Knowledge Centre

More women and those assigned female-at-birth (AFAB) are reporting depression during menopause, but can menopause cause depression? Here we explore the links between menopause and depression, how they influence each other, treatment options including lifestyle changes and medication and how to support a loved one struggling. Quick facts: Understanding menopause and mental health Menopause is a natural part of ageing. It’s when your ovaries stop making the hormones oestrogen and progesterone. It marks the end of your reproductive years—you can no longer become pregnant and your periods stop. Since your sex hormones, oestrogen and progesterone, affect so much of your bodily functions including how you think and feel, the hormonal shift can cause emotional and psychological symptoms. These shifts can put you at a higher risk of developing mood disorders like depression. Changes in mood and energy can be frustrating and can have a knock-on effect on your relationships, work, life and confidence. Potential psychological side effects of menopause can include: On top of this, having trouble sleeping during menopause is common, and lack of sleep can worsen other mental health symptoms. Can menopause cause depression? Lots of women experience difficulties with depression and their mental health during menopause, but what’s the link? In multiple studies, it becomes evident that if you’re perimenopausal (the years before menopause when your hormones take a dip and you start getting menopause symptoms), you’re more likely to experience depression.  Such an enormous shift in hormones can be life-changing. Many women feel hopeless, out of control, anxious and overwhelmed. Studies found that more women in their menopausal years experience depression compared to pre-menopausal years. Additionally, women and those AFAB who have a personal or family history of depression are also more likely to experience a relapse during menopause. One study suggests that those who have had premenstrual dysphoric disorder (PMDD), or postpartum depression are also more likely to develop depression during menopause. So what’s the cause behind the correlation between the increased risk of depression during menopause? Simply put, hormones have a lot to answer for. Primarily, a dip in oestrogen can cause depression, along with other menopause symptoms. Oestrogen plays an important role in mood regulation. Without it, neurotransmitters serotonin (known as the “feel good” hormone) and norepinephrine can be affected leading to depressive symptoms and mental health difficulties. It’s important to note that depression during menopause is not a given. Not everyone going through menopause will experience depression. Symptoms vary for each individual. There are lots of treatment options to reduce and prevent menopausal depression.If you or someone you know is struggling with menopause and mental health difficulties seek professional help from a Menopause Specialist or mental health professional. Identifying depression during menopause Signs and symptoms of depression during menopause include: These symptoms are not just related to menopause, they can overlap with other menopause symptoms, and be different for everyone. The risk of developing depression seems to decrease in the 2-4 years after your last period. Menopause is marked by a single point in time when it’s been a year since your last period. If you’re experiencing any of these symptoms, or want more support with depression or menopause symptoms, contact a menopause specialist who can advise you. Factors contributing to depression in menopause Depression during menopause can be influenced by several factors. A genetic or family history of depression could influence the probability of you experiencing depression. Your medical history can play a part too. Having at least one chronic health condition like cardiovascular disease or diabetes can also double the risk of experiencing depression during menopause. Studies say that potential biological risk factors for depression during menopause include vasomotor symptoms (VMS) like hot flashes and night sweats can increase the likelihood of depression.  These symptoms can feel debilitating, and paired with tiredness, poor concentration and fatigue from the lack of sleep, can affect confidence and self-esteem often resulting in feelings of sadness and depression. Getting enough sleep is key to mood regulation. If your roles change because of physical health problems that come with menopause, which, for example, cause you to take early retirement, some studies suggest that the risk of developing depression increases by 88%. The Fawcett Society, in their report Menopause and the Workplace, found that 1 in 10 women leave their jobs because of menopause symptoms. Sadly, women and those AFAB aren’t getting the support they need at work. Hertility aims to change this by encouraging more employers to become Reproductively Responsible™. Seeking help and treatment for depression Seeking help for menopause-related depression is key to overcoming it. There are lifestyle changes as well as medical treatments available. Natural treatment options for menopausal depression include making lifestyle adjustments. Well-balanced, gut-healthy nutrition and regular physical exercise can improve your mood and reduce the risk of depression during menopause, along with helping to alleviate other menopause symptoms. Eating a nutritious diet Firstly, eating well and often is important. Eating protein with every meal, staying hydrated and fuelling your body will keep your energy and mood stable throughout the day. Fibre with each meal will help to keep you fuller for longer and aid your digestion. Read our piece on ways your diet can help manage menopause solutions. Experiments suggest that your gut has close links with and could play a crucial role in depression (the gut-brain axis). Eating 30 different fruits and vegetables, ideally as many different colours as possible, each week is recommended by nutrition experts to support your gut health. Probiotics like live yoghurt, tempeh and kimchi also keep your gut happy. Getting regular physical exercise Incorporating regular physical exercise can help to reduce depression and anxiety during menopause. Exercise releases endorphins—the feel-good hormone. It’s also thought that physical exercise has beneficial effects on mental health through distraction and boosting self-belief. Getting regular physical exercise also supports your energy and boosts your general health and wellbeing. It keeps your heart healthy, helps you maintain a healthy weight, and reduces the risk of chronic health conditions. Bonus! Having […]

