establish flexible work options. Fertility treatment is time-consuming because it means having to attend multiple tests, appointments, consultations and procedures. Appointments can often end up with long wait times or need recovery time. For most people, a single cycle of IVF can take between four and six weeks. Usually, the time employees take off work for fertility treatment is deducted from their paid time off or sick leave. Not having a fertility treatment leave policy has been linked to greater levels of distress, risk of burnout and reduced performance. Providing flexible working hours and arrangements can help support employees with the time they might need to attend clinic appointments. 5. Find the right partner to support with fertility benefits. Selecting the optimal partner is paramount when developing and implementing employee reproductive health benefits. To ensure your workforce receives the most comprehensive support possible, the chosen solution should address the full spectrum of the fertility and hormone journey. A truly comprehensive benefit package should aim to integrate several critical components: Hertility Health is dedicated to shaping the future of Reproductive Health, providing individuals with the tools to understand and manage their fertility and hormone health from menstruation through menopause. To learn more about implementing our Reproductive Health Education and Benefits within your organisation reach out to: benefits@hertilityhealth.com or visit our website: https://hertilityhealth.com/workplace.

Absenteeism, presenteeism, and stigma in the workplace. The profound impact of menstruation on workplace productivity and attendance is often overlooked, but period, PMS and symptoms associated can be extremely debilitating. Every day, millions of people show up to work and perform at the highest level while silently navigating the complexities of reproductive health. Many might try to manage it with home remedies and over the counter medication; for up to 1 in 10 women, it can cause severe debilitating chronic pain, impacting their daily routine due to a condition called endometriosis. “I never did say to work, that I was off because of period pain because I worked for years in a very male dominated banking environment…I felt there was an issue of stigma with saying I was off…I would have to invent reasons month after month, soldier on, dose yourself up and try and get through the days best you could. Then collapse when you go home.” – (Gender Health Gap Report, 2024) The Data: How can employers support this? 1. Help people understand the basics of their reproductive health. A supportive workplace can improve employee productivity and loyalty, reduce absenteeism and improve DE&I. Here are a few recommendations on how you can support your employees better through inclusive healthcare. Many women grew up believing period pain was a normal part of life. Social and cultural taboos combined with a lack of education on menstrual health could explain why someone might not discuss their period-related symptoms or ignore them altogether. Employers can help break this cycle of misinformation by referring employees to resources to understand their reproductive health better. Additionally, organising lunch & learns and workshops can be a stepping stone to open dialogue and normalise conversations around period pain in the workplace. 2. Establish support in the workplace. Experiencing pain in the workplace is challenging for employees. Providing flexible working hours, rotas and arrangements such as a quiet room, period products, heat packs, or modified workstations can support employees with the time they might need to prioritise their health. Research on menstrual workplace policies from Monash University found that flexible policies based on the individual employee’s needs were more effective than a blanket period leave. Beyond policies, ensuring that managers are well-trained to talk about reproductive health and support employees through their struggles will also help create a supportive environment at work. 3. Find the right partner to support reproductive health policies. Taking the first steps in making the workplace more period-friendly is a big task, which is why it is important to find a reputable expert provider who can support employers in educating their workforce, instating progressive policies and providing solutions to employees’ worries around their reproductive health. Hertility Health is shaping the future of reproductive health by giving women the ability to understand and manage their hormone health from menstruation to menopause. We believe in a proactive approach to reproductive health – by detecting issues early, helps prevent issues later down the line. We deliver our world-class reproductive health benefits to many leading companies and improve access to reproductive healthcare and education. We provide in personalised plans – for you and your employees – and offer a range of corporate plans and coverage options to suit your needs, from educational workshops, to female health assessments and consultations with in-house experts. For early adopters that have existing fertility treatment benefits for employees, we help you protect your budget – our proactive hormone tests are a fraction of the clinic price and by identifying issues early we can prevent costly treatment. Where treatment is required, our blood tests are accepted by partner clinics and reduce time to treatment. We provide DE&I impact reports, so you can see the tangible impact on your workforce and your bottom line. To learn more about our Reproductive Health Education and Benefits for Employers, reach out to benefits@hertilityhealth.com or visit our website https://hertilityhealth.com/workplace

