Knowledge Centre

Period poo. What is it and why does it happen? In this article, we take a look at why our bowel movements seem to wreak havoc during our periods and some tips for managing any symptoms. Quick facts: What is period poo? Period poo is basically any changes to your bowel movements during your period. This can be loose stools, diarrhoea, more frequent bowel movements, constipation, or more wind.  Although period poo might not be the most hotly debated dinner party conversation, it’s actually really common—with one study citing that up to 73% of people who menstruate experience period poo.  What causes period poo? Throughout our menstrual cycles, our hormones cause a whole host of changes, some of which can affect our digestion and gastrointestinal tract. Here are some of the changes that occur in the lead-up to our periods specifically, which can lead to changes in bowel movements.  Prostaglandins and muscle contractions Prostaglandins are chemical messengers that your uterus (womb) produces around your period. They act on the uterine smooth muscles to help them contract and shed their lining each month. This means you have prostaglandins to thank for your period cramps.  Sometimes, excess prostaglandins can act on smooth muscles elsewhere in the body, including the bowels. This causes an increase in muscle contractions in the intestines and bowel, leading to loose stools or diarrhoea.  On the flip side, too little prostaglandins can have the opposite effect, causing things to slow down in the gastrointestinal tract. This is one theory of why some people experience constipation at the time of their period (3).  Increased progesterone levels Although the exact relationship is not well understood, your gut – as well as your uterus – also has receptors for sex hormones like progesterone and oestrogen. This means your gut is sensitive to the changes in hormones that come about at the time of your period. Just before your period, progesterone levels are high, which can cause gut sensitivity, including bloating, diarrhoea or constipation, in some people.  For people who already suffer from Irritable Bowel Syndrome, this can be exacerbated at this time of the month. If you’re experiencing flare-ups, stick to your prescribed symptom management plan and if you think you need more relief, speak to your doctor about alternative ways to manage your IBS during your period.  Diet changes and cravings An increase in progesterone levels just before our periods can cause cravings for certain foods. Changing your diet, for example eating more, consuming more carbs and processed foods, consuming less fibre and not drinking enough water can all affect digestion and lead to changes in stools.  Increased stress or anxiety A common symptom of Premenstrual Syndrome (PMS) that is often experienced just before or during our periods is increased levels of anxiety, overwhelm or stress. Each of these symptoms can lead to a change in bowel movements, as our guts are intimately linked to our stress levels (think the nervous poos).  How to manage period poo symptoms There are certain lifestyle changes you can adopt to help alleviate any gastrointestinal symptoms you notice around your menstrual cycle. Try some of the following tips to help make that time of the month a little less crappy. Eat lots of natural fibre  Fibre is like your bowel’s best friend—it helps to move things through and keep your digestion and bowel movements regular. Make sure you’re getting lots of high-fibre foods like fruit, vegetables and whole grains in the run-up to and during your period. Try not to overeat processed foods and carbs as these often have the opposite effect.  Limit caffeine If you’re experiencing loose stools and diarrhoea, try cutting down on your caffeinated drinks and foods (like dark chocolate). This is because caffeine stimulates the gut, resulting in you needing to go more frequently.  Coffee in particular (even decaf) can stimulate the gut, so best to skip the morning coffee at your time of the month and opt for another way to energise yourself, like a morning walk or some yoga. If you do experience diarrhoea, be sure to increase your water intake to prevent dehydration.  Get moving  Movement and exercise are great for the gut and bowels. They help keep things moving through your digestive tract and can reduce the instances of bloating as well as helping to alleviate period cramps. If you’re not feeling up for your usual fitness routine, some yoga or simple stretching and walking are all great options.   Stay hydrated If you’re experiencing either constipation or diarrhoea, then drinking plenty of water is essential. Being adequately hydrated is very important for a healthy functioning gut and if you have diarrhoea you are at risk of becoming dehydrated quickly if you aren’t replacing lost fluids.  Painkillers and stool softeners It’s not unusual to mistake period cramps for bowel urges and vice versa during your period. Pain and cramps associated with either gut problems or your period can be eased with exercise, heat pads, or painkillers. You can also try stool softeners if you’re experiencing bad constipation. Resources:

Is it harder to conceive with your second child? It can be but it’s different for everyone. Unfortunately, infertility affects 1 in 6 people, so if you are struggling, you’re not alone. This article will share everything you need to know about what secondary fertility is, what causes it, and the treatment options available to you. Quick facts: What is secondary infertility? Secondary infertility is when you are having difficulty conceiving after previously conceiving and giving birth. To be defined as secondary infertility, the previous birth must have occurred without help from fertility treatments or medications like IVF (in-vitro fertilisation). The definition of primary infertility, in comparison, is when someone who’s never conceived a child has difficulty conceiving. So, how common is secondary infertility? Struggling to conceive might come as a shock if you’ve already had a baby. Secondary infertility, however, is a challenge faced by lots of individuals and couples who are trying for more children.  A World Health Organization (WHO) report suggests that around 1 in 6 (17.5%) people are affected by infertility (primary and secondary infertility) worldwide. Secondary infertility: definition and signs You can be diagnosed with secondary infertility by a healthcare professional when: The main sign of secondary infertility is being unable to get pregnant when you’re having regular, unprotected sex for up to six months or a year depending on your age. It could also include several failed artificial insemination (IUI) attempts.  