Age is a big factor when it comes to fertility, but on the whole, people are having children much later than previous generations—some well into their 30s. If you’re looking for advice on how to boost your fertility naturally in your 30s, there are several things you can do. Read on to find out.  Quick facts: Fertility in your 30s Age is a big factor when it comes to fertility and we’ve all heard of the infamous biological clock. In other (more scientific) words, your biological clock refers to your ovarian reserve.  This is the number of eggs you have left and equally as importantly, the quality of your remaining eggs. Both of these factors unfortunately decline over time, significantly so after your mid-30s.  That’s not to say that you can’t have a very healthy and even easy pregnancy in your 30s, it’s just worth bearing in mind that as you get older, it becomes more difficult to get pregnant and to keep the pregnancy. Luckily there are many different types of fertility treatments, like egg freezing and IVF, which can help those who have more difficulty conceiving naturally.  When you’re trying to conceive in your 30s, whether you’re using fertility treatments or trying to get pregnant naturally, every little helps. Your lifestyle choices, nutrition, menstrual cycle awareness and mental health can play a crucial role in your fertility journey in your 30s, and at any age. Let’s take a look at some of the key lifestyle factors and medical factors that can help you on your journey. Medical considerations and check-ups Boosting fertility naturally in your 30s begins with a proactive understanding of your reproductive health. Regular medical check-ups, including an advanced hormone and fertility test, can help you to understand if any underlying conditions may be affecting your reproductive health and help you address any potential hurdles to pregnancy. Lots of healthcare providers recommend only visiting a fertility specialist if you’ve been trying to get pregnant for a year without success, but you don’t need to wait that long.  While some couples have no trouble conceiving, 1 in 6 heterosexual couples face fertility struggles. Knowing your body from the inside out means you can seek support and advice faster with all the facts, should you need it. When it comes to getting pregnant in your 30s, timing is everything. By taking charge of your reproductive health through regular check-ups and fertility screenings, you equip yourself with the knowledge needed to optimise your chances of a successful pregnancy.  You may also want to consider getting a pelvic ultrasound scan to give you your definitive Antral Follicle Count (AFC). This gives you a clear and accurate picture of your remaining ovarian reserve Lifestyle changes to boost fertility Despite common misconceptions, you can implement lots of lifestyle changes to help support your fertility and reproductive health. While some aspects of fertility are out of our control, there are actions you can take to improve your chances of getting pregnant in your 30s, with and without fertility treatments. Lifestyle changes can help to boost your fertility naturally. Choosing a well-balanced and nutritionally rich diet, doing regular physical exercise, managing your stress and getting enough sleep can all support your fertility. Physical exercise to boost fertility Getting at least 150 minutes of physical exercise a week is important for supporting overall health—physical and mental.  Broken down, that could look like five 30-minute workouts, a week. This can be anything from a brisk walk to a gym session, yoga, swimming—or any kind of movement that’s right for you.  30-60 minutes of physical exercise per day was shown to reduce the risk of anovulatory infertility (infertility due to an ovulation disorder). Exercise not only balances your hormones, but it can boost your mood, help you manage stress and support your energy. However, being underweight, or doing vigorous physical exercise (more than 60 minutes a day) combined with eating in a calorie deficit, can negatively impact your fertility. This can have a knock-on effect on your hormones, which can lead to irregular periods and ovulation. Your menstrual cycle relies on a delicate hormone balance, and if your weight is too low or too high can throw them out of sync affecting your chance of conceiving. Stress management strategies for fertility Stress can also throw your hormones off balance, causing irregular periods and ovulation. It might also affect your desire to get intimate and reduce your sex drive.   Manage stress to boost fertility in your 30s by identifying coping strategies that work for you. You could try relaxation techniques like breathwork, yoga, meditation and mindfulness to help you relax.  If you find that self-help measures are not helping out, you can always consider seeking professional help.  The connection between sleep and fertility It’s recommended to get between 7-10 hours of sleep every night regardless of your health concerns. Sleep is associated with better health outcomes all round, including reproductive health.  So, how does sleep affect our fertility? A lack of sleep can cause your circadian rhythm (responsible for your sleep-wake cycle) to become dysregulated. This can cause knock on affects for your hormones and in turn your menstrual cycle and fertility.  One study revealed that in a survey of nurses of reproductive age, 53% reported menstrual cycle changes while engaging in shift work. To get a healthy sleep routine, try switching all screens off two hours before bedtime, and have a wind-down routine which could include a hot bath, calming tea, stretching or bedtime yoga. Try to stick to a schedule by going to bed and waking up around the same time each day, so your sleep-wake cycle is regulated. It’s usually easier to fall asleep when it’s quiet, dark and cool, but test different sleep environments to see which works best for you. Morning sunlight is proven to improve your ability to sleep too. Exposure to sunlight in the first hour of waking for 10-30 minutes a day, and in the afternoon as the sun […]