COVID-19 and the shift to remote working has catalysed the demand for mental health benefits – it is now a “must have” for employers in 2021. In fact, in a recent survey, 91% of respondents stated that a company’s culture should support mental health. It is no coincidence that mental well-being is included in how reproductive health is defined by the World Health Organisation, stating that “Reproductive health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes”. These two elements of well-being are interconnected. As a result, it is impossible to provide comprehensive mental health benefits without considering the impact that reproductive health conditions can have and figuring out how employees dealing with those can be supported. How do reproductive health conditions affect mental health? InfertilityTake infertility, which affects 1 in 6 couples in the UK. Despite its prevalence, it is often met with confusion and denial.. This can seriously impact mental well-being – feelings of anxiety, depression and loss are all common. Besides, treatment can be time-consuming, stressful and a significant financial burden for individuals. Leading employers in the benefits space are recognising the impact that infertility may have on mental health and offering “fertility leave” as well as compassionate leave after miscarriage. EndometriosisReproductive health conditions such as endometriosis are associated with difficulty conceiving and chronic pain, both of which impact quality of life. Alongside having increased sick leave and loss of productivity, women with endometriosis feel their career goals were impacted negatively. Premenstrual syndrome (PMS)PMS describes the array of physical and emotional changes that occur as part of the monthly cycle. Approximately 90% of people who menstruate experience PMS. In some cases, this can be debilitating, a condition known as premenstrual dysphoric disorder (PMDD). PMDD can be so severe that suicidal thoughts are common in these women. Undiagnosed health issuesUnfortunately, it is not just the physical manifestations of the conditions alone that may impact employees’ mental health. Stigma and shame on reproductive health conditions from society and inadequate support from healthcare with symptom dismissal and months or years required to get to a diagnosis can be a significant cause of anxiety or depression for people suffering from a reproductive health condition. Many things in this journey even after getting the answers are outside of employees’ control. There are no guarantees that fertility treatments will succeed; failed attempts can seriously affect mental health, especially in those cases where little can be done to change the outcome. How can you support your employees on their reproductive health journey?There are several things that you can do to help alleviate the burden reproductive health conditions can place on mental health. Destigmatise reproductive health conditions by encouraging education and learning. This is a great way to challenge the current attitude to reproductive health conditions in the workplace and facilitates supportive conversations. Joining schemes provided by charitable bodies such as the Endometriosis Friendly Employer scheme can help you to make those first steps. Create a supportive workplace environment through flexible working hours for those who need to attend multiple appointments, inclusive leave policies and offering free menstrual products in bathrooms. Provide comprehensive reproductive health benefits by partnering with companies like Hertility to connect your employees to expert care and help them make informed decisions with regards to their reproductive health. These can include things such as proactive testing opportunities with actionable insights, fertility counselling, referrals to trusted clinics and specialist care with experts in the field. About Hertility HealthHertility Health is shaping the future of Reproductive Health by giving women the ability to understand and manage their fertility and hormone health from menstruation to menopause. 1 in 3 women suffer from a reproductive health issue, yet conversations around fertility, menopause and menstrual symptoms are still stigmatised in the workplace. As employees suffer in silence – up to £4k is lost per year per employee due to reduced productivity, absenteeism and presenteeism. Hertility reduces the need for unnecessary appointments and delay in diagnosis time through an online health assessment and at home test. To learn more about our Reproductive Health Education and Benefits for Employers, reach out to benefits@hertilityhealth.com or visit our website.

Deciding to start a family is never an easy process, but for some employees who identify as part of the LGBTQ+ community, their journey to parenthood might need some more support. Being a 21st-century employer means establishing an inclusive, progressive and supportive work environment to attract and retain employees. A 2017 study by Mercer found that 33% of UK respondents do not offer equal benefits to LGBTQ+  employees because they do not know how to implement such a benefit! Check your fertility Here are some ways to provide support to your LGBTQ+ employees in their fertility journeys Recognise that there are multiple paths to parenthood Partner with experts like Hertility to raise awareness about the advances in fertility treatments such as IVF (in vitro fertilisation), IUI (intrauterine insemination), surrogacy, etc., that made it possible for LGBTQ+ couples to have biologically related children. Refer your employee to resources like