If you’re worried about your fertility, discuss it with your GP or a healthcare professional. Common causes of secondary infertility The causes of secondary infertility are the same as the causes of primary infertility. For women and those assigned female-at-birth (AFAB), these include age-related fertility decline, hormonal imbalances, blockages in your reproductive environment (uterus, fallopian tubes or ovaries) and lifestyle choices such as your weight, nutrition, sleep, stress, and smoking and alcohol. For males and those assigned male-at-birth (AMAB), the causes of secondary infertility are similar. These include age-related fertility decline, lifestyle choices, and hormone imbalances. However, specific concerns for males and those AMAB are testicular damage, genital infections, or problems with ejaculation or sperm. Age-related causes of secondary infertility Age-related fertility decline could be a cause of secondary fertility. For women and those AFAB, it’s natural for the quantity (ovarian reserve) and quality of eggs to diminish, leading to a decline in fertility. In your 20s, your fertility peaks. Then, fertility gradually declines in your 30s, particularly after age 35.he chances of getting pregnant each month during your 30s are about 20%. That means that for every 100 fertile 30-year-old women trying to get pregnant in one cycle, 20 will be successful and the other 80 will have to try again.  By age 40, the chance is less than 5% per cycle, so fewer than five out of every 100 women are expected to be successful each month. Advanced maternal age is associated with increased risks of infertility and complications during pregnancy. Factors like decreased ovarian reserve and higher rates of chromosomal abnormalities can contribute to challenges in conception. Hormonal imbalances affecting secondary infertility Hormonal imbalances are a leading cause of primary and secondary infertility. Hormones regulate your menstrual cycle—consider them the orchestrators of your fertility. Hormonal imbalances can indicate conditions like Polyendocrine Metabolic Ovary Syndrome (PMOS, formerly known as PCOS) or thyroid issues and can affect ovulation, meaning you might not release an egg every month or the release may be delayed. If an egg isn’t released, pregnancy can’t occur. Hormonal changes can also negatively affect male fertility, reducing sperm production, mobility and motility.  Infections and STIs affecting secondary infertility Infections, both viral and bacterial, can affect your fertility. Some infections, particularly Sexually transmitted infections (STIs), can have lasting negative effects on your fertility if left untreated so it’s important to get regular checkups. Other viral and bacterial infections might temporarily affect fertility. For male secondary infertility, the testis are particularly susceptible to viral infection. Evidence is also emerging that Covid-19 might impact the testis. A common cause of secondary infertility in males or those AMAB, is poor semen quality, including a low sperm count, and low motility. This means sperm that isn’t moving properly or abnormally-shaped sperm which makes it harder for them to move and fertilise an egg. There’s a male fertility misconception that the type of underwear someone wears can affect fertility. Although there seems to be a link between increased temperature of the scrotum and reduced semen quality, there’s no evidence to suggest that the type of underwear worn by men and those AMAB can affect infertility. If you’ve had any infections, surgeries or medical diagnoses in the last 12 months, it might be worth mentioning to your GP if you’re having trouble conceiving or with secondary infertility. Medical diagnoses and treatments affecting secondary infertility Unfortunately, cancer treatments like radiation and chemotherapy, surgery, or a medical diagnosis can affect secondary infertility. If you’ve recently undergone cancer treatment or are about to, you might want to check your fertility with a advanced hormone and fertility test and consider fertility preservation treatments like egg freezing, IVF (in-vitro fertilisation), and donor eggs or embryos. Lifestyle considerations for secondary infertility Lifestyle choices can affect secondary infertility. Things like being underweight or overweight, smoking, using drugs and drinking alcohol. These can all increase the risk of secondary infertility by disrupting your hormone balance and impacting your overall health and well-being. Poor nutrition can negatively impact fertility Poor nutrition like eating lots of trans fats and saturated fats found in ultra-processed foods, and having a high-sugar diet have been shown to negatively impact fertility. Regular exercise to support fertility Although regular physical exercise is considered healthy and will support weight management and optimise fertility, excessive exercise can negatively affect ovulation and fertility in women and those AFAB. Getting enough sleep to support fertility Studies suggest that sleep disturbances correlate with adverse reproductive health outcomes like menstrual irregularities, increased time to and reduced rates of conception, and increased miscarriages. Women with diminished ovarian […]

Egg donation is a procedure where one individual donates their eggs to be used in someone else’s fertility treatment. In this article, we’ll explain who might benefit from egg donation, the process and how you can choose a donor.  Quick facts: What is egg donation? Egg donation is when a woman or person assigned female-at-birth, donate some of their eggs to someone else’s fertility treatment. It’s proven to be a successful option for people unable to get pregnant using their own eggs.  Sometimes eggs are donated to friends or family that are unable to get pregnant. More commonly, eggs are donated anonymously to help couples or individuals trying to conceive. Who might need an egg donor? There are lots of different reasons why someone may need to use an egg donor. Some of the reasons could include:  What is the egg donation process? The egg removal, fertilisation and embryo transfer procedures used in egg donation are the same as standard IVF treatment.  How to choose an egg donor The first step in choosing an egg donor is deciding if you want a known egg donor or not. You might prefer to use a friend or someone you know as an egg donor.  