In this article, we’ll delve into the five main lifestyle factors that play a pivotal role in female fertility, and how you can shape and optimise your lifestyle to support your reproductive health. Quick facts: Understanding female fertility When embarking on your fertility journey, whether it’s trying to conceive for your first or your fifth—planning is everything.  Understanding the various lifestyle factors that can affect your fertility is crucial for both individuals and couples looking to begin their conception journey.   Lots of couples conceive without any issues, but 1 in 6 heterosexual couples face fertility struggles, so if it’s taking longer than you’d hoped, know that you’re not alone.  The earlier you know what’s going on inside your body, the earlier you can take action to support your future fertility goals.  There are lots of different factors that can impact female fertility—including age, lifestyle factors, hormones, reproductive health conditions and environment.  To get pregnant and have a baby, lots of these biological and environmental factors come into play. When one or more of these factors fall out of sync, that’s when you might face difficulties with fertility. Let’s take a look at some of these factors and how you can prepare for your fertility journey. Age and fertility First, let’s explore what fertility is from a biological perspective. Ovulation plays a critical role, marking the release of an egg from the ovary. For a pregnancy to occur, a healthy egg must meet healthy sperm (usually in the fallopian tube) where the egg gets fertilised. Plus, the uterus (womb) must be in optimal condition so the fertilised egg can implant and grow into a healthy baby. But unfortunately, biology often has other plans for us. We hear a lot about the ‘biological clock’ when it comes to women and those assigned female-at-birth (AFAB). This references the deterioration of both the quality and quantity of your eggs over time—known as your ovarian reserve.  Women and those AFAB are born with all the eggs they’ll ever have. Each menstrual cycle, you lose eggs. Once you hit your mid-thirties, this decline increases even more rapidly. Add in hormonal changes as a result and collectively, it reduces your ability to become, and often stay, pregnant. For a pregnancy to occur, you need healthy eggs. So from a biological standpoint, the younger you are, the healthier your eggs will be.  While an Anti-Müllerian Hormone (AMH) test can help you to understand how many eggs you have left, it can’t tell us the quality of the eggs we have. Additionally, after the age of 35, there’s a higher risk of pregnancy-related complications and negative health outcomes for the baby. There’s also a higher risk of miscarriage, high blood pressure, and gestational diabetes. Plus, chromosomal conditions like Down’s syndrome are more common. Despite misconceptions, ageing affects male fertility too. From age 40 onwards, sperm quality and sperm function decrease with significant implications to pregnancies and births including increased time to conception and increased risk of miscarriage. Lifestyle choices and fertility The idea that our fertility is out of our control is somewhat of a myth. Whilst biological and genetic factors play a big role—there’s a lot we can do to support our reproductive health.  Through lifestyle choices, we can impact the quality of our eggs and contribute to a healthier reproductive environment. Eating a well-balanced, nutritionally rich diet, getting regular physical exercise, managing stress, getting enough sleep and stopping or reducing smoking and excess alcohol can contribute to improving your fertility. This is because your lifestyle choices directly impact your hormones, and hormonal balance (involved in regulating your menstrual cycle) is crucial to a successful conception, pregnancy and healthy baby. Let’s take a look at some lifestyle tips that can help take care of your fertility Eat a fertility-friendly diet One of the best things you can do to support your fertility is to focus on your nutrition. Eating a Mediterranean diet—one that’s based on plant foods like fruit, vegetables, nuts, beans and whole grains with a moderate amount of dairy, fish, meat and eggs—can be really beneficial.  Check out our fertility-friendly meal plan, and fertility nutrition shopping list to support your healthy diet.If you’re trying for a baby and in the first 12 weeks of pregnancy, taking prenatal supplements like folic acid is important as it can help prevent major birth defects by supporting neural tube development. Get regular physical exercise Getting regular physical exercise is healthy no matter where you are in your fertility journey, but be wary of overexercise. Too much vigorous physical activity can stop ovulation, cause irregular periods or stop them altogether, known as hypothalamic amenorrhea. An absent period is often a sign that something’s not quite right, so it’s worth speaking with a healthcare professional if you’re worried. Limit smoking and alcohol Smoking, alcohol and recreational drug use are associated with an increased risk of miscarriage and complications during conception and pregnancy. Cigarette smoke contains chemicals that can disrupt your hormones and impact your fertility. It’s also been linked with early onset menopause. There’s limited evidence to know how vaping affects fertility (although early studies suggest it could affect the ability to implant and result in lower birth weights) but if you’re trying to get pregnant, not vaping is safer than vaping.  The lack of information doesn’t mean it’s safe, but by stopping, you’re being exposed to fewer chemicals. Get help to quit smoking in the UK with the NHS. Excess alcohol consumption is not only associated with hormone imbalances, there is no safe level of alcohol that can be consumed during pregnancy as it can lead to adverse health effects for the baby.  In women and those assigned-female-at-birth, disrupting your hormones can affect your menstrual cycle causing irregular periods which can affect ovulation, reducing your chances of conceiving. As well as its impact on our hormones, drinking and smoking negatively impact our general health which can lead to knock-on impacts on our fertility making it harder to become and stay pregnant, […]

In this article, we’ll delve into the world of egg freezing—but most importantly whether or not there is a perfect age to freeze your eggs. Read on to find out.  Quick facts: If you’re considering egg freezing, get in touch to see how we can help. Why egg freezing is becoming so popular According to the HFEA (Human Fertilisation & Embryo Authority), egg freezing and embryo storage cycles are the fastest-growing fertility treatments in the UK.  More people than ever are turning to egg freezing and assisted reproductive technologies (ARTs) to help them navigate their future fertility. Having children later in life is also becoming the norm. The Office of National Statistics found that more and more people are turning 30 without having had children. Between “biological clocks”, careers, relationships, medical history, genetic conditions, family expectations and more, fertility planning is tricky business.  Why fertility treatments are on the rise could be explained by a few factors. More people are looking to conceive later in life when natural conception is harder. More same-sex couples and people pursuing solo parenthood are accessing fertility treatments to conceive. And general awareness around treatments is increasing. Understanding egg freezing As you age, the quality and quantity of your eggs decline, which means getting pregnant and sometimes staying pregnant becomes more difficult. Freezing your eggs will preserve their quality as they are now, ready for when you want to have a baby.  