Hertility that may help them understand the basics of all things reproductive health will make them more confident in their reproductive journeys. Don’t treat fertility treatment as a lifestyle choice Gender-affirming treatments can impact fertility, and therefore, many require fertility preservation, such as banking eggs, sperm or embryos before medical transition. With the number of NHS-funded cycles declining rapidly, LGBTQ+ couples have to fulfil extensive criteria before being eligible for a funded cycle, because of which,  many are opting for private treatment, where the average cost per cycle can be about £5,000, varying significantly depending on the treatment options chosen and the clinic (HFEA). Listen to feedback from employees,  ask them what they would want to feel more supported in their choices and try to develop policies around them. Establishing fertility benefits policies – covering proactive fertility testing, fertility treatment or egg freezing costs or providing low-interest loans – can help align your interests with your employees, supporting their individual journeys to parenthood, facilitating equality, diversity and inclusion. Ensure you have fertility leave policies and make sure they are inclusive If you have existing family planning and health benefit policies, revisit the language and clauses to ensure LGBTQ+ employees are eligible for the equal benefits to support them as they embark on their parenthood journey, whether that be through fertility treatment, surrogacy, adoption, or parental leave. Hertility can help train your staff on all things related to policies. About Hertility Health Hertility Health is shaping the future of Reproductive Health by giving women the ability to understand and manage their fertility and hormone health from menstruation to menopause. 1 in 3 women suffer with a reproductive health issue, yet conversations around fertility, menopause and menstrual symptoms are still stigmatised in the workplace. As employees suffer in silence – up to £4k is lost per year per employee due to reduced productivity, absenteeism and presenteeism. To learn more about our Reproductive Health Education and Benefits for Employers, reach out to benefits@hertilityhealth.com or visit our website. Trusted resources: https://www.imercer.com/uploads/dmi/2017_lgbt_sample.pdf https://www.bpas.org/media/3484/bpas-fertility-investigation-nhs-funded-fertility-care-for-female-same-sex-couples.pdf

Testosterone is an important androgen hormone in people of all sexes. In this article, we’ll cover exactly what it does in the body, what the symptoms and causes of high or low testosterone are and how you can ensure your levels are balanced and healthy.  Quick facts: What is testosterone? Testosterone is an important hormone for regulating sex drive (libido), bone and muscle mass and fat distribution. It’s part of a group of hormones called androgens.  There are a lot of misconceptions about testosterone being just a “male” hormone. Whilst testosterone plays an important role in the development of the male sex organs and male secondary sex characteristics, people of all sexes have testosterone.  Everyone produces and requires a certain amount of androgen hormones for reproductive development. The difference is just how much testosterone we have based on our sex-at-birth. How is testosterone made? In women and people assigned female-at-birth, testosterone is produced by the ovaries and adrenal glands. It’s then converted to hormone–oestrogen. Testosterone production is age-dependent and it gradually declines with age. Most of the testosterone in the body is inactive. It remains bound to a protein called, sex hormone-binding globulin (SHBG). The small amount of testosterone that’s unbound and therefore active, is called freely circulating testosterone (free T).  Free T can enter cells to bring about its effects. Our free T levels are affected by the levels of SHBG. Low levels of SHBG result in higher free testosterone, whereas high levels of SHBG result in lower free testosterone. What does testosterone do in the body? Some of the functions of testosterone are: What are the symptoms of high testosterone? Excess levels of testosterone in the body is called hyperandrogenism. This can bring about symptoms like:  Some studies suggest that high testosterone levels may increase the risk of developing high cholesterol, heart disease and type 2 diabetes. What causes high testosterone levels? The most common causes of high testosterone levels are underlying health conditions. It can also be caused by certain medications and lifestyle factors. Let’s look at the main ones… PMOS (formerly PCOS) Polyendocrine Metabolic Ovary Syndrome (PMOS, formerly known as PCOS) is a hormonal and metabolic condition affecting 1 in 10. The exact cause is still being researched, however, the proposed causes include an excess of androgens and insulin, genetic and environmental factors. If you suspect you might have PMOS, our at-home tests can give you a better insight into your hormones.  Congenital andreal hyperplasia Congenital adrenal hyperplasia (CAH) is an inherited condition that affects the adrenal glands. These are small glands located on top of the kidney. They produce hormones like cortisol (stress hormone), dehydroepiandrosterone (DHEA) and testosterone. People with CAH are unable to produce an enzyme necessary to regulate the production of these hormones, which can result in an overproduction of testosterone. It’s been found to be more common in some ethnic groups such as people of Hispanic, Mediterranean, Yugoslavian and Ashkenazi Jewish descent. Cushing’s syndrome is another hormonal condition impacting the adrenal glands. It results in excessive cortisol and androgen production. Medications Testosterone levels can rise due to certain medications, such as: Alcohol Excessive alcohol consumption may increase levels of testosterone in premenopausal women, however, research is conflicting.  