If this is the case, your egg donor will need to go through ovarian stimulation and egg retrieval at the clinic you’ve chosen for your treatment. It is more common for people to choose an unknown donor. Most clinics will have a list of donors you can choose from. Some clinics might have long waiting lists for donor eggs but you can shop around to find a clinic with shorter wait times if you’re keen to get started. Some clinics have special licences that allow them to offer the option of importing eggs from abroad. Your clinic can’t provide you with identifying information about your donor. However, the profile available is extensive and transparent enough to allow you to make an informed judgement on your donor’s character and personality as well as including an accurate physical description. The information available about your donor will include: To get an idea of your donor’s character and personality, most clinics will have a questionnaire and profile completed by your donor. This will include their interests, a brief personal history and why they chose to become a donor. Some donors chose to write a goodwill message at the time of their donation to any potential children. You won’t receive any information that could reveal the identity of your donor and they won’t receive any information about you or your child once they’re born. If you choose a donor through a licenced UK clinic, they will be subject to a strict screening process. This involves background family health checks, screening for inheritable genetic disorders and testing to rule out infectious diseases like HIV, syphilis, gonorrhoea, and hepatitis. If you choose to use a known donor, they are still subject to the same checks at the clinic. What are the laws on donor eggs? The Human Fertilisation and Embryology Authority (HEFA) oversees assisted human reproduction in the UK. There are several laws in place to regulate licensed fertility clinics and donor conception. It’s illegal in the UK to pay a donor for anything other than expenses. The donor’s expenses are usually covered by your overall treatment cost with the clinic but you can double-check this with your clinic if you’re unsure. Donors have no legal rights or responsibilities to any children born with their eggs. That means if you conceive by donor egg, your donor will not appear on your child’s birth certificate, they won’t have any rights over how your child is raised, and they’re not required to contribute financially to the upbringing of your child. In the UK, egg donation is anonymous at the time of donation. This means the egg donor and you, the recipient, won’t know each other’s identity. However, when a donor-conceived person turns 18 they have a legal right to know their donor.  This means that if you have a donor-conceived child, they can choose to learn identifying information about their donor once they turn 18. The donor does not however have legal rights, claims or responsibilities towards your child and will not be able to contact your child or your family.  You can learn more about the rules around releasing donor information and identity from the HFEA. Are there risks involved with donor conception? As with any medical procedure, there are risks with egg donation. There is some evidence that people who conceive with donor eggs are at a higher risk of some pregnancy complications, including higher blood pressure, small gestational size, early delivery, and caesarean section. Are there any support networks for egg donation? There are plenty of support networks for people who have already been through or are just beginning their donor conception journey. DefiningMum.com founder and donor mum, Beaky Kearns, started the Paths to Parenthood support network to help you from the beginning of your donor conception journey through to parenting your donor-conceived child.  Members have access to regular interactive webinars and live chats from other parents and experts. Here, you can share your experience, find support and chat to other members for advice. Including how to choose your donor.  The site is full of resources from webinar recordings, personal stories, tips and other recommended resources. Resources

Premature Ovarian Insufficiency (POI) is when the ovaries stop working normally before the age of 40. Getting a diagnosis can be worrying at first, but there are options available. Let’s take a look at what you need to know about POI including symptoms and treatments.  Quick facts: What is Premature Ovarian Insufficiency? In short, Premature Ovarian Insufficiency (POI) is when the ovaries stop functioning properly before the age of 40. It can significantly reduce your fertility.  This doesn’t always mean that you don’t have any eggs left in your ovaries or that you couldn’t carry a baby. It means your body is failing to mature eggs or to ovulate each month.You may have heard of Premature Ovarian Insufficiency (POI) being referred to as premature ovarian failure. It is also referred to as Primary Ovarian Insufficiency, gonadal dysgenesis, and hypergonadotropic hypogonadism. Premature Menopause Premature Menopause is when someone before the age of 40 experiences menopause. This means they will not have any more periods and are permanently no longer able to become pregnant.  This is different to POI, where although fertility becomes significantly reduced, there is a chance of spontaneous ovulation, and hence a period might still occur. Some people are still able to conceive spontaneously after their diagnosis. However, POI and Premature Menopause do share many of the same symptoms. What are the symptoms of POI ? POI symptoms are similar to menopause and low oestrogen. You’re likely to experience: Other than menopausal symptoms, loss of skin pigmentation caused by vitiligo or hyperpigmentation can accompany POI. As can hair loss caused by alopecia.  Fatigue, anxiety, and depression can also be common symptoms as a result of other symptoms or a diagnosis (3). If you’re missing your period for three or more months, it’s important to get your hormones tested to try and decipher what’s going on.  You can miss your periods for a number of reasons, including increased stress, changes to your diet or exercise routine. Some people might even like the idea of not getting a period every month, but sudden changes should always be investigated to check the cause of the change and rule out POI or something more serious. What causes POI ? Roughly 1 in 100 people will experience POI and it can affect people up to the age of 40, with some affected as early as their teens (4). But despite its prevalence, the causes, like for many female-reproductive health conditions, are still relatively unknown (2).  