Known medically as “oocyte cryopreservation”, egg freezing is a medical procedure that involves having your ovaries stimulated with hormones so that they produce multiple eggs. This is instead of a single egg, as in a typical natural menstrual cycle.  These unfertilised eggs are then surgically removed, frozen and stored in a fertility clinic until you’re ready to use them. The egg-freezing cycle, from ovarian stimulation to egg retrieval, takes around two weeks. You can learn more about the egg freezing process here, including a detailed breakdown of the steps.   Egg freezing can be both physically and emotionally draining. Additionally, it can cost up to £8,000 in the UK.   Egg freezing offers an opportunity to preserve your fertility if you plan on having children in the future. Maybe you want more time to focus on your career, travel the world or just haven’t found the one yet. Or perhaps you’re about to undergo medical treatments or gender-affirming therapy that could affect your fertility.  Egg freezing allows you to live this part of your life without worrying so much about your fertility. It takes the pressure of having to decide whether to have a baby now.  It’s important to note, though, that egg freezing isn’t a fail-safe method for having a baby, and its success relies on healthy eggs and a healthy reproductive environment. Generally, younger eggs are healthier eggs. If you’re considering egg freezing, at Hertility, we support you through the egg-freezing process with our partner clinics.  What is the best age to freeze your eggs? Technically, you can freeze your eggs at any age before menopause, but The earlier you do, the better your chances of having a pregnancy. Eggs retrieved in your 20s and early 30s usually result in better outcomes than those in your late 30s and 40s.  In our early to mid-twenties, we are at our most fertile, but there’s still only a 25-30% chance of us getting pregnant each cycle naturally. That number drops as the years go by—at 40, it’s only 5%.  Age also increases the risk of pregnancy-related complications like miscarriage, genetic disorders in the baby and gestational diabetes, especially after your mid-thirties. Despite the best time to freeze our eggs being under 35, the average age is 38. This potentially means that a lower quality and quantity of eggs will be retrieved, and you may need more cycles to collect enough eggs. Who is egg freezing for? There are a few instances where you may be considering egg freezing as a viable fertility preservation treatment. These are roughly split into what’s known as medical egg freezing and social egg freezing.  More obviously, medical egg freezing is when you freeze your eggs for a medical reason, for example when a medical procedure or diagnosis might increase your risk of infertility. You might choose medical egg freezing if you’re diagnosed with cancer, need cancer treatment like chemotherapy or radiotherapy, are diagnosed with an autoimmune disease or you’re having gender-affirming therapy. Genetic conditions might also influence the decision to freeze your eggs. To increase the chances of being able to have a baby in the future, women or those AFAB with a family history of early menopause or another genetic condition might consider egg freezing as a precautionary measure. The other type of egg freezing, known as elective or social egg freezing,  is more about life choices. This could include holding off on family plans because of career goals, ticking things off your bucket list or just because you’re not quite ready to have kids right now.  Your relationship status could be a deciding factor too. Maybe you haven’t found the right person, or you have but you’re both not ready for children yet. Previous difficulty with fertility might make you want to freeze your eggs as a proactive measure, or religious and cultural expectations might come into play too. Is there an egg freezing age limit? Although there’s technically no age limit for egg freezing, specific fertility clinics might impose one. This stems from the likelihood of live births reducing dramatically after 40. Fertility clinics might set age limits for various reasons, including ethical concerns. The journey of egg freezing and fertility preservation can be quite a ride, both emotionally and physically. When the odds of a successful pregnancy are slim, clinics may put age restrictions in place to safeguard the health and well-being of their patients. If you’re aged 40 or over and considering freezing your eggs, connect with a fertility advisor for personalised advice. As you age, your ovarian reserve naturally declines. An AMH (Anti-Müllerian […]

Having a healthy diet and active lifestyle is essential for good health at all times, but when you’re trying to conceive or pregnant—it’s even more vital. Here, we’ve laid out everything you need to consider for your nutritional health if you’re starting your conception journey.  Quick facts: Nutrition and fertility During all stages of the conception journey—right from trying to conceive, through to pregnancy and postpartum—nutrition needs to be front and centre for both your health and your baby-to-be.  Questions we frequently hear include ‘which foods increase fertility?’, ‘what are the best foods for pregnancy?’, and ‘what nutrients are needed for pregnancy?’. In this article, we’ll tell all and take a deep dive into everything pregnancy and fertility nutrition. Follow these tips for what to and what not to eat for optimal health during your conception journey. Key nutrients to eat when you’re trying to conceive When trying to conceive, you’ll need a high-nutritional diet. This is because nutrition directly impacts our fertility and can shape the health of your baby during those vital first 9 months of its life.  Whilst there are no specific guidelines for a recommended ‘fertility diet’, the Mediterranean diet offers a great template for the kinds of foods you should be consuming.  This diet is rich in fish, vegetables, fruits, legumes, nuts, seeds, whole grains, beans and unsaturated fats such as olive oil. It includes smaller amounts of dairy, eggs and lean meat and limits processed and red meats and ultra-processed foods.  Due to the abundance of fruits, vegetables and whole grains in the Mediterranean diet, it is rich in antioxidants which have been shown to protect sperm and eggs from DNA damage and oxidative stress.  Diets opposing this way of eating, such as those poor in fruit, veg and dairy, but high in saturated fat, have been associated with an increased risk of pregnancy complications.  