How to lower my testosterone levels? Treatment for high testosterone depends on the cause, but generally, it is a combination of lifestyle changes and medications. Achieving a healthy weight by including a healthy balanced diet and exercise routine may help with the symptoms of a hormonal balance.  Medications used to treat high testosterone, and associated symptoms include: What are the symptoms of low testosterone? If you’re experiencing low testosterone, you may experience some of the following symptoms:  Low testosterone over a long period may also contribute to long-term health conditions such as heart disease, memory issues and loss of bone density. Often, the symptoms of low testosterone in women are undiagnosed or misdiagnosed. Some of the conditions that low testosterone may be mistaken for include stress, depression and the side effects of menopausal changes in women. What could cause low testosterone levels? The most common causes of low testosterone levels are often age, underlying conditions and problems with certain glands. Age Testosterone levels naturally decrease as we age. As it’s produced in the ovaries, the natural decrease in ovarian function with age means that some may experience low testosterone levels as they transition from the perimenopausal phase into menopause.  Underlying health conditions Premature ovarian insufficiency (POI) can increase your risk of low testosterone. Additionally, surgery, such as the removal of the ovaries, can cause lowered testosterone levels.  Problems with the hypothalamus or pituitary gland Underlying health conditions impacting the pituitary, hypothalamus, or adrenal glands can also cause lowered testosterone levels. This is because these parts of the brain are responsible for the secretion of hormones which control the proper functioning of the ovaries.  A disruption in the pituitary gland can also impact the adrenal gland. Addison’s disease or adrenal insufficiency is a hormonal condition that occurs due to underactive adrenal glands and can cause a low level of its hormones. What can I do to increase my testosterone levels? Low testosterone levels effects and treatments in women are still being researched and treatment is usually recommended only if symptoms are significantly impacting health and quality of life.  Testosterone replacement therapy is a form of hormone replacement therapy (HRT) based on the replacement of testosterone. It may be prescribed orally, as injections, gels or skin patches. DHEA is a precursor to testosterone, and it is believed that taking DHEA supplements could increase the amount of testosterone. It is always recommended to speak with a doctor before starting any medication or supplements. How to test testosterone levels? If you’re experiencing any of the symptoms mentioned above, our Advanced At-Home Hormone and Fertility Test can determine your testosterone levels. Hormone testing is the only way to know what your testosterone levels are for definite.  Our Doctors can recommend a care plan for you, based on your symptoms, hormone […]

When our reproductive hormone levels are affected, it can cause menstrual cycle disruptions that can result in fertility issues. In this article, we’ll take a look at alcohol’s effects on the main female reproductive hormones. Quick facts: How alcohol and hormones interact According to recent data, women and those assigned-female-at-birth are, on average, drinking more alcohol than ever before. Whilst many people are aware of the immediate health consequences of drinking—including the caloric impact and the dreaded hangover, there’s still very limited awareness of the effects that alcohol can have on female hormonal health.  Hormones act as chemical messengers, which control and coordinate various bodily processes. Each of our hormones relies on a complex system of interactions, often with other hormones, to maintain their levels and carry out their intended functions.  Drinking alcohol, as well as other lifestyle factors like smoking, can affect our hormones, both directly and indirectly. Which hormones are affected by alcohol? Hormones affected by alcohol include: Our hormones are sensitive. They rely on a complex set of interactions, both with one another and other bodily processes in order to stay in balance and perform their functions properly.  Alcohol consumption is known to affect our levels of oestrogen, progesterone and testosterone significantly—three very important hormones in the regulation of the menstrual cycle and overall health. It can also affect our levels of Anti-müllerian Hormone (AMH), gonadotropins like Follicle stimulating hormone (FSH) and Lutenising hormone (LH), thyroid hormones and prolactin.  Let’s take a look at each of them in turn. Oestrogen and alcohol Oestrogen is probably the hormone you know best—it plays an important role in many elements of our health, including the regulation of the menstrual cycle, maintaining bone density and skin health. Acute consumption of alcohol has been shown to increase oestrogen levels. Increased oestrogen levels over a prolonged period can be associated with breast cancer development in those assigned-female-at-birth. The United Kingdom Million Women Study revealed that every additional drink per day contributed to 11 breast cancers per 1,000 women up to age 75. Progesterone and alcohol Follicle-stimulating hormone (FSH) and luteinising hormone (LH), are involved in egg maturation and ovulation, two key elements of the menstrual cycle and female fertility. A surge in your levels of LH triggers the egg to be ovulated, however, there is some evidence that alcohol consumption may affect both the levels of LH in general and the ability of the egg to respond to LH. Excessive alcohol consumption may even affect how the cells within the fallopian tubes function. Testosterone and alcohol Testosterone is typically associated with male sexual development and fertility, but it also plays an important role in female sexual development and fertility, including regulating female libido.  