POI can happen spontaneously. However, there are a few known risk factors that may increase your risk of developing POI. These include: How is POI diagnosed? To receive a POI diagnosis, you’ll need to get a hormone test. High FSH (greater than 25) and low oestrogen levels, also seen at the onset of menopause, are indicators of POI. This is accompanied by absent, unpredictable or irregular periods for at least two consecutive months.  If POI is suspected, you might also be sent for an internal ultrasound to check your antral follicle count (AFC). Antral follicles are small fluid-filled sacs in your ovaries containing immature eggs. An AFC count is an indicator of the number of eggs you have left in your ovaries, also known as your ovarian reserve. What does POI mean for my overall health? POI can increase the risk of other illnesses or health problems if left untreated. People with untreated POI have an increased risk of developing heart disease and stroke.  Also, because oestrogen plays such an important role in bone health, low oestrogen seen in POI is known to lead to lower bone density, increased risk of bone fractures, and osteoporosis.  There is also evidence that lower oestrogen levels earlier in life can increase the risk of developing Alzheimer’s disease or dementia (3,4). If you have received a POI diagnosis, your doctor will likely recommend hormone therapy to you. This could be in the form of HRT or taking some form of hormonal contraception.  Hormone therapy can help to alleviate symptoms and reduce the risk of developing the associated conditions mentioned above. Does POI affect fertility? Often, yes, POI can reduce your fertility significantly. This can mean getting a diagnosis can be stressful and upsetting, particularly if you want to start or grow your family.  Although POI means your ovaries aren’t functioning properly, as many as 25% of people with POI do spontaneously ovulate. Another 10% do conceive and deliver after their diagnosis (5). If you are looking to get pregnant, there are treatment options available if you have POI—including In Vitro Fertilisation (IVF).  Egg donation is also an option for some people. POI is a condition that affects the ovaries, not the uterus. This means egg implantation and your ability to carry a pregnancy are not greatly affected by a POI. Think you might be experiencing POI symptoms? If you suspect POI symptoms, like irregular or absent periods, it’s important to get checked. Our at-home advanced hormone and fertility test can give you a better insight into your hormones and any symptoms you might be experiencing.  Our team of experts will help you understand whether your symptoms are related to POI or other underlying health conditions. We can also support you with follow-up fertility treatments and fast-track you to specialists for tailored care plans. References:

For trans and non-binary people considering medical transition, it can be difficult to find the right information about how fertility can be impacted and what treatments are available. We sat down with Asher, who shared their story about embryo freezing, pre-medical transition. Quick facts: Fertility concerns for trans+ individuals Thoughts about fertility may seem very far away when you’re experiencing the distress of having a body that doesn’t align with your identity.  But for trans and non-binary people considering a physical transition, whether with hormone therapy or gender-affirming surgery, the decisions made before and throughout can have a lasting impact on fertility.  Trans healthcare can be incredibly hard to access, with waiting lists for NHS Gender Identity Clinics in the UK being an average of 10 years wait or more.  Educational resources and personal stories of transition can also be hard to find. So we sat down with Asher, who was willing to share their journey with egg freezing to preserve their fertility before transitioning.  Before we dive into Asher’s story and the important decisions people may need to make around preserving their fertility, let’s understand some important terminology: Now let’s meet Asher. After many challenging years of living with gender dysphoria, they were able to access gender-affirming care. Yet it wasn’t until diagnosis and the start of a physical transition, that Asher was made aware of the fertility implications they could face.  Did anyone along your journey recommend preserving your fertility before undergoing any treatment? I discovered the importance of this process at the same time I was about to begin physically transitioning — literally the same day I was diagnosed with gender dysphoria and recommended for Testosterone HRT (hormone replacement therapy).  What were your fears and how did you overcome them? At the point of discovering this, I had surpassed the tipping point of how long I could cope with the soul-destroying experience of suppressing who I am in order to live in a world that taught me I shouldn’t exist. Managing gender dysphoria and trying to present yourself as something you’re not is an always-on 24/7 painful mask and bodysuit that you can’t take off. By the time I broke through internal and external barriers and played the arduous waiting game to speak with a doctor, I didn’t want to live another second with that feeling. My whole being was exhausted, terrorised, neglected and desperate for relief. Hearing then that I should freeze my eggs if I ever want children in the future not only felt like an extra obstacle for something so seemingly distant and intangible. The experience itself also sounded like it would be even more painful than what I’d been living with, as it essentially sounded like it would take me in the opposite direction.  On top of that, the information felt impossible to make sense of and the whole process itself seemed daunting, uncertain and expensive. I’ve always known that if life permits I’d love to raise a child someday, but I was totally unable to connect to this purpose. After a few off-putting initial conversations and appointments and my own research, I didn’t think I would be able to cope and was about to walk away.  Luckily, this is when I was introduced to Hertility and thank goodness I was! Finally some humane guidance, clarity and crucially being seen and understood as a trans person. The whole process became a lot clearer and felt more manageable, and honestly, I started to feel inspired by the gift of being able to do this. Was it easier than you expected to freeze your embryos? Yes. Although it wasn’t exactly easy, the actual process wasn’t nearly as bad as I imagined, especially with triggering my dysphoria. I suffered most in the angst-ridden anticipation before speaking with Hertility! It’s all the unknowns and uncertainty that make things feel worse than they are when you just take things day by day. How did you feel once it was over? So happy and so grateful. At the offset, I couldn’t have fathomed how joyous it would feel to get through this and know I’d honoured the future parent in me. This feeling only served to enrich how amazing it felt to start my physical transition after. Do you think we need more awareness in the community about fertility preservation so people know their options prior to gender reassignment surgery?  Absolutely. I wish I had been more informed and sooner but there was no mention of it, and even when it was it was almost a side-note. Transitioning alone is not an easy, self-determined process so we need to be informed about everything to expect as early as possible to start preparing, mentally and practically.  Help with gender dysphoria and transition If like Asher you are living with gender dysphoria and are considering physically transitioning, it is important to understand the implications this may have on your fertility, should you want children in the future.  Loads of great organisations can help you with the medical, practical and emotional aspects of gender journey and transition including: 

After a 9 year battle with pain, Abbie finally got a diagnosis for endometriosis. This is Abbie’s story, detailing the ordeal she went through to finally get treatment for her pain.  Quick facts: Meet Abbie My name is Abbie (@cheerfullylive) and in May 2019 I was finally diagnosed with endometriosis after a 9-year battle with pain.  If you aren’t aware, endometriosis is a chronic and debilitating condition where cells similar to the ones in the lining of the womb are found elsewhere in the body like the ovaries and fallopian tubes.  In response to your hormones, these cells break down and bleed, similar to the lining of your womb. This can cause inflammation and symptoms like painful periods, as well as possible infertility, fatigue, bowel and bladder problems, as well as many other symptoms. This is my story with endometriosis, from pain to diagnosis and treatment. I hope it can help you if you suspect you may have endo symptoms, or just want to learn more about this condition. Living in pain I can remember distinctly the first time I had severe pain. It was about a year before I had my first period. It was absolutely terrifying and things only got worse from there. My periods started when I was 15 and month by month the pain gradually became more debilitating. It got to the point where I could no longer get out of bed or do normal activities.  I would miss school, university and even work, but my pain and symptoms were deemed ‘normal’ period pain. I was told repeatedly that ‘I just had a bad period’, ‘I had a low pain threshold and ‘it was just something I would have to endure as a woman’.  This was even when I was having fainting episodes and vomiting due to the excruciating pain I was getting between periods. Because it was doctors telling me this, I genuinely believed it was just ‘normal’ and put up for it for many years of my life. Years to diagnosis It was only when my pain became chronic in December 2018, that my health was investigated fully. After going back and forth to my GP, A&E, urology and gynaecology, I was sent for an MRI in April 2019.  After so many years of believing this pain was normal, I didn’t expect my MRI to come back with severe endometriosis adhesions all over, but it did.  I was immediately booked in for an appointment with an endometriosis specialist. He told me I had extensive endometriosis on the left side of my pelvis, my left ovary and my bowel (sigmoid colon). I was also told that it was highly likely I had endometriosis growing on my bladder, my kidneys and on the right side of my pelvis. But only this wouldn’t be known until I had surgery. Managing my endometriosis It’s been over a year since I was diagnosed and I’ve tried so many different things to help with managing endometriosis. I’ve gone from being on the combined pill to the mini pill to extra hormones on top of that.  I’ve come off those extra hormones, gone on the waiting list for excision surgery, have taken different painkillers, tried yoga, hot water bottles, a TENS machine and trialled sacral steroid injections!  It’s been a long, hard journey and there are still many difficult days, but I seem to have found a few things that have personally helped me along the road. Deciding to have an expert excision of my endometriosis I’m still waiting for a surgery date, but just being able to make this informed decision with my consultant made me feel empowered. It made me feel like I was able to have some control over my endometriosis and how much it affected my life.  Being on the mini pill This is something that has helped me, as I no longer have periods anymore, which reduces the debilitating monthly pain and anxiety that comes with it. However, I understand that hormones are a very personal choice and you have to do what’s right for YOUR body. Pain management  Investing in a decent hot water bottle and a heat pad, as well as a TENS machine has really helped me manage my everyday chronic pain. Looking ahead Despite the struggles I’ve faced and the pain I’ve had to endure whilst living with endometriosis, I’m very grateful for all the positive experiences that have come out of this journey.  I started up my own blog, enjoyed being creative on Instagram and found an incredible community of #EndoWarriors! A fellow Endo warrior and I wrote a powerful blog post on “What Endo Means To Me”. Thank you to Hertility for having me on their blog to share my journey with endometriosis! If you feel you may have endometriosis or are concerned about your symptoms, please reach out to someone and don’t suffer in silence. Whether that’s your GP, sexual health clinic, hospital or a company like Hertility who can help you get answers on your reproductive or gynaecological health. You can find me over on my blog at www.cheerfullylive.com or on Instagram at @cheerfullylive www.instagram.com/cheerfullylive. I’m always open to having a conversation around women’s/period health, pelvic pain or endometriosis! Let’s break down the stigma and have more of these conversations!

Ovulation tracking can be a great way of either avoiding or planning sex during your fertile window. There are lots of ovulation detection methods, each with varying degrees of reliability. Read on to find out which could be right for you. Quick facts: What is the fertile window? The fertile window is 6 days around the midpoint of your cycle when you ovulate. It includes the 5 days before ovulation and the day after.  Ovulation is when you release an egg from one of your ovaries, and it travels down the fallopian tube to the uterus where it hopes to reach a sperm and be fertilised.  If you have regular periods, it is a good sign that you are ovulating (releasing eggs), every month. Your egg is capable of being fertilised 12 to 24 hours after ovulation but sperm can survive in the female genital tract for up to five days. So it’s possible to get pregnant if you have sex in the days leading up to ovulation. Ovulation tracking methods Lots of people choose to track ovulation, either to avoid or to plan to have sex during their fertile window. There are a few different methods available to predict your fertile window each month, but not every method will work for everyone—so it’s useful to try a few to find your fit.  Cycle tracking Tracking your periods is a helpful starting point for finding your fertile window. If your cycle is like clockwork and lasts 28 days, the chances are you’ll ovulate halfway through your cycle on day 14. Everyone’s cycle is unique and often not 28 days. It’s important to keep track of how long your cycles last, how long your periods are and any symptoms along the way. Ovulation generally occurs 11 to 16 days before your next period but this can also vary from cycle to cycle. You can use cycle tracking apps, some of which will predict your fertile window based on your previous cycle data—but these are not always 100% accurate.  Ovulation detection kits Ovulation detection kits involve a pee stick, which you use when you’re around the time in your cycle when you’re approaching ovulation. Ovulation sticks are considered the best way to identify if you are ovulating  From the start of your cycle, your oestrogen levels will increase to thicken the lining of your womb in preparation for pregnancy. When oestrogen levels reach a certain point, it signals the release of luteinizing hormone (LH), which triggers ovulation. Although LH is always present at a low level, it significantly increases 24-36 hours before you ovulate, known as the LH surge, which is what the kits detect. Changes in cervical mucus  The consistency of your cervical mucus (discharge) changes throughout your menstrual cycle. Just before ovulation, your discharge becomes clear and stretchy, a bit like egg whites. This is to help the sperm swim through the cervix and towards the egg.  Although this can be a good indicator of when you’re nearing ovulation, remember the appearance of discharge can also be affected by many other factors. This includes infections, sex and medications, and can also naturally alter within each cycle. Basal body temperate tracking After you ovulate, your basal body temperature (BBT) increases by 0.4-1°C. It is unlikely you’ll be able to feel this change, but it can be monitored with an accurate thermometer.  To use this method effectively, you must take your BBT first thing every morning before getting up, to get an accurate reading.  Again, there are lots of things that can cause your resting temperature to vary, such as sleep changes, alcohol consumption and fighting off a cold. This means using temperature changes alone may not be the most reliable. It is also important to consider that this method will only tell you that you have ovulated and won’t be able to predict your fertile window ahead of time.  Changes in saliva Your saliva can also vary throughout your cycle. High levels of oestrogen just before ovulation can cause there to be more salt in your saliva, which can be tracked using a testing kit. A specific pattern is seen in the saliva at ovulation which is called “ferning”, but this can be quite difficult to identify.  Similar to BBT tracking, saliva testing is not always reliable, as it can be easily influenced by the things you eat and drink, so shouldn’t be used alone.  Ovulation pain  Ovarian pain, also known as Mittelschmerz, is a fairly common symptom experienced by around one in five people who menstruate. Ovulation pain can be caused by stretching of the sac of fluid which contains the egg (the follicle) during its development, or by ovulation itself (when the egg is released from the follicle).  This isn’t a reliable method of fertility tracking and isn’t usually recommended as it can also vary from cycle to cycle. If you’re experiencing pain that’s disrupting your daily activities, speak to a specialist about treatment or pain relief options. Understand your cycle As ovulation is controlled by your menstrual cycle hormones, testing your hormones can give you insights into whether you’re ovulating regularly or not.  If you’re experiencing any symptoms like irregular periods, long or short cycles, it’s a good idea to get your hormones tested to understand what’s going on with your cycle hormones.  Check out our at-home Hormone & Fertility tests to find out more. 

IVF can be a highly effective fertility treatment for some people, but it doesn’t guarantee a successful pregnancy. Here we cover what the IVF process entails, who could benefit from it and things to consider if you’re thinking about undergoing a cycle.  Quick facts: What is IVF? In-vitro fertilisation (IVF) is a fertility treatment for those who can’t or don’t wish to conceive naturally. It’s one of the most common fertility treatments in the UK, with as many as 50,000 people undergoing IVF in the UK each year.  IVF involves removing eggs from the ovaries, attempting to fertilise them with sperm in a lab and then transplanting any successfully fertilised eggs (embryos) into the uterus. This is called an IVF cycle. It’s an invasive procedure and doesn’t guarantee a successful pregnancy.  Whether or not it’s right for you will depend on a range of personal and medical factors, as well as carefully considering the IVF cycle process. Fresh cycle vs frozen cycle IVF cycles can be fresh or frozen. Once an egg has been successfully fertilised by a sperm in the lab, it creates an embryo. This embryo is then typically incubated in the lab for 3-5 days.  In a fresh cycle, it will then be transferred to the uterus. In a frozen cycle, the embryo will be frozen at this point and transferred to the uterus at another time. This might be done if your uterus isn’t prepared to receive an embryo, or if you had several embryos that were successfully fertilised, they will be frozen, rather than transferring more than 1 at time, which is associated with multiple pregnancies (expecting two or more babies from a pregnancy). Who is IVF for? IVF can benefit lots of different types of people. Some instances where IVF may be explored could be: What happens in an IVF cycle? There are four key stages involved in an IVF cycle—ovulation stimulation, egg retrieval, egg fertilisation and embryo transfer. The entire process may take between 4 to 6 weeks but will vary and depend on you. Ovulation stimulation Firstly, you’ll take a course of fertility medication to stimulate your ovaries to mature multiple eggs. Usually in one menstrual cycle, you’ll only release one egg for ovulation. But this medication stimulates many eggs to mature.  During this time you’ll need to go to the clinic regularly for ultrasounds and blood tests to analyse your progress. The simulation period generally lasts for around 10 days.  Egg retrieval and sperm collection Once your eggs are mature, you’ll undergo a retrieval procedure. Egg retrieval is carried out under ultrasound guidance, where a small transvaginal needle is used to suck follicular fluid  that contains your mature eggs, out of your ovaries. You’ll have the option to have the procedure done under general anaesthetic or mild sedation. Whilst your eggs are being retrieved, your partner or sperm donor will be required to go into the clinic and produce sperm cells which will be used to fertilise your eggs, unless your partner or donor sperm has previously been frozen. Egg fertilisation During the fertilisation step, your eggs and the sperm will be combined in a lab. The goal is for the sperm cells to break into and enter your egg cells where an embryo will be formed.  There are multiple techniques in which your eggs can be fertilised. One technique is called conventional IVF which involves placing the mature eggs in a petri dish full of sperm. Another technique is called intracytoplasmic sperm injection (ICSI), where one sperm cell is selected based on morphology and injected directly into your egg cell. The technique used depends on the sperm, clinic and whether or not you have attempted conventional IVF successfully or not before.   Embryo transfer If you undergo a fresh cycle, any successful embryos will be transferred 2-5 days later. If you have a frozen cycle, you will be given medication to prepare the uterus lining and depending on your progress, your doctor will determine a transfer date.  However, this doesn’t guarantee a pregnancy. The embryo will still need to successfully implant to your uterus. You will be given a pregnancy test roughly 2 weeks later, which can confirm whether or not the IVF process has been successful.  The process for an embryo to grow into a healthy baby and undergo live birth is a very complicated and precise journey. A certain number of chromosomes, which is our genetic information in the form of our DNA, is required for an embryo to develop into a baby.  The test that is used to understand and analyse the number of chromosomes in the embryo before implantation is called Pre-implantation Genetic Screening. However, many other screening techniques can be used too depending on your clinic. Is only one embryo transferred? If more than one egg is fertilised, your doctor will choose one to transfer, based on trying to assure the maximum possibility of a pregnancy. There are multiple criteria that the clinics use to determine this, including:  Sometimes you will be given the option to transfer more than one embryo. This may increase your chances of developing multiple pregnancies but again, doesn’t guarantee a pregnancy. Can you get IVF on the NHS? The NHS provides full funding for IVF for those who: Whether or not you are eligible for IVF under the NHS also depends on where you live as different trusts have different requirements and funding availability. You must discuss thoroughly with your gynaecologist or GP and if you are not eligible, there are many private clinics available for IVF treatments.  The cost for 1 cycle of treatment is roughly £5,000. This depends on the clinic you choose and the treatment protocol you follow.  How effective is IVF? Yes, IVF can be an effective fertility treatment and many women can successfully become pregnant and give birth to healthy babies via IVF. The success rate depends on a range of factors, including age, medical history, sperm quality and success rates of your clinic.  As younger women […]

We’re all sold the ideal of perfect skin by skin care companies. But sometimes the cause of our breakouts is more than skin deep. So how do we know if our skin troubles are hormone-related? Read on to find out. Quick facts: What is hormonal acne? Hormonal acne is acne or breakouts that are related to hormonal fluctuations or imbalances.  Typically hormonal acne is found on the lower face, cheeks and jawline chest, neck, shoulders and back. Hormonal acne can affect people of all ages. Whilst it’s common during puberty when lots of hormonal changes are occurring, it can also be common as an adult, especially for women and people who menstruate, due to hormonal fluctuations throughout the menstrual cycle. What causes hormonal acne? Your skin has many small glands, called sebaceous glands, that produce an oily substance called sebum. Sebum helps keep your skin supple, smooth and healthy.  These glands also have receptors for our sex hormones, particularly androgens like testosterone, and oestrogen. Both of these hormones stimulate the production of sebum. When excess sebum is produced, this buildup causes visibly oilier skin and can clog the pores, resulting in inflammation and acne breakouts. Hormonal acne and androgens When our bodies produce excess amounts of androgens, it can cause hormonal acne and other skin problems. If androgen levels are higher than normal, there is more androgen binding to the sebaceous gland receptors, promoting more sebum production.  There can be lots of reasons for elevated androgens. A common cause is Polyendocrine Metabolic Ovary Syndrome (PMOS, formerly known as PCOS). Those who experience PMOS are more likely to experience excess androgen-related symptoms like acne, excessive facial and body hair growth (hirsutism) and skin darkening.  Trans and non-binary people who begin taking testosterone as part of their transition journey may also notice acne breakouts because of raised androgen levels. Hormonal acne and oestrogen Sebum production is also influenced by the menstrual cycle, specifically by the hormone oestrogen.  Oestrogen fluctuates throughout the menstrual cycle. It’s at its lowest level during your period and gradually rises to a peak at ovulation, around the mid-point in your cycle. Although the impact of oestrogen on the sebaceous glands is not fully known, it has been shown to suppress sebum production at high levels. Therefore when your oestrogen levels are higher, generally your skin will be clearer. This is why lots of people experience hormonal acne flare-ups just before or during their periods when oestrogen levels are low.  Oestrogen is also associated with increased collagen production, skin thickness, skin hydration and wound healing—which all contribute to clear-looking, healthy skin. After menopause, your oestrogen drops. Some people find that this drop causes hormonal acne and may also leave their skin dry, itchy and saggy. For some individuals, HRT to reduce the symptoms of menopause can also cause hormonal acne. How to treat hormonal acne? If you think you suspect you’re suffering from hormonal acne, there a number of treatments you can explore.  Firstly, if you’re not already, begin tracking when you have flare-ups and your periods. You can do this with a period tracking app or just using a calendar. This will help you to understand when in your cycle you’re getting flare-ups and whether it could be due to hormonal fluctuations during your cycle.  Testing your hormones will be able to give you answers as to whether you have raised androgen levels. Our advanced hormone and fertility test can help you identify any hormonal imbalances.  There are topical treatments available that can help with flare-ups, as well as some contraceptives like the combined pill that has anti-androgenic properties. Lifestyle changes like diet, exercise, stress and alcohol reduction can also have a significant impact.  If you’re struggling with your skin, don’t suffer in silence. Reach out to us and get on a plan to find the root cause of your skin issues. References:  

The menstrual cycle is an incredibly important process that governs female fertility and can be a signifier of your overall health. The menstrual cycle is made up of two separate cycles that each run from bleed to bleed. Here’s everything you need to know, from your period to the proliferative phase.  Quick facts: The Menstrual Cycle: More Than Just Your Period When we talk about the menstrual cycle, periods often steal the spotlight. But did you know that your period is just one small part of a much bigger process? Cultural stigmas, taboos, and limited sex education have left many people with gaps in their knowledge about the menstrual cycle. However, understanding your cycle is essential—not just for fertility but also for overall health because it’s intimately linked to your overall health. It can easily be influenced by other factors such as stress, diet, weight fluctuations, exercise, sleep, illness and medications. The American College of Obstetricians and Gynecologists (ACOG) has now classified the menstrual cycle as a vital sign—putting it right up there with your heart rate and blood pressure. So yeah, your menstrual cycle is a big deal. Period. What is the menstrual cycle?  The menstrual cycle starts on the first day of your period and ends on the first day of your next period. It is broken down into 2 main cycles, the ovarian cycle (happens in the ovaries) and the uterine cycle (prepares the uterus for pregnancy). Both of these cycles happen in tandem and are carefully regulated by your incredible cycling hormones—oestrogen, progesterone, luteinising hormone (LH) and follicle-stimulating hormone (FSH). What happens during the ovarian cycle? During the ovarian cycle, one of your ovaries will develop an egg which will be released mid-cycle, during ovulation. The ovarian cycle includes three main phases, the follicular phase, ovulation and the luteal phase. Let’s look at each phase in detail. The follicular phase Day 1 of your period is counted as day 1 of your menstrual cycle—it’s also when the follicular phase begins.  For most people, this phase lasts around 10-16 days, ending mid-cycle, around ovulation. (although this can vary from cycle to cycle and person to person). Changes to the length of your follicular phase are usually the main reason why your cycle length may vary from month to month.  During the follicular phase, a few immature eggs in one of your ovaries are selected and begin to mature. The follicular phase kicks off when gonadotrophin-releasing hormone (GnRH) is made from your brain, which promotes the release of follicle-stimulating hormone (FSH).  FSH stimulates your follicles—little sacs in your ovaries containing immature eggs, and a few selected follicles will begin to grow and mature. As these follicles grow, they make oestrogen—the main female sex hormone.  Thanks to the rise in oestrogen, generally, this time in your cycle you’ll likely be feeling your best, most confident, sexy and unstoppable. However, not all of the follicles make it. Only one follicle will be picked as the chosen one for that month and the others will stop maturing. This chosen one is called the dominant follicle and will be prepped for release during ovulation. Ovulation Oestrogen gradually increases during the follicular phase and peaks around the middle of the cycle. This triggers the brain to make a hormone called luteinising hormone (LH).  A sudden rise in LH levels triggers ovulation, which is when the now mature egg will be released from the ovary.  Ovulation takes place 12-36 hours after the onset of the LH surge. The released egg will travel through the fallopian tubes, where it will wait in hopes of being fertilised by a sperm.   Ovulation usually happens around the middle of your cycle, if you’re having regular periods. This is usually estimated to be around day 14 of your cycle, but this is based on the assumption that everyone has a 28-day cycle, which is not always the case. Menstrual cycles vary in length and ovulation usually happens 10 to 16 days before the start of your next menstrual cycle. Your fertile window is the 5 days leading up to ovulation and the day of ovulation itself. This is when you’ll be most likely to conceive.  If you’re trying to conceive,, there are a few things you can use to track ovulation.  The luteal phase The luteal phase of the menstrual cycle lasts from the day after ovulation until the day before your next period. It lasts about 14 days. During this time, your progesterone levels rise, which causes the glands in the lining of your uterus to thicken. You might wonder why this is so crucial. If the egg released during ovulation was fertilised by a sperm, then it may travel down the Fallopian tubes and implant into the lining of the wall of your uterus. It helps if the lining of the walls of your uterus are thick and ready to provide nutrients so your fertilised egg can attach firmly and grow.  However, if you don’t conceive i does not happen, a drop in both progesterone and oestrogen levels triggering your period causes the lining of your uterus to break down, shed, and leave your body in the form of your period.  Your period marks the start of a new cycle, and your body goes through this whole process all over again.  This is also the point in your cycle when PMS (premenstrual syndrome) symptoms start to appear. Everyones symptoms are different and can vary from month to month, but the most common symptoms of PMS include: What happens during the uterine cycle? The uterine cycle happens alongside the ovarian cycle and involves all of the changes happening in the endometrium as it prepares to welcome in a fertilised egg.  The menstrual phase  This is when you’re menstruating or having your period. Your endometrium builds up during your cycle. But if no pregnancy occurs, falling oestrogen and progesterone just before your period will trigger the breakdown of the endometrium, because it’s no longer needed to support a pregnancy.  Your endometrium is shed along […]