Here are some key nutrients and minerals found in the Mediterranian diet that are especially important for pregnancy. Vitamin D How much Vitamin D do I need when trying to conceive? Folic acid and folate If you are currently trying to become pregnant, it is advised to take at least 400 mcg of folic acid supplement every day. You should supplement for 12 weeks before conception and at least three months after conceiving.  It is also a good idea to include food sources of folate in the diet such as dark green leafy veg, avocado, citrus fruit, peas and lentils. Folate (Vitamin B-9) is very important in red blood cell formation and for healthy cell growth. Studies have shown that taking folic acid can greatly reduce neural tube defects in the baby (defects in the brain and the spine). Neural tube defects affect one in 1,000 pregnancies, with 190 babies born with an NTD every year in the UK. Omega-3 fatty acids Omega- 3 Polyunsaturated fatty acids (PUFAs) are antioxidants that are found in oily fish such as salmon, herring, anchovies, sardines or mackerel. Aim for two portions per week of fish (140g each), one of which should be oily.  Plant-based sources include flax, hemp, chia seeds, pumpkin seeds, walnuts, rapeseed oils, linseed vegetable oils and soya products. Plant-based sources aren’t as rich, so you may want to consider supplementing with 450mg EPA/DHA per daily adult dose of Omega-3 every day if you’re vegetarian or vegan. Avoid taking Omega-3 supplements that contain fish liver, such as cod liver oil. Some benefits of taking Omega-3 fatty acids when trying to conceive are:  Fat plays a crucial role in the production of hormones and is needed to absorb fat-soluble vitamins A, D, E and K. So in addition to omega-3 PUFAs, you should also be focusing on including healthy fats from monounsaturated fats such as olive oil, olives, nuts, avocados and seeds. Monounsaturated fats are associated with improved pregnancy and live birth rates.  Fibre In a study in the US, higher fibre intake was associated with an increased chance of conception. Those who had a higher fibre intake had a 13% higher chance of conceiving, compared with those who had a lower fibre intake. How much fibre should I be eating when trying to conceive? In the UK, it is recommended that we all aim for 30g of fibre per day. The carbs-to-fibre ratio is also extremely important. More carbs than fibre can lead to reduced fertility, whilst more fibre-to-carbs is more beneficial for fertility. Some foods that are high in fibre: Protein Adequate protein intake whilst trying to conceive can positively affect egg and sperm development. To increase your chances of getting pregnant, make sure you and your partner are getting enough daily protein.  The average adult needs around 0.75 grams of protein per kilogram of body weight daily. However, active individuals, especially those doing weightlifting or resistance training, will need to up their intakes.  What foods are high in protein?  Animal meats are high in protein but according to a study by the Harvard School of Public Health, it found that infertility was 39% more likely in women who ate high intake of animal proteins.  Women who ate plant-based proteins were much less likely to be diagnosed with infertility, linked to a reduced risk of ovulatory infertility. High-protein foods that can help aid fertility include fish, eggs, lentils, beans, tofu, quinoa, chickpeas, yoghurt, seeds and nuts. What’s the best type of protein when trying to get pregnant? The best type of protein when trying to get pregnant is plant-based protein. Including more minimally processed, plant-based sources of protein in the diet and fewer animal sources of protein could improve ovulatory infertility. This doesn’t mean you have to become fully vegan. You can simply limit your consumption of animal proteins and make a conscious effort to consume more plant-based proteins (better for you and the environment). Some plant proteins include chickpeas, lentils, beans, tofu, tempeh, nuts, seeds and quinoa. Iron and planning for pregnancy Iron is essential for the reproductive system and too little iron can cause anaemia. Women need 14.8mg of iron […]

In this article, we’ll look at how to prepare before stopping the pill, the potential side effects, symptoms and shifts you might experience when you come off the pill and crucially, when to test your hormones depending on which type of contraception you’ve been using. Read on to understand how to support your reproductive and overall health as you manage your post-contraception journey. Quick facts: How to prepare before coming off the pill Coming off the pill doesn’t have to feel like stepping off a cliff. A little preparation in the weeks and months beforehand can make your transition much smoother both physically and emotionally. Start tracking your cycle now Even if you’re still on the pill, you can begin noting how your body feels day to day. Use a cycle tracking app like Hertility or even just a notebook, note your cycle length, energy levels, mood, skin and sleep. This gives you a baseline before your natural hormones return, so you can spot patterns more quickly afterwards. Review your reason for going on the pill in the first place Many people start the pill to manage symptoms like  irregular cycles, painful periods, acne or conditions like PCOS or endometriosis. If that was the case for you, it’s worth speaking to a healthcare professional before stopping, so you have a plan in place for those symptoms potentially returning. Consider your contraception timeline If you’re stopping contraception specifically to try to conceive, it’s worth factoring in the timeline for your hormones to settle before tracking ovulation. In most cases, we recommend waiting at least 3 cycles post-pill before testing your hormones, but this varies depending on the type of contraception you’ve been using (see section below). Common side effects of coming off the pill Whilst side effects like mood swings, irregular periods and acne, the experience of coming off the pill (or any hormonal contraception) is totally unique to each individual. This is because each of our hormonal make-ups is unique.  