There is some evidence that moderate alcohol consumption may increase testosterone levels, causing an imbalance in androgen levels. High testosterone levels can lead to symptoms like acne, excessive facial and body hair growth (hirsutism), irregular periods, mood changes and loss of libido. Anti-Mullerian Hormone (AMH) and alcohol AMH is produced by the granulosa cells within your ovarian follicles and is used as an indicator of ovarian reserve (your egg count). The relationship between alcohol consumption and AMH is slightly contentious. Some studies have found no change in AMH levels in people who consumed alcohol but more recent studies have shown those who engage in “binge drinking” had lower levels of AMH.  Binge drinking is defined by the Centres for disease control (CDC) as “a pattern of drinking that brings a person’s blood alcohol concentration (BAC) to 0.08 g/dl or above”. Basically, consuming 4 or more drinks in the space of 2 hours.  Because of AMH’s close ties to your ovarian reserve, lowered AMH levels can indicate a low ovarian reserve. Gonadotropins and alcohol There are two types of gonadotropin hormones in the body—Follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Both FSH and LH are involved in egg maturation and ovulation, two key elements of the menstrual cycle and female fertility.  A surge in LH levels at the midpoint of the menstrual cycle is what triggers ovulation—that month’s mature egg being released into the Fallopian tube.  There is some evidence that suggests alcohol consumption may increase LH levels in general and also impair the ability of our eggs to respond to LH. Excessive alcohol consumption may also affect how the cells within the Fallopian tubes function. Thyroid hormones and alcohol Your thyroid is a butterfly-shaped gland that plays an important role in the regulation of many different bodily functions such as your heart rate, body temperature and growth development.  Alcohol consumption has been shown to alter the levels of the thyroid hormones, thyroid-stimulating hormone (TSH), thyroxine (T4) and triiodothyronine (T3) with heavy use showing decreased levels of T3 and T4. Low levels of thyroid hormones are known as hypothyroidism and can cause a huge number of symptoms including fatigue, weight gain, heavy or irregular periods, fertility issues and irregular ovulation, depression and more. Prolactin and alcohol Chronic alcohol consumption is associated with increased prolactin levels. Consistently high levels of prolactin in your body is called hyperprolactinemia and is significantly associated with infertility through interference with other hormones such as oestrogen and progesterone. Alcohol and trying to conceive When trying to conceive, cutting down on your drinking is often one of the first things on your preconception to-do list. The dangerous effects of alcohol on the developing foetus can range from physical to mental and generally disrupt their development in the womb (see foetal alcohol syndrome).  It is also known that alcohol consumption affects the success of IVF treatment, with one study showing people who had at least four drinks per week were 16% less likely to have a live birth than those who had less than four drinks. Additionally, a 21% lower live birth rate was found for couples in which both drank more than four drinks per week. Other effects of alcohol on the body As well as impacting our hormones, alcohol has other broad-reaching effects on the body and the […]

For many, the journey to parenthood can be a challenging process, both physically and emotionally. We’re here to help you understand the different causes of infertility, and the options available for those who need support. Quick facts: What is infertility? Infertility is defined as not being able to conceive after one year (or longer) of trying. This could be despite having regular unprotected sex with a partner, or trying using methods like artificial insemination (IUI).  There are 2 types of infertility: In the UK, as many as 1 in 7 heterosexual couples experience infertility, yet the causes are sometimes preventative, or treatable.  Causes of infertility  There can be many different reasons why you might struggle to conceive. This can include structural fertility issues, ovulation problems, underlying health conditions and hormonal imbalances. Let’s take a look at each. Ovulation issues  Anovulation, also known as the inability to ovulate, is the most common cause of infertility. Ovulation is when a mature egg is released from one of your ovaries, each month, during your menstrual cycle. The egg travels into the Fallopian tube, where it prepares to be fertilised by a sperm, before then travelling down the tube to the uterus.  When trying to conceive, ovulation is a crucial event, with the 5 days before ovulation and ovulation day itself often referred to as your ‘fertile window’.This is the time of the month when you’ll be most likely to get pregnant.  Research suggests that as many as 25% of infertility cases are caused by anovulation. Anovulation can be caused by: Another possible explanation is a problem with the egg maturation process. This means that an “immature” egg may be released from your ovaries when it is not quite ready and unable to fertilise. Underlying health conditions Polyendocrine Metabolic Ovary Syndrome (PMOS, formerly known as PCOS) PMOS is the most common underlying condition affecting fertility. PMOS affects as many as 1 in 10 people with ovaries.  People with PMOS produce higher levels of androgen hormones, like testosterone. This can disrupt your menstrual cycle, ovulation, and balance of cycling hormones—like oestrogen, follicle-stimulating hormone and luteinising hormone (LH). As PMOS is still under-researched and misunderstood, many people are left undiagnosed and are unaware they have it until they are actively trying to conceive. This is why it’s a good idea to check in on your hormones before you start your conception journey.  Primary ovarian insufficiency (POI)  POI is when the ovaries stop working properly before the age of 40. POI is far less common than PMOS, affecting only 1 in 100 women younger than 40. Your ovaries produce oestrogen and progesterone—two cycling hormones responsible for the regulation of your menstrual cycle. When their function is disrupted, ovulation can also become disrupted or stop completely.  People with POI also have a lower ovarian reserve, meaning fewer eggs for their age. Without a sufficient amount of eggs and the correct level of hormones needed to regulate your cycle, the possibility of conceiving is reduced considerably. According to the National Infertility Association, POI can be caused by genetics, autoimmune factors, induced by chemo or radiotherapy, or it can have an unknown cause. Uterine fibroids Uterine fibroids are noncancerous tumours that affect as many as 25% of people with a uterus. They can cause symptoms such as heavy periods, intermenstrual bleeding, and pelvic pain. In some cases, depending on the location in which they grow, and whether they affect the shape of the uterus or cervix, fibroids can also cause infertility.  This is because they can block the fallopian tubes, stopping eggs from meeting sperm, or reaching the uterus for implantation. They can also get in the way of implantation if they are near the inner lining of the womb.  Despite being less common than other causes of infertility, around 5-10% of infertile women and those assigned female-at-birth are found to have uterine fibroids, with their instance being much more common in Black women.  Endometriosis Endometriosis is a common reproductive health condition that affects around 1 in 10 women and people assigned female-at-birth. With endometriosis, tissue similar to the tissue that makes up the lining of the womb starts to grow in other places, such as the ovaries and the fallopian tubes, causing lesions and scarring.   This can cause several life-altering symptoms, such as painful and heavy periods, pain during or after intercourse and pelvic pain. It is also another common cause of infertility, with research suggesting it is present in around 20-50% of infertility cases. The exact link between endometriosis and infertility is unknown. However, some theories suggest that lesions and scarring can cause structural problems with the reproductive organs and chemical changes in the lining of the uterus. Structural infertility  Structural infertility is a problem with the anatomical structure of the reproductive organs. This can include blockages, structural damage or abnormal growth in the fallopian tubes, uterus or ovaries.  Structural issues with the ovaries or fallopian tubes can prevent eggs from being released from the ovaries or stop them from moving through the fallopian tubes to reach a sperm for fertilisation.   Additionally, if the structure of your uterus is abnormal or damaged, it may prevent eggs from implanting into the endometrium (uterus lining). This is needed to create a healthy embryo and pregnancy.  Structural infertility problems can also be caused by scarring from surgery, infections, injuries, or endometriosis.  Also, the growth of noncancerous tissues such as uterine polyps on the lining of the uterus, can cause blockages. Polyps occur when additional tissue grows on your uterus. However, sometimes tissue grows elsewhere in your reproductive system potentially blocking your fallopian tubes and preventing pregnancy.  Implantation failure Other possible explanations of implantation failure are: Infections and auto-immune disorders  Untreated sexually transmitted infections (STIs) may have serious consequences for your fertility. STIs like chlamydia or gonorrhoea can cause scarring and blocking of your Fallopian tubes.  Additionally, if syphilis is left to develop, it can cause stillbirth. There are also other forms of infections of the cervix with human papillomavirus (HPV) […]