While coming off the pill may have some side effects, most can be managed or treated and fertility, including a regular menstrual cycle, typically returns to normal within a few months. Knowing how to manage and prepare for any possible symptoms will make your post-pill journey much easier. Let’s take a look at both the physical and mental side effects of coming off the pill. What are the physical side effects of coming off the pill? Stopping the pill may bring on physical side effects including changes in your menstrual cycle, skin issues and weight fluctuations. Menstrual cycle changes after coming off the pill Hormonal fluctuations can cause your menstrual cycle to change. While on the pill, your body receives a steady and specific dose of synthetic oestrogen and/ or progestogen to prevent pregnancy. When you stop taking the pill, the synthetic hormones gradually leave your system, allowing your natural hormones to kick back in. But since your body hasn’t needed them recently, it can take a while for them to find their rhythm. It takes some time for your natural hormones to balance and your menstrual cycle to regulate. A key sign of hormonal balance is a regular menstrual cycle. After coming off the pill, most people notice cycles return to what was normal within 2-3 months. While we can test some of your hormones while you are on hormonal contraception, if you want to do your hormone blood test without the effect of external hormones, we recommend waiting three months. If your menstrual cycle doesn’t return after three months, we would recommend reaching out to our in-house fertility experts for guidance. They can provide insights, conduct Advanced At-Home Hormone and Fertility Test and offer personalised advice based on your specific situation. Your periods may also feel different to how you remember them. Heavier flow, stronger cramps, and a shift in cycle length are all common in the months after stopping, especially if you originally went on the pill to manage those exact symptoms. The pill effectively puts a lid on your natural hormonal fluctuations, so when that lid comes off, it’s like your body is starting all over again. This doesn’t mean something is wrong. But it does mean it’s worth paying attention. Tracking your cycle from the moment you stop, noting flow, pain levels, mood and energy gives you a detailed picture of what your natural hormones are doing, and makes it much easier to spot anything worth investigating further. An important thing to remember is that you can get pregnant after getting off birth control. Many women think it takes a long time to conceive after they stop the pill, but you might start ovulating as soon as 1-3 months post stopping. Skin problems after coming off the pill Some birth control pills have an anti-androgenic effect, meaning they lower testosterone levels in your body, which can reduce acne, which is a common symptom of PCOS. When you stop, testosterone levels can rise again and your skin may react. Breakouts along the jaw, chin and cheeks are particularly common in the first few months post-pill. For most people this settles within 3–6 months as hormones find their new equilibrium. If your acne is persistent, severe, or is hitting your confidence, it’s worth speaking to a dermatologist, but it’s also worth looking at the hormonal picture underneath it. Acne can be a signal of elevated androgens, which is a key marker we test for at Hertility Unwanted hair growth after coming off the pill If you were taking a pill with an anti-androgen effect, unwanted hair growth may return after you stop taking it. This is because the pill was suppressing testosterone, and when that suppression lifts, androgen levels can rise again. Hair growth on the chin, upper lip, neck or chest, called hirsutism is one of the more noticeable ways this can show up. While this can happen to anyone stopping an anti-androgenic pill, it’s also one of the hallmark signs of elevated androgens more […]

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

Myths are everywhere when it comes to reproductive health and fertility. But how can we dispel fact from fiction? Here we’ve broken down some of the most prevalent fertility myths and swapped in the facts. Read on to find out.  Quick facts: What are the most common fertility myths? Fertility myths are everywhere. This is in part due to the lack of education and awareness surrounding reproductive health, exacerbated by today’s age of online misinformation.  From questions around age and gender to addressing whether contraception or lifestyle factors can really cause infertility, we’ve broken down some of the most common myths and corrected them with evidence-based facts.   Let’s get into it… Myth 1: Infertility only affects people over 35  Age is the most important factor in determining female fertility. This is because we are born with all the eggs we will ever have. As you get older, the number and quality of your eggs will decline.  As you approach your mid-30s the rate of decline increases which makes it more likely that you might experience difficulty getting pregnant.   However, this doesn’t mean that you can’t experience fertility issues before that. There are causes of infertility that can happen at any age, like PCOS, endometriosis, pelvic inflammatory disease, fibroids, and cancer treatments like chemotherapy and radiotherapy exposure. If you’re under 35 and have been trying to conceive for a year with no success, you should seek medical advice. You should also seek help after 6 months if you’ve been trying to conceive and are over 35 or have an underlying health condition.  Myth 2: Infertility only affects women and those assigned-female-at-birth This is simply not true. About one-third of infertility cases are due to male factors, another third have inconclusive or unknown causes, and the remaining third are due to female factors.  There are a variety of reasons that can cause male infertility such as poor sperm quality, number, and erectile dysfunction which can cause issues when trying to get pregnant. While male fertility isn’t limited by age (and some men can father children well into their 60s and 70s), it doesn’t mean that male fertility is limitless. Myth 3: Male fertility doesn’t decline with age Just like female egg quality, sperm quality declines with age. There’s an increased risk of miscarriage, birth defects and autism with increased paternal age.  Hormonal changes can affect male fertility, affecting sperm production, mobility and motility. This is essentially the ability for sperm to move and swim towards the egg.  Myth 4: Infertility won’t be a concern if you’ve already been pregnant Unfortunately, even if you have had one or more children previously without any issues, you still might struggle to conceive or give birth in the future. If you are struggling to conceive after having a child, this is called secondary infertility and affects approximately 10% of people. Secondary infertility can be caused by factors such as age, complications from a previous pregnancy, medical treatment or damage to your reproductive organs.  If you’ve been trying to conceive again for some time without success, seek medical advice. Myth 5: Irregular periods mean you’re infertile  Irregular periods are common, but it’s possible to become pregnant even if you have them.  Lots of factors impact the regularity of your periods and menstrual cycle. Stress, sleep disruptions, changes to your exercise routine, medication and more can impact your hormonal balance. Irregular periods can mean irregular ovulation, which can make trying to conceive difficult because it is more difficult to know when your fertile window is. In this way, irregular periods can impact fertility.  