Whether it is from browsing online or from talking to a friend about your infertility, the name ‘Clomid’ often seems to make an appearance. You may have read many success stories on fertility blogs, but what do experts and clinicians have to say about Clomid, and is it an infertility cure? Here’s what you need to know. What is Clomid? Clomiphene Citrate AKA Clomid is a drug often prescribed to promote or induce ovulation to occur more regularly. If you have been diagnosed with ovulatory dysfunction and/or PCOS and have been unable to conceive naturally, then you may have been offered to take Clomid by your GP or Gynaecologist. But, what does it actually do? Ovulation- how does Clomid affect it? Certain hormones regulate and control our menstrual cycles which in turn, regulates our ovulation (the release of an egg). Two of our key sex hormones, FSH (follicle-stimulating hormone) and LH (luteinising hormones) levels are increased by Clomiphene which is an oestrogen-like hormone, by acting on the ovaries, but also the hypothalamus and pituitary glands in the brain. Oestrogen, FSH and LH are partners in crime. Oestrogen not only repairs and grows the lining of the uterus wall after each menstrual cycle but later on, in our cycles, it also exerts positive feedback on LH and FSH production. Both FSH and LH manage the release of an egg by triggering ovulation. Clomid, therefore, can induce our bodies to produce more than one egg during each cycle by increasing the levels of these hormones and in turn increasing ovulation. Our hormones have multiple roles, from triggering your periods to ensuring an egg is released at ovulation, where it has the opportunity to be fertilised by sperm. Before we understand what Clomid does, let’s get more familiar with some of the key sex hormones, and what they do throughout your cycle. The three main parts of the show, go to oestrogen, follicle-stimulating hormone (FSH) and luteinising hormone (LH), which all work in tandem with each other during your cycle. Whilst oestrogen not only repairs and encourages the regrowth of the uterus wall after each period, it also exerts positive feedback of LH and FSH production later on in your cycle. Together, both FSH and LH are responsible for triggering ovulation. You can understand more about what happens throughout your cycle here. When taken, Clomid, which is an oestrogen-like hormone, increases the levels of FSH and LH, by acting on the ovaries, hypothalamus and pituitary glands. Clomid does this by mimicking the action and effects of oestrogen on these organs. By increasing oestrogen and other hormone levels, Clomid encourages our bodies to produce more than one egg during each cycle and therefore also increases the number of times you ovulate. More eggs released from the ovaries = more opportunities for a sperm to reach one. Is Clomid for me? There are many factors that can affect your ability to conceive, from hormone levels, lifestyle choices, structural infertility causes (such as tube blockages) and multiple health conditions. As Clomid acts on one small, yet incredibly significant area of our fertility, it is usually prescribed to people who cannot ovulate due to certain conditions, such as PCOS. It may also be prescribed to people that do ovulate, but are still experiencing infertility, or are struggling to conceive due to irregular cycles and are unable to determine their ovulation window.  When considering Clomid, it is crucial to be mindful of all if the factors that can affect your fertility, and Clomid may not be for you if you have other complications such as large ovarian cysts, blocked fallopian tubes or other uterine abnormalities, low ovarian reserves or if you have previously had a bad experience with Clomid treatment in the past. Obviously, there will be side effects…? Every drug can come with it’s side effects. Whilst they work as fascinating little chemicals doing wonders in our bodies and helping treat or possibly cure many of our health conditions, they can also cause complications and/or disruptions in other areas of our bodies. Some common side effects of Clomid are: Nausea Vaginal Bleeding Headaches Blurred vision Enlarged ovaries However, one side effect and/or complication that stands out a bit is the likelihood of twins, triplets and possibly more. According to Hughes E, Collins J, Vandekerckhove (2000), you have a 10% chance of having twins with Clomid treatment. Having triplets or quadruplets, however, has a less than 1% likelihood. Although research on Clomid and it’s side effects is limited, a recent study (Celano et al., 2011) found that 45% of women on Clomid experienced a depressed mood, and 41% of them experienced mood swings. So much so, that the term “Clomid Crazies” was invented by meme-makers on social media for the mood swings caused by Clomid.  In addition, a recent study has suggested that children born from mothers receiving fertility treatment with Clomid may be slightly more likely to develop childhood epilepsy. Notably, this increase was shown to be minimal. Nonetheless, as with any drug, it is important to evaluate the potential risks, regardless of how small they are, before treatment. Clomid success rates… According to Dr Carla, a consultant from Zita West clinic and Budinetz et al. (2015), Clomid is extremely effective: “A few women might be Clomid-resistant, however, 80% of women with irregular ovulation or anovulation will ovulate with Clomid.” It is still important to note that we are complicated and unique individuals, and therefore a lot of factors need to be considered when taking Clomid for conception.  One crucial factor, is knowing when to have sex. This depends and varies on your cycle lengths; however, it is known that with Clomid it is best to have sex during your most fertile period which is 12-16 days before your period starts. It is also helpful and recommended to catch your ovulation period by having sex every other day between day 10  and day 21 of your cycle.  About 40-45% of women conceive within 6 cycles of […]

Exercise can greatly improve your overall health, including your reproductive health. In this article, we’ll break down different types of exercise, their impact on fertility and how to find movement that’s right for you.  Quick facts: Finding the right exercise for you We all have different feelings towards exercise. Some of us can’t go a day without it and some of us simply can’t bear it.  Whichever team you’re on, there’s no denying that exercise comes with some serious health benefits—some of which extend to your fertility and reproductive health.  But getting the balance right, with the right amount of exercise, supplemented with good quality nutrition that covers your personal energy and calorie requirements is essential.  We know that finding the right balance for you and your body can be difficult, especially if you’re just getting started with your movement journey. Here we’ll break down some different types of exercise and intensity that you can consider.  Remember, movement will look different for everyone. If your movement is restricted, you may want to speak to a physio or occupational therapist who can help you find the best way to meet your movement goals. Is exercise good for fertility? The health benefits of exercise are too many to mention. It affects every system in your body from your cardiac system to your digestion and even your bone health.  It would be unfair if your reproductive system didn’t get a share of the health kick you get from your chosen exercise regime but thankfully, it does.  There is more and more evidence emerging that physical activity and exercise can improve reproductive health and pregnancy rates (1). Some fertility benefits to exercise might be indirect but they are helpful nonetheless. Insulin regulation People with a high BMI and elevated blood sugars are known to be at greater risk of fertility challenges. Insulin resistance can affect the maturation of your eggs and inhibit ovulation.  Fortunately, regular exercise decreases abdominal fat, blood sugar, and insulin resistance (3).  Hormone balance  Regular exercise also increases sex-hormone binding globulin (SHBG), a protein that regulates the amount of testosterone in your tissues (4). Menstrual cycle benefits Many studies report that exercise improves menstrual cycle abnormalities including premenstrual syndrome (PMS) and dysmenorrhoea, or period pain (5), as well as reducing the risk of anovulation (failure to ovulate) (6).  Stress reduction Exercise is also known to reduce stress, improve self-esteem and greatly improve symptoms of poor mental health and low mood. Reducing chronic stress on the body can do wonders not only for your hormones and reproductive health but your overall health too. What exercise is good for fertility? There are different types of exercise, all of which can have benefits for fertility and your reproductive health for different reasons. Let’s take a look at each. Cardiovascular or aerobic exercise This is generally any exercise that gets your heart beating faster and increases blood flow to your muscles. Cardio is most beneficial for your heart health and blood vessels. It lowers blood pressure, regulates weight, blood sugars, and sleep, boosts mood, and strengthens your immune system.  All of these benefits will have knock-on benefits to your reproductive health. Brisk walking, running, swimming and cycling all fall into the cardiovascular or aerobic exercise category.Cardiovascular exercises are important but try to get at least two strength training sessions in a week too. Strength training  Strength or resistance training will better protect your bone and muscle health. It will make you stronger and help you to develop better body mechanics.  Strength training isn’t all about bulking up, using weights and going to the gym. You can start strength training using just your body weight at home or outside. Things like yoga, pilates and tai chi all count as strength training, as well as swimming which is a combination of strength and cardio. Flexibility and balance Working on your flexibility and mobility will help avoid injury and, if you’re older, lower your risk of falling. Both can be practised with stretching, yoga, pilates or a dedicated mobility routine.  If you plan on getting pregnant, strength and flexibility will help your body to adjust to the changes that come with pregnancy. Types of exercise intensity Exercise is categorised into three different intensity levels: low, moderate, and vigorous. We all do some bit of low-intensity exercise, whether that’s doing the housework, doing the shopping or strolling to the bus. Other examples are beginners yoga, tai chi or a casual walk.  You can make any of these moderate exercises by upping the pace. Moderate exercise can be thought of as anything that raises your heart rate and makes you breathe faster, but not so much that you’re unable to speak without taking a breather.  Any activity that makes your breathing harder and faster would fall into the vigorous exercise category. Examples include running, rowing, high-intensity interval training and spinning. The NHS recommends 150 minutes of moderate activity or 75 minutes of vigorous activity a week. As a general rule, try and aim for 30 minutes of moderate physical activity a day. If you’ve always been active you can continue your usual training regime at the same level to maintain your health. If you’re new to exercise or you’ve taken a long break from fitness, start to build up your level of activity, starting with low to moderate-intensity exercises. If you just don’t feel like doing a high-intensity workout today, then don’t do one. Start with some slow exercises, or try some yoga to help calm your mind. Finding time for exercise Our lives today have hectic schedules and exercise isn’t at the top of everyone’s priority list. If you can’t squeeze in a training session, remember that some exercise is better than none. Ask a colleague to join you for a 10-minute brisk walk at lunchtime, take the stairs instead of the lift or consider getting off a stop early on your work commute. NHS-approved apps for managing and mapping your progress will help you with time management […]