Irregular periods, coupled with heavy, painful or infrequent periods (if they happen more than 35 days apart), can be a sign there’s something else going on. If this is the case, it’s worth getting a advanced hormone and fertility test to understand if there might be any underlying hormonal issues that might be causing your symptoms. Myth 6: Long-term contraception will negatively impact your fertility The idea that hormonal contraception will cause infertility is a very common misconception, but thankfully it’s not true. Whether you’re on the pill, have an implant, an IUD (the coil) or the injection, the evidence suggests that there is no permanent impact on your fertility. Depending on the type, your use of hormonal contraception may temporarily suppress your ovarian reserve. It can take several months for both your ovarian reserve and periods to return to what is normal for you.  For example, if you’ve been on the pill, it could take 2-3 cycles for things to return to normal. If you were on the Depo injection, it might take up to 8-12 months. This is because it takes time for your hormones to get back to baseline. So, whilst there is no evidence to suggest that hormonal contraception can impact fertility in the long term, it’s worth knowing your body may need time to get back to normal when planning future pregnancies. Myth 7: Your lifestyle doesn’t matter because it’s all about sex  For conception to occur, sperm must meet the egg to become fertilised. So for those conceiving in a heterosexual relationship, this means you need to have sex at the right time—after you’ve ovulated. But this is not the only factor that impacts fertility. Leading a healthy lifestyle including exercising in moderation, eating a healthy, balanced diet, keeping stress to a minimum and avoiding or limiting alcohol and smoking may shorten the time it takes to get pregnant. If you need personalised diet recommendations to support fertility, you can speak with one of our fertility nutritionists. Myth 8: The more sex you have, the better your chances of conceiving Your fertile window exists only around ovulation—in the 6 days leading up to ovulation, the day of ovulation, and the day after.  This is because of the limited lifespan of both your eggs and sperm. Your egg will only survive about 2-24 hours after ovulation if not fertilised, while sperm can survive in the genital tract for up […]

Most of us have heard of the hot flushes, irregular periods and mood swings. But did you know there are actually up to 34 symptoms of menopause? Check out our list for the full rundown of physical and mental symptoms.  Quick facts: Understanding menopause For women and those assigned female at birth, menopause is when your ovaries stop making the hormones oestrogen and progesterone and stop ovulating. Because of this, your periods stop, and you can no longer become pregnant. Menopause usually happens between the ages of 45 and 55, with the average age being 51. A small number of women experience early menopause where you might go through menopause between the ages of 40-45 or premature menopause or premature ovarian insufficiency (POI) where the ovaries stop working before the age of 40, which is seen in 1% of cases. The length of time menopause lasts varies (up to 14 years) but it’s generally around four years. During this time you’ll experience three stages of menopause: Menopause is a natural part of ageing which marks the end of your reproductive years, but the hormonal shift can make you feel misunderstood and isolated. Recognising and understanding the symptoms of menopause can prepare and empower you to tackle menopause with confidence. The 34 menopause symptoms: What are they? Since oestrogen affects so many of your bodily functions, the hormonal change can lead to the onset of various and often frustrating physical, emotional and physiological symptoms, which can disrupt your relationships, confidence and work life. Everyone experiences menopause differently but these common menopause symptoms may be a sign you’re entering the next chapter of your life. 1. Changes to your periods Your periods become irregular during perimenopause (the run up to menopause) and stop altogether. Once you’ve not had a period for 12 months, you’ve experienced menopause. You may notice your cycle length getting shorter and flow getting lighter too. 2. Hot flushes Hot flushes are a sudden rush of heat or ‘burning up’ sensation which can cause redness or sweating usually in the chest, neck, and face. You can try fans, cooling face masks and always carry a cool drink with you to reduce flushes. 3. Night sweats Night sweats are profuse sweating during the night, so much so that you wake up in wet bed sheets or pyjamas. Night sweats can disrupt sleep and it’s important to remember to hydrate in the morning. 4. Anxiety Feeling worried, nervous, on edge, jittery or tense are all signs of anxiety. You might also have sweaty hands, a racing heart, and be overthinking. 5. Low mood Low mood can include things like feeling down, sad or hopeless. Read our blog post on ‘Can Menopause Cause Depression?‘ if you’re experiencing these symptoms. 6. Mood swings This includes your mood shifting in a short space of time. You may experience things like crying for no apparent reason, suddenly feeling very angry or overwhelmed, feeling low, anxious or jittery.  7. Brain fog It’s common to experience brain fog and find it difficult to concentrate on normal tasks or be more forgetful than usual and feel confused. 8. Forgetfulness You may experience memory loss, forget the names of places, people or things, or walk into rooms and can’t remember why. These are all very common. 9. Reduced sex drive This includes a lack of interest in sex or an inability to feel aroused during sex. This can be exacerbated because of pain during sex (another common symptom).  10. Vaginal dryness or pain Vaginal dryness might cause itchiness and soreness, or make sex painful. 11. Breast tenderness Your breasts or nipples may feel sore to the touch, which can make lying on your front, sleeping and possibly exercising uncomfortable. 12. Headaches or migraines These can include painful headaches or more severe migraines that may affect your ability to do daily tasks. 13. Difficulty sleeping or insomnia This may include trouble falling asleep, staying asleep or waking up feeling tired. This can all affect your mood, eating habits and productivity and may exacerbate other symptoms.  14. Muscle and joint aches and pains Sore muscles, tension and joint pain can make everyday tasks and exercise more difficult. It’s also more common for women to develop osteoarthritis and rheumatoid arthritis during menopause. 15. Bloating Stomach aches, gut problems or a bloated stomach can affect your confidence and ability to enjoy food, exercise and do everyday tasks. 16. Electric shock sensations (ESS) This can feel like pins and needles, prickling, pinching or burning. You may experience this on different parts of your body or skin. 17. Restless legs This is an overwhelming urge to move your legs or a crawling sensation. 18. Itchiness The urge to itch or scratch your skin can be frustrating, and cause redness and irritation. 19. Concentration issues Struggling to focus can make daily tasks more difficult. 20. Brittle nails You may find your nails become weak or brittle and are easily broken or damaged. 21. Hair thinning Hair can become sparse, fall out and break off easily. 22. Weight gain Hormones affect metabolism and appetite, and the change can lead to weight gain and body composition changes which can affect confidence. Speaking with a nutritionist can help. 23. Urinary issues or UTIs You might need to go to the toilet more often, experience recurrent urinary tract infections, or leak urine when you cough or laugh. 24. Allergies You may find you are more sensitive to allergies with itchy skin, rashes, redness and congestion. Skin conditions like eczema and rosacea can worsen.  25. Feeling dizzy or faint You may experience bouts of lightheadedness, feeling dizzy or faint and in general feel less alert. 26. Heart palpitations This includes your heart feeling as though it’s beating faster than normal, skipping a beat or beating irregularly. This can cause panic and it’s worth getting checked out by a doctor to rule out any cardiovascular issues. 27. Fragile bones and reduced muscle mass If you are breaking bones more easily, it […]

Thyroid hormones are made in the thyroid gland and play a crucial role in regulating many different body functions. But what happens when these hormones get out of balance and what is a thyroid disorder? Read on to find out.  Quick facts: What are thyroid hormones? Thyroid hormones are incredibly important hormones for overall health. They play a crucial role in influencing many, many different bodily processes.   There are three thyroid hormones—TSH, T4 and T3. Each has a different function in the body which we’ll explain in a second.  TSH is made in the pituitary gland in the brain. TSH then stimulates the thyroid gland—a butterfly-shaped gland in your throat to produce T4 and T3. What are the different types of thyroid hormones? There are three main thyroid hormones: What do thyroid hormones do in the body? Thyroid hormones play an essential role in many different functions of the body, including: The thyroid hormone feedback loop Just like lots of hormones, our thyroid hormones are all linked—involved in what’s known as a feedback loop. Essentially they all depend on each other to work optimally.  Here’s how the thyroid feedback loop works: Can thyroid hormones become imbalanced? Yes. Thyroid imbalances, known as thyroid disorders, are really common and can disrupt many aspects of your health—bringing on a whole range of unwanted symptoms.  1 in 8 women are estimated to develop thyroid problems during their lifetime. Thyroid disorders are caused by either an underactive thyroid (known as hypothyroidism) or an overactive thyroid (hyperthyroidism). Let’s take a look at each in turn. Hypothyroidism: an underactive thyroid Hypothyroidism is when your thyroid isn’t producing enough T4 (and sometimes T3). This means you have an abnormally high level of TSH, compared to your T4 and/or T3 levels. Because of the thyroid hormone feedback loop, when T3 and T4 are low our brains will overcompensate. This means you’ll produce more TSH to try and boost your T3 and T4 levels. This results in the classic low T3 and T4 levels paired with high TSH reading seen in hypothyroidism. Symptoms of an underactive thyroid  Hypothyroid symptoms include: Having an underactive thyroid can also increase the risk of developing long-term health problems such as cardiovascular conditions, insulin resistance, nerve damage and a swollen enlarged thyroid (goitre).  Causes of an underactive thyroid Hypothyroidism can be caused by a range of factors including age, poorly balanced diets and pre-existing medical conditions like Polycystic Ovary Syndrome (PCOS). Additionally, taking certain medications such as oestrogen-containing hormonal contraception and high doses of steroids can interfere with thyroid function.  Treatments for an underactive thyroid Hypothyroidism is typically treated with a medication called Levothyroxine that replaces T4. Cytomel, a T3 replacement, may also be required in specific cases. Lifestyle changes can also improve your thyroid function. Eating iodine-rich foods like milk and dairy products and adding more white fish, eggs, beans, pulses or red meat into your diet can help. Stress is a big factor in many hormone imbalances and conditions. So, like always, try to find a stress management method that works for you. If you smoke, consider quitting. Cutting down on your alcohol intake can help too. Hyperthyroidism: An overactive thyroid An overactive thyroid means you’re making too much T4 and T3. This triggers your brain to make less TSH—giving the characteristic low TSH paired with high T3 and T4. Symptoms of hyperthyroidism: Causes of an overactive thyroid Much like an underactive thyroid, lifestyle factors like poor diet, smoking, alcohol and stress can cause an overactive thyroid.  Genetics, autoimmune disorders like diabetes or Grave’s disease in addition to long-term problems with cardiovascular health and weight loss are associated with an overactive thyroid. Excess iodine consumption has also been linked to an overactive thyroid. Be mindful of rich sources of iodine like kelp and seaweed and take extra care to check any supplements. Treatments for an overactive thyroid Prescription medications like carbimazole can be prescribed to decrease the function of your thyroid. Beta-blockers can also provide symptom relief from a racing heart or heart palpitations. If needed, surgical intervention to partially remove your thyroid gland can also be an option. Can a thyroid imbalance affect fertility? Thyroid disorders can affect your fertility indirectly, because of the various issues they can cause to your metabolism and other hormones. One study demonstrated that 76% of women who fixed their thyroid were able to conceive between 6 weeks to 1 year afterwards.  Thyroid disorders can indirectly cause: Why should I test my thyroid hormones? If you suspect you have an issue with your thyroid or are experiencing any hormonal symptoms, testing your thyroid levels is the best place to start to help you understand whether you may be suffering from a thyroid disorder.  Most thyroid function tests will not measure T3 unless you are known to have problems with your thyroid. This is because you are unlikely to have abnormal levels of T3 without having abnormal levels of TSH and/or T4. Resources: