There’s a fine line between awareness and anxiety, and in the past six years, that line has been closely trodden, especially when it comes to our health. The booming post-COVID longevity conversation, combined with the proliferation of AI and social media, has made medical information (and misinformation) more accessible than ever. The result? A whole new world of knowledge and, simultaneously, confusion about what ‘healthy’ really looks like.

Women’s health, and particularly our reproductive health, has undeniably been impacted. Thanks to a combined effort by researchers, government select committees, femtech brands and health influencers, we’ve seen a huge growth in awareness about the gaps in research and care for women’s bodies. At the same time, advertising for fertility services and solutions, from egg freezing to at-home hormone tests, has ramped up, with a report by the advertising regulator finding at least 9,340 ads for fertility services posted on Google and Meta between 2024 and 2025.

In one way, the conversation has been vital and enlightening. On the other, it’s contributed to a rise in cyberchondria - the phrase coined for internet-fuelled health anxiety. In fact, The Independent reported in 2024 that 22% of young adults felt pressure from social media to freeze their eggs or sperm.

It’s why I was initially cautious about covering the connection between ovarian health and longevity. As research increasingly explores the role our ovaries may play in healthy ageing, it's a difficult topic to ignore, but one that could easily create more anxiety than understanding. After years of worrying about the sharpness of your fertility cliff, the endless array of reproductive health conditions, the risks of miscarriage and many challenges of menopause, the last thing you want to hear is that the rate at which your ovaries age may influence your lifespan.

The evidence suggests, however, that the two are connected, and it doesn’t need to be bad news. In fact, as Dr Natalie Getreu, global expert in ovarian biology and co-founder of Hertility, explains, ovarian ageing isn’t something to worry about. Instead, it’s about getting curious. “The narrative that women should be anxious about egg loss, racing against a biological clock, or treating their fertility as something fragile and finite is both scientifically oversimplified and genuinely unhelpful,” she explains. “There is a meaningful connection between ovarian health and long-term wellbeing, but it’s part of a much bigger picture.”

The best news? Many of the factors linked to healthy ovarian ageing are the same habits that support overall long-term health, and the chances are you're already doing some of them. Ahead, Dr Getrue and gynaecologist Dr Charis Chambers, chief medical officer at Clue, share the daily habits they practice to protect their ovarian health and promote healthy ageing.

If you’re interested in learning more about the intricacies of your health in simple, science-backed ways, be sure to check out our guides to cycle tracking, how to tackle persistent fatigue, and what the renaming of PCOS to PMOS means for women’s health. We’ve also got investigations into medical trauma and endometriosis and the issue of misdiagnosis amongst women with PMDD.

I'm a gynaecologist - these are the daily habits I prioritise for healthy ovarian ageing

What is ovarian ageing?

A completely normal and natural part of the ageing process, ovarian ageing is the “decline in the number and quality of eggs that ultimately ends with menopause,” says Dr Chambers.

Though most of us become aware of this decline during mid-life, the process actually begins whilst we’re still in our mother’s uterus. “We’re born with our lifetime supply of eggs, which typically sits between one and two million,” says Dr Getreu.

Dr Getreu explains that the ageing process does typically speed up in our mid to late thirties so that by the time we reach menopause, only a few hundred eggs remain. But the rate at which this happens is highly individual, based on a mix of genetic, lifestyle and environmental factors. “Whilst ovarian ageing is universal, its pace is deeply personal, which is exactly why a one-size-fits-all timeline doesn't really exist,” she says.

How does ovarian ageing impact longevity?

The important thing to note here is that, whilst ovarian ageing has close links to our overall longevity, it’s not a cause-and-effect relationship. Going through menopause earlier doesn’t guarantee a shorter life, whilst later menopause doesn’t determine that you’ll live to be 100.

That said, it is an important relationship to be aware of and understand because research consistently shows links between later menopause and longer lifespan.

“Women who reach menopause later tend, on average, to live longer and have lower rates of cardiovascular disease, osteoporosis, and cognitive decline,” confirms Dr Getreu, who explains that much of this comes down to the loss of oestrogen that occurs during perimenopause and menopause. “Oestrogen is profoundly protective for our heart, skin, brain and bone health,” she says. “The longer the body is exposed to its own natural oestrogen, the longer those protective effects appear to last.”

What this means, Dr Getreu concludes, is that our ovaries are a useful window into our wider health. “The same factors that protect your cardiovascular and metabolic health tend to support your ovaries too, and vice versa,” she says. “Think of it less as a separate concern and more as one thread in a much larger picture of wellbeing.”

How much control do we have over ovarian ageing?

It’s really important not to panic about ovarian ageing, especially because half of it is determined by your genetics. “Family history is a strong predictor of age at menopause,” explains Dr Chambers. “Many women destined for early menopause have increased ovarian reserve depletion due to a change in their DNA response pathways. This means that they don’t repair damage to their DNA as well, which results in earlier ovarian ageing.”

There are, however, things we can do to slow ovarian ageing. “About half of our ovarian ageing is influenced by modifiable lifestyle, environmental and medical factors,” says Dr Chambers, who, along with Dr Getreu, shares the things she does to protect against ovarian decline.

9 gynaecologist-approved habits for healthy ovarian ageing:

1. Avoid smoking

“Smoking is one of the most impactful modifiable risk factors in ovarian ageing,” says Dr Chambers, who explains that the degree of impact depends on the amount and duration of smoking.

“Menopause occurs up to four years earlier in smokers,” she says, explaining that this is due to a faster decline in anti-müllerian hormone (AMH), which provides “an important marker of ovarian function and reserve.”

2. Exercise regularly, without overtraining

The magic of exercise is in the balance, says Dr Getreu. “Moderate, consistent exercise supports insulin sensitivity, reduces inflammation and helps to regulate the hormones that govern ovarian function,” she explains, pointing to walking, swimming, cycling and strength training all as great protective forms of movement for ovarian health.

But, she caveats, “very high-intensity exercise without adequate recovery can suppress reproductive hormones. The sweet spot is regular, enjoyable movement rather than unmanaged extremes.”

If you’re worried or unsure about your training load, it’s always best to consult a qualified doctor or PT who can advise you on programming.

3. Eat an antioxidant-rich diet

“Oxidative stress is a key driver of egg quality decline,” says Dr Getreu. “Foods high in antioxidants, such as berries, leafy greens, nuts, olive oil and oily fish, help to counteract this.”

She recommends the Mediterranean diet, known to be high in plant-based foods, healthy fats and antioxidants, as having the strongest evidence base for better reproductive health.

4. Prioritise sleep

We all know that sleep is a superpower, and it turns out that our ovaries love it too. “Seven to nine hours of good-quality sleep is genuinely one of the most powerful things you can do for hormonal health across the board,” emphasises Dr Getreu.

On the flip side, she explains that “chronic poor sleep elevates cortisol and affects the reproductive hormones that support ovarian health,” whilst Dr Chambers says that disruption to our circadian rhythm can advance AMH depletion by around one year.

5. Limit alcohol consumption

It will come as no surprise that alcohol doesn’t do our ovarian health any favours. And whilst neither expert says that we need to eliminate it entirely, they are clear that moderation is essential.

“Alcohol, in excess, disrupts hormonal signalling and is linked to elevated oestrogen metabolism,” says Dr Getreu, who explains that over time, this can impair ovarian function.

NHS guidance for alcohol consumption is no more than 14 units a week, though it’s important to note there are no completely safe levels of alcohol consumption.

6. Maintain a healthy body weight

BMI is far from a perfect measure of health, but both experts are confident in their assertion that body weight does play a role in ovarian health.

“Both excess and very low body fat affect oestrogen metabolism and ovarian function,” says Dr Getreu. “Our adipose (fat) tissue produces oestrogen so extremes in either direction can throw hormonal balance off.”

7. Keep an eye on chronic stress

Women’s health issues are very often pinned to stress, which Dr Getreu says can sometimes be misleading. “Stress alone does not explain most fertility issues,” she clarifies, “but chronic stress can affect sleep, inflammation, libido, cycle regularity and lifestyle behaviours.”

The goal, she explains, is not to eliminate stress (honestly, who could?), but to build moments of recovery into our daily life. “Recovery looks like movement, boundaries, therapy, breathwork, time outdoors and social connection - whatever is genuinely sustainable for you,” she says.

8. Don’t ignore menstrual cycle changes

How many times have you groaned at the sight of your period? Too many, probably.

Our menstrual cycle gets a bad rap, but it’s actually a vital indication of health, as Dr Getreu tells us.

“Irregular, absent, very heavy, very painful or suddenly changing periods can sometimes point to underlying health issues,” she explains. “Seeking help early doesn’t mean something is seriously wrong, but it gives you information and options.”

For help, it’s always best to speak to your GP or a registered healthcare provider before turning to the internet for answers.

9. Consider environmental exposures

There’s still some grey area on this one, as research is still evolving. But whilst it’s difficult to control everything we’re exposed to, reducing unnecessary exposure to endocrine-disrupting chemicals is likely to be beneficial to your hormones.

“EDC's are found in certain plastics, pesticides and personal care products,” says Dr Getreu, who suggests “making sensible precautions where practical, such as choosing glass or stainless steel over plastic for food storage or opting for fragrance-free products.”

Shop MC-UK approved hormone health resources now:

Modern womanhood involves an astonishing amount of clenching. We’re clenching through stressful meetings. Through traffic. Our jaws while we sleep. Our core. Clenching every muscle in our body while replying “no worries!” to an email that, in fact, is causing quite a lot of worries. But there is one place you probably haven't unclenched.

​In a classic “of course there is” fashion, there’s a name for it - part of a growing, long-overlooked conversation around pelvic health and how we hold stress in the body. Enter “stress holding” - what pelvic health experts are calling the way chronic stress shows up as unconscious, sustained muscle tension.

​For all our fluency in stress symptoms above the waist: the stiff neck, the familiar headache behind the eyes, a jaw set in permanent grit, the pelvic floor has largely been left out of the picture. And despite recent research suggesting pelvic floor dysfunction affects millions of women worldwide, with recent studies estimating symptoms affect around 40% of women, many of us still associate pelvic health entirely with pregnancy, childbirth or ageing.

The irony is that we’ve never had more information about our bodies. We know about cortisol spikes. We track our sleep. We buy supplements for our supplements. Yet mention pelvic floor and most of us are suddenly operating on GCSE Biology levels of knowledge.

Perhaps that’s why it's never occurred to me that stress might have something to do with it. Pelvic health was mentally filed away as “future me’s problem” - somewhere between pension planning and understanding how mortgages work, not something shaped by anxiety, exercise habits, or a nervous system permanently stuck on high alert.

Quick group-chat poll: when was the last time you thought about your pelvic floor? If the answer sits somewhere between “never” and “only after seeing this headline”, stick with me.

TLDR: The pelvic floor isn’t just a pregnancy concern - it reflects how we live today. Stress, constant “holding on,” and pelvic floor dysfunction are deeply connected, yet still under-recognised - particularly in younger women balancing desk work, pressure, and an always-on lifestyle.

If that resonates, consider yourself seen. Stress shows up in surprising ways, and at MC, we’re here to talk about it. Here are five signs to look out for.

Women are "stress holding" in their pelvic floors - your guide

First, What does it mean to be "stress holding" in your pelvic floor?

Have you ever been told that you’re “holding onto stress”? Well, it turns out your body may have taken that instruction rather literally.

​“Stress holding” is the term pelvic health experts are using to describe the unconscious habit of carrying tension in the pelvic floor muscles in response to physical, emotional or psychological stress. According to Anna Wooley, pelvic health specialist at Core LDN, this can lead to what’s known as “hypertonic pelvic floor - where the muscles become overly tight and remain switched on for prolonged periods of time.

​The reason it happens, she says, “comes down to the body’s stress response. When we’re stressed, the sympathetic nervous system - better known as fight-or-flight mode - kicks in, increasing muscle tension throughout the body as it prepares us to respond to a threat. While most of us notice this in our shoulders, jaw or neck, the pelvic floor is often recruited into the process, too.”

​Which might be less of an issue in modern life if it wasn’t one long exercise in being mildly stressed. As Wooley explains, “Over time, that heightened muscle tension can become the body's default setting, meaning the pelvic floor remains tight even when the original stressor has long disappeared.”

​The challenge here is that a hypertonic pelvic floor doesn't always make itself known in the way we’d expect. Instead, its effects can show up across multiple areas of health, contributing to everything from pelvic pain, bladder and bowel issues, painful sex, reduced sexual pleasure, constipation and persistent hip or lower back discomfort.

​The body, it seems, is an excellent note-taker - only its reminders tend to surface in the least obvious corners. The real mystery is why so many of us know exactly what stress feels like in our shoulders, yet have never been taught what it might be doing lower down.

Why are so many women holding tension in their pelvic floor without realising it?

At the crux of it is a curious contradiction: women are expected to know an awful lot about their bodies, yet the pelvic floor remains one of the least understood parts of women's health. In fact, RCOG polling found that 69% of UK women have never spoken to an NHS healthcare professional about their pelvic floor at all. For a muscle group involved in everything from bladder function to sexual wellbeing, that's a remarkable silence.

According to women's health expert Dr Nighat Arif, that's a big part of the problem. "Awareness stays low because pelvic floor problems are still framed as birth damage or a niche rehab issue," she explains. "Even though women can experience symptoms well outside pregnancy and the postnatal period."

As a result, many women simply aren't looking for pelvic floor dysfunction in the first place. Symptoms such as urinary urgency, constipation, pelvic discomfort or painful sex are often dismissed as stress, a sensitive bladder, getting older, or simply the unavoidable side effects of a busy life.

There's also a wider cultural issue at play. In many communities, conversations around pelvic health remain limited or non-existent. As Dr Nighat points out, "some women have never been given the language to describe their pelvic floor at all, while others have grown up believing discomfort is simply part of being a woman and something to be endured rather than treated." For something so fundamental to some very important functions, it’s still one of women’s health’s best-kept non-secrets.

Which perhaps explains why so many women are carrying tension there without ever realising it.

The Missing Link Between Pelvic Health and Pleasure

Hands up if you know more about your libido than the muscles that help make pleasure possible in the first place? Chances are, most of us probably just sat still for a second then - and that small moment of awareness says a lot. According to psychosexual therapist and author of The Science of Sex, Kate Moyle, “stress holding” in the pelvic area can affect sexual wellbeing in multiple ways.

"When there is chronic pelvic floor tension, often driven or exacerbated by stress, it can affect sex in multiple ways. Physically, penetration may become painful, uncomfortable or difficult, which interrupts pleasure and can gradually dampen desire."

Moyle notes that this is often where stress and sexual function begin to overlap. When the pelvic floor is already in a heightened state of tension, the body can start to associate sex with guarding and anticipating discomfort, rather than relaxation and pleasure.

“What this means is that symptoms can feel harder to work with in the moment, and people may find themselves being more in their heads, distracted, and less able to stay present,” she says. “That can then affect how someone feels about themselves sexually, as well as their confidence in relationships.”

Stress holding also matters when it comes to orgasm. The pelvic floor plays a key role in the rhythmic contractions involved in climax - but, Moyle explains, it isn’t just about strength. “A strong pelvic floor is important, but it’s equally important to be able to relax, release and respond flexibly,” she adds.

In the field, this is something that’s increasingly reflected in pelvic health research, including a 2024 review in The Journal of Sexual Medicine linking pelvic floor muscle function with sexual response and dysfunction, with wider evidence also connecting pelvic floor overactivity with sexual pain.

5 Signs You May Be Stress Holding In Your Pelvic Floor

If you're now very aware of your pelvic floor (my job is done), let us dive into what "stress holding" looks like in practice. Anna Wolley breaks down five of the most common signs so you're equipped with the right tools to take back control.

1. You’re going to the loo more often than your usual

If you feel like you’re constantly planning your day around bathroom access, your pelvic floor could be involved. Wooley explains that an overactive pelvic floor can irritate bladder signalling pathways, creating that persistent sense of urgency when the bladder isn’t full. If it’s persistent, affecting daily life, or involves pain, leakage or recurrent UTIs, it’s worth getting assessed.

2. Sex or tampon use feels uncomfortable or painful

This one is the most commonly missed sign of pelvic floor tension.

Wooley explains that tight pelvic floor muscles can struggle to relax, which may create resistance, discomfort, or pain with penetration.

Important: this is not something to normalise or push through, and it definitely warrants assessment by a healthcare professional.

3. You struggle with constipation

The pelvic floor has a direct role in bowel function, and it needs to relax and lengthen for things to work properly.

When it’s too tight, this process becomes harder, often leading to straining or ongoing difficulty. Wooley warns that persistent straining can increase the risk of pelvic floor dysfunction and should not be ignored. “If things don’t improve with diet and lifestyle changes, don’t ignore it - get assessed.”

4. You’re dealing with persistent pelvic, hip or lower back discomfort

Because the pelvic floor works closely with surrounding muscles and joints, tension doesn’t always stay local.

Wooley explains that it can contribute to pain in the pelvis, hips, lower back, and, in some cases, even discomfort further down the body. If pain is lasting more than a few weeks, worsening or affecting movement, it should be assessed.

5. You feel like you can’t fully switch off - even when resting

This is one of the most overlooked signs.

Wooley notes that many women with pelvic floor tension also report jaw clenching, shallow breathing, abdominal gripping or a general sense of being “switched on”.

She also points out that the pelvic floor often reflects what’s happening elsewhere in the nervous system, so if the pattern feels familiar, your body may be signalling that stress is being physically held, not just mentally experienced.

Final Thoughts

If there’s one quiet shift in all of this, it’s that the real story here isn’t that women are holding stress - it’s that we’re only just learning where to look for it.

Stress, as experts are now showing, doesn’t just disappear when the day ends. It shows up in the body in ways we’re only just beginning to name. And perhaps that’s the most useful part of “stress holding”: not that it tells us something is wrong, but that it finally helps us understand what’s been happening all along.

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​Picture the scene: it's 28°C outside, every window in your house is flung open in a futile attempt to summon a breeze, and you’re working from home in little more than your underwear, rotating between whichever surface feels remotely cool. The last thing you need is your period arriving uninvited.

Whether you’re someone who breezes through your cycle or someone who spends a week every month negotiating with a hot water bottle, having your period during a heatwave feels like an entirely different sport, requiring a different level of skill. The bloating somehow feels bigger. The fatigue hits harder. The headaches linger longer. You’re sweaty, irritable, struggling to sleep and questioning why your body suddenly feels incapable of functioning at a normal level.

If you’ve recently found yourself lying spread-eagled in front of a fan, clutching an electrolyte drink and wondering whether your period is genuinely worse this month or whether you’re simply being humbled by the weather, welcome to what appears to be a very crowded corner of womanhood.

Undoubtedly, there comes a point in this crossover where the questions start rolling in. Why do I feel so much more exhausted? Why am I suddenly so bloated? Why does PMS feel like it’s been dialled up several notches? And perhaps most importantly: is any of this actually in my head?

As it turns out - no. We know hormones can influence everything from our mood and energy levels to our sleep and appetite, but fewer of us stop to consider what happens when those shifts collide with extreme heat. Below, experts explain whether fluctuations in oestrogen and progesterone affect how we tolerate hot weather, plus why some phases of the menstrual cycle feel harder in a heatwave.

This isn’t just another guide on surviving summer while bleeding, bloated and battling PMS - it's an investigation into why our bodies seem to respond differently when temperatures soar, plus what experts say we can do about it.

Period feel worse during a heatwave? Here's why

First Things First: Why Does My Period Feel Worse During a Heatwave?

If it feels like your period symptoms have dialled up several notches the moment the temperature rises, that’s because they probably have. It’s not just one thing at play. It’s a multi-layered situation. Or, less politely: everything that can be involved is involved, all at once.

To make sense of that overlap, we spoke to Dr Nirusha Kumaran, a GP and Functional and Longevity Medicine Physician. “Hot weather places an additional physiological demand on the body at a time when many women are already navigating hormonal fluctuations, changes in fluid balance, and increased energy requirements," she explains. "When you add heat to the equation, the body must work harder to regulate temperature, maintain hydration, and support circulation. This can leave women feeling more fatigued, light-headed, bloated, or emotionally sensitive.

Which may explain the surge in struggle: your cycle and extreme heat are both drawing on the same internal systems at the same time, and neither is especially willing to cooperate.

And there’s evidence this overlap is doing more than simply making you feel a bit off. A 2026 study of nearly 20,000 people found chronic exposure to extreme heat was associated with lower levels of oestradiol, progesterone and testosterone. Given these hormones help regulate mood, energy, pain and fluid balance, it’s easy to see why period symptoms can suddenly feel dialled up.

Now for our second layer - inflammation. As Dr Charis Chambers, OB-GYN and gynaecologist at Clue, explains, “Menstruation is already an inflammatory process, and heat exposure independently activates similar pathways. Put together, the body isn’t simply responding twice - it’s responding louder.” Cue increased sensitivity. More fatigue. And a slightly reduced tolerance for absolutely everything.

And yes - bloating doesn’t escape the equation either. It’s one of several ways the body tends to feel a little more “off” when heat and hormones collide, which is why everything feels a little more… expanded than expected.

The Hormone-Heat Connection: Why Certain Phases of Your Cycle Feel Harder Than Others

The plot thickens when you factor in where you are in your cycle.

As Chambers explains, not all phases respond to heat in the same way, largely due to the opposing roles of oestrogen and progesterone in regulating your body’s temperature; one helping the body release heat, the other working against it.

“Oestrogen helps the body release heat more easily and lowers core body temperature, whereas progesterone increases body temperature and slows down the body’s cooling response.”

This becomes most noticeable in the luteal phase - the two weeks before your period (a collective shudder at the thought), when progesterone is at its highest. “It’s the point in the cycle where the body is already operating at a slightly elevated baseline temperature, with a less responsive cooling system.”

Ladies, you guessed it... in a heatwave, that matters. Your body is effectively layering heat on heat, working with an internal cooling system that’s not exactly firing on all cylinders.

No prizes for guessing what follows: fatigue, headaches, dizziness, and that familiar overheated, slightly irritable feeling that creeps in faster than usual.

From here, the picture widens. Even bloating has more going on beneath the surface. “It isn’t simply water retention misbehaving, but a mix of fluid redistribution and vascular changes influenced by shifting oestrogen and progesterone,” says Chambers.

Put simply, heat doesn’t just dehydrate - it changes how fluid is moved and managed in the body. “During menstruation, when inflammatory activity is already higher, these effects don’t just stack - they amplify.”

But of course, it's not just your body that gets dragged into the equation. No one needs convincing that this isn’t just a physical experience - it can also affect mood. Recent research suggests that heat stress can disrupt sleep and interact with stress and inflammatory pathways involved in mood regulation. Add poor sleep into the mix, and everything gets amplified.

Which brings us to a slightly inconvenient reality: some phases of your cycle are just less heat-compatible than others.

Why PMDD, Endometriosis and Migraines Can Feel Worse in Hot Weather

Managing PMDD, endometriosis or migraines during a heatwave can feel a bit like playing a game on hard mode. Not because the condition itself is changing, but because many of the systems that help keep symptoms in check suddenly have more to contend with.

As Dr Martin Hirsch, gynaecologist, explains: “While heatwaves do not appear to alter the underlying biology of conditions such as endometriosis or PMDD, they can amplify many of the factors that make these conditions challenging.” Less a flare-up out of nowhere (always my default thought), and more background systems becoming harder to keep in balance at once.

“Sleep, pain and migraine pathways are central to this. Hot nights disrupt sleep, and poor sleep is closely linked to increased pain sensitivity, lower mood and more frequent migraine attacks - enough on its own to tip things from manageable to not.”

For endometriosis specifically, there’s also the nervous system to consider. “A 2021 review suggests many people with chronic pelvic pain develop central sensitisation, where the nervous system becomes more responsive to pain signals. While heat doesn’t directly worsen the condition itself, factors commonly associated with heatwaves - disrupted sleep, physical stress and exhaustion - can make pain feel more intense and harder to regulate.”

And it doesn’t stop there. As Chambers explains, “heat stress activates many of the same inflammatory, hormonal and neurological pathways already involved in these conditions. In PMDD, it can further disrupt systems linked to mood regulation. In endometriosis, it adds to an already inflammatory environment. And for migraines, dehydration, physiological stress, and changes in blood flow can all lower the threshold for an attack.

The reassuring news is that small, practical changes can make a noticeable difference. Cue the practical bit.

How To Survive Your Period During a Heatwave: 5 Expert-Backed Strategies That Actually Help

Below, Dr Charis Chambers shares their top tips for getting through your period during a heatwave.

1. Cool the body, not just the room

Our first instinct in a heatwave is to head for the coolest room - and, if you’re lucky enough, the air conditioning. Don’t shoot the messenger, but that’s not always the most effective fix for your body itself. Chambers explains that active cooling tends to work better. Think cool showers, cold flannels on the neck or chest, or anything that brings your core temperature down directly, not just the air around you.

TDLR: fans alone can actually lose effectiveness in extreme heat and may even contribute to dehydration if humidity is high.

2. Protect your sleep like it’s part of your treatment plan

We only need a few bad nights’ sleep in the heat to understand how much of a driver it is in making PMS, PMDD, migraine and pain worse. As Dr Chambers suggests, one of the most effective starting points is simple: cooling the bedroom, cooling the body before bed (think showers or cold compresses), and keeping the room as dark as possible.

If it takes several cold showers to get you there, then consider it part of the process.

3. Move earlier, move smarter

A personal favourite of mine, as someone who becomes increasingly frustrated when her routine Pilates classes are met with a period-heatwave combo. This isn’t a “stop exercising” situation - it’s a “work with your body, not against it” situation. Shift movement to the cooler parts of the day (early mornings or evenings) and dial down the intensity when symptoms are heavier.

Think yoga, Pilates or lighter strength work - enough to feel the benefits, without layering on extra heat and stress.

4. Hydration, but make it strategic

Heat loves to drain you in the background - and that fluid loss on your period can show up as fatigue, dizziness and migraines. So, it’s not just about drinking water when you suddenly realise you feel awful - it’s about keeping hydration steady all day, with electrolytes in the mix if you’re feeling depleted, bloated or headachy.

5. Think about what’s quietly increasing heat load

As much as I love to blame the heat on my increased period symptoms, Dr Chambers points out that not everything comes down to hormones and heat - some medications can also play a role, including SSRIs, anticholinergic drugs and hormonal treatments, which may interfere with temperature regulation. If symptoms feel particularly bad in hot weather, she suggests it’s worth a quick check-in with a clinician.

MC’s Essentials for Surviving a Heatwave on Your Period

Premenstrual dysphoric disorder, a debilitating condition which affects approximately 824,000 UK women and people assigned female at birth, was only formally recognised in the World Health Organisation’s International Classification of Diseases in 2019.

I’ll say that one more time. A condition which affects 824,000 people in the UK, and which is associated with depression, anxiety, social isolation, paranoia and a seven times higher risk of suicide, has only been officially recognised for seven years.

It’s a concerning reality, one with major repercussions for women’s health today. Here in the UK, it takes an average of 12 years for someone to be correctly diagnosed with PMDD, with the International Association for Premenstrual Disorders estimating that up to 90% will receive a misdiagnosis during that time.

“I was repeatedly treated for depression without anyone connecting symptoms to my menstrual cycle,” says 31-year-old Robyn, who waited 16 years for a correct PMDD diagnosis. When, after seeking help from a private gynaecologist, she was finally diagnosed, she says the feeling was a mixture of relief and frustration. “I spent years believing there was something fundamentally wrong with me,” she explains. “It’s difficult not to feel let down by the system.”

So why are women like Robyn being left for so long without answers? What’s behind the confusion and misunderstanding surrounding PMDD? And crucially, what needs to change? In search of answers, we spoke to leading neuroscientists, psychotherapists and doctors specialising in PMDD, along with women who live with the condition, to understand why so many are currently being failed.

If what you read here resonates, I recommend checking out our investigation into the connection between medical trauma and endometriosis. We’ve also got expert-led guides to PMOS, how to recognise the symptoms of endometriosis and Dr Hazel Wallace’s advice for advocating for yourself in medical settings.

Over 800,000 Women in the UK Have PMDD—Your Guide

What is PMDD?

A cyclical disorder in which the brain reacts abnormally to changes and fluctuations in hormone levels, PMDD has historically been described as severe premenstrual syndrome (aka PMS).

But while the two do have some crossover, psychotherapist and founder of the PMDD Collective, Ally McHugh, says this description misrepresents and undermines the severity of the condition. “To some degree, PMS is normal,” she explains. “The symptoms of PMDD, on the other hand, are not. In referring to them as ‘bad PMS’, people are left feeling they should be able to manage their symptoms. When they’re unable to do that, they understandably feel a lot of guilt and shame.”

These symptoms, which range from depression, rage, anxiety, social anxiety, paranoia and insomnia, to joint pain, fatigue, inflammation, acne flare-ups and migraines, can last for up to two weeks out of the month, after ovulation and before a period. In fact, “many people feel a complete disconnection from themselves,” says McHugh, whilst Dr Louise Newson, GP and author of The Power of Hormones, describes it as feeling like “Jekyll and Hyde.”

It’s a reference 38-year-old Caroline and 33-year-old Abi* can relate to. “There were two days a month where I genuinely wanted to divorce my husband,” says Caroline. “I would yell at him, slam doors and yell at my kids. It felt completely out of control. And then, when it passed, the guilt was overwhelming.”

Abi* echoes her. “It feels like there’s another person living inside me.”

It’s not entirely known why some people’s brains react differently to the hormonal fluctuations that occur throughout the menstrual cycle, but research does indicate which brain regions may be involved. “The leading evidence centres on the brain’s GABA region,” says Alice van der Schoot, neuroscientist, nutritionist and founder of Ditto. “In the luteal phase when progesterone rises and falls, our GABA receptors should adapt to maintain a calming effect. In PMDD brains, that adaptation appears to fail, resulting in mood instability that can feel completely uncontrollable.”

She adds that there are also visible differences in the structure of PMDD brains. "Brain imaging studies have revealed smaller grey matter volumes in several brain regions, including the major processing centre for emotions. These brain structure differences are so distinct that AI could distinguish PMDD brains from controls."

What that means, she makes clear, is that PMDD is "not someone being dramatic. There are measurable, biological differences."

Why is PMDD so often misdiagnosed?

For such a life-altering condition, you would think that prompt and accurate diagnosis would be standard. But as the statistics at the beginning of this story showed, this is far from the case for many women, who go beyond a decade living with debilitating mental and physical symptoms. The question is, why is PMDD proving so difficult to spot?

“There are two major layers to this crisis,” says van der Schoot. “First, there’s a massive lack of awareness. And second, there’s the ongoing dismissal of women whose concerns are not being taken seriously.”

She’s right. Data indicates that less than 10% of medical professionals are confident in diagnosing PMDD; a fact that, in the US, has resulted in women seeing up to ten different experts and being prescribed five different medications, before gaining the correct diagnosis.

The issue, it appears, begins with the education in our healthcare system. “Many doctors just aren’t trained in PMDD,” explains Dr Newson, who says that she herself wasn’t trained in the condition at the beginning of her career.

The upshot is that many PMDD symptoms are mistaken for other disorders. “Often people will report the psychological symptoms of PMDD and be referred to psychiatry or given antidepressants when actually what they might need is a referral to a gynaecologist,” says McHugh, who says that common misdiagnoses include bipolar type 2, emotionally unstable personality disorder and depression.

It’s here that, according to McHugh, medical dismissal and gaslighting can really go into overdrive. “Once you’re labelled with one of these conditions, it can be difficult to get to the point of correct diagnosis because of the stigma around mental health,” she explains. “Often people find that these labels make it harder to be listened to.”

On the other end of the spectrum are women, like 33-year-old Abi*, who have their symptoms diminished and reduced without any form of diagnosis. “I’ve been told it was just anxiety, or just bad periods,” she says. “They made it out to be my problem, and that I just needed to look after myself better.”

How does misdiagnosis impact women with PMDD?

Whether you’re incorrectly diagnosed or simply brushed off, the consequences of PMDD going untreated can be fatal, with over a quarter of people living with the condition having attempted suicide and 82% reporting suicidal thoughts.

“I remember sitting on the bathroom floor, thinking about death in a strangely comforting way,” remembers Caroline. “I never thought about the practicalities of suicide, but death was on my mind a lot.”

It’s a reality Dr Newson confronts in her clinic regularly. “Finding the appropriate treatment for someone with PMDD is not just life-changing, it can be life-saving,” she says, speaking from both personal and professional experience, having supported her own daughter, Jess, through her diagnostic journey.

But even beyond this worst-case scenario, PMDD can be destructive to careers, relationships and self-esteem when not properly managed and supported.

“Every month, I find myself looking at the people I love most in the world and thinking ‘I want to run away and start a completely different life,’” says Robyn, whilst Caroline remembers having to talk to her manager because symptoms were so debilitating. “It was incredibly hard to show up and pretend everything was fine,” she says. “Sometimes I would just start crying in the middle of a meeting for no reason.”

Caroline was fortunate to have a manager who responded empathetically, but this is far from the norm. In fact, unemployment amongst women with PMDD is 29% higher than average, with sick leave also up by 38%. “Even when symptoms lift, the pressure to catch up and overperform before the next luteal phase can lead to burnout, strained relationships, career stagnation and, for some, leaving jobs altogether,” confirms van der Schoot.

Of course, this highlights the socioeconomic burden of PMDD, but the stress of being unsupported, disbelieved or dismissed also takes a toll. “Being told that it’s normal to feel low before your period, or that you’re just more sensitive, leads many to feel they are overreacting, or to question their own experiences,” says van der Schoot. “This is devastating and can lead people to internalise their symptoms as a personal failure.”

How can diagnosis and treatment for women with PMDD improve?

Clearly, something needs to change here, and the onus, say the experts, is on the healthcare system, rather than us as individuals.

But unusually for a women’s health condition, van der Schoot says the answer isn’t necessarily more research. “Lots of helpful studies already exist,” she says. “The diagnostic framework exists. What's missing is awareness, education, a willingness to listen, and an end to the pattern of dismissal.”

McHugh agrees, adding that there needs to be more conversation about menstrual health generally within medical appointments. “Enquiring about menstrual health should be a standardised part of any GP appointment or mental health assessment,” she suggests.

Stretching beyond diagnosis, van der Schoot says that treatment pathways also need to improve. “Hormonal contraceptives are currently a first-line option, yet these show highly inconsistent results. The other standard option, which is SSRIs (antidepressants), can help a proportion of people but fail to work for 39%.”

What’s needed, she says, is a more individualised approach to treatment. “PMDD is complex, and the solution is rarely just one thing. It’s a journey of finding out what works for an individual, which often combines medical and holistic approaches. That needs to be better recognised and supported.”

5 tips for women navigating diagnosis and treatment for PMDD:

Whilst changes to the healthcare system are essential, for women living with PMDD right now, they can feel like a frustrating and abstract future. That’s why we asked the experts for tips to help women advocate for themselves in the here and now.

1. Validate your own experience

First, van der Schoot says, it’s important to know that “a black cloud descending over you every month is not normal, and not something you should have to push through alone.” Simply validating that can be a powerful first step in remaining steadfast in your reality.

Beyond that, however, all three experts say that doing as much research as you can will help you to feel informed and prepared to have conversations with doctors, managers, family and friends.

“I find that if something makes sense to a patient, it’s probably right,” says Dr Newson, “which is why it’s important that you get as much information as possible.” Her own free app, Balance, contains a library of information, plus a symptom questionnaire and tracker that can be useful for women navigating PMDD.

Elsewhere, the IAPMD has facts, figures, support and self-screening tools, whilst both van der Schoot and McHugh post regular PMDD information on Instagram via their pages, @ditto.daily and @the.pmdd.collective.

2. Track your symptom patterns

Once you have the information you need, the experts say that tracking your symptoms is a crucial next step. “The pattern of your symptoms is your evidence,” says van der Schoot, who tells us to track mood changes, depressions, shifts in thinking or feelings of being unlike yourself.

“Track physical symptoms too,” says Dr Newson, who says that skin changes, heart palpitations and joint pain can all be contributing evidence of PMDD.

3. Be specific about their impact

Before you go to your doctor, van der Schoot says it’s helpful to be clear on the ways that PMDD is affecting your life. “This is the impact it’s having on your work, your relationships; anything that impinges on your daily life,” she says. “The more concrete you are, the harder you are to dismiss.”

4. Find a community

This one is essential, as social support is one of the biggest protective factors for mental health. “It can be overwhelming to fight a battle like this yourself,” recognises Dr Newson. “This is why it’s important to share the information with someone you trust, who can advocate on your behalf.”

This could be a friend, family member or partner, but it could also be through a support group or community, says McHugh. “Whether it’s PMDD-specific therapy, peer support groups or community, this network is crucial whilst navigating the medical system,” she says.

Examples of community support groups include McHugh’s own PMDD Collective and The PMDD Project, a charity with various online and in-person support groups across the UK.

5. Don't give up

Easier said than done, we know. Being dismissed by a doctor is undeniably upsetting and off-putting, and something you should never have to experience.

Unfortunately though, it remains common. Which makes it very important that you don’t give up. “Until the system stops failing women with PMDD, many have to fight to be heard,” says van der Schoot. “If your doctor dismisses you, find another one. You are not overreacting, you are not making it up, and you are not alone.”

Unless you've been absent from social media, you'll know that our feeds are lit up right now with hot takes on Steven Bartlett's latest claims. No stranger to causing controversy, the entrepreneur turned self-proclaimed wellness guru has ignited fury (once again) by asserting on his Diary of A CEO podcast that a night out drinking (two glasses of wine, to be precise) 'ruined' his life for three days.

Everyone from celebrities to wellness influencers has been weighing in. Somewhat surprisingly, given the intense current trend to optimise our health at every turn, there's been a backlash, with the majority agreeing that this is a case of biohacking gone too far.

Missed it? Here's the gist. "I had a couple of glasses of wine, [and while] I didn’t get drunk, it ruined three days of my life because of the domino effect it caused," he says on his podcast. "I got worse sleep that night and ate more poorly the next day... because my dopamine system or cortisol system or whatever was all messed up. Then I podcasted worse, and I didn’t go to the gym the day after, and I could track all of this on my Whoop [wearable tech], hashtag ad, hashtag sponsor, investor... whatever."

Our relationship with alcohol is a complex one; on the one hand, the facts are clear: alcohol does us very little good, health-wise. Research (such as this recent 2026 study, published in the journal Nature Health) shows a consistent link between alcohol consumption and negative health outcomes, with an increased risk of cardiovascular disease, liver disease, stroke and cancers, to name a few.

This being said, there will always be a strong argument for moderate and balanced drinking as part of a healthy social life, as referenced by studies (like this one, from the journal Nutrients) showing a correlation between small amounts of red wine and a decrease in stress markers and cardiovascular risks.

But the crux of the Bartlett furore is (much) less about the dos and don'ts of alcoholic consumption, and entirely about our fixation with optimisation culture. Should it really be the case that a couple of social drinks on a night out with friends is the cause of an avalanche of self-flagelation and regret? Certainly, it must sting to be the mates with whom your (albeit temporary) downfall is associated, right?

So, should we be concerned about this potentially damaging trend of black-and-white thinking around health habits? Keep scrolling for the experts' take on (over) health optimisation. And don't miss out our guides to the top wellness trends of 2026, the best Scandi fitness hacks, our favourite Blue Zone living Mediterranean health tips and healthy ageing habits, while you're here.

Steven Bartlett's claims have raised an important debate health optimisation - the experts take

What is health optimisation?

Over the past few decades, our understanding of health and wellness has undergone a radical transformation. Largely due to advances in tech, we now have the ability to track, monitor and assess almost every aspect of our lifestyles, in a bid to be the healthiest version of ourselves we can possibly be.

This, in a nutshell, is health optimisation. "Optimisation culture is the belief that almost every aspect of our lives can be measured, improved and maximised," explains Dr Ritz Birah, consultant counselling psychologist, expert speaker and founder of Reflect with Dr Ritz. "We track our sleep, monitor our recovery, count our steps, measure our productivity and increasingly look for ways to gain an edge."

You're likely either wearing a tracking device (Oura rings, Whoop bands, Apple watches) or you know someone who is. Our algorithms are locked in: you can't scroll for a moment without a barrage of ultra-luxe, aesthetically appealing tech wearable-related content.

Scratch the surface of the trend, and it's easy to see why it's taken off: as humans, our default is to want to improve, evolve and grow - something optimisation culture taps firmly into. After all, who doesn't want to be better?

"The idea here is that we are all on a journey of continual ‘optimisation’, improving different aspects of our lives to make us ‘better’ in some way," agrees counsellor Georgina Sturmer. "More productive, more effective, more successful, fitter, healthier, wealthier, wiser. Better colleagues, parents, partners, children, friends. It’s almost as if workplace productivity and wellness had some kind of hybrid lovechild."

Are there any benefits to health optimisation?

Now, we're not saying for a moment that investing time, money and energy into improving our health and wellbeing is wrong. Knowledge is power, and nowhere is this more relevant than when it comes to our health.

"The benefits of health optimisation are real," advises Dr Birah. "Optimisation can encourage healthier habits, greater intentionality and improved awareness of behaviours that influence our wellbeing."

It's also something that makes us feel connected and fosters a sense of community - albeit largely online, as chartered psychologist Dr Rachel Evans explains.

"A big benefit is feeling like you’re part of a community, which people might feel like they’re lacking in this digital age," she tells MC UK. "Additionally, society tends to reward or praise determination and dedication – being part of self-optimisation culture is a way to show you have those traits."

We can't deny the feeling of near-euphoric excitement when we close those activity rings/upgrade our resilience rating/achieve a sleep crown. Not only are these great for physical health, but they can help to enhance mental health, too.

"You can derive a huge sense of satisfaction and pride in achieving your goals, which can encourage people to set even more specific or tougher challenges, making it intrinsically motivating," shares Dr Evans.

Why is health optimisation so prevalent right now?

Wondering why this kind of perfectionist thinking is so widespread right now? The reasons are manifold, but modern life has created the perfect petri dish for optimisation culture to thrive.

"Arguably the biggest reason is tech," shares coaching psychologist and health expert James Davis. "We have easy access to affordable devices that will measure and track for us, so self-tracking is easier than ever. We don’t need to go to a health professional; we can track it all ourselves."

He continues: "Going hand in hand with that is the rise of social media. This has normalised comparison and made us competitive over our scores - we’re exposed daily to messages suggesting we could be healthier, wealthier, more productive, more resilient, and more successful."

Finally, from a psychological perspective, he also points out that we’re in an age of uncertainty. "Tracking our personal metrics gives us a sense of perceived control, which can be comforting."

Not forgetting the mercenary element to our fixation on wellness - it's human nature to want to grow and evolve. Social media has well and truly capitalised on this instinct. When we're made to feel that we are less than, research shows that we spend money. New clothes, new gadgets, new ways to track and motivate ourselves - you name it, we can be convinced that we need it. It's no surprise, then, that tech companies are rubbing their hands with glee over our collective obsession with optimising every aspect of our lives.

What are the drawbacks of health optimisation?

Let's be clear: anything that actively encourages us to be healthier and happier is undoubtedly a good thing, but herein lies the rub: there's a tipping point where optimisation turns from a healthy challenge and aspiration into yet another stick to beat ourselves with.

Bartlett's admission about how his alcohol intake affected his week is telling, as it's clear that he is berating himself for supposed weak or poor choices. But the fact is, we're human - and the pursuit of perfection is not only impossible, but it's also not a particularly healthy goal, either.

"Excessive optimisation can fuel perfectionism, anxiety, burnout, and self-criticism," cautions Davis. "There's the risk that people can become so focused on measuring life that they forget to actually experience it. Think: are you running because you enjoy it or because you feel like you should? Is your run ruined if your device didn’t track it?"

In effect, optimisation culture has created an environment where we feel we'll never truly measure up, and that only ends one way: in failure.

"The challenge with striving for ‘optimisation’ - or perfection, by another name - is that it’s never truly attainable," agrees Sturmer. "This can leave us feeling frustrated or dissatisfied, or worse, it might leave us feeling ashamed or self-critical. Optimisation feels like a socially acceptable form of perfectionism. And the difficulty with perfectionism is that it can leave us feeling less happy, less fulfilled, more overwhelmed - and ironically less perfect - than when we started."

Even the most stoic among us can lose sight of the real value and joy of just being when we relentlessly measure, share and compare our metrics, Dr Birah cautions. "Human beings are not machines," she warns. "We are complex, emotional and relational creatures. Yet much of optimisation culture encourages us to think of ourselves as systems to upgrade rather than people to understand."

Put simply: we all have off days, weeks or even months, and the danger with all-or-nothing rhetoric like Bartlett's is that we struggle to allow ourselves the grace to accept this and move on.

"Life should be about joy and feeling good enough, being self-compassionate, not self-critical," shares clinical psychologist and host of podcast Psychology, Actually, Dr Marianne Trent. "It's also about balance. Self-acceptance and the ability to tolerate not being perfect can be so very important to our overall sense of wellbeing."

What's driving the move away from strict health optimisation?

It's clear from the response to Bartlett's post that there's a backlash against highly prescriptive, rigorous health optimisation routines and protocols, despite our fascination with ideas such as biohacking, longevity and healthier ageing.

"My hope is that people are beginning to recognise that optimisation and wellbeing are not the same thing," shares Dr Birah. "The most psychologically minded people I meet are not those who optimise every moment. They are the people who have developed a strong relationship with themselves; the goal is not to become perfectly disciplined but rather to develop the ability to watch yourself."

It probably won't surprise you to hear that, as always, the benefits with any kind of health 'maxxing' trend lie somewhere in the middle. When it comes to drinking (or indeed many other lifestyle factors), there will always be people who can handle a few drinks and operate pretty well the next day, while others (hi, it's us) tend to struggle with fatigue, low energy and a dip in mood.

"It's worth considering that alcohol, nicotine and unprescribed drugs are all coping strategies," notes Dr Trent. "If over time you can learn more adaptive and functional ones, then in the long term your body and your mind are likely to thank you for it."

Only you know how you personally respond - and the experts are clear that the key to healthy and balanced health optimisation is to understand yourself and how your body works.

"Knowing yourself in this way requires a different skill altogether, one I like to call 'brainflossing'," shares Dr Birah. "Consider whether you have the ability to observe your thoughts rather than being automatically driven by them. For example, can you notice when your body genuinely needs eight hours of sleep and honour that, and are you also able to recognise when staying up late talking with a friend, celebrating a milestone or sharing a bottle of wine with your partner is a worthwhile trade-off?"

So, rather than perfection, what we should be striving to achieve is resilience, according to the experts.

"In many ways, resilience looks less like optimisation and more like a rubber band," Dr Birah states. "There are times when we need structure, discipline and routine. There are also times when we stretch, adapt and embrace spontaneity. The strength comes from our ability to move between the two."

TLDR? Opt for meaning over metrics. "Instead of asking, 'How can I get the maximum performance from my life?' perhaps we should be asking, 'What kind of life am I trying to create?'," Dr Birah muses. "Those are very different questions, where one tends to lead us towards metrics and the other tends to lead us towards meaning."

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How many times have you turned to a friend and asked, “Why weren’t we taught this at school?” when talking about your health? My guess is: too many to count.

And that’s because, until recently, women’s health had fallen by the wayside in both research and education. In fact, in 2020, only 5% of global research was allocated to women-specific health conditions, with 4% of that focused on cancer alone. Across all clinical trials, only 5% analysed their data separately for men and women, meaning women are often diagnosed and treated based on male biology.

Understandably, that’s resulted in a significant knowledge gap amongst researchers, educators and, ultimately, women ourselves. Depressingly, a survey by Plan UK found that a quarter of 12- to 21-year-olds had spent less than an hour learning about periods at school, whilst a report published this year by femtech company Hertility found that one in four of us don’t know the length of our menstrual cycle.

Even as a health writer, I’ve been in that position. Thanks to years of hormonal imbalances and missing periods, I’d become pretty disconnected from my own body. But as I inch closer to 30 and conversations about PMOS, egg freezing and peri-menopause become more frequent amongst my friends and family, I’ve started to feel uneasy about just how much I still don’t know about my own internal world.

I debated buying a wearable or downloading an app, as many of my friends have. But after a friend introduced me to fertility awareness educator Bethan Walters, who explained that I could gain a better understanding of my cycle manually, using my own biomarkers, I was intrigued. Because, as Hertility’s report shows, although more than 50% of us use apps to track our cycle, many of us don’t have the knowledge to make meaningful use of the data.

So, with Walters’ help, I’ve spent the last month taking a course in my own biology, tracking just two key biomarkers that have given me unprecedented insight into my cycle. For everything I’ve learnt, read on.

And for more support navigating female health conditions, make sure to read our investigations into medical trauma and endometriosis, the shift from PCOS to PMOS and Dr Hazel Wallace’s research findings on the state of women’s menstrual health in the UK. We’ve also got a longevity doctor’s tips for healthy ageing plus expert advice on strength training through menopause from a certified coach.

I Didn’t Realise How Little I Knew About My Cycle –Then I Started Tracking These Two Biomarkers

What is a biomarker?

First things first: what do we mean when we talk about biomarkers? Essentially, it’s any measurable sign or process in the body that helps us understand what’s going on with our health.

The menstrual cycle itself is a key biomarker - often referred to as the fifth vital sign of health, alongside blood pressure, body temperature, heart rate and respiratory rate. “The menstrual cycle is often minimised to a product of our reproductive organs,” says Dr Faye Bate, co-host of the Her Discussions podcast, “but it’s actually a hormonal symphony that falls out of tune when our thyroid, blood sugar, stress levels or nutrition are off.”

She explains that changes to our menstrual cycle can be some of the earliest indicators of underlying health conditions, which is why understanding our own patterns matters for far more than fertility alone. “If our body is not functioning optimally, it shifts its priorities away from baby-making,” says Dr Bate. “By tracking signs of ovulation, you can assess whether your body is playing in tune or whether there’s a disruption that deserves a conversation with your doctor.”

Which biomarkers can be used to track the menstrual cycle?

When it comes to tracking our menstrual cycle, it’s important to realise that what we’re actually trying to follow is ovulation, not menstruation. And that’s because sometimes we can still get a period even when we’re not ovulating. “Someone might still bleed occasionally, giving the impression that everything is fine,” explains Walters. “This is why simply tracking periods isn’t enough.”

When it comes to tracking our menstrual cycle, it’s important to understand that what we’re really trying to identify is ovulation, not menstruation. That’s because ovulation is one of the clearest signs that our hormones are functioning as they should - making it an important marker of overall health, not just fertility. It’s also possible to still experience bleeding without actually ovulating. “Someone might still bleed occasionally, giving the impression that everything is fine,” explains Walters. “This is why simply tracking periods isn’t enough.”

To track ovulation, we can use two key biomarkers: basal body temperature and cervical fluid - each of which reflects changes in a different reproductive hormone. Basal body temperature is driven by progesterone, while cervical fluid is influenced by oestrogen.

“Basal body temperature is the body’s lowest resting temperature, usually recorded first thing in the morning,” says Dr Bate. “It’s typically lower in the follicular phase and rises by around 0.2-0.5°C after ovulation.” This shift, she explains, is driven by progesterone and can be used to indicate that ovulation has occurred.

Cervical fluid, on the other hand, changes in response to oestrogen levels, which is why its texture and appearance shift throughout the menstrual cycle. “Cervical fluid is a mucus-based secretion from the cervix which changes in composition and texture across the cycle to protect the reproductive tract and regulate when sperm can pass towards the egg,” explains Dr Bate.

In a typical cycle, Dr Bate says we tend to see fewer, drier secretions just after menstruation, with fluid becoming wetter, clearer and more slippery as ovulation approaches. “These changes signal the start of your fertile window,” she explains. After ovulation, discharge usually becomes thicker and creamier, which “works to prevent sperm reaching the egg”.

Tracking cervical fluid can also help us spot potential signs of infection, adds Dr Bate. “If your discharge patterns change significantly from what’s normal for you, there’s a strong smell, or it appears yellow or green in colour, speak to your GP.”

What are the benefits of biomarker tracking?

You might be wondering why you’d bother taking your temperature every day or studying the fluid in your knickers when an app or wearable could seemingly do the work for you - especially if you’re not actively trying to get pregnant.

But as we now know, ovulation isn’t just about fertility. “Each time you ovulate, your body produces progesterone, which plays a crucial role in mood, sleep, anxiety regulation, metabolism, bone density and the regulation of the endometrium - aka the inner lining of our uterus,” says Walters. “Ovulation also reflects a healthy rise and fall in oestrogen, which supports cardiovascular health, brain function, skin health and bone density.”

When we aren’t ovulating, it can be a sign that the body is under too much stress. “Stress can come from lifestyle factors, nutritional deficiencies, or underlying hormonal issues,” says Walters. “Whatever the case, tracking ovulation gives you insight into whether your brain, ovaries and hormones are communicating effectively. It’s essentially a monthly check-in on your endocrine health.”

Where manual tracking differs from wearable data is in the immediacy of the information it provides. While many wearables can track temperature changes, they often estimate fertile windows using algorithms and past cycle data, whereas manual methods teach you how to interpret your body’s signals as they happen. “Manual tracking using basal body temperature and cervical fluid is based on observing your body in real time,” explains Walters. “Wearables, on the other hand, tend to rely heavily on temperature trends and algorithms. Some are helpful, but many are still predicting ovulation based on past data rather than identifying what’s happening in the moment.”

By equipping ourselves with this real-time data, says Dr Bate, we’re also better positioned to advocate for our health and seek support sooner when something feels off. “The beauty of the menstrual cycle, unlike most health data, is that we don't need a doctor to access this information. And when we do see a doctor, having that data can potentially help them reach a diagnosis faster, before invasive testing.”

Who is biomarker tracking best for?

Tracking your cycle through biomarkers can be useful for anyone with a uterus, even if you don’t regularly menstruate. “It’s for anyone wanting to gain a deeper understanding of their body’s signals,” says Walters, who encourages those still learning to work with a trained practitioner who can help them interpret what these biomarkers are indicating.

In particular, however, biomarker tracking can be especially useful for those experiencing hormonal imbalances, irregular cycles or conditions such as PMOS, as well as those coming off contraception. “Tracking BBT and cervical mucus offers a way to see whether and when ovulation actually occurs, helps with timing treatments in cases of infertility, and gives clinicians rich, longitudinal data for diagnosis and monitoring,” says Dr Bate.

Of course, for those actively trying to conceive (or, equally, not to conceive), tracking ovulation can also be invaluable. “The ability to recognise the few days leading up to ovulation by tracking cervical mucus can aid in identifying the fertile window (when a woman can get pregnant),” says Dr Bate. “This allows us to optimise the timing of sex for the best chances of conception,” - or, alternatively, to know when to avoid sex or use additional protection to avoid pregnancy.

There’s also a case for biomarker tracking among women who exercise heavily (of which there are an increasing number). “Exercise, nutrition and stress can all affect ovulation and cycle regularity,” says Dr Bate. “Tracking basal body temperature and cervical mucus offers a low-cost way to spot warning signs that you may not be eating enough, are overtraining, or that your body is under too much stress.”

Given how important exercise is for women’s hormonal and overall health, having the tools to spot when we’re pushing too hard is essential. “It could be the difference between exercise being one of the most protective things you do for your long-term health and one of the most damaging,” says Dr Bate, who reminds us that “not ovulating isn’t a perk of being fit - it’s a red flag.”

I Tracked Two Simple Biomarkers for a Month – and It Completely Changed How I Understand My Cycle

Weeks one and two:

Throughout my first month of biomarker tracking, I had weekly lessons with Walters, where she took me through the ways my BBT and cervical fluid could change across the month. She gave me the language to describe the fluctuations I was seeing in fluid texture and colour, and guidance on the degree of temperature change I could expect.

I quickly learned it was important to take my temperature within the same 30-minute window each morning, before eating or drinking. That’s because the fine margins we’re looking at (BBT only changes by around 0.2–0.5°C across the month) are very sensitive to outside influence, with factors like poor sleep or alcohol potentially skewing the results. Walters reassured me this didn’t mean I needed to stop drinking entirely, or feel like I’d failed if I’d slept badly, but that I should note it in case the data looked unusual that day.

I fell into the routine of temperature tracking fairly easily. I kept the thermometer by my bed and took my temperature as soon as I woke, which meant I very rarely missed a day.

Checking my cervical fluid, however, was more challenging. Since I was already aware that some days it appeared whiter and milkier than others, and that volume could vary significantly, I naively assumed I was quite clued up on how it can look throughout the cycle. But as I soon discovered, it’s not only the days when it’s obviously present in your underwear that it requires tracking.

As Walters explained, everyone’s baseline of cervical fluid is different. For some, the baseline is no noticeable fluid, with it only appearing as ovulation approaches. For others, like me, there is always some fluid present, but it increases and changes consistency throughout the cycle. I didn’t just regularly forget to check (you’re meant to do it several times a day), but I also often lacked the language to describe it – whether sticky, stretchy, thin, crumbly or gluey. The changes day to day can be subtle, which means it requires real familiarity with your own patterns to distinguish what’s normal for you.

That, I was told, is largely trial and error, and becomes easier the longer you pay attention - something that I discovered was, in itself, an unexpected challenge. I wouldn’t describe myself as someone shy about investigating my own body, but getting used to touching and examining cervical fluid was definitely unfamiliar territory.

Don’t be put off, though, because once I got used to it, I actually found it empowering and connective. In some ways, it brought me closer to my internal world.

Weeks three and four

By week three, I was still getting to grips with recognising changes in cervical fluid, but I was beginning to see patterns in my temperature chart. Walters had explained that, if I had ovulated, I should see a sustained rise in temperature afterwards. I was also struck by just how much, as she had said, alcohol and sleep affected my readings. On nights when I’d had even two drinks, the following day’s temperature was noticeably higher.

By the end of the month, my cervical fluid tracking was still a little inconsistent, so it was hard to tell whether I had actually ovulated. Walters had explained that when the body is trying to ovulate but not quite succeeding, we can see an ebb and flow of cervical fluid - where it becomes transparent, stretchy or slippery, but never reaches its peak consistency. This felt like it could apply to me based on what I was seeing, but as I’m still getting to grips with consistent tracking and interpretation, I’ll need to continue for a few more months to get a clearer picture.

What I have gained, through Walters’ teaching and daily tracking, is a much deeper appreciation of the complexity of my body, as well as a sense of empowerment from understanding what these signs can reveal about my health. Having never really understood why my cervical fluid changes, and not even knowing that temperature plays a role in ovulation, it feels exciting to finally be equipped with this knowledge.

Even as a purely educational experiment, I’d encourage all women to start becoming more familiar with their cycle. For me, it’s created greater compassion for my body, more confidence when talking about it, and a clearer sense of how I can advocate for myself in medical settings if I ever need to.

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37-year-old Georgie Wileman just won a BAFTA. Her documentary film, This is Endometriosis, depicts the reality of living with the full-body inflammatory condition, which affects one in ten people assigned female at birth and involves tissue similar to the uterine lining growing on other areas of the body, where it causes symptoms such as inflammation, scarring and severe chronic pain.

It’s a condition deeply connected to trauma in more ways than one. To begin with, research involving over one million women shows that adversity in childhood increases risk of endometriosis after menstruation begins, thanks in large part to the prolonged, low-grade inflammation that trauma leaves in the body. Given that endometriosis is an inflammatory condition, trauma has the power to worsen symptoms and potentially even trigger onset.

Then, there’s the pain of endometriosis itself. In the last month, I’ve spoken to over a dozen women who have shared stories of nights spent curled on bathroom floors, trapped between bouts of violent vomiting and diarrhoea. Of months of rectal bleeding which led to anaemia and cancer scares. Of body image destroyed by extreme bloating, which triggered disordered eating. And of chronic pain so severe that it’s rendered them wheelchair-bound for months on end.

Of course, there’s also the trauma of what endometriosis can do to one’s body and relationships. Hormonal dysfunction, structural scarring and inflammation can result in painful intercourse and low libido, before you even mention the potential for infertility, which often completely alters the course of women’s lives, regularly forcing impossible decisions, shame and isolation.

Georgie has lived all of this and more. And yet, our conversation focuses on the one area of this condition you wouldn’t expect to find trauma: that is, in the healthcare system that is designed to diagnose and treat endometriosis. And yet, amongst all of the women I’ve interviewed, medical trauma was their most shared experience. Whether it was a GP telling them their pain was imagined, an endoscopist performing an invasive procedure without proper consent, or referral letters arriving twelve years after consultation, every woman I spoke to had been left with emotional scars caused by medical dismissal, insensitivity, gaslighting, and neglect.

It begs the question: how, in an age where medical diagnostic and treatment pathways are so sophisticated, have we found ourselves in a situation where a condition as common as asthma, and which causes pain akin to childbirth, takes an average of nine years and four months to diagnose - and in that time, is so frequently mismanaged and misunderstood?

Ahead, with the help of psychologists, reproductive health researchers and the women who live these experiences every day, I explore the connection between medical trauma and endometriosis: from its origins, to its impacts and what needs to happen to make real change.

If you’re here looking for further information on endometriosis, make sure to read our guide to spotting the most common symptoms of the condition, alongside the important facts one writer wished she’d known sooner. We’ve also got expert advice from Dr Hazel Wallace on how to advocate for yourself in medical settings, whether you’re struggling with endometriosis or another reproductive health condition, such as PMOS.

What is medical trauma?

To understand how medical trauma has become so common amongst women with endometriosis, we first need to make sense of what it actually is.

Simply speaking, medical trauma is an emotional and physical response to painful, difficult, uncomfortable or frightening health experiences. It can be triggered by a single, isolated event, such as a traumatic surgery, but can also be caused by repeated or prolonged exposure to negative experiences which overwhelm the nervous system.

Importantly, however, trauma is not actually about the event(s) themselves but about how the body adapts in response. “Trauma is a dysregulated nervous system trying to protect itself,” says Dr Farideh Banafshei, counselling psychologist and founder of Harley & Chelsea private therapy. “That’s why two people can go through the same experience, and one may develop trauma while the other does not.”

The way our nervous system adapts to a potential trauma often hinges on the way other people treat us in the moment and aftermath of the event, which is why the care we receive from medical professionals is so instrumental in the development of post traumatic symptoms. “Often the point the brain gets stuck is not the traumatic health event happening, but the moments of not being believed or helped,” confirms Dr Sula Windgassen, health psychologist and author of It’s All In Your Body. “These moments communicate that I will not be helped when in trouble, and that is a fundamental threat to survival.”

How does medical trauma impact women with endometriosis?

Medical trauma doesn't just impact women psychologically and emotionally - it's physical, too. Research shows that trauma dysregulates the immune system, leading to chronic inflammation in the body, which can worsen endometriosis.

Practically, medical trauma impinges on women’s ability to seek treatment by causing them to fear, lose trust and at times, disengage with the healthcare system entirely. “Medical trauma can manifest in severe anxiety before medical appointments, intrusive memories or flashbacks related to previous procedures, or even nightmares about medical settings,” says Dr Banafshei. “Some people feel numb or dissociated when they enter hospitals or clinics, while others begin to avoid healthcare altogether, including both medical and mental health support.”

Georgie knows this all too well. “Now I’ll only ever go to A&E if paramedics tell me I could die,” she says, explaining that the trauma of reentering a medical setting makes her pain worse. “Even medical sounds, such as the beeping of lorries reversing, can trigger me. I have to wear headphones and sunglasses in hospitals to dull the experience and try to avoid panic attacks.”

25-year-old Tia has a similar reaction. “I repeatedly have panic attacks going into appointments and procedures because of the way my pain has been disbelieved over the years. I don’t want to seek mental health support because I’m worried it will lead to more dismissal.”

Deciding to avoid treatment due to trauma has long-term impacts on women’s health outcomes. “Beyond the physical pain, patients often experience depression, strained intimate relationships, disruptions to their education or careers, and in some cases impaired fertility,” says Dr Charis Chambers, OBGYN & Chief Medical Officer at Clue.

Medical trauma also disrupts women’s sense of self. “There are so many times where I ask myself, ‘Am I making this up?’” says Georgie, who explains that it wasn’t until the fourth surgery that she began to believe her pain was real.

Georgie's loss of trust in her body was the product of countless moments of gaslighting by medical professionals. One psychologist even wrote in a pre-surgery report that she was using her wheelchair as an excuse to lean into the pain. “After the operation, my surgeon looked me in the eye and apologised because I had 39 lesions across my body,” she tells me. “It took him looking inside to believe my pain.”

This is an all too common experience. In fact, 83% of women diagnosed with endometriosis have been told by a doctor they were ‘making a fuss about nothing’ according to data from Endometriosis UK. This, combined with frequent misdiagnosis and long treatment delays, “means many women go through failed treatment after failed treatment, leaving them questioning their own experiences and wondering if relief will ever come,” says Dr Chambers.

Why is medical trauma such a widespread issue amongst women with endometriosis?

It’s almost unimaginable that these failings could be happening on such a large scale across the UK -especially as, for the most part, doctors are not causing deliberate harm. Making sense of it requires us to look at a combination of factors, which span the gendered history, politics and economics of pain.

1. A lack of medical knowledge and understanding

Endometriosis is often reduced to a gynaecological condition, rather than the full-body systemic condition that it is. That gap in research, education and knowledge means that symptoms affecting other parts of the body are often missed, leading to unnecessary invasive procedures.

That was true for 30-year-old Lucy, who was subjected to a flexible sigmoidoscopy to check for colorectal cancer, which left her with trauma. “I nearly passed out from the shock and pain,” she says. As a private gynaecologist pointed out to her later, the procedure was not only performed insensitively, it was entirely unnecessary, and could have been avoided had doctors understood how endometriosis can affect women’s bowels. “He actually put his head in his hands in despair at what was missed,” she recalls.

Dr Chambers confirms Lucy’s experience. “Endometriosis is complex, but medical training often dedicates limited time to it, leaving many clinicians without the depth of knowledge needed to recognise and manage it effectively,” she explains.

2. A cultural normalisation of menstrual pain

There’s also a cultural bias impacting the way women’s pain is treated, with research showing that women are consistently prescribed less effective pain relief than men.

Period pain, in particular, is normalised across society. “Painful periods, pelvic pain, and fatigue being routinely dismissed as ‘normal’ by families, friends, and healthcare professionals," says Dr Helen O’Neill, associate professor in Reproductive and Molecular genetics and co-founder of Hertility.

“This leaves an unfair burden on patients to prove their suffering,” adds Dr Chambers. “This, layered onto chronic pain, can be exhausting and over the years, can be deeply traumatising.”

3. A shortage of medical resources

Currently, 3 million women are waiting on NHS gynaecology lists - the longest across any speciality in UK healthcare. “This creates “a diagnostic bottleneck where women are trapped in a cycle of GP appointments without resolution,” says Deirdre O’Neill, Co-founder and Chief Commercial and Legal Officer at Hertility.

How can we reduce medical trauma amongst women with endometriosis?

1. Compulsory menstrual education in schools

“Many women don’t know what endometriosis is until years after symptoms begin, because we are never taught that severe period pain is not normal,” says Dr O’Neill.

By equipping young girls with knowledge about the early symptoms of endometriosis, which include but are not limited to fatigue, painful periods, painful bowel movements and pain during sex, we put them in a better position to advocate for themselves in medical settings and maintain internal trust throughout the diagnostic and treatment process.

2. Improved diagnostic measures and training for healthcare professionals

Until now, surgery has been required to confirm an endometriosis diagnosis, which has led to years of untreated pain, uncertainty and potential organ damage for many women. But new guidance from the American College of Obstetricians and Gynaecologists, published just last month, indicates that this shouldn’t be necessary to diagnose and commence treatment.

“The shift away from surgical gatekeeping could shorten diagnostic delays and would mean patients no longer need surgery to ‘prove’ their pain is real before accessing care,” says Dr Chambers.

4 tips for women navigating diagnosis and treatment for endometriosis:

Of course, while healthcare reforms are needed to prevent future harm to women with endometriosis, care is also needed for those who are already living with medical trauma.

If that’s you, or someone you know, the specialists have some advice.

1. Validate your trauma

It sounds trivial, but recognising and validating your experiences is an important step to healing. “If your experiences in the medical system have felt frightening, violating, or dismissive, it is important to acknowledge that,” says Dr Banafshei. “Part of healing involves untangling your real experience from a system that may have failed you.”

Bringing someone with you to appointments can also help here. “A trusted person can provide emotional support and help you feel less alone during the process,” Dr Banafshei says.

2. Don’t be afraid to seek mental health support

Seeking help from a therapist, especially one who is trauma-informed, can be a helpful step. “Over time, addressing the trauma can help separate the suffering caused by the illness from the suffering created by the medical system around it,” says Dr Banafshei.

A word of advice. When you seek therapy, it’s important that your therapist knows whether the trauma is still ongoing or if it’s in the past. “If trauma is still occurring, stabilising the nervous system and providing supportive care comes first,” explains Dr Banafshei.

In contrast, if trauma is entirely connected to an event in the past, then techniques such as EMDR can help you to process the experience. “EMDR can work with both the memory itself and the bodily sensations connected to that memory, which is why it can be particularly effective for processing emotions such as shame,” says Dr Banafshei.

3. Track and document your symptoms

Documenting your symptoms can help you feel more prepared to re-enter medical environments, says Eve Lepage, Reproductive Health Specialist at Clue. “Instead of relying on memory alone, symptom tracking allows you to point to patterns and trends in your own data, which can become a form of self-advocacy.”

LePage suggests logging the following information about your cycle. “These help to create a longitudinal health record that can reveal patterns that might otherwise be overlooked,” she says.

Bleeding patterns

• Heaviness
• Spotting
• Colour

Symptoms

• Headaches
• Cramps
• Bloating
• Mood changes

Lifestyle factors

• Sleep
• Exercise
• Sexual activity

4. Seek second opinions

Losing trust in the healthcare system often leads us to turn to social media in search of answers. But whilst online spaces such as Reddit’s r/endometriosis community can provide validation and connection to other women, they aren’t a replacement for medical care, which is why it’s important not to give up on medical diagnosis, as frightening and off-putting it can be.

“If you don’t feel safe or respected with a healthcare provider, you have the right to seek someone else,” says Dr Banafshei, who says that regaining choice is an important step to healing medical trauma. “Feeling empowered in how you approach your care rebuilds autonomy and internal trust because your entire health isn’t in someone else’s hands,” she says.

If you, or someone you know has been affected by medical trauma during their diagnosis and treatment of endometriosis, the following services can provide resources, advice and support.

Endometriosis UK

The Endometriosis Foundation

For private healthcare, Hertility offers at-home diagnostic testing and endometriosis-specific referral for ultrasounds and specialist consultation, which can reduce diagnostic timeframes.

Anyone might think there’s already enough written about hormone imbalance. Honestly, I’ve contributed to the library myself. But despite hormones becoming the wellness topic everyone has an opinion on, there are still huge gaps in how we actually understand them, particularly when so many women feel they're doing everything “right” yet still feeling completely… off.

Growing up, I was taught that hormones explained everything. Tired? Hormones. Emotional overreaction to something objectively minor? Hormones. Breakouts, sore boobs, random rage? Hormones again - just to be safe.

And more often than not, it does feel like they’re running the show. Loudly.

We’re all very quick to blame hormones for pretty much any shift in energy or mood, but no one really mentions the everyday habits quietly doing the heavy lifting behind the scenes. So instead, we end up in this modern hormone-management spiral, trying to optimise everything short of our entire lives, all to feel “normal” again.

And perhaps the confusion isn’t that surprising. Hormonal health has become one of the internet’s favourite things to debate, and when we want answers, we instinctively turn to the internet. TikTok has effectively become the group chat, therapist and hormone educator many women never had. One recent UK survey found that one in five women now turn to social media before their GP for advice on PMS and PMDD symptoms, while searches like “do I have PMDD quiz” have skyrocketed by 350% in the past year.

Which explains why words like cortisol, oestrogen, and cycle syncing now sit alongside oat flat whites and dating horror stories. The upside? This is finally a normal conversation. The downside? It’s increasingly hard to separate evidence from wellness noise.

Hormonal health is far more nuanced than diet, exercise or supplements alone. You can do all the “right” things and still feel out of sync if the baseline system: stress, sleep, recovery, is constantly under pressure. The real gap isn’t effort, it’s trying to apply blanket wellness advice to individual bodies.

So, if you've found yourself googling "why do I feel so off" for the fifth time this week - scoot over, this one is for you. Ahead, experts break down three surprisingly common habits that may be quietly disrupting hormonal balance without us even realising, and what actually helps the body feel like it’s finally on your side again.

The Everyday Habits Experts Say Could Be Quietly Affecting Your Hormones

Habit 1: Staying Constantly Switched On

The first habit won’t exactly trigger a collective gasp. We all know stress isn’t great for us - groundbreaking insight, I know. But what’s changed is how normal it now feels to be slightly “on” all the time.

​It’s answering emails while half-watching TV. Booking a workout to de-stress, then rushing straight back into work. It’s feeling exhausted all day, then suddenly wide awake at midnight, replaying a conversation from 2018. Functioning. Technically, yes. Resting. Gosh, no.​

And our hormones are paying attention.

Research published last year in BMC Psychology highlights how chronic time pressure and ongoing mental strain are linked with increased stress, anxiety, and overwhelm - showing just how much low-level pressure can accumulate in the body over time.

As Dr Charis Chambers, OB/GYN and Chief Medical Officer at Clue, explains, this can be taking its toll on our hormones. Chronic stress affects women’s health over time by causing a sustained activation of the brain-to-adrenal-gland signalling pathway. When this pathway is constantly activated, it suppresses the function of reproductive hormones.”

Over time, she adds, this can affect cortisol regulation, sleep quality, energy and menstrual health - often showing up as fatigue, emotional sensitivity, irregular periods.” That persistent feeling of being 'off'? It’s not imaginary. It’s physiological - and being "on" all the time is feeding the shift.

Habit 2: Out-Wellnessing Yourself (and Losing)

There’s a particular kind of burnout that hides behind” good habits”: the supplements, the steps, the workouts, the magnesium, the iced coffees, the cortisol hacks - all habit stacked together in the name of balance and "bettering ourselves".

But as Dr Samar Samy, medical doctor and embryologist, explains, “Many habits marketed as ‘healthy’ can become hormonally disruptive when they’re done excessively or without enough recovery. Over-exercising, fasted training or high-intensity cardio without adequate fuel can elevate cortisol and disrupt reproductive hormones.”

Nutritionist Hannah Alderson adds that under-eating is another major stressor. “If women aren’t eating enough protein, fibre, healthy fats and overall energy, the body struggles to feel safe enough to support hormone production and recovery.”

There’s also a clear physiological reason for this: A 2024 study in Applied Physiology, Nutrition and Metabolism found that when energy intake consistently falls short of what the body needs, the brain reduces reproductive hormone signalling. This can lower luteinising hormone activity- a key player in cycle regularity, as the body shifts into survival mode over reproduction.

Habit 3: The Moment When Sleep Stops Supporting Hormones

It’s safe to say I’m guilty of checking my Oura ring, seeing eight hours of sleep, and assuming I’ve done my job. What I pay less attention to is whether that sleep was actually restorative, because eight hours in bed doesn’t always mean eight hours of recovery.

And there's increasing evidence that restorative sleep matters far more than simply clocking in (and hoping) for our eight hours. A 2024 study published in Psychoneuroendocrinology found that disrupted sleep can throw our cortisol rhythms out of sync, leaving the body physiologically stuck somewhere between stress and recovery overnight.

"Sleep consistency may be more important for overall health than sleep duration,” says Sleep scientist Sophie Bostock. Many women, she adds, “are going to bed in a state of 'hyperarousal' - where the stress system is still partially switched on." You might fall asleep, but the body is still standing on business. Common triggers tend to be: caffeine, blood sugar crashes, alcohol (or just “the one glass” that rarely ever stays that way), and ongoing stress.

From a hormonal perspective, that matters. As Dr Samy notes, “poor-quality sleep can elevate cortisol and disrupt reproductive hormone regulation, contributing to fatigue, cycle changes, and that lingering feeling of being 'off' even when everything looks fine on paper.”

The result is familiar: low morning energy, irritability, cravings, poor focus, low motivation - all signs the system hasn’t fully reset.

4 Simple Habits to Focus on Instead

By now, it’s clear the biggest mistake we’re making is, ironically, trying to hack and optimise ourselves into better health - when all it’s really doing is optimising exhaustion. The truth is, the most effective approach is often the least glamorous. Enter the everyday habits we should actually be focusing on, according to our experts, span:

1. Sleep

• Morning daylight exposure is vital to anchor your circadian rhythm
• Maintain a consistent sleep-wake routine to regulate your internal rhythm
• Prioritising consistent, good-quality sleep rather than sporadic rest
• Protect at least seven hours in bed to allow proper physiological restoration.

2. Nutrient-dense food

• Eat enough regularly, and avoid long gaps or skipped meals
• Start your day with a protein-rich breakfast within 60-90 minutes of waking
• Eat consistently across the day - ideally three structured meals rather than grazing or long gaps that will destabilise blood sugar
• Try to include as many cruciferous vegetables and ground flaxseeds as possible in your meals - this will support liver function
• Stay hydrated.

3. Nervous system regulation

• Support your nervous system daily through small resets: breathwork, creativity, time in nature, laughter, and connection
• Manage chronic stress levels before they become a constant background noise
• Build in short pauses throughout the day - ten minutes can help reset stress load.

4. Moving in a way that feels

• Build strength through resistance training, rather than only focusing on cardio or depletion
• Move your body in ways that feel enjoyable - not depleting (if that means swapping your HIIT class for an hour walking, then so be it.)

Ultimately, it’s not that hormones are broken; it’s that we’re overlooking the everyday habits quietly shaping them in the first place. In trying to optimise every variable, many of us end up creating the very stress their routines are meant to reduce. As Alderson puts it, “Hormonal health isn’t perfection. It’s consistency, recovery, and the small daily behaviours that allow the body to stop bracing.”

So perhaps the real habit formation isn’t about telling our brains we need to do more, but about returning to what our bodies have been asking for all along.

MC UK Approved Products for When You Feel Out of Sync

Why am I so tired all the time? It’s a question I’ve asked myself so many times (ironically, adding to my exhaustion), usually while staring into my third coffee, fresh off eight hours of sleep, and vaguely militant commitment to hydration. By most modern wellness standards, I’m doing reasonably well. I exercise regularly, eat well, take magnesium supplements with near-religious consistency, and own enough supplements to suggest I am, at the very least, deeply committed to trying. And yet, despite technically doing everything “right”, I feel persistently exhausted.

Not dramatic, can’t-get-out-of-bed burnout. More of a constant, low-level depletion that no amount of “wellness bandaids” is capable of fixing. Feel vaguely familiar? Sadly, recent research indicates that this isn’t rare. A 2026 survey found that around 67% of women report feeling exhausted within a typical month, even when sleep and lifestyle appear “normal”, which highlights the ever-growing gap between how much rest we’re getting and how rested we actually feel.

And the strange part is just how hard we’re working to not feel this way. We are arguably the most optimised generation of tired women imaginable: drinking electrolytes, tracking everything, and listening to podcasts about cortisol while trying to hold together relationships, finances, friendships, and inboxes. Somewhere along the way, exhaustion stopped feeling like a warning sign and became a personality trait. And in the name of carrying on, I can’t keep responding to “why are you so tired?” with “I’m just a girl,” as though chronic exhaustion is an inevitable side effect of womanhood.

Because the reality for many women is simple: fatigue isn’t just physical; it’s the invisible mental load of holding everything together against the backdrop of everyday life.

So yes, while I’m here to ask why so many of us are running on empty, this is also for the women who are tired of being tired - of doing all the “right” things, but still waking up so exhausted, tear-jerkingly exhausted. Consider this a space to have that properly seen, understood, and explained.

From hormones and nutrition to nervous system overload, poor sleep, chronic stress, and invisible cognitive load, I’ve spoken to the experts to understand what’s really driving this, and crucially, what actually helps, beyond the usual “have you tried going to bed earlier?” advice we’ve all been lovingly offered at one point or another.

If you're tired of feeling constantly exhausted - these tips are for you

Firstly, why is fatigue so prevalent in women?

If modern womanhood had a mascot, it would probably be a woman answering emails in a queue for coffee, while her wearable gently informs her that she is, once again, under-recovering. We are, collectively, trying very hard, which is exactly why it feels so confusing when exhaustion persists despite healthy habits.

According to Immunologist Dr Jenna Macciochi, it may be linked to a near-constant state of “physiological vigilance”, where the brain and body are continuously scanning the environment, asking: Am I safe enough to rest, repair, and recover?

And “safety" here isn’t just physical danger. Poor sleep, emotional strain, financial pressure, information overload, constant notifications, loneliness, and never feeling truly “done” all register as stress signals. “For many women,” Macciochi explains, “there’s no real off-switch anymore.” So even when we are resting, the body may still be lagging.

“Through psychoneuroimmunology - the study of how psychological experience influences immune function, we now understand that perceived stress alone can keep the body in a low-grade activated state, even with good sleep, meditation, or supplements.” Over time, this becomes what Macciochi describes as an “energy triage” state, where resources are diverted toward coping rather than repairing.

Which helps explain the paradox here: why so many women can tick all the “energy-supporting” boxes, and still feel completely depleted.

When should I be worried about my fatigue?

The horrors of exhaustion may persist, but so do we. And if we’re honest, normalising fatigue has become a performance many of us have mastered. The culprits? Work, stress, hormones, bad sleep - and often, those things are part of the picture. But according to GP and women’s health specialist, Dr Raj Arora, it can also be “one of the earliest signs that something deeper in the body needs attention.”

That doesn’t mean panic - it means pattern recognition. “Iron deficiency, thyroid disorders, vitamin deficiencies, sleep apnoea, anxiety, depression and autoimmune conditions can all present first as fatigue, before anything else becomes obvious. And the clues are often subtle: heavy periods, waking unrefreshed, hair loss, brain fog, breathlessness, feeling unusually cold, or persistent low mood.”

But fatigue is rarely a one-cause drama. Beyond the usual suspects, there are quieter, often-overlooked energy thieves quietly working behind the scenes, too.

According to functional medicine practitioner Sandra Ishkanes, one of the issues is food sensitivities. “Things like gluten, dairy, eggs or certain grains can create a low-grade inflammatory response in the body,” she explains. The issue is not just digestive - it’s energetic. “That immune response is metabolically expensive - it pulls energy and nutrients away from the systems that keep us feeling well,” she says, sometimes producing what researchers call “sickness behaviour”: brain fog, heaviness and deep fatigue.

Then there’s hydration, but not in the way we usually think about it. “If you’re losing sodium, potassium and magnesium faster than you’re replacing them, your cells can become effectively dehydrated - you can drink plenty of water and still feel exhausted at a cellular level.”

Thanks to recent research, we know that even mild dehydration can affect mood and fatigue. At the same time, electrolytes like sodium, potassium, and magnesium play a key role in regulating how water moves into and is retained by cells. So, what does this mean? Hydration isn’t just about how much we drink, but how well our bodies can actually use it.

Which is why you can drink all the water in the world and still feel tired, foggy, or strangely flat, and why hydration isn’t always as simple as we’ve been told.

Is eight hours sleep a night enough to rid my exhaustion symptoms?

Eight hours. Two words that have long been held up as the gold standard for curing exhaustion, as if rest can be measured so neatly. But as Dr Anna Persaud, Biochemist and CEO of This Works, explains, sleep duration and sleep quality are very different things. Resting doesn’t always equate to recovery.

“It’s about the depth of restoration the brain and body are actually able to reach to recover from the day just gone,” she says. In other words, how rested you feel could, in fact, come from what your body has been able to do during that time.

Macciochi goes on to describe this as the nervous system remaining in a state of “cognitive and emotional labour”, still tracking, planning and processing, even when we’re asleep.

So while the hours may add up, the recovery often doesn’t.

And that’s the subtle shift many women don’t realise is happening: not that they’re sleeping less, but that sleep is no longer delivering the same depth of restoration it once did.

5 habits that restore energy and reduce fatigue, backed by experts

I think we’re beyond hearing the usual advice to “sleep more” or “reduce stress” (I can already feel the eye rolls). So instead, here’s the opposite of that: five habits from Sandra that actually help you reclaim a bit of that energy you’re constantly giving away.

1. Reset the light in your room

Did you know? Five to ten minutes in a completely dark, quiet room acts like a neurological reset. It removes visual input, giving the brain a much-needed break from constant processing and allowing the nervous system to fully shift out of alert mode and into recovery.

2. Protect the sleep window before 11 pm

The goal isn’t just more sleep - it’s deeper sleep, with science proving that the earlier you get to bed, the better. Sandra’s advice? Keep the bedroom cool and completely dark, avoid screens for at least an hour before bed, skip alcohol within three hours of sleep, and try to finish eating a few hours beforehand, too.

​Why? Because cortisol is meant to dip around midnight, and anything that keeps it elevated late into the evening disrupts deep “slow-wave” sleep - the stage linked to repair, recovery and brain “clean-up.”

​As Sandra puts it: “Sleep started after 1 am gets the hours but misses the wash.” Which, frankly, explains a lot.

3. Try somatic shaking

Hear us out on this one, because it's a firm favourite of mine. Vigorously shake your limbs and body for 30 seconds to 2 minutes. Known as the "shaking medicine", it’s meant to mimic animal behaviour to discharge any trapped stress energy held in your muscles, signalling safety to the brain and resetting your nervous system.

4. Move strategically

Think strength training two to three times a week to build muscle and daily walking for nervous system regulation (ideally 20 minutes after meals) to help steady glucose levels.

For an exhausted woman, the prescription isn’t more - it's less. Capacity is built through load and recovery, not constant grinding.

5. Finally, learn the power of “no”

A habit I’ve personally become rather accustomed to is saying no. And sticking to it. As Sandra notes, sometimes the most powerful cortisol intervention isn’t a supplement, it’s a boundary. Our nervous systems aren’t designed to be constantly “on,” and there’s a cost to carrying too much for too long.

Start by auditing your load: what is truly yours, what defaulted to you, and what you’re holding because no one else will. Then begin putting some of it down. Because boundaries aren’t a lifestyle tweak - they’re physiological protection.

Final Thoughts

If there’s anything to take away from this exposé on modern-day fatigue, let it be this - it's not always a sign that something is wrong with you; often, it’s a signal that something in your system needs recalibrating. And while there is no single fix, there is something quietly powerful in learning to understand what your body is asking for, and permitting yourself to actually listen.

Because you can’t keep pouring from a half-gulped cup, and maybe that’s the shift - not pushing through at all costs (revolutionary, I know), but noticing, gently, when you’ve been running on empty for far too long. Not as failure, not as weakness, just information. And from there, finally beginning to stop normalising it.

MC’s Essentials for When You’re Running on Empty

In unprecedented news and after a decade of campaigning, the female health condition PCOS (Polycystic Ovary Syndrome) has officially been renamed to Polyendocrine Metabolic Ovarian Syndrome (PMOS).

This comes after decades of campaigning, misdiagnosis, and global consultation.

The name change, which was first published in The Lancet journal yesterday and formally announced at the European Congress of Endocrinology, was the result of fourteen years of discussions and observations from globally diverse six patient groups.

Leading the charge with the name change was an endocrinologist called Professor Helena Teede, who on Tuesday said the old name didn’t encompass the “multi-system burden that people with this condition have suffered."

The condition affects 170 million women worldwide, and yet remains one of the most underresearched and undiagnosed health conditions. First termed PCOS in the 1930's, the name has long caused confusion because not everyone with the condition has “cysts” on their ovaries, and having polycystic ovaries doesn’t mean you have PCOS. PCOS - now “PMOS” - is a condition which affects your entire body, including your hormones, metabolism, mood, and more.

The change is undoubtedly a step in the right direction, and provides a more accurate and clear label for the female health condition.

It also validates what women globally have long known about our bodies, and could mean earlier diagnosis, better screening, and a more 360 approach to how to ease symptoms.

That said, more still needs to be done to fund research into the condition and ensure women are listened to in medical settings. So if, like me, you are a woman with PCOS who has felt shut down in a medical setting, this article's for you. It's for anyone who's felt overlooked by a doctor, ignored about their health concerns, or like they weren't getting the professional support that they needed.

Experts like Dr Hazel Wallace are a great start. "As a woman and a health provider to many other women, I've realised that our health needs are underserved and overlooked," she shares. "I want to change the accepted narrative that, in medical circles, women are simply 'small men' and argue that they should instead be seen and understood in their own unique way."

Below, she shares her top tips for advocating for yourself, if you think you may have an undiagnosed female health condition and the tips she wishes she'd known herself at the start of a two-year-long process to being diagnosed with PCOS herself. As she says in her book, "With the right education, awareness and support, we can help women reclaim their cycle, harness their hormones and take control of their health. For anyone who has ever felt confused about, or been made to feel ashamed of, their menstrual cycle – this is a step towards reclaiming that narrative and embracing your power."

For more on PCOS, now PMOS, specifically, don't miss our expert-led guides to the most helpful and well-researched PMOS treatments, plus nutritionist-approved PMOS supplements, here.

7 things I've learnt about advocating for your health, as a female health doctor

While many GPs and doctors are hugely supportive, we learned from the Women’s Health Strategy for England how women have not been listened to when it comes to their pain - being told that heavy and painful periods are "normal" or that they would "grow out of them."

Many shared stories of how they spoke to doctors on multiple occasions over many months or years before receiving a diagnosis for conditions such as endometriosis.

It’s so important that we are able to discuss any distressing symptoms with our doctors - and that we feel listened to. In our survey, we found that women who are comfortable accessing support from healthcare providers experience less-severe menstrual symptoms and feel more supported compared to those who do not feel comfortable engaging with healthcare providers about their menstrual health.

If you are experiencing period problems, the first port of call in the UK will be your GP. At the time of writing, I’m aware that getting time with a GP is easier said than done, but it is worth persisting, as they really can help. From there, if required, you can be referred to an NHS gynaecologist. You can also see gynaecologists through private healthcare. If your problem is urgent, such as very heavy bleeding that is causing you to be unwell, dizzy or sick, then you should go to A&E.

While it’s unfortunate that women often need to advocate for themselves in the doctor’s office, and it’s absolutely not your responsibility to fix a flawed system, you can take proactive steps to improve your experience and access to healthcare.

Here are some self-advocacy tips to help you make the most of your medical appointments.

1. Keep a symptoms diary

First things first? Keep a symptom diary for at least two to three menstrual cycles and bring it with you to the appointment.

2. Order in priority

Next up - prioritise. If you have a number of concerns, talk about the most important thing first, as GPs often have a limited time to spend on each patient.

3. Don't downplay the severity of your symptoms

Avoid downplaying the severity of your symptoms, and be sure to tell your healthcare provider how these symptoms are affecting your life.

4. Share your concerns

Next up - if you're concerned that you have a specific condition, such as endometriosis or PMOS, share that concern so that your doctor can address it.

5. Request a GP you feel comfortable with

If it’s possible, request a GP you know and feel comfortable with. If you feel like your health concerns are not being taken seriously, you can ask to see another doctor.

6. Bring someone with you

If you feel more comfortable, you can bring someone with you to your consultation. Sometimes having someone with us who we trust can help us feel more con dent speaking up.

7. Come prepared

Come prepared with questions you would like to ask – for example, if you will need any tests or investigations, or simply what happens next. However, depending on your symptoms, your doctor may not need to do any specific tests, and if this is the case, you can ask them to explain why.

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Six days after giving birth to her son, Alex Light went to a routine postnatal check-up. Instead of asking how she was coping, the midwife immediately commented on her body.

Privately struggling with debilitating postpartum anxiety, the moment crystallised for Light just how intensely — and immediately — the pressure to “bounce back” begins. Here, as part of Marie Claire UK’s new What It Feels Like series, the activist and author of The Price of Pretty, talks about postnatal pressure, shame, the silence around gaining weight after pregnancy, and why she no longer wants to “erase” what her body has been through.

What It Feels Like To Battle The Pressure To ‘Bounce Back’ Postpartum

As told to Mischa Smith

I remember the six-day check-up so clearly.

I had a huge amount of swelling when I was pregnant, especially towards the end, and after giving birth, it just dropped off me. My body went back really quickly to how it was before, which I know is not the normal experience – and it didn’t end up staying like that – but in that initial period after giving birth, I dropped a huge amount of weight. I remember the midwife saying to me, “I can’t believe you’ve just had a baby. You don’t look like you’ve had a baby. Where’s your stomach?” And I remember thinking, I don’t care. I don’t care. I don’t care. Why are you talking to me about my body? I have this six-day-old baby, and I am terrified, and I’m so anxious, and I have to keep this lovely little thing alive. This is the craziest thing I’ve ever done in my entire life.

I was just looking at her, completely dumbstruck, while she was talking about my body. A lot of people opened with that, actually. A lot of people commented on how slim I looked. And I was like, I cannot believe this is what you’re focused on. I have grown and delivered a whole human. I have been through the most intense mental, emotional and physical upheaval I’ve ever experienced, and people are still talking about the size of my body.

It made me really sad because it felt like proof that no matter what women do, the most interesting thing about us, according to society, will always be how we look. I wanted people to stop talking about my body. I thought, I need help, I need advice, I need someone to tell me whether my baby is feeding OK, whether he has tongue-tie, whether I need to wake him up to feed him. I don't need you to tell me how slim I look.

I’ve always had anxiety, so it wasn’t a surprise that I was going to have anxiety as a mother. Suddenly, you have this precious, tiny, fragile person who is entirely dependent on you and your decisions, and I found that absolutely terrifying. I didn't sleep for more than 10 minutes at a time for four weeks because I was checking that he was breathing every 10 minutes. The constant state of anxiety was paralysing.

I had intrusive thoughts as well, which I only realised afterwards are really common postpartum. These horrible, intrusive thoughts would plague me and haunt me. I was scared to take him outside in case something happened to him. I was scared to put him in the car. I was just terrified all the time.

Food has always been one of my emotional coping mechanisms, and during postpartum anxiety, I turned to it because it brought relief. That meant I ended up putting on weight afterwards, which is actually quite common, but something that’s not talked about because the focus is so often on bouncing back and losing the baby weight.

Around six weeks postpartum, I remember thinking, right, I want to stop living in leggings and oversized jumpers. I want to put make-up on. I want to wear one of my old outfits and feel more like myself again.

So I tried on one of my old outfits, and it went nowhere near me. I was really shocked. I realised in that moment that I had put on a significant amount of weight. I felt completely blindsided by it because nobody talks about gaining weight postpartum. The focus is always on losing weight, shrinking yourself, getting back to your pre-baby body. I didn’t realise that this was a common experience, and so I felt like a failure. I remember thinking, I’m supposed to be losing weight after birth, not gaining it.

But looking back now, it makes complete sense. I was going through an unprecedented, extraordinary time. I can't stress enough that I was so, so tired. I needed sugar. I needed that boost of energy.

It makes total sense now, but because we’re culturally so fixated on weight loss, it didn’t feel acceptable.

I have never craved sugar like that in my life. I’m usually a savoury person, but postpartum, all I wanted was cake, biscuits, pastries — anything sugary. I became obsessed with Gail’s almond croissants to the point that now I can’t even look at them because they remind me of that time. I couldn’t get sugar into my body fast enough.

At the time, I felt a lot of shame about that, too. I thought I should be fuelling my body in the “right” way. I thought I should be eating perfectly nutritious meals and nourishing myself properly.

And I think a lot of that pressure comes from the messaging women absorb around postpartum bodies. Everything is about shrinking. You’re surrounded by messaging about getting your body back, losing the baby weight, snapping back. I felt intensely targeted on social media by postpartum diet content when I was pregnant and after I gave birth.

I feel really strongly about the words “bounce back”; it’s a phrase that’s used so casually as part of the normal timeline of motherhood. But our bodies are not rubber balls. They’re not supposed to bounce; they’re supposed to grow and expand and adapt and evolve. Pregnancy is such a physical, mental, emotional and hormonal transformation. It literally rearranges your organs and shifts your bones and stretches your skin. Why are women expected to erase all traces of that afterwards? Why are we expected to look exactly the same?

It feels vastly unfair, and it happens during one of the most vulnerable periods of your life. Your priority at that stage should be surviving, healing, bonding with your baby and keeping this tiny human alive. But at the same time, there’s this pressure to “snap back” into your jeans and erase all evidence of what your body has gone through.

I think it prioritises aesthetics over women’s wellbeing. Even now, there’s such a huge double standard around parenthood and bodies. People joke about “dad bods” and how they show that a man is too committed to his kids and fatherhood to go to the gym — like, isn’t that commendable? But when it comes to mothers, the expectation is completely different. Women are expected to erase every sign of motherhood from their bodies. The double standard is wild.

A few days after giving birth, I looked in the mirror and realised my body looked completely different. I had what they call a “C-section shelf” — loose skin and stretch marks where the scar is tight, so the tummy sort of hangs over the scar. My boobs were bigger than they’d been before. And I realised this wasn’t going away. But I also realised I didn’t necessarily want it to.

Growing and delivering my son changed me physically forever, and honestly, I want it to show. I want to bear the scars of that. It’s the best thing that's ever happened to me, and I’m proud of what my body did.

People say all the time that women should appreciate their bodies for what they do rather than what they look like, and honestly, pregnancy made me understand that on an entirely different level. Creating and delivering another human being is unbelievable. It’s magical. I refuse to let society tell me that the physical evidence of that is something shameful.

What surprised me most was how much pregnancy changed my relationship with my body overall. I struggled with disordered eating and eating disorders for most of my life. By the time I was an adult, I was completely disconnected from my body. I stopped listening to hunger cues years earlier. Pregnancy actually bridged that gap for me. For the first time in my life, I felt genuine awe and gratitude towards my body. I felt connected to it rather than at war with it. And that felt incredibly emotional because I’d spent so many years fighting against it.

When I eventually spoke about gaining weight postpartum on Instagram, the response was overwhelming. So many women messaged me saying they’d experienced the same thing and had never heard anyone talk about it before. It was a huge relief. It took away that feeling that I had somehow failed right after giving birth.

I’m pregnant again now, and this experience has been different. I’ve gained weight much earlier this time because of hormones and IVF treatment, and there have still been moments where I’ve struggled with the loss of control that can come with your body changing. But I also have so much more grace for myself now. I trust my body in a way I didn’t before. I trust that it’s doing what it needs to do.

And I think that’s what I wish someone had told me the first time around: that your body changing after birth is not failure. And that there is nothing shameful about a body that shows evidence of motherhood.

As told to Mischa Smith

There’s a scene in my novel, Turn Back Time, when my main character Erica is looking back on life as a midlife woman, now that she’s had the—fictional, I hasten to add—WULT® treatment to make herself look twenty years younger. “Middle-aged women are background noise”, she muses. “Unless you’re in a ‘role’, like being a mother, or doing your job, or you’re famous or something.”

When I was writing Turn Back Time, I became interested in exploring the different things invisibility can mean to us in midlife: whether we notice the moment we disappear, and what—if anything—we choose to do about it.

Spoiler alert: midlife invisibility is not just about that deafening silence from the building site when you walk past, which actually came as a huge relief to me. Like most women, I hated wondering what would be shouted out, and trying to walk normally while knowing that at every step I was being scrutinised. For me, this would usually result in a strange, bow-legged walk akin to a cowboy in one of those stand-offs you see in old westerns.

It’s also more than that day-to-day preference the world has for a younger, attractive woman: it’s what Sam Baker, author of The Shift, describes as the point at which women become “underestimated and ignored”; not because they have less to offer, but because society decides they’re no longer useful.

If it hasn’t happened to you yet, here’s a PSA: you won’t write about it in your diary. Because it’s not the big moment you might think. It creeps in uninvited, some parts welcome, some less so. And you explain it away at first: “I didn’t get served for ages at the bar because the barman was chatting to his friends”... “Nobody let me out at the junction today because I was wearing my old hoodie and had no makeup on”...

Each time, there’s a reasonable explanation, and all the while, undetected, we are fading like Marty does in that photo in Back To The Future. Which I realise is a very Gen X example to use, and dates me somewhat.

Not getting these minor ‘leg-ups’ that you can enjoy as a young woman is liveable. However, stage two of invisibility, which, I warn you, comes hot on the heels of stage one, isn’t just about being overlooked, but about being ignored, discounted and even spoken over.

And yes, you still make excuses to begin with: “They didn’t listen to my point in that meeting because the Zoom was running over and nobody wants that on a Friday”... “The email thread moved on without my input but it was urgent, so I get why”...

This stage is hard to stomach. Because it’s about opinions becoming disposable and authority depleting as fast as collagen levels. Collagen I can stir into my smoothie, but this feels like something that will take generations to change.

As Erica observes in the book, it’s about roles, and visibility is dependent on them. Once your role as an attractive young woman—or, more sepcifically, a fertile young woman—is over, then what do you ‘do’? How do you ‘serve’? Are you a mother? OK then. A carer? Fine. A worker? Check. But if you're just a middle-aged woman and don’t fit neatly into one of those categories, it can truly feel like nobody can see you.

Playing with the idea of having that visibility switched back on in Turn Back Time was fascinating. It’s like a test: what happens when the gradual fade is interrupted? What do we notice? What interested me most wasn’t the novelty of being seen again, but what came next for Erica. Because once you’ve noticed the photograph fade, you know what happens… and you can’t ‘un-know’ it.

As midlifers, mid-youthers, or—and I’m quite comfortable with this moniker—middle-aged women, we might not get to decide how visible we are to the world, but we do get to decide what’s important to us and where we channel our energy.

For many women, that means caring less about being what society expects of us and more about being honest—and about being ourselves. Speaking up. Taking up space. Choosing the people we have around us and not putting up with relationships or friendships that don’t serve us. There’s such a power in this; a lot more power, in fact, than getting let out at a junction, or being served first at the bar.

And I’m here for it.

Turn Back Time by Eleanor Tucker is out now

As a marathon runner, female health expert and registered nutritionist, I'm hugely passionate about educating women on their menstrual cycle, as well as how their period can impact their day-to-day lives. A former NHS doctor, I set up The Food Medic back in 2012, and have written two books - The Female Factor in 2022 and Not Just a Period in 2025.

But today, I want to get into training around your cycle. The biggest myth about periods and performance? That you can’t perform at your best during your period. You absolutely can. Women compete, set personal bests, and win gold medals while on their period.

That’s not to say it doesn’t make things harder for some. Symptoms and practical concerns - like managing period products, changing tampons mid-race, or worrying about leaks - can take up a lot of mental space.

While there’s definitely more awareness and conversation than ever before, I think some brands and influencers are overstating or oversimplifying the evidence, particularly around things like cycle syncing. We need to be careful not to replace one extreme with another, and the goal should be evidence-based, flexible guidance that helps women understand their bodies without creating more rules on what they can and cannot do.

With the London Marathon just gone, what better time to deep dive into how best to approach marathon training and your menstrual cycle? Interest in running is at an all-time high, with the highest number of runners ever completing the iconic course on Sunday, setting a new Guinness World Record (59,830 runners). Not just that, but the largest number of female finishers crossed that finish line over the weekend - a total of 26,071 women, up 4.6% from 2025.

Without further ado: keep scrolling for my science-backed take.

How does the menstrual cycle actually affect endurance performance across a marathon training block?

Across a full training block, the menstrual cycle is unlikely to have a consistent or predictable impact on endurance performance, but there may be a small dip in the perimenstrual window (just before and during your period).

In a study of 195 Australian athletes preparing for the Tokyo Olympics and Paralympics, many reported that they felt they performed worse during their period, so perception plays a big role.

I would say, though, the effects are small and variable, so training, fuelling and recovery remain far more important than cycle timing alone.

There’s some evidence that the late follicular phase (after your period) may feel better for higher-intensity work, as oestrogen is higher and progesterone is low, which may support recovery and reduce perceived effort. The early to mid-luteal phase may also be well-suited to endurance work, as higher oestrogen can promote greater fat utilisation and help spare glycogen, potentially supporting longer efforts.

However, rising progesterone may offset some of these benefits, particularly by increasing body temperature and making exercise feel more demanding, especially in the heat.

In short, if you're a runner considering adapting your training plan across the four phases of your cycle, you don't need to.

Is it realistic—or even necessary—for amateur runners to sync marathon training with their cycle?

No. While there may be small changes in performance and recovery across different phases of the menstrual cycle, the impact is small for many and can vary between women. So it’s not evidence-based or necessary to follow a cycle-synced running programme, and it may hold you back from making progress if you’re only “allowed” to do high intensity or long runs on 1-2 weeks of the month.

What is helpful, though, is being cycle-aware and understanding your own needs and being guided by your symptoms. For example, if you wake up with tender breasts, fatigue, bloating and so on in your premenstrual week and you have the option to move your longer/harder run to later in the week, then why not?

Often women don’t realise their cycle is a vital sign and tells us so much about their overall health - so if your period suddenly goes missing or your cycle length is progressively getting longer during a training block, that’s a red flag! This often occurs when the body doesn’t have enough energy to support both exercise and essential functions such as hormone production, bone health, and recovery – a state called Low Energy Availability (LEA). When this happens, the body switches off signals from the brain to the ovaries, stopping ovulation and periods until more energy becomes available. Most women think that losing their period isn’t a big deal (maybe convenient?), but it can have important consequences for both health and performance. Studies have shown low energy availability is associated with reduced bone density, a higher risk of stress fractures and injury, impaired recovery, low mood, disrupted sleep and reduced performance in exercise and sport.

While this has traditionally been documented in elite athletes, it’s increasingly being seen in everyday active women, too. In one study of nearly 2,000 female recreational runners, 53% were identified as being at risk of low energy availability and around 62% reported menstrual disturbances.

How should nutrition shift across the menstrual cycle when training for a marathon?

In the luteal phase, there may be a small increase in metabolic rate, so you might feel hungrier. Rather than resisting that, it’s important to lean into it by increasing overall intake, particularly carbohydrates, to support training and recovery.

A regular menstrual cycle can be a useful sign that you’re fuelling adequately, although this feedback isn’t the same if you’re using hormonal contraception.

Rather than drastically changing nutrients by phase, the priority is getting the basics right. One key nutrient for female runners is iron. Iron deficiency is relatively common in runners, particularly women, due to factors like menstrual blood loss, higher training demands, and foot-strike haemolysis. Low iron can impact oxygen transport, leading to fatigue, reduced endurance, and poorer performance. So try to include iron-rich foods regularly (especially around menstruation) and consider checking levels if you’re experiencing persistent fatigue.

Should I change my recovery strategies throughout my cycle?

Ideally we want to be consistent across the cycle but you might find markers of recovery (like HR, HRV and readiness score/recovery score if you use something like a WHOOP) decline in the luteal phase and sleep disturbance is more common here also so I would priortise sleep hygiene more so in this phase, respect rest days, integrate stress management and try not consume alcohol (which will worsen recovery further).

Final note for marathon runners keen to take their cycle into account?

If you’re not on hormonal contraception, use your cycle as monthly report card to check in on how you’re balancing training and nutrition – and don’t ignore any cycle changes like irregular or missing periods.

Managing your period can be tricky if you’re doing a long run so choose routes with bathrooms you can access, use period products that you trust and are comfortable with, limit your caffeine and fibre intake before runs (because period poops are a thing, and running can impact that more!). If you choose to take painkillers, Ibuprofen is best avoided before or during long runs as it can put extra strain on your stomach and kidneys, especially if you’re dehydrated. If you’re really uncomfortable with cramps/heavy flow, perhaps move your longer/harder runs to day 4 or 5 of your cycle when your symptoms should be easing.

At this point, you don’t need to worry about matching up your training to your cycle, but if you consistently have 1 week of the month where your symptoms are bothersome or you notice a significant dip in performance, you could strategically place a deload week here with shorter, easier runs – but for most women, this isn’t necessary. Let your cycle and symptoms guide you but you don’t need a rigid cycle syncing plan.

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Looking after my hormonal health has often felt like a losing battle. In a world where most healthcare professionals will suggest the contraceptive pill or a series of pricey supplements as the only solution to combat conditions like PCOS, cycle irregularities, or hormonal imbalances, many of us are left doing absolutely nothing. Someone who shares this feeling is Grace Beverley, the brains behind supplement brand Shreddy, and she reckons she's created a women's wellness blend that could be the answer to many of our woes. Naturally, I had to try it out for myself.

Shreddy's Superwoman formula is a superblend of eight different supplements, including 4,000mg of Myo-Inositol, which is commonly studied in clinical research related to women's wellness and found in most PCOS support supplements. The goal is to have a once-a-day drinkable formula that supports normal fertility, normal testosterone levels, normal carbohydrate metabolism, normal blood glucose levels, and healthy hair and skin. In short, it addresses a range of the most common PCOS symptoms.

While hormonal medication and adjusting your lifestyle with things like PCOS workouts can do some good, expert-backed supplements are the one thing that can do some good for everyone. After testing for a month, this is my verdict on Superwoman.

Ingredients and claims

Now, it's important to note that Superwoman isn't marketed as an exclusively PCOS-support supplement. It's an all-rounder, feminine support formula that contains essential nutrients you may be lacking. Most importantly, it tastes just like apple and blackcurrant squash.

The full supplements included are:

• Myo-Inositol - A nutrient spinning a lot of plates and commonly studied in clinical research related to women's wellness.
• CoQ10 - A naturally occurring coenzyme that works inside your cells' mitochondria, often referred to as the body’s energy centre.
• NAC - N-Acetyl L-Cysteine - a stable form of L-Cysteine that is involved in the body’s natural production of glutathione.
• Folate (from folic acid)- Contributes to the reduction of tiredness & fatigue. It also plays a role in supporting normal homocysteine metabolism.
• Selenium - Contributes to the maintenance of normal hair, skin and nails, and supports normal thyroid function.
• Chromium - Contributes to normal macronutrient metabolism and helps maintain normal blood glucose levels.
• Zinc - Supports normal skin, fertility, cognitive & immune function, and contributes to the maintenance of normal testosterone levels in the blood.
• Vitamin D - Vitamin D contributes to the maintenance of normal bones and immune system function.

This unique blend takes a host of everyday supplements that many of us are probably taking separately and puts them into one drinkable formula.

How to take it

One of the best things about Superwoman is how easy it is to take. You just mix 8g, or one scoop (which comes in the bag), with 500ml of water. You can adjust the amount of water based on your flavour intensity preference.

As mentioned, it tastes exactly like squash—and I mean exactly. If I did a blind taste test, it would be almost impossible to distinguish between apple and blackcurrant cordial off a supermarket shelf. Best of all, it blends completely with no lumps or grittiness whatsoever.

Superwoman: My review

The first thing I want to note is that I haven't actually been diagnosed with PCOS, but I have almost every single symptom. My lack of diagnosis is a whole other issue up for discussion, but I've spent the last few years seeking out anything designed to help with PCOS symptoms. I know they won't do any harm, and anything is worth a try in my book.

Shreddy notes that "Superwoman was formulated as a women's wellness blend and is suitable for anyone with PCOS. As with all supplements, it is not intended to treat or cure any medical condition. It is a supplement and not a medicine, so individual experiences will vary." However, it can also "be taken by anyone looking for a daily women's wellbeing supplement," not exclusive to those with PCOS. Great news.

When it comes to tablets, I am admittedly terrible at taking supplements. I hardly remember to take my prescriptions every day. This becomes even trickier when I have five or more supplements to take on a daily basis—the whole thing just goes out the window.

So, any supplement that requires no more effort than drinking a glass of water in the morning is just what appeals to me. However, I've previously spoken about my struggle with many drinkable powders. Most of them I don't find particularly tasty, I don't like the gritty texture, or they're inconvenient to take (i.e. mixed in a smoothie, which can be simply too much effort some days).

If you haven't already gathered, Superwoman couldn't be further from that. Opening the packet for the first time was a little intimidating, as it looks just like a protein powder and has a slightly artificial scent. So, I was expecting not to particularly enjoy the taste and to be met with lumps in my drink. However, it's totally different when dissolved. I used my small electric whisk to mix one scoop with a glass of water the first time I tried it, and it took no more than five seconds to blend. You're left with a liquid that looks exactly like squash, as well as tasting like it.

After establishing this was something I felt happy to drink every day—and, in fact, started to look forward to—the next step was to see how it made me feel. And honestly? While I don't want to claim it's a miracle worker or has improved my symptoms tenfold, I have felt better in myself. I feel less tired, more well-rested, and have more energy day-to-day. I'll have to test for a few more months, but I'm looking forward to doing so—not something that I can readily admit about other supplements I've tried in the past.

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37-year-old Georgie Wileman just won a BAFTA. Her documentary film, This is Endometriosis, depicts the reality of living with the full-body inflammatory condition, which affects one in ten people assigned female at birth and involves tissue similar to the uterine lining growing on other areas of the body, where it causes symptoms such as inflammation, scarring and severe chronic pain.

It’s a condition deeply connected to trauma in more ways than one. To begin with, research involving over one million women shows that adversity in childhood increases risk of endometriosis after menstruation begins, thanks in large part to the prolonged, low-grade inflammation that trauma leaves in the body. Given that endometriosis is an inflammatory condition, trauma has the power to worsen symptoms and potentially even trigger onset.

Then, there’s the pain of endometriosis itself. In the last month, I’ve spoken to over a dozen women who have shared stories of nights spent curled on bathroom floors, trapped between bouts of violent vomiting and diarrhoea. Of months of rectal bleeding which led to anaemia and cancer scares. Of body image destroyed by extreme bloating, which triggered disordered eating. And of chronic pain so severe that it’s rendered them wheelchair-bound for months on end.

Of course, there’s also the trauma of what endometriosis can do to one’s body and relationships. Hormonal dysfunction, structural scarring and inflammation can result in painful intercourse and low libido, before you even mention the potential for infertility, which often completely alters the course of women’s lives, regularly forcing impossible decisions, shame and isolation.

Georgie has lived all of this and more. And yet, our conversation focuses on the one area of this condition you wouldn’t expect to find trauma: that is, in the healthcare system that is designed to diagnose and treat endometriosis. And yet, amongst all of the women I’ve interviewed, medical trauma was their most shared experience. Whether it was a GP telling them their pain was imagined, an endoscopist performing an invasive procedure without proper consent, or referral letters arriving twelve years after consultation, every woman I spoke to had been left with emotional scars caused by medical dismissal, insensitivity, gaslighting, and neglect.

It begs the question: how, in an age where medical diagnostic and treatment pathways are so sophisticated, have we found ourselves in a situation where a condition as common as asthma, and which causes pain akin to childbirth, takes an average of nine years and four months to diagnose - and in that time, is so frequently mismanaged and misunderstood?

Ahead, with the help of psychologists, reproductive health researchers and the women who live these experiences every day, I explore the connection between medical trauma and endometriosis: from its origins, to its impacts and what needs to happen to make real change.

If you’re here looking for further information on endometriosis, make sure to read our guide to spotting the most common symptoms of the condition, alongside the important facts one writer wished she’d known sooner. We’ve also got expert advice from Dr Hazel Wallace on how to advocate for yourself in medical settings, whether you’re struggling with endometriosis or another reproductive health condition, such as PCOS.

What is medical trauma?

To understand how medical trauma has become so common amongst women with endometriosis, we first need to make sense of what it actually is.

Simply speaking, medical trauma is an emotional and physical response to painful, difficult, uncomfortable or frightening health experiences. It can be triggered by a single, isolated event, such as a traumatic surgery, but can also be caused by repeated or prolonged exposure to negative experiences which overwhelm the nervous system.

Importantly, however, trauma is not actually about the event(s) themselves but about how the body adapts in response. “Trauma is a dysregulated nervous system trying to protect itself,” says Dr Farideh Banafshei, counselling psychologist and founder of Harley & Chelsea private therapy. “That’s why two people can go through the same experience, and one may develop trauma while the other does not.”

The way our nervous system adapts to a potential trauma often hinges on the way other people treat us in the moment and aftermath of the event, which is why the care we receive from medical professionals is so instrumental in the development of post traumatic symptoms. “Often the point the brain gets stuck is not the traumatic health event happening, but the moments of not being believed or helped,” confirms Dr Sula Windgassen, health psychologist and author of It’s All In Your Body. “These moments communicate that I will not be helped when in trouble, and that is a fundamental threat to survival.”

How does medical trauma impact women with endometriosis?

Medical trauma doesn't just impact women psychologically and emotionally - it's physical, too. Research shows that trauma dysregulates the immune system, leading to chronic inflammation in the body, which can worsen endometriosis.

Practically, medical trauma impinges on women’s ability to seek treatment by causing them to fear, lose trust and at times, disengage with the healthcare system entirely. “Medical trauma can manifest in severe anxiety before medical appointments, intrusive memories or flashbacks related to previous procedures, or even nightmares about medical settings,” says Dr Banafshei. “Some people feel numb or dissociated when they enter hospitals or clinics, while others begin to avoid healthcare altogether, including both medical and mental health support.”

Georgie knows this all too well. “Now I’ll only ever go to A&E if paramedics tell me I could die,” she says, explaining that the trauma of reentering a medical setting makes her pain worse. “Even medical sounds, such as the beeping of lorries reversing, can trigger me. I have to wear headphones and sunglasses in hospitals to dull the experience and try to avoid panic attacks.”

25-year-old Tia has a similar reaction. “I repeatedly have panic attacks going into appointments and procedures because of the way my pain has been disbelieved over the years. I don’t want to seek mental health support because I’m worried it will lead to more dismissal.”

Deciding to avoid treatment due to trauma has long-term impacts on women’s health outcomes. “Beyond the physical pain, patients often experience depression, strained intimate relationships, disruptions to their education or careers, and in some cases impaired fertility,” says Dr Charis Chambers, OBGYN & Chief Medical Officer at Clue.

Medical trauma also disrupts women’s sense of self. “There are so many times where I ask myself, ‘Am I making this up?’” says Georgie, who explains that it wasn’t until the fourth surgery that she began to believe her pain was real.

Georgie's loss of trust in her body was the product of countless moments of gaslighting by medical professionals. One psychologist even wrote in a pre-surgery report that she was using her wheelchair as an excuse to lean into the pain. “After the operation, my surgeon looked me in the eye and apologised because I had 39 lesions across my body,” she tells me. “It took him looking inside to believe my pain.”

This is an all too common experience. In fact, 83% of women diagnosed with endometriosis have been told by a doctor they were ‘making a fuss about nothing’ according to data from Endometriosis UK. This, combined with frequent misdiagnosis and long treatment delays, “means many women go through failed treatment after failed treatment, leaving them questioning their own experiences and wondering if relief will ever come,” says Dr Chambers.

Why is medical trauma such a widespread issue amongst women with endometriosis?

It’s almost unimaginable that these failings could be happening on such a large scale across the UK -especially as, for the most part, doctors are not causing deliberate harm. Making sense of it requires us to look at a combination of factors, which span the gendered history, politics and economics of pain.

1. A lack of medical knowledge and understanding

Endometriosis is often reduced to a gynaecological condition, rather than the full-body systemic condition that it is. That gap in research, education and knowledge means that symptoms affecting other parts of the body are often missed, leading to unnecessary invasive procedures.

That was true for 30-year-old Lucy, who was subjected to a flexible sigmoidoscopy to check for colorectal cancer, which left her with trauma. “I nearly passed out from the shock and pain,” she says. As a private gynaecologist pointed out to her later, the procedure was not only performed insensitively, it was entirely unnecessary, and could have been avoided had doctors understood how endometriosis can affect women’s bowels. “He actually put his head in his hands in despair at what was missed,” she recalls.

Dr Chambers confirms Lucy’s experience. “Endometriosis is complex, but medical training often dedicates limited time to it, leaving many clinicians without the depth of knowledge needed to recognise and manage it effectively,” she explains.

2. A cultural normalisation of menstrual pain

There’s also a cultural bias impacting the way women’s pain is treated, with research showing that women are consistently prescribed less effective pain relief than men.

Period pain, in particular, is normalised across society. “Painful periods, pelvic pain, and fatigue being routinely dismissed as ‘normal’ by families, friends, and healthcare professionals," says Dr Helen O’Neill, associate professor in Reproductive and Molecular genetics and co-founder of Hertility.

“This leaves an unfair burden on patients to prove their suffering,” adds Dr Chambers. “This, layered onto chronic pain, can be exhausting and over the years, can be deeply traumatising.”

3. A shortage of medical resources

Currently, 3 million women are waiting on NHS gynaecology lists - the longest across any speciality in UK healthcare. “This creates “a diagnostic bottleneck where women are trapped in a cycle of GP appointments without resolution,” says Deirdre O’Neill, Co-founder and Chief Commercial and Legal Officer at Hertility.

How can we reduce medical trauma amongst women with endometriosis?

1. Compulsory menstrual education in schools

“Many women don’t know what endometriosis is until years after symptoms begin, because we are never taught that severe period pain is not normal,” says Dr O’Neill.

By equipping young girls with knowledge about the early symptoms of endometriosis, which include but are not limited to fatigue, painful periods, painful bowel movements and pain during sex, we put them in a better position to advocate for themselves in medical settings and maintain internal trust throughout the diagnostic and treatment process.

2. Improved diagnostic measures and training for healthcare professionals

Until now, surgery has been required to confirm an endometriosis diagnosis, which has led to years of untreated pain, uncertainty and potential organ damage for many women. But new guidance from the American College of Obstetricians and Gynaecologists, published just last month, indicates that this shouldn’t be necessary to diagnose and commence treatment.

“The shift away from surgical gatekeeping could shorten diagnostic delays and would mean patients no longer need surgery to ‘prove’ their pain is real before accessing care,” says Dr Chambers.

4 tips for women navigating diagnosis and treatment for endometriosis:

Of course, while healthcare reforms are needed to prevent future harm to women with endometriosis, care is also needed for those who are already living with medical trauma.

If that’s you, or someone you know, the specialists have some advice.

1. Validate your trauma

It sounds trivial, but recognising and validating your experiences is an important step to healing. “If your experiences in the medical system have felt frightening, violating, or dismissive, it is important to acknowledge that,” says Dr Banafshei. “Part of healing involves untangling your real experience from a system that may have failed you.”

Bringing someone with you to appointments can also help here. “A trusted person can provide emotional support and help you feel less alone during the process,” Dr Banafshei says.

2. Don’t be afraid to seek mental health support

Seeking help from a therapist, especially one who is trauma-informed, can be a helpful step. “Over time, addressing the trauma can help separate the suffering caused by the illness from the suffering created by the medical system around it,” says Dr Banafshei.

A word of advice. When you seek therapy, it’s important that your therapist knows whether the trauma is still ongoing or if it’s in the past. “If trauma is still occurring, stabilising the nervous system and providing supportive care comes first,” explains Dr Banafshei.

In contrast, if trauma is entirely connected to an event in the past, then techniques such as EMDR can help you to process the experience. “EMDR can work with both the memory itself and the bodily sensations connected to that memory, which is why it can be particularly effective for processing emotions such as shame,” says Dr Banafshei.

3. Track and document your symptoms

Documenting your symptoms can help you feel more prepared to re-enter medical environments, says Eve Lepage, Reproductive Health Specialist at Clue. “Instead of relying on memory alone, symptom tracking allows you to point to patterns and trends in your own data, which can become a form of self-advocacy.”

LePage suggests logging the following information about your cycle. “These help to create a longitudinal health record that can reveal patterns that might otherwise be overlooked,” she says.

Bleeding patterns

• Heaviness
• Spotting
• Colour

Symptoms

• Headaches
• Cramps
• Bloating
• Mood changes

Lifestyle factors

• Sleep
• Exercise
• Sexual activity

4. Seek second opinions

Losing trust in the healthcare system often leads us to turn to social media in search of answers. But whilst online spaces such as Reddit’s r/endometriosis community can provide validation and connection to other women, they aren’t a replacement for medical care, which is why it’s important not to give up on medical diagnosis, as frightening and off-putting it can be.

“If you don’t feel safe or respected with a healthcare provider, you have the right to seek someone else,” says Dr Banafshei, who says that regaining choice is an important step to healing medical trauma. “Feeling empowered in how you approach your care rebuilds autonomy and internal trust because your entire health isn’t in someone else’s hands,” she says.

If you, or someone you know has been affected by medical trauma during their diagnosis and treatment of endometriosis, the following services can provide resources, advice and support.

Endometriosis UK

The Endometriosis Foundation

For private healthcare, Hertility offers at-home diagnostic testing and endometriosis-specific referral for ultrasounds and specialist consultation, which can reduce diagnostic timeframes.

I’m a former NHS doctor, a registered nutritionist, and an author who's always been really interested in the link between nutrition, lifestyle and medicine. That's why I set up The Food Medic about thirteen years ago, back in 2012.

My interest in women’s health really grew during my time working in the NHS, where I noticed how often women’s symptoms were dismissed or not taken seriously – whether that was painful periods, chronic fatigue, or conditions like endometriosis and PCOS.

When I started digging into the research, I realised that a lot of the medical evidence we rely on today has historically been based on male bodies - something we never spoke about at medical school. That really opened my eyes to the gaps in women’s health research - we were basically leaving much of what we know about women up to guesswork. It’s what led me to write my first book, The Female Factor, in 2022, and later Not Just a Period, which came out in 2025. Now much of my work focuses on women’s health, both through my writing, research and in clinic, where I work with women to support their health through nutrition and lifestyle.

Last year, I decided to take matters into my own hands, undertaking my own research study and really diving deep into how women feel about their own menstrual cycles. Menstrual cycles are a natural part of many people’s health, yet are subject to stigma and misinformation, which can affect the experience of menstrual-related symptoms and overall well-being.

Getting to the bottom of how women are really feeling about their cycles

We had quite a bit of emerging research looking at how female physiology - for example, our hormones - impacts things like exercise, performance and strength. But there’s much less research exploring the real-life lived experience of the menstrual cycle and how symptoms and our perception of the cycle affect day-to-day life.

We quizzed nearly 5,000 women over the age of eighteen who had menstruated in the previous twelve months. What I was really interested in understanding was whether the way someone feels about their menstrual cycle might shape how they experience it. For example, if someone has a more positive perception of their cycle, does that influence how severe their symptoms feel, or how much those symptoms impact their life?

We also wanted to explore how menstrual symptoms affect real areas of daily life, such as work, social activities, and relationships, because there’s very little research that explores those lived experiences.

Interestingly, in total, over 7,000 women accessed the survey from only one Instagram story, which really shows how keen women are to have their voices heard and to contribute to research in this space. In the end, we had just under 5,000 complete responses that we could analyse.

Our findings

The findings showed that menstrual cycles impact many areas of our life.

• 90.7% said menstrual symptoms disrupted their work in some way.
• 31.8% had taken time off work or university in the past year because of their cycle.
• 76.2% said their concentration was affected when working or studying while experiencing symptoms.
• 59.4% said they feel the need to hide or downplay symptoms at work.
• 84.3% said their cycle disrupted intimate relationships.
• 92.4% said symptoms affected intimacy with a partner in the past 12 months.

90% of women feel their periods disrupt work in some way

Perhaps the most shocking finding was that over 90% of participants (women) said their symptoms disrupted their work in some way, and around one in three had taken time off work or university in the past year because of their cycle. That really highlights how big the impact can be, yet it’s something we still don’t talk about very openly.

The other interesting finding was the link between perception and experience. Women who viewed their menstrual cycle more positively actually reported lower levels of pain (about 18% lower on average) and fewer mental health symptoms. While we can’t say one causes the other, it does suggest that how we understand and talk about the menstrual cycle may influence how we experience it.

One area that stood out (and isn’t talked about nearly enough) was the impact menstrual symptoms can have on relationships. In our survey, over 84% of respondents said their menstrual cycle disrupted their intimate relationships, and many reported that symptoms affected intimacy or their comfort during intimacy. What was particularly interesting was that people who felt more comfortable seeking support from their partner reported less disruption to intimacy.

When it comes to periods, they’re often framed as something we just have to “put up with” or brushed off as a minor inconvenience, but the data really showed the opposite. For many women, their periods and menstrual cycles have a significant impact on their lives, affecting work, concentration, relationships and mental wellbeing. It also confirmed that many women still feel uncomfortable discussing their cycles. Many said they still feel the need to hide or downplay their symptoms, particularly at work, which shows there is still a lot of stigma around menstruation.

The gap between what we know and how seriously menstrual health is taken

We also hosted a focus group that helped shape my most recent book, Not Just a Period. While that research isn’t published yet, it was built on the findings from this study and gave us deeper insight into women’s lived experiences.

One anonymous quote from the focus group really stayed with me because it highlights the power of open conversation and support when it comes to the menstrual cycle: “I basically learned about my period in my late 20s, early 30s, and on social media - because none of us were taught it at school. And now we finally understand our bodies. It's one of our favourite things to talk about (because it means) we're able to support each other better. I feel like it's made my friendships deeper, and (even) my partner can support me better - I feel like it's actually brought us closer. It's definitely helped being able to talk about it with each other. It's really scary to think that we all just learned about it on social media."

Improving menstrual health education and literacy is a key priority

One of the questions I’m most interested in exploring next is whether improving menstrual health education and literacy can actually change how people experience their cycles. If people better understand what’s happening in their bodies and feel more comfortable talking about it, could this influence how they perceive and manage symptoms? I think this could be especially powerful for younger girls coming up after us, so they can have a better experience of their cycles

Policymakers, workplaces and healthcare providers, menstrual health isn’t just a personal issue; it has wider impacts on productivity, careers and relationships. We need better education, more supportive workplace policies, and healthcare systems that take menstrual symptoms seriously and provide people with the support they need.

In future, I'd love to see future research which explores whether improvements in the above - better menstrual health education, introducing workplace policies, or reducing stigma - can positively influence how people experience their cycles. (Our findings suggest that perceptions of the menstrual cycle may be linked to how people experience their symptoms and how much those symptoms affect their lives, but because this was a survey, we can’t determine causation).

Bottom line? It's never *just* a period

I hope this information encourages more open conversations. Our research showed that when people feel more comfortable talking about their symptoms and seeking support, whether from healthcare professionals, partners or friends, it can make a real difference to how supported they feel.

Next time you find yourself in a doctor's office not being listened to, or a colleague or companion undermimes your symptoms, please remember: Its not just a period.

This research highlights the gap between what we know and how seriously menstrual health is often taken in practice. Too often, period-related issues are still dismissed as “just a period,” which is actually where the title of my book comes from. Many people experiencing severe pain, heavy bleeding or mood changes are told it’s something they simply have to put up with. I hope this work changes that narrative.

Shop Dr Hazel Wallace books now:

There’s a particular performance women with endometriosis get very good at: looking completely fine whilst everything inside is screaming otherwise. We know what it does to the body - pain, missed social events, fertility struggles - and that one in ten women in the UK are living with it. But there’s one cost that rarely makes the headlines: the impact on careers.

For 1.5 million of us in the UK, the workplace can be another battlefield, navigated quietly through sick days, whispered explanations, and the constant fear of being seen as unreliable. Symptoms may be invisible, but the professional consequences aren’t.

If this sounds dramatic, the numbers suggest otherwise. 50% per cent regularly miss work, 30% per cent take more than three days off a month, and many lose up to 16 hours a week. The scale is staggering. In fact, the number of women currently waiting in the UK just to see a gynaecologist is so high it could fill Wembley Stadium eight times over.

Then there are the consequences that stretch far beyond a few missed meetings. One in six women with endometriosis leaves their careers entirely because of the condition. 28% say they’ve had to change or quit their job. And perhaps most telling of all, 40% say they fear losing their job altogether because of their symptoms.

Statistics alone can’t quite capture what it’s like to plan deadlines, meetings, and ambitions around a condition that can disrupt a day without warning.

Too often, endometriosis is packaged as “just” a gynaecological problem, rather than the full-body, systemic condition it is. With a cost to the UK economy of over £8 billion a year, the professional toll is glaring, and it’s time to break the silence.

The piece starts that conversation. We spoke with women whose endometriosis has taught them resilience, endurance, and the quiet skill of holding it together - all while unrelenting pain. Our goal? To give women the language, confidence, and evidence to advocate for themselves at work. Because managing a chronic condition shouldn’t mean sacrificing your professional life, and that’s a story worth telling.

So, let’s get loud. And, for more on how to advocate for yourself in a medical setting, don't miss our guide from Dr Hazel Wallace.

The Career Cost of Endometriosis in 2026 is Shocking - and Not Spoken About Enough

Firstly, How Do Flare-Ups Actually Affect Women at Work?

If there’s one thing you can count on, endometriosis doesn’t respect a schedule. Just when your body lures you into a false sense of security, a flare-up will remind you who’s really holding the reins.

Martin Hirsch, endometriosis specialist and gynaecologist, explains that it comes down to inflammation. “Each month, misplaced endometrial-like tissue responds to hormones like the uterine lining - thickening and breaking down. But outside of the uterus, that blood and inflammatory material has nowhere to go.”

Ever sat at your desk rereading the same email three times, trying to remember the sentence you started five seconds ago, while quietly staring at the wall like it might hold the answer - welcome to endometriosis fatigue. If you’re wondering what this has to do with your condition, Hirsch puts it plainly: “The exhaustion you feel isn’t just poor sleep due to pain - chronic inflammation drains energy. Pain changes how the nervous system processes signals, creating the ‘brain fog’ many women describe: difficulty concentrating, slower thinking, forgetfulness.” And to top it off, if all of that wasn't already enough, hormonal changes can make it a whole lot worse.

Most symptoms are invisible, which is part of the problem. When no one can see what you’re dealing with, the pressure to keep going only adds another layer of anxiety. Hirsch explains: “Some women experience unpredictable spikes, making attendance inconsistent. Others can push through, but at reduced productivity - something we refer to as ‘presenteeism’”. One study shows women with endometriosis lose, on average, 11 work hours per week due to symptom flare-ups - comparable to people living with type 2 diabetes.

Endo veterans, this will sound painfully familiar. But for the uninitiated, it bears repeating: endometriosis isn’t just a gynaecological issue - it’s a full-body, full-time condition…and sadly it comes with no annual leave.

When Workplace Rules Don’t Work for Women with Endometriosis

Ask anyone in the endometriosis community, and you’ll likely hear the same thing: most days, it feels like the system is set up to work against us.

The modern 9-5 runs on efficiency, deadlines, and performance reviews, and sometimes, the unpredictability of endometriosis doesn’t always slot neatly into that system. The numbers reflect that reality.

Over half of women report career setbacks, and that constant gnawing feeling that their ambition is on hold, not because of a lack of talent, but because their body won’t cooperate. In fact, recent data shows that 27% of women say they missed out on promotions because of their symptoms.

The constant negotiation with our bodies stretches far into workplace culture and policies. A recent survey shows that few managers are trained to support menstrual or chronic conditions, and formal policies are rare. So many women keep symptoms to themselves, fearing the classic ‘but you look fine’ response.”

Harriette Wright, producer of the BAFTA-winning short film This Is Endometriosis, argues, “if workplaces truly understood the complexity of the disease and recognised the need for a multimodal treatment approach, the practical accommodations would be obvious.”

And yet, somehow, we keep showing up, finding our own rules, and carving out the space we need - because who else will?

Why Are Workplaces Still Failing Women with Endometriosis

We spoke to women who know this reality firsthand.

Sophie Richards, bestselling author and endometriosis campaigner, recalls feeling forced to choose between her health and being seen as committed.

“I've left workplaces in the past because I didn't feel properly supported. Now, I'm very open about it, but that confidence came later. What needs to change is the culture. We have to normalise the idea that health is relevant at work. How well someone feels directly impacts the quality of their work, and chronic conditions sometimes require flexibility or reasonable adjustments. That should not be controversial. There were moments when I had to decide whether to protect my health or push through, especially when flexible working was misunderstood.”

Now, she structures her work around her cycle, scheduling outward-facing tasks when she has the most energy and reserving low-energy days for behind-the-scenes work.

That experience of navigating work while managing symptoms is something many women recognise.

Amie Flynn, Head of Product at Mori and co-founder of Kuratd Studio, who echoes this experience. “When workplaces don’t understand that this is a whole-body condition, you feel like you have to hide what you're going through, which can impact confidence. I’ve had comments like ‘everyone gets period pain’ or ‘it can’t be that bad if you’re still working.’ That kind of dismissal makes you question yourself.”

Endometriosis has shaped how Amie leads, builds resilience, and even inspires her entrepreneurial spirit, designing products that genuinely support women navigating similar challenges. With her sister Bobbie, she’s even designed the first endo-friendly piece of denim.

What Can Change - and How Can Women Advocate for Themselves

If endometriosis makes showing up at work feel less like a job and more like steering through a rigged obstacle course, there’s a silver lining: women are finding real, practical ways to reclaim control, while the workplace slowly catches up. Sophie Smith, co-founder of Grand Aesthetics, knows exactly how this starts, and it’s self-advocacy.

“Looking back, living with endometriosis has influenced every inch of my career. I run my business and lead a team of 17, so there’s always a real responsibility to show up every day because people rely on me. This has shaped how I've learned to manage both my health and workload. The lack of a flexible environment I’ve seen has influenced what I’ve created. Feeling supported rather than judged can make the difference to someone’s ability to keep showing up and doing their job well, so this is why I say be your biggest advocate - don’t feel ashamed for telling someone what you’re going through - in fact, I suggest you do.”

Hirsch notes that while everyone’s experience is unique, there are strategies that can reduce flare-ups and their impact on your work life:

• Anti-Inflammatory medication: Taking NSAIDs like ibuprofen or naproxen proactively can be more effective than waiting for pain to peak.
• Heat therapy: A discreet heat patch relaxes pelvic muscles and eases pain during the day.
• Gentle movement: Light stretching or short walks can reduce pelvic congestion and stiffness.
• Hydration and regular meals: Stable blood sugar combats fatigue and nausea.
• Pacing and micro-breaks: Intentional short pauses help manage pain and cognitive strain.
• Stress reduction techniques: Even 2-3 minutes of deep breathing or grounding exercises can dampen pain perception.
• Music: Enjoyment signals in the brain can compete with pain signals, helping to reduce discomfort.

Navigating a chronic condition is messy, exhausting, and often unfair - but it’s also powerful. While we wait for workplaces to catch up, we must continue to carve our own boundaries, fight for the support we need, and be transparent.

Every conversation, every small adjustment, every strategy is a step forward. And yes, while the office bathroom floor can continue to be our unsung hero ( the blissful feeling of a cold tile to the cheek for that instant hit of relief) in the gaps left by stigma and absent policies, there is a community: a network of women sharing experience, advice, and solidarity.

So readers, grab your heating pad and settle in. With persistence, awareness, and the right tools, it’s not just possible to survive endometriosis at work, it’s possible to reclaim your health, career, and confidence.

Marie Claire's 9-5 Endometriosis Essentials Kit

I must’ve slipped into a time vortex because I’m suddenly 35 and closer to menopause than the start of my periods, yet every time I scuttle to the bathroom with a tampon up my sleeve, I’m thrown back to secondary school, embarrassed and ashamed of my monthly bleed.

Whether it’s tucking keys between our fingers when walking home alone or folding a pad into our palm, as women, our lives are made up of these small gestures. We learn early on to accept that this is just the cost of being a woman. There are literal costs too, and they aren’t cheap.

New research from period and cycle tracker Clue puts a number on it: £20,359 over a lifetime: that’s the estimated amount people who menstruate in the UK spend managing their periods. It’s a staggering figure, but once you start adding it up—pads, tampons, pain relief, emergency purchases, ruined clothes—it makes frustrating sense.

As Ashley James , who’s partnered with Clue to raise awareness of the ‘Cost of Bleeding’ and campaign for change, points out, £20k isn’t just about period products; it’s everything that comes with them. “Since having my kids, my periods are so heavy that I’m always having to replace bed sheets and clothes,” she explains. “And then I’m going through private healthcare testing… like that endometriosis battle that I think so many of us have to go through.” According to the same research, more than a quarter of people are now paying for private healthcare to manage conditions like PCOS or endometriosis, often because NHS wait times are too long. It’s a statistic that shows we’re living in a system where being able to function increasingly depends on what you can afford. “It feels like a financial luxury to be able to function,” agrees Ashley.

We tend to talk about periods as a personal issue, something we have to grin and bear, but the reality is more complex. Nearly 40% of people say they’ve cut back on essentials like food, bills or transport to afford period products. A similar number have resorted to makeshift alternatives like tissues or wipes. “That is so dehumanising… how can we expect women and girls to thrive when their dignity is robbed from them just because they cannot afford basic health needs?”

It’s been just over five years since sanitary products stopped being taxed as luxury goods. As recently as 2020, when the UK economy suffered a record annual slump and ‘austerity’ was shoehorned into seemingly every political speech, women were still paying a ‘tampon tax’ on essential healthcare.

For context, exotic meats, edible cake decorations, and Jaffa Cakes were all zero-rated for VAT. Tampons, by contrast, were subject to a 5% VAT rate, while period pants were taxed at 20% until 2024. “I think there’s a real lack of compassion and understanding about period pains and how much pain that is normal to tolerate,” says Ashley.

“How many of us feel empowered to say, ‘actually, do you know what, I’ve got really bad period pain, I’m not able to come into the office’?” Instead, we push through, and, over time, learn to second-guess our own bodies. I’ve seen this kind of internalised misogyny in real time when a colleague once asked to work from home because of her excruciating period pain (this was pre-pandemic), only for our female boss to audibly scoff.

In Ashley’s case, she lived with severe iron deficiency for two years without even realising, dismissing the exhaustion as the byproduct of work and motherhood. “I felt like I was really tired, but I kind of just put it down to being a new mum… and again I dismissed it,” she says.

The word advocate comes up repeatedly in our conversation. Not just Ashley’s need to self-advocate in healthcare settings, but everywhere. The time it takes to explain symptoms, to be believed, to push for referrals, tests, and, if we’re lucky, answers. Even with private healthcare, Ashley describes it as “still a bit of an uphill battle.” This is one of the least visible costs of menstruation: not just money, but time, energy, and persistence. Add in the mental load, the motherhood penalty, the medical gap, the gender pay gap, and it’s hard to name a space where women aren’t on the back foot.

“I just wrote a book, Bimbo, and it looked at shame and how society and patriarchy kind of strips women of dignity and confidence through shame,” Ashley tells me. “And I think often when something is seen as a woman or girls' issue… we very much view nearly everything through the male gaze and male comfort.” You can see it everywhere, from the blue liquid still used in adverts as a clinical stand-in for blood to the language of “hygiene” around periods, implying something inherently unclean; the instinct is to conceal.

Heaven forbid we make a man mildly uncomfortable.

As we trade teenage ‘shame’ stories—me with my school sleeve wadded with a pad, Ashley playing lookout so a friend could buy sanitary products without being spotted by boys—it becomes clear how early this conditioning starts, and how long it lasts. At 35, I still avoid light clothes if I’m on my period. Ashley remembers a moment she “bled through” on a flight as “mortifying.”

“I feel like it’s all very much seen as something that’s like a dirty taboo secret that we should do in silence,” she says. But silence has consequences; it impacts how seriously pain is taken and how quickly conditions like PCOS and endometriosis are diagnosed, as well as how policies are prioritised, or, more often, not prioritised. It’s why something as basic as access to period products can still feel precarious in objectively rich countries like England and Wales.

“We’re punished because of our biology,” Ashley says. “Which seems crazy when none of us would be here if it weren’t for periods.” There are structural shifts needed: better research, better healthcare, and more supportive workplaces. But there is also a clear starting point: free, accessible period products. “It’s a no-brainer,” Ashley says.

“When you think about the financial implications… how can we expect women and girls to thrive when their health needs are not being met because of money?” We’ve been taught to treat periods as something private, something to manage discreetly. The £20,359 figure doesn’t just expose the financial cost of that silence; it reveals how much we’ve been expected to pay, physically, emotionally, and financially, without question.

Sign the petition today to make period products free and widely available in England.

I used to think What to Expect When You’re Expecting covered the full brief. You get pregnant. You prepare. You panic-buy a book.

But somewhere along the line, we entered the spin-off era: What to Expect When You’re Expecting to Expect. These days, according to my TikTok FYP, you should start optimising your womb six menstrual cycles in advance, with a meticulously curated supplement stack and a home free from toxins.

Trying to become pregnant, whether you're navigating fertility challenges or not, can be incredibly stressful. And everyone, it seems, wants to give their two-penn’orth. Eat this. Don’t eat that. Track everything. Detox. Upgrade your air quality. Scroll long enough, and you’ll learn your hypothetical child would quite like a perfectly balanced microbiome, zero cortisol spikes and perhaps a fenu-shui-approved nursery.

This is the "Trimestor Zero" trend; preconception rebranded as a self-improvement project. Routines are engineered for theoretical embryos, and before the baby even exists, you’re encouraged to ensure your body is operating as a five-star accommodation.

Beneath the wellness gloss, there are fundamental medical principles that truly matter. For example, the World Health Organisation recommends starting folic acid before conception, and the NHS advises reaching a healthy weight, limiting alcohol, and stopping smoking. To be clear, these aren’t TikTok trends; these are pearls of factual wisdom that have been passed down from generation to generation.

And when you consider that around 1 in 7 couples in the UK experience fertility challenges, the urge to be proactive makes so much sense. Even in healthy couples under 35, the chance of conceiving in any given cycle is only around 20-25%. In other words, biology doesn’t always run to schedule. When outcomes feel uncertain, optimisation can feel like action - something to do while you wait.

In a nutshell, what we're looking at is preconception framed as preparation-meets-performance, where doing “something” feels far safer than sitting with uncertainty.

So, take a seat. Close the ovulation apps (just for a minute.) We’ve spoken to the experts, sifted the evidence from the algorithm, and unpacked what actually matters - so you can step away from the doom scroll.

Seen the "Trimester Zero" trend doing the rounds? Top experts unpack the trend

Firstly, Let’s Unpack ‘Trimester Zero’

At first glance, "Trimester Zero" sounds reassuringly official. The kind of term you imagine printed in bold inside a hardback pregnancy manual, somewhere between “folate” and “fundal height.” In reality, it’s less a medical milestone and more of a cultural mood.

“Trimester zero is a cultural idea that pregnancy now begins long before a positive test,” says Eve Lepage, Reproductive Health Specialist at Clue. “It describes the growing pressure to optimise your body in the months or even years in advance by balancing hormones, eliminating “inflammatory” foods, detoxing your home, tracking every biomarker and treating conception like a performance project.”

In other words, although the fundamental elements of preconception care remain the same, what has changed is the level of intensity with which individuals approach it.

“Social media has absolutely altered how women approach fertility before they come to the clinic,” says Dr. Amit Shah, Consultant Gynaecologist & cofounder of Fertility Plus clinic. “Ten years ago, most patients came in after trying for a while. Now many arrive having already spent months working on egg quality.’ They’ve eliminated food groups, taken multiple supplements, tracked basal temperatures, worn continuous monitors, and done private hormone panels. They’re often exhausted before they’ve even started.”

And increasingly, he says, some delay seeking medical advice because they feel they must “optimise” first.

“That’s the part that concerns me. Fertility is time-sensitive, so waiting to become ‘biologically perfect ' may do more harm than good.”

Why Has Fertility Become Another Self-Optimisation Project?

Ironically, the more we track, the louder our bodies feel. Admit it - uncertainty is unbearable. So we optimise, tweak, and micromanage everything we can: our sleep, our meals, our stress, even the air quality in the living room. Because if there’s any corner we can control, why wouldn't we?

As Dr Shah puts it, “Fertility is uncertain, and modern culture struggles with uncertainty. We optimise careers, fitness, nutrition, and sleep. It feels logical to apply the same framework to reproduction.”

The problem here? Reproduction is probabilistic, not linear. Effort does not guarantee outcome.

Even fertility treatment can dip its toe in optimisation culture: more scans, more monitoring, more adjuncts, more “just in case.” As Dr Shah notes, patients can start to feel that declining add-ons is somehow an irresponsible move.

And when care isn’t consistent, advice can quietly escalate. “Continuity matters enormously,” he explains. “A steady clinician can hold the line.” In an inherently unsteady process, that steadiness can be the difference between feeling supported and feeling like you’re spiralling into the next upgrade.

What Does Science Actually Says About Pre-Pregnancy Optimisation?

Trimester Zero sells something very compelling: the idea that if you try hard enough and optimise diligently, biology will reward you, and, to no surprise, the evidence-based recommendations are far more straightforward than the internet suggests.

As Lepage explains, "Evidence suggests starting at least 400mcg of folic acid before conception and in early pregnancy, keeping chronic health conditions under medical guidance, avoiding smoking and recreational drugs, moderating or cutting out alcohol while trying, staying up to date on vaccines, screening for STIs where relevant, and supporting overall physical and mental wellbeing. These behaviours are what major health organisations actually recommend - not just internet advice masquerading as science."

These basics really do matter. Recent UK research shows taking folic acid before and in early pregnancy can dramatically cut the risk of serious birth defects - in fact, the right levels could prevent up to 80% of cases. That’s why the NHS still recommends supplementation: it’s simple, effective, and one of the few preconception moves that actually make a big difference.

Perhaps the most sobering statistic of all? Even under the ideal conditions, the chance of conceiving in any given cycle is only around 20-25%. Which means, statistically speaking, patience isn’t a personal flaw - it’s part of the process.

“The danger,” Lepage explains, “is when preparation becomes framed as moral responsibility. When pregnancy doesn’t happen quickly, people may start auditing every coffee, every stressful week, every plastic lunchbox.”

When Preparation Tips Into Pressure, and How to Spot It

Even if you follow the evidence to the letter, fertility remains gloriously unpredictable. And that’s where the pressure seeps in. The urge to “do everything right”, worship at the altar of your ovulation app and side-eye your scented candle for fear of sabotage - can turn something natural into a quarterly performance review for the uterus.

Lepage cautions, “There’s a danger of moralising preparation: when pregnancy doesn’t happen quickly, people start scanning and scrutinising their past for mistakes.” Every drop of caffeine, the nail polish they’ve used, every missed supplement - all a potential culprit.

It’s a pattern Dr Shah sees in clinic, “women arrived exhausted and anxious before they’ve even officially started trying. Preparation becomes pressure when it stops being proportionate,” he explains. “I see it when patients describe guilt over a single missed supplement dose, or when intercourse becomes a scheduled task, rather than intimacy.”

The tipping point; “When optimisation delays medical advice because someone feels they must become “biologically perfect” first. It’s when repeated private hormone panels uncover “borderline” abnormalities that are clinically insignificant but psychologically wavering. It’s when the supplement stacks grow without medical guidance, and add-ons are framed not as a choice, but as a “why wouldn’t you do everything if you could?”

From where I’m sat, there’s a thriving ecosystem around all of this. The rattle of several supplement packets in your bag, various tests to run, upgrades to apps you never knew existed. The message we’re being sent is clear: if you can act, you probably should. Understanding where that line sits, and who benefits when it shifts, is crucial if preparation is to remain supportive, rather than tipping into something self-punishing.

So How Should Women Really Approach Preconception Health?

Readers, put down your ovulation app for a second and pull up a chair; it’s time to have a real chat about preconception. There’s so much pressure on women to become the “perfect vessel” for pregnancy; perfectly nourished, hormonally balanced, and stress-free - sounds like the dream doens’t it? The truth, from what we know so far, is that it’s a little bit of luck (and a lot of biology)

Lepage recommends a balance, evidence-led approach. “For someone healthy but feeling pressure to ‘do everything right,’ it looks like this:

• Start folic acid before trying.
• Check in with a healthcare provider if you have chronic conditions.
• Review medications for safety in pregnancy.
• Aim for general well-being by prioritising sleep, nutrition, and movement.
• Track your cycle to understand your fertile window.
• Leave room for uncertainty.

Dr Shah adds that knowledge is meant to empower, but perfection isn’t. “If you feel pressured into add-ons with limited evidence, ask direct questions: ‘Does this improve live birth rates for someone with my profile? What happens if I decline? Is this recommended by regulatory guidance or considered experimental?’ A reputable clinician should answer without defensiveness. The goal is to feel informed, not perfect.”

So, Trimester Zero: a trend born from our urge to feel in control when the one thing we really can’t control - biology - feels completely unpredictable. Ironic? Absolutely. But here’s the takeaway: preconception health isn’t a to-do list for your womb.

At its heart, it’s about balance. Smart, evidence-backed choices. Enough flexibility to respect what’s beyond your control. And a focus on your mental wellbeing. Do that, and preparing for pregnancy feels less like ticking boxes, and more like the ultimate act of self-care - the smartest, kindest prep any future baby could hope for.

Shop Marie Claire UK’s Optimisation essentials now:

My daughter’s nursery is a stone’s throw from the fertility clinic where she was conjured into being. Despite walking past the entrance four times a day, several times a week, the drab building still seems remarkable to me, a place of worry and wonder. I often think about that time in my life, and lately have considered why it took getting pregnant for me to really open up about it.

Initially, we told select friends and family. It seemed such a momentous process that keeping it between the two of us didn’t feel possible — how else would I explain why I couldn’t commit to the hen do around the time of my egg collection, or my sudden switch from wine to nettle tea? Most people we told were concerned and supportive, but some — to our surprise — seemed purely excited. Perhaps they hadn’t known if we were going to have children and were pleased we were (hoping to), or possibly they had a skewed idea of the success rates, like I used to.

Typing IVF into a search engine brings up a range of content, almost all of it focused on positive outcomes. Most is clever advertising from fertility clinic websites; the rest tends to be articles about people in their mid-to-late 40s having children through IVF. Since the HFEA reports a birth rate of under 5% per embryo transferred for women aged 43 and over, these stories really are remarkable. They are not the norm. There’s already a culture of toxic positivity within the world of fertility treatment, where the reasonable advice of reducing stress has morphed into a need for absolute positivity; a deranged idea that by chilling out, women can manifest a pregnancy. And the media’s obsession with success stories adds greatly to this, making it harder to tell those around you when a round has failed.

People aren’t good at failure; most of us fear it. The psychologist Jonathan Atkinson characterises this fear as “the capacity or propensity to experience shame upon failure”. We seek out books on how to overcome it, podcasts on how to do it, and therapy to unpack the consequences of it. Studies show that women are much more likely to fear failure and to adopt avoidance-based goals as a consequence. Whiteboards are encouraged in primary schools so that wrong answers can swiftly be erased and children — particularly girls — will be more likely to have a go. When you’re struggling to conceive, the fear of failure is constant. Each month brings around the same disappointment and an overwhelming feeling that your body is failing you.

The reason the NICE Guidelines recommend three rounds of IVF is that most of us aren’t lucky enough to get two blue lines on our first attempt, though given a few chances, many eventually will. Failure of some sort is commonplace, though it’s still rarely spoken of. Before being added to the waitlist, our consultant asked if we were sure we wanted to proceed, reminding us that even in the most favourable age category, a round of IVF is much more likely to fail than succeed. Her unexpected candidness went against all the think-positive propaganda we’d consumed, allowing us to prepare ourselves for the possibility of negative outcomes, and in doing so, protect ourselves.

It’s difficult to practice self-preservation without coming across to friends and family as having lost all hope. People would remind me of a colleague or even a stranger whose sixth round was successful, but these narratives rarely brought reassurance. I wasn’t sure I’d be able to endure or finance such a marathon, and I worried how people would react if I were to just step away, if I simply stopped. It felt like women were celebrated for pushing themselves to the brink, and those who didn’t were made to feel less. With each setback, I sought stories of people finding happiness despite not having the children they desired. I was searching for a blueprint of a different life, evidence that things would be okay either way. A protective — not preventative — mindset. It wasn’t that we’d lost hope; we just carried it carefully, close to our chests, worried it might shatter if released.

It took three scans, sixteen weeks, and my jeans to no longer fit before we told anyone beyond our close circle that we were pregnant. When we did, we always added that it was through IVF — it felt too miraculous not to mention. We were high on gratitude and relief and yes, hope — this time, the soaring kind. And people understood how huge it was for us, their celebratory hugs coming back in for a second squeeze.

As of 2025, there are now only three Integrated Care Boards in the UK that meet the NICE Guidelines and offer three NHS rounds of IVF; the vast majority offer one. We lived in one of the six areas in the UK that didn’t offer any NHS-funded IVF at all, but since the treatment area is dictated by the postcode of your GP rather than your home address, we were offered two. This administrative detail is likely the reason we are lucky enough to have children. It doesn’t sound fair, because it isn’t.

Many people end up paying for additional rounds; many people can’t afford to. In the online world of trying to conceive, infertility is often described as a battle, its participants: warriors, and I think it’s important that we keep listening to those who put down their swords, who know when to step away, or have no choice but to. Opening up the conversation to all eventualities isn’t losing hope; it’s gaining insight, paving the way for easier, better conversations.

Close your eyes and imagine a belt cinched tight around your lower waist. Then, picture bricks hanging from said belt. A deep ache radiates into your back and thighs, a weight that doesn’t lift whether you stand, sit, lie down, or sink into a bath so hot it borders on blistering. Add the unpredictability: one moment a dull throb, the next a pain sharp enough to steal your breath.

This is a “normal” day with adenomyosis, layered with relentless fatigue and bleeding so heavy it dictates everything from what you wear to whether you dare leave the house.

While it may sound extreme, it's sadly the quiet reality for many women, made more alarming by the recent data, which revealed that 77% of the public have never even heard of adenomyosis. We were taught from day one that periods are meant to hurt - and that belief is precisely why this condition remains so widely misunderstood.

Adenomyosis lives in a strange, infuriating grey area: common enough to affect one in ten women, yet invisible enough that most of us go years without hearing its name. I certainly did.

And I’m far from alone. Recent studies show it overlaps with endometriosis in about one third of cases, a silent reminder that so many women are suffering in plain sight, their pain routinely normalised.

For decades, adenomyosis was thought to affect only women in their later reproductive years, largely because diagnosis relied on a hysterectomy. But advances in imaging are rewriting this story for us, with more recent research showing that Adenomyosis can appear much earlier than we once thought.

A formal diagnosis can take years, and after more than a decade, I now understand that being an advocate for your own health is often the only real control any of us has. You can’t fast-track waiting lists, shortcut referrals, or decide when a doctor finally says, "I think I know what’s wrong." You can’t control how often women are told their pain is "just a bad period," or how easily conditions like this slip through the cracks. But spoiler: the one thing you can control is never refusing to stop questioning - even when you’re tired, anxious, and quietly wondering if you’re the problem.

I am one in 10. And as I sit here, I can’t help but wonder how many women are still suffering simply because they don’t yet have the language - or the insight - to name their pain. For more expert information on what exactly adenomyosis is, how the condition so many of us are living with impacts the body, and why it's so unheard of, keep scrolling. And don't miss our science-backed guides to the common endometriosis symptoms, how to get an endometriosis diagnosis, or how to adjust to living with endometriosis, while you're here.

Adenomyosis is the common health condition impacting one in ten women - yet 77% of Brits have never heard of it. Your guide

What is adenomyosis?

Imagine your uterus as a perfectly organised apartment. Now imagine the wallpaper deciding it wants to move into the walls themselves, turning your living space into a construction zone. That’s adenomyosis.

As Dr Raj Arora, women’s health expert and GP, explains, “Adenomyosis occurs when the tissue that normally lines the uterus grows into the muscular wall of the uterus, causing it to become swollen, inflamed, and painfully sensitive.”

Endometriosis, on the other hand? Same wallpaper, just sneaking into the neighbours’ flat and throwing chaos there too - making periods a full-blown evacuation.

So yes, same tissue, different location, different mechanisms - but both somehow turn every day into a high‑stakes negotiation with your own body.

Why are younger women suddenly being diagnosed with adenomyosis?

Finding out I had adenomyosis at 22 felt like another punch in the uterus (quite literally) - another medical plot twist I hadn’t asked for, and proof that my pain wasn’t "just in my head."

And many young women like me are only just starting to get answers, as Dr Faye Bate, women’s health doctor, explains, “For a long time, most cases were identified in women in their 40s and 50s, largely because the condition was typically confirmed after a hysterectomy - in other words, doctors would only discover adenomyosis when examining the uterine tissue post-surgery. Naturally, that meant diagnoses skewed towards older women who were done having children or needed surgery for other reasons.

She adds that high-resolution ultrasounds and MRIs are now doing the heavy lifting, spotting adenomyosis without surgery and giving women in their twenties and thirties answers they never had before. “Add to that a cultural shift away from the old ‘grit your teeth and bear it’ approach, and younger women are finally being taken seriously."

It’s progress worth celebrating: with studies showing that early diagnosis can protect fertility, improve quality of life, and spare years of unnecessary suffering. But it also raises a rather sobering question: how many women before us endured all this simply because no one had the tools… or the curiosity… to look?

What are the main symptoms of adenomyosis?

We’ve normalised talking about periods like they’re supposed to hurt, and when pain becomes part of the vocabulary, it stops sounding like a warning. That’s one of the biggest problems with adenomyosis, says Dr Faye. “The two major symptoms are heavy menstrual bleeding and painful periods. Society tends to tell us from a young age that periods are supposed to be miserable, so we end up assuming even extreme symptoms are normal. But there’s a point where it’s not normal - and it’s crucial to recognise that line.”

​That normalised language doesn’t just shape how we talk about periods, it shapes what we ignore. According to Dr Faye, many of the key red flags of adenomyosis are symptoms we’ve been taught to dismiss - pain and periods, a packaged duo. Heavy bleeding is a prime example here. No one really teaches us what ‘too heavy’ actually looks like. So, here are the red flags to watch for:

• Soaking through a pad or tampon every one to two hours, especially for several hours straight
• Needing to use two types of protection at once, because one isn’t enough
• Passing large clots, bigger than a 10p coin
• Periods lasting longer than seven days
• Bleeding or pain so severe that it keeps you from work, school, or social activities.

Readers, nothing about extreme pain is normal, yet this is another symptom that often gets normalised. Some cramping is expected, yes - but pain that stops you from living your life, leaving you curled up in a ball for hours, vomiting, or fainting, gosh, that is far beyond “normal”.

How to Advocate for Yourself When No One Else Does

Advocating for yourself often begins long before a diagnosis ever arrives. According to Dr Raj, “It can look like asking for a second opinion when you feel dismissed, or requesting a GP with a women’s health interest - something most surgeries will quietly have, if you know to ask. It can mean keeping a pain diary, not just to validate your experience, but to give shape and pattern to symptoms.”

And it can mean leaning on community: charities, helplines, symptom checkers - places where women’s pain is spoken fluently.

This conversation doesn't end in despair - there's real hope here. As more of us open up, we’re becoming remarkably good at finding one another. We share. We compare notes. We scream and shout about our bodies and our pain. Learning the language of our pain is powerful, and education is key. Context gives pain credibility, and knowledge gives it direction. When we can name what’s happening in our bodies, we are a hell of a lot harder to dismiss, easier to help, and better equipped to demand care that meets us where we are.

"The people who live with these conditions know the most, because this is our life.”

For Lillie Bleasdale, a marathon runner, Head Coach and Founder of female running collective Passa, the long wait for answers wasn’t just exhausting; it quietly reshaped her life.

Lillie didn’t know she had adenomyosis until she was 25 years old. Between the ages of thirteen and eighteen, her life became a cycle of GP appointments, pill hopping, and trying to “control” her periods. No one questioned why she was in pain; the focus was always on symptom management.

The signs were clear: a constant heaviness in her lower back, hips, and pelvis, shooting pains down her inner thighs, and periods so heavy she needed three pads, a super-maxi tampon, and a towel to get through the day - and was still told this was “normal”.

As a teenager, the only solution she was offered was another pill. The progesterone-only pill helped physically, but came with severe mental health side effects - something she still questions to this day. “It makes me wonder,” she says, “everything they give to help - is it actually making us sicker?”

One appointment still stands out for her, "I went to the doctor to change my pill because it wasn’t working, and instead I was told, ‘You shouldn’t be on contraception anyway, it’s not what God would want.”

Over time, the pain stopped being something she could compartmentalise. She describes feeling unwell in her entire body: sex was painful, and bleeding after became a common occurrence. Living inside that level of discomfort made a traditional 9-5 seem impossible to maintain, eventually pushing her to leave altogether.

"Sometimes I’d just sit there and feel unwell - it’s a feeling you can’t quite describe; it wasn't just physical pain, it’s every part of you. It just hurts. It’s completely and utterly consuming.”

It took twelve years for Lillie to receive a diagnosis. She was referred through the NHS, but after long wait times, she chose to go private, where she was finally diagnosed with both endometriosis and adenomyosis.

"The real issue is that the typical approach is basically symptom management - no one is asking why they’re happening, or where anything stems from. There’s zero investigation until you scream for it. And by the time women get proper treatment, they’re already totally ruined by it. Mental Health. Gone. Our faith in the system. Non-existing.”

To this day, she’s still waiting to hear back from that original referral. On paper, she’s just another number on an ever-growing list.

"The people who live with these conditions know the most, because this is our life. I wish I’d been given the education earlier - to trust myself and advocate sooner.”

SHOP MC'S ADENOMYOSIS ESSENTIALS

Just after dawn in her London home, Sarah Lomas lies on a PEMF (pulsed electromagnetic field) mat, bathed in the blood-red glow of a light chamber – she pairs the two longevity treatments to save time. Lomas, it could be said, is hacking biohacking, or as she calls it, “stacking modalities”. She has already meditated, and after this double dose of red light and PEMF therapy, she’ll swallow a precision-designed sachet of supplements, each ingredient selected from her genome and recent bloodwork. Lunch – typically eggs and spinach or soup – and exercise are also informed by DNA sequencing: every meal and workout is variable. “I don’t believe anybody should have a static daily, weekly, or monthly protocol anymore,” she says. “Your body is talking to you all the time. The only way we can hear that is through testing.”

Testing, in her case, is constant. Blood draws every four weeks. DNA sequencing. Mitochondrial analysis. Toxicity panels. She cycles through anti-inflammatory supplements at noon, detox support at night, and ends her day in an infrared sauna. Her blood metrics, ChatGPT recently informed her, place her in “the top 2% of the world’s average general population.”

Lomas, founder of REVIV, a global precision-health company, sits squarely within the rapidly professionalising longevity-tech sector. The industry’s aesthetic – immaculate labs, hyper-optimised bodies, billionaire patrons – suggests a future built on advanced gene therapies, cellular reprogramming, and an almost devotional commitment to measurement, most synonymous with former Mormon turned poster boy for “not dying”, Bryan Johnson.

And it’s not just the ultra-rich who are drawn in. The Reddit community r/Biohackers sees over 335,000 weekly visitors, with year-on-year growth of 55%. On TikTok, more than 260,000 posts use #biohacking. The 2024 Annual Longevity Investment Report shows investment in longevity has more than doubled, hitting $8.5 billion in 2024. While the US dominates the market, Europe and Asia are catching up, and cutting-edge treatments are increasingly crossing borders.

The Rise of Experimental Medical Tourism

If you’ve watched the Netflix documentary Don’t Die: The Man Who Wants to Live Forever, you might recall Bryan Johnson flying to Roatán, an island off the coast of Honduras, for Minicircle’s experimental, non-FDA-approved follistatin gene-therapy injections, costing around $20,000 to $25,000 per dose. Johnson claims the treatment slowed his biological ageing to the equivalent of one birthday every 19 months.

Lomas – whose UK-headquartered company REVIV Global has just announced a strategic partnership with Abu Dhabi’s M42 and 10X Health in the States – also travels to Latin America for emerging longevity treatments. In September, she flew to Mexico for natural killer (NK) cell therapy, an immunological treatment whereby NK cells (white blood cells that helps the immune system resist viruses and cancer) are collected from the patient or a donor, expanded and “activated” in a lab, and then infused back into the body. While NK cell therapy shows promise for certain cancers and carries a lower risk of complications than some other cell therapies, it remains largely experimental and is still being tested for effectiveness and durability. Lomas says she will have this treatment every six months for the rest of her life.

These longevity pilgrimages have created a booming medical-tourism economy, with health centres popping up all along the US-Mexico borderlands. Clinics, especially in border cities like Tijuana, market MSCs, exosomes, NK cells, and other regenerative tools to a ballooning class of wellness tourists. Kim Kardashian’s recent stem-cell treatment in Mexico, reportedly costing between $4,000 and $15,000, has also accelerated the trend. Yet this boom has a shadow side: a 2023 web-surveillance study found scores of Tijuana providers operating without verified COFEPRIS licensing, which is issued by the Mexican government’s regulatory body, and there have been CDC-linked cases of drug-resistant infections tied to unregulated injections.

At the same time, a more polished, high-tech wave of longevity tourism is emerging. REVIV’s partnership with 10X Health and Abu Dhabi’s M42 exemplifies it: DNA, blood markers and lifestyle data are combined to produce detailed health reports and bespoke therapies, from precision IV drips to microbead supplements. For Lomas and other early adopters, these treatments promise the ultimate control over ageing, but they also raise an unavoidable question: who truly has access, and how much of the promise is science versus aspiration?

The Slow Longevity Movement

For every high-tech, globe-trotting longevity seeker, there’s someone like Eva Maran. Founder of Eha, a Nordic wellness retreat, Maran sees the longevity boom differently. “I think the industry often overcomplicates what it means to live a long, healthy life,” she says. “True longevity isn’t built on extremes – it’s built on the small, consistent habits we practise every single day, right up until the end.”

Maran spent seven years immersed in functional medicine and biohacking, following protocols with monastic precision – until she realised the irony: “Doing everything ‘perfectly’ was leaving me exhausted.” Now, her philosophy rests on gentler pillars: relationships, sleep, movement, nutrient-rich food, and a handful of daily staples – magnesium, omega-3, vitamin D and K2, MCT C8 oil, and functional mushrooms. Her retreat – which is inspired by the five-season calendar to incorporate “springrise” on Hiiumaa, the island where Eha is based – embodies this approach, she says: “Our aim is to show people that longevity isn’t about chasing perfection but about building sustainable rituals that support you every day.”

The luxury wellness world is beginning to follow suit. “As biohacking evolves beyond performance optimisation to embrace recovery and restorative balance, sleep has become the ultimate luxury,” says Ida Ayu Widiaptini, director of spa operations at Conrad Maldives Rangali Island. At the exclusive Cotswolds’ retreat The Lakes by YOO, the executive team notes that women increasingly seek a holistic approach to biohacking, one that merges cutting-edge treatments with nature-led practices. In Greece, Stella Arvanitakou, senior spa and wellness director at Four Seasons Astir Palace, sees wellness travellers redefining luxury. Treatments may include oxygen therapy, laser light, or lymphatic compression, but the focus is precision paired with care, and a sense that wellness is now the purpose of the trip, not an add-on.

The Gender-Gap in the Longevity Boom

Roxanne Pryor, founder of the functional mushroom brand Superoom, has seen first-hand how the longevity industry has overlooked women. “Longevity conversations have historically been designed by men, for men,” she says. “The metrics, the biomarkers, the optimisation frameworks – they’re all built on male physiology. Women’s bodies fluctuate.”

Her own path into longevity began after copper toxicity and a long period of recovery. Functional mushrooms, she says, were among the few things that helped rebuild her system. But her concerns go deeper: decades of research still ignore women’s bodies, “anti-ageing” language pathologises natural changes, and the high cost of many treatments keeps longevity feeling like an exclusive club.

“Women don’t need to be told to reverse time,” she says. “They need support to optimise the phases their biology already moves through.” Like many women in the space, she has also lived the consequences of what she refers to as “over-optimisation”. “I tried keto. I trained five times a week with such intense HIIT that my period stopped completely. I understand what it means to optimise to the point of depletion.”

Now her longevity routine is based around regulation instead of extremity: “Longevity shouldn’t demand self-punishment or hyper-discipline,” she adds. “It should feel sustainable, nourishing, and intelligent.” Like Maran, Pryor embodies a growing movement of women in the field who want strategies that honour their bodies, not force them into a male-centric blueprint of optimisation.

The Slow Science of Ageing Well

Even in aesthetics – a field often swept up in futurism – we’re seeing a shift. Alice Henshaw, founder of Skincycles and a specialist in regenerative skin treatments, says her approach has “become far more gentle and far more intelligent”.

“We’re moving into an era where we’re not just softening ageing; we’re influencing how the skin ages biologically.” But she warns against believing that longevity has to be complicated or expensive. “The biggest misconception is that longevity is complicated or expensive,” she says. “The basics do 80% of the work: sleep, sunlight, protein, movement, and stress reduction.”

Her advice is refreshingly simple: focus on fundamentals and make them non-negotiable. “Longevity isn’t about intensity; it’s about consistency,” she adds. “Small decisions every day compound into extraordinary results over a decade.”

Who Gets to Live Longer?

The paradox of modern longevity is that the most headline-grabbing innovations – gene therapies, NK-cell infusions, experimental stem cells – remain largely unproven and, for now, the preserve of the ultra-rich. Yet the most impactful levers of long-term health may be the least glamorous: sleep, movement, emotional connection, nourishment, and stress regulation.

Evidence for many next-generation therapies still lag behind their marketing, and regulation varies wildly across borders. But aside from the enormous price tags, the economic implications are profound: models suggest that slowing biological ageing could significantly reduce lifetime healthcare costs. According to UK Research and Innovation, an extra year of healthy life is worth £5 trillion to the UK economy, factoring in productivity, volunteering and care roles.

Lomas says if she could change one thing in prevention, it would be that countries tell their populations the truth: “Healthcare systems aren’t here to give you a longer life. Not even a better quality of life – we’re here to save your life.” She adds, “You need to take control of yourselves and look after yourself.”

When we speak over Zoom, Lomas raises her own critical questions: who gets to benefit from longer, healthier lives? And if someone can’t afford therapies, why not let them trade their own data on their own terms to fund care, rather than allowing big companies to collect it for free? “We will never sell people’s data,” she says, adding: “I’m a believer that if we could broker that to fund treatments for every individual on this planet who can’t afford them, we could do something really good.”

Right now, longevity is not only a medical frontier but a crossroads, caught between the dazzling allure of longevity experiments and a softer movement rooted in recovery, nourishment, and connection – the basics that women like Maran, Pryor and Henshaw champion. Lomas suggests yet another path: a belief that precision medicine will eventually become democratised enough to make radical health-spans accessible.

So, how long does Lomas plan to live? “I could live to 120,” she says. But only on one condition: “You only want to live that long if your family can too.”

She rejects the idea that only wealthy futurists will get to triple digits. “People assume it’ll be the rich,” she says. “It actually isn’t. Wealth gives you something else – scarcity freedom. You don’t have a scarcity of food, restaurants, or alcohol.” Despite her own high-tech interventions, Lomas believes people will live long lives simply through nutrition, stress reduction, and movement. “What’s changing is not that people with wealth will have better health,” she says. “It’s that people are realising their health is their wealth.”

Every day in England and Wales, around 760 people will have an abortion. For most, it’s a private decision. Increasingly, though, the path to care is crowded, not just with protestors, but with an American-style culture war quietly staking a claim in British politics.

For women seeking abortion services across the UK, the final stretch of their journey to a clinic can be fraught in ways they hadn’t anticipated: crossing a pavement where strangers stand in silence, perhaps praying, offering leaflets or attempting to strike up conversation. There may be no shouting, placards, pushing or shoving, but these encounters can still feel intrusive and unsettling at one of the most vulnerable moments of a person’s life.

“Getting to the clinic felt like the longest part of my journey,” remembers *Georgie, 29, who had a medical abortion at 11 weeks. “They just stood there,” she says, referring to the silent protestors outside the clinic who made her feel “watched” and “judged.”

Abortion clinic safe zones were introduced to protect people like Georgie, but those protections are now being challenged, not only by British campaigners, but by a powerful American legal organisation whose work helped overturn Roe v. Wade in the US. That same organisation is now attempting to reframe British restrictions on clinic protests as threats to free speech and religious liberty.

Polling suggests the wider picture is shifting, too. New research from Plan International UK, based on a survey of over 2,000 adults, reveals a growing sense of backsliding on gender equality. Nearly a quarter (24%) believe progress on women’s and girls’ rights globally is weak and could be lost.

“Despite some progress, the fight for gender equality is far from over,” says Amelia Whitworth, Head of Policy, Campaigns & Youth at Plan International UK. “Attempts to roll back reproductive rights are not isolated — they are part of a wider attack on women and girls’ rights, gaining ground here in the UK and across the world. Hard-won freedoms are being challenged, and organised efforts are gathering pace that seek to reverse decades of progress.”

Nelly London, an activist and body positivity content creator, sees those pressures playing out online and IRL. “People definitely assume that abortion care is safe in the UK and that it will always be there for them,” she says. “But sadly, the influence coming in from the far right in America is really real, and I see it more and more every day.”

“Our rights to abortion care in the UK are — I don’t want to say under attack — but they’re definitely being looked at. So we do have to continue to defend them and continue to fight for them,” she adds.

At the centre of this shift is the Alliance Defending Freedom (ADF), a US-based anti-abortion legal organisation that has been scaling up its UK presence. Journalist Peter Geoghegan, author of the Substack Democracy for Sale, reports that ADF now “regularly represents buffer-zone protesters, lobbies Westminster, attends the all-party parliamentary group on Freedom of Religion or Belief, briefs MPs and officials — and quotes Nigel Farage approvingly in its press releases.”

Jane Bradley, the New York Times investigative reporter who has examined ADF’s international strategy, describes its approach as a Trojan horse. “They market their work as free speech cases,” she explains, “rather than abortion cases.” Legal challenges defending people who silently pray outside abortion clinics — spaces designed to protect patients — are presented as battles for religious liberty, masking what critics argue is the real aim: restricting women’s bodily autonomy.

Bradley says the UK is seen as a strategic bridge to Europe, a place where legal precedents and cultural shifts can ripple across the continent. Through litigation and public campaigns, ADF is backing challenges to abortion clinic buffer zones, reframing healthcare access as an ideological battleground and reopening a debate many believed had long been settled.

The consequences are already visible. Even where abortion is legal, access in the UK is far from equal. Rural areas, low-income communities and younger people face the greatest barriers — a situation worsened, campaigners say, by the rise of unregulated “crisis pregnancy centres.”

Ophelia Chidgey, PhD, co-chair of Amnesty Feminists, warns that these centres are deliberately misleading. “They position themselves as pregnancy support services,” she explains. “They use names that sound medical. They advertise ‘free pregnancy tests’ and ‘counselling.’ But they’re run by non-medical staff with explicit anti-abortion agendas.”

“They spread medically false information, telling people abortion causes breast cancer, infertility and mental illness,” Chidgey says. “None of that is true. They pressure vulnerable people. They delay access until it’s too late. They’re not healthcare providers — they’re political operations funded to stop abortion.”

Chidgey points to the scale of the funding behind this movement. “Alliance Defending Freedom isn’t just operating in the UK — they’re scaling up at breathtaking speed. Since 2019, anti-rights groups have spent £106 million in the UK,” she says. “This is the organisation that joined forces with conservative politicians and weaponised the US courts to systematically dismantle Roe v. Wade. Now they’re importing that exact playbook to the UK, and with serious money behind them.”

For those watching from the US, the warning signs are familiar. Becca Rea-Tucker, a reproductive justice advocate in Texas and author of The Abortion Companion, has seen the consequences unfold in real time. “Abortion bans destroy families,” she says. “People are dying after being denied care. These deaths were preventable.” Her message to the UK is stark: legal protections mean little if they can be hollowed out through culture, courts and stigma.

American abortion rights activist Amelia Bonow, co-creator of the #ShoutYourAbortion campaign, agrees. “Abortion bans don’t eliminate abortion,” she says, pointing to new data that shows that the abortion rate in the US has actually increased in the years since the Dobbs decision. “But these restrictions do create a minefield of struggle that will be most difficult and dehumanising for marginalised people to navigate safely.”

“What’s often missing from mainstream debate,” Bonow adds, “is that abortion restrictions are not abstract moral questions. They are policy choices that distribute harm in ways designed to compound existing economic and racial inequalities.”

Politically, the pressure is mounting. Louise McCudden, UK Head of External Affairs at MSI Reproductive Choices, notes that while public and parliamentary support for abortion remains strong, it is not immune to erosion. “Most people in the UK are pro-choice and so are most MPs,” she says. “However, with the US-led anti-abortion movement funnelling over a million pounds a year into the UK, and with Reform leader Nigel Farage making comments that threaten the consensus on abortion access, it’s no time to be complacent.”

“In recent years,” McCudden adds, “MPs across all major parties have voted to stop prosecuting people for ending their own pregnancies, to ban harassment outside abortion clinics and to make at-home abortion care legal. The anti-abortion movement threw everything it had at opposing these popular reforms, but MPs rightly listened to women instead.”

Still, gaps remain. Abortion is one of the few medical procedures in Britain that requires sign-off from two doctors. Access varies widely by postcode. Wales and Northern Ireland continue to experience inconsistent provision. “Your geography determines your rights,” Chidgey says. “People in rural areas, those on low incomes, and those experiencing domestic violence face the biggest barriers.”

“Legal abortion means nothing when access is designed as a battlefield,” she adds. “And anti-rights groups are systematically funding organisations to block the door.”

The cultural strategy extends well beyond abortion. Bradley notes that ADF is investing heavily in campus organising and professional networks. “There’s a big focus on university campuses,” she says — building a pipeline of future doctors, lawyers and policymakers “who can then carry the torch.”

Deborah Frances-White, AKA The Guilty Feminist, is blunt about the risk. “Never doubt that allowing a radical right-wing populist party with links to MAGA endangers our bodily autonomy,” she says. “Look at how quickly rights were stripped away in the US.”

“They’re incredibly effective at changing the public mood”, Bradley adds. Her reporting shows ADF pursuing a long-term agenda: reframing anti-choice positions as religious protection, steadily reshaping public discourse, and influencing UK policy from behind the scenes. What makes the Alliance Defending Freedom so effective, she says, is not speed but patience. In the UK, where abortion still enjoys broad public and political support, the organisation has learned not to fight on abortion openly. Instead, it packages cases around buffer zones as battles over free speech and religious liberty — softening public opinion, building legal precedent, and laying the groundwork for long-term cultural change.

Abortion care is healthcare. Yet as American money, messaging, and legal tactics seep into British life, women are once again being asked to justify control over their own bodies. The lesson from the US is clear: rights assumed to be settled can still be lost.

The question now is whether the UK recognises the warning signs, or only understands them when it’s too late.

Grab a chair, because we need to talk about what “effective exercise” really looks like for women today. And spoiler: it’s not gasping into a yoga mat like it’s a survival challenge. The buzz on the gym floor is that slow weighted workouts are quietly brutal, impossible to ignore, and humbling - trust me, I learned that early on. One slow squat in, and my ego quietly exited the room.

Here’s the irony: we’ve often been sold the idea that faster equals better, but maybe a slower, steadier approach actually makes more sense for women’s bodies. And apparently, everyone’s thinking the same, with searches on Google going up by +4700% in just the last two weeks.

One thing’s clear: for anyone who fears burpees like me, slower doesn’t mean easier, it just humbles you in a very different way.

That spike isn’t random. We’re finally having honest conversations about hormones, fatigue, and what our bodies actually need. As Lianna Swann, ex-olympic swimmer and certified SHREDDY PT, puts it: “In a social media world filled with HYROX and 5 am HIIT workouts, slow weighted training for women - and those with endocrine conditions like Polycystic Ovarian Syndrome, or PCOS - feels like a breath of fresh air.”

Case in point: a 2025 trial found that women who followed a resistance-based training programme saw significant improvements in insulin sensitivity, cholesterol, and hormone levels - which are exactly the kind of results that matter long after the sweat dries.

Curious why experts swear by them for women with PCOS, hormonal shifts, or just everyday life? Keep reading - we’re breaking down what slow weighted workouts really are, and why they’re quite frankly brilliant for women at every stage of life. For more weight content, don't skip our guides to the different types of strength training, the best strength training exercises, and the best 30-minute home strength workouts.

Experts Swear by Slow Weighted Workouts - Here’s Why They Work for Women at Every Stage of Life

What are Slow Weighted Workouts?

Now, before you imagine pottering around the gym with tiny weights, let's clarify what slow weighted workouts actually are. We spoke to Hollie Grant, Founder of Pilates PT + The Bump Plan, about how slow weight training differs from your usual strength training: “A slow weighted workout is exactly what it sounds like: lifting weights at a deliberately slower tempo, usually with longer time under tension and more control through each phase of the movement."

"Instead of rushing through reps or chasing heart rate spikes, the focus is on controlled eccentric phases (lowering slowly), pausing at challenging points, and moving with intention rather than momentum.” She adds, “This differs from traditional strength training that’s focused purely on load progression - slow weighted work isn’t about lifting heavier every week, but about how you move the weight you have.”

In short, you’re not racing through reps or relying on sheer momentum to get you through - you’re simply slowing everything right down, which forces the muscle actually to do the work. It’s the difference between flinging a weight around and owning every inch of the movement. Sound easier than your usual 7 am HIIT? I can confirm, it isn’t.

Research also helps paint the picture here. A 2025 trial published in the Journal of Physiological Anthropology found that slow, controlled movements, even at the lowest intensities, actually led to greater muscle fatigue because the muscles were under constant tension.

Bottom line - when you take momentum out of the equation, your muscles have nowhere to hide, quietly demanding more - without the drama.

​So, what does this all mean for women? Big spoiler: your body doesn’t need chaos to get stronger. In fact, slowing down might be one of the smartest ways to get stronger, balance hormones, and see real results - especially when navigating PCOS.

Why slow weighted training is becoming a go-to workout for women with PCOS

By now, it’s clear that slow weighted workouts aren’t just about building muscle; it’s about helping the body function better, which is exactly why experts recommend it for women with PCOS.

Lianna dives deep (pun fully intended), “There have been studies that show both slow weighted workouts and more intense exercise to be effective for managing PCOS symptoms, making the ‘most effective’ approach one that is sustainable for the individual and manages their stress levels best.”

She adds that resistance work is especially useful because it improves insulin sensitivity, a key issue for women with PCOS who often experience higher rates of Insulin resistance than those without.

Interestingly, findings mirror this. Research from 2025 showed that women with PCOS who took part in a combined strength and endurance training programme saw meaningful improvements in Insulin and insulin resistance - alongside better cholesterol and hormone markers, compared with those who didn’t exercise. That’s exactly the kind of metabolic benefit Lianna is talking about.

Hollie adds, “Many women with PCOS experience chronic fatigue, joint discomfort, or slower recovery. Slow, controlled training allows them to train consistently without feeling wiped out or inflamed afterwards, which is key - because it’s consistency, not intensity, that drives real metabolic change.”

For women with PCOS, it's a long overdue shift. Workouts stop being something you survive with a towel and a prayer, and start becoming something you can actually own and sustain.

Beyond PCOS, what makes slow weighted workouts beneficial for women at different stages of life

It’s no shock that slow weighted workouts aren’t just for symptom management. In fact, their benefits extend well beyond PCOS. As Bianca Wise, ALO Wellness Club Pilates instructor and clinical naturopath, explains, “Slow weighted workouts help women build lean muscle mass, support metabolic health and insulin sensitivity, and do so without placing excessive stress on the nervous system.”

She adds, “They also support bone density, joint health, and posture - key factors for long-term health and hormone balance. This form of training becomes especially important for women around age 30, helping maintain bone density, overall well-being, and hormone balance.”

That’s why experts agree - this style of training works across decades, not just diagnosis. Leila Martyn, founder of MyOva, advocates slow weighted workouts for every woman. “Every major life stage for women involves hormonal change, whether coming off the pill, recovering postpartum, entering perimenopause, or managing stress. These workouts provide the strength and structure we need, minus the overwhelm on the body.”

And for the evidence? Oh, it’s all there. And benefits aren’t limited by age - a 2025 study found that resistance training improves strength, balance, muscle mass, and body composition across pre-, peri-, and post-menopausal women without added strain.

​So there we have it, for a woman of any age, slow weighted workouts aren’t just about getting stronger (although this is a huge bonus), it’s about finding something that grounds you in confidence, and finding a strength that carries you through every stage of life.

​Now let’s look into the routines that’ll make slow feel seriously effective, with strength trainer Aimee Victoria Long breaking down the expert-approved moves worth your time.

5 expert-picked slow weighted workouts to do from home

1. Tempo Push-Ups OR Chest Press

Why? A slow lowering phase builds upper-body strength and shoulder stability while engaging the core more deeply.

What? Lower for 4 seconds, pause at the bottom, then press up with control (either bodyweight or with dumbbells/barbell).

How long? 3 sets of 8-10 reps.

2. Controlled Shoulder Press

Why? Slowing the press builds shoulder strength while protecting the joints and improving muscular control.

What? Press weights overhead smoothly, then lower them back down over 4-5 seconds without locking out aggressively.

How long? 3 sets of 6-8 reps.

3. Controlled Deadlifts

Why? Slow deadlifts strengthen the posterior chain (glutes, hamstrings, lower back) while reinforcing proper lifting mechanics.

What? Lift the weight steadily, then lower it back down over 5 seconds, maintaining a neutral spine throughout.

How long? 3 sets of 6-8 reps, resting well between sets.

4. Slow-Weighted Lunges

Why? Moving slowly through lunges improves balance, coordination, and unilateral strength, which is key for injury prevention and everyday movement.

What? Holding weights at your sides, step into a lunge, lower for 4 seconds, then return to standing with control.

How long? 3 sets of 6-8 reps per leg.

5. Slow-Tempo Squats

Why? Slowing down the squat increases time under tension, which improves muscle strength, joint stability and muscle control while reducing injury risk.

What? Using dumbbells or a barbell, lower into a squat for 4-5 seconds, pause briefly at the bottom, then stand up with control.

How long? 3-4 sets of 6-8 slow, controlled reps.

Shop weight workout essentials, below:

I’ve lived with a chronic illness for years, so I’m used to questioning my body - but nothing prepared me for what happened when social media joined the conversation last year.

One evening, after yet another day of fatigue, bloating, and a mood so volatile I practically quarantined myself to avoid biting my partner’s head off, I turned to Dr Google (yes - I know, my first mistake). Within seconds, TikTok and Instagram delivered their diagnosis: a “hormone imbalance.” No specificity. No diagnosis. Just a catch-all label that somehow explained everything and nothing at once.

And clearly I wasn’t alone. Searches for “hormone imbalance symptoms,” “cycle syncing,” and “birth control side effects” have now surged past 480 million Google and TikTok hits. Meanwhile, a recent Medical Journal study found that over 65% of reproductive-health content on TikTok contains medical inaccuracies.

And just like that, hormone imbalance hasn’t just become a health curiosity - it’s become a trending diagnosis. Once you fall headfirst into the algorithm's version of women’s health, the “solutions” arrive fast: another pill, a supplement stack, a restrictive diet, a £300 at-home hormone test, or a 30-day “reset” promising to rebalance your entire endocrine system.

I tried more of these than I’d ever publicly admit, each one dangling just enough hope to make me think, maybe this one will finally fix me. After all, with that many options, surely one of them had to be the magic answer…right?

Then I spoke to actual medical experts - and discovered the internet’s version of hormone health is, frankly, its own parallel universe.

​Dr Nirusha Kumaran, GP, Functional and Longevity Medicine Physician, told me: “More women are coming to their clinic appointments saying they want to "balance" their hormones, but often what they’re really expressing is that something feels off in their body. In functional medicine, we don’t dismiss that. Instead, we explore what’s driving those symptoms - whether it’s stress, disrupted sleep, gut issues, toxic loads, nutrient deficiencies, or genetics. Most women don’t necessarily have a hormone problem; they have an imbalance somewhere upstream that’s showing up in their hormones.”

Her words stopped me in my tracks because they explained something the internet never had: it wasn’t my hormones that were “broken”; it was the narrative I’d been sold. For the first time, the story actually made sense - and it wasn’t the one my algorithm had fed me.

So, I started digging deeper. If my hormones weren’t the problem, then what exactly was? For more on whether your hormones can really be imbalanced, keep scrolling. Elsewhere on the site, we've got guides to hormone balancing hacks that may be harmful, the nutritionist-approved foods for hormone health, and anti-inflammatory recipes to try, here.

I was sold a one-size-fits-all approach - so, can your hormones really be imbalanced or is the trend a fad?

What is a hormone imbalance?

When I asked actual medical specialists what the term meant, the answer drastically contradicted anything I’d seen online.

​Dr Kumaran, sees this confusion every day: “A hormone imbalance means that hormone blood levels or hormone signalling are out of sync with what the body needs. But the key is that this dysregulation usually stems from deeper issues: inflammation, blood sugar instability, microbiome imbalance, poor detoxification, and chronic stress. Social media tends to define hormone imbalance as any uncomfortable symptom, without recognising the network of systems influencing hormones.”

​A 2022 peer-reviewed paper summed it up bluntly: “hormone imbalance” is a vague, biologically unrealistic concept popularised by multi-million-pound wellness brands because it can be used to sell almost anything - supplement stacks, detox plans, hormone “reset” programmes, even at-home testing kits of questionable accuracy.

​The key takeaway? You can’t fix hormones by targeting hormones, as they don’t exist in isolation. Instead, they respond to signals from your gut, liver, brain, environment and even your genes. The real work isn’t in chasing a supplement or “reset”, it’s in addressing the systems that actually regulate them.

How do hormone imbalances occur?

Something important I’ve learned recently is that when something feels “off” hormonally, it’s usually a sign that other systems like digestion, stress, or blood sugar are under strain, which means that any meaningful investigation has to go deeper and take a multi-pronged, whole-body approach.

​Registered Nutritional Therapist Eleanor Hoath sees this pattern repeatedly in clinic: “The most common drivers I see are: gut dysbiosis (SIBO, lack of beneficial bacteria and leaky gut), dysregulated blood sugar (skipped meals, high sugar intake, energy crashes), chronic stress and high-cortisol, under-eating, thyroid inefficiencies, post-contraceptive changes as the body readjusts, and exposure to hormone-disrupting chemicals.”

​This shows that hormone symptoms usually sit on top of disrupted foundations such as digestion, metabolism, stress, and nourishment - not an isolated hormonal “fault.”

​At the same time, lifestyle factors don’t explain every hormonal condition. As Dr Hazel Wallace, female health expert and former NHS doctor, clarifies: “Stress and lifestyle factors can affect symptoms or impact hormonal regulation, but they don’t cause conditions like PCOS or thyroid disease. PCOS is believed to be multifactorial, but nutrition and movement can support symptoms like insulin resistance, energy, and cycle regularity."

How do you confirm if you have a hormone imbalance?

If you think you have a hormone imbalance, don’t panic-book eight supplements and a TikTok test kit, and whatever you do - do not consult the likes of social media to help confirm anything. As Dr Kumaran puts it, the real pathway starts with someone who looks at your whole body, not just your hormones. That means a proper assessment combining a detailed health history, targeted blood tests, gut and nutrient testing when needed, evaluation of detox pathways, environmental exposures, and even genetic variations that influence hormone metabolism. In other words, they’re not asking what is happening; they are asking why. And that’s where the real answers live.

While this kind of deep investigation can uncover the real root cause, it can also feel utterly overwhelming. In the UK, especially, long wait times, the fear of not being believed, or past experiences of being dismissed, can make many women avoid seeking help altogether.

But it’s important to remember: you’re entitled to a second opinion, you’re allowed to advocate for how you feel in your own body, and you have every right to ask questions and do your research. The right practitioner won’t rush you, minimise you, or offer a quick fix - they’ll do exactly what Dr Kumaran describes and look at the whole picture,

Which quick fixes are circulating that don't address the root cause?

According to Dr Kumaran, the most concerning trends are those that sell shortcuts. One supplement to balance everything sounds appealing, but hormones don’t work that way.

This is exactly why one-size-fits-all solutions fall short: two women can experience identical symptoms but have completely different drivers beneath the surface. “Seed cycling isn’t harmful, but it won’t resolve deeper issues like inflammation or impaired detox pathways. Tests like DUTCH can be useful in the right clinical context, but without proper interpretation, they often send women down expensive rabbit holes,” shares Dr Kumaran. The biggest red flag she tells me: “Anything that distracts from finding the root cause while costing hundreds and delivering very few answers.”

​To cut through the noise, Dr Hazel Wallace offers clear guidance. “If someone is giving personalised hormone advice, they should be medically qualified - a doctor, registered dietician, or regulated professional. Be sceptical if advice is tied to selling supplements, tests, or programmes. Supplements can help in specific cases, but they’re not risk-free or universal fixes.” While shared experiences online can feel validating, what works for one person shouldn’t replace evidence-based, individual medical care.

My "hormone balancing" journey

For a really long time, I thought something was simply “wrong” with my hormones. I couldn't explain the exhaustion, yet contradicting, I felt wired. Planning my outfits around my bloating tummy was now a part of my daily routine, along with bouts of anxiety, brain fog, and feeling utterly disconnected from my body in a way I couldn’t explain. Like many women, I went looking for answers online, and I found comfort in strangers’ advice. I was soon pulled into a world of conflicting opinions, endless supplement protocols, costly retreats, and neatly packaged labels that promised clarity but delivered overwhelm.

​What changed wasn’t a miracle supplement or a hormone reset. It was zooming out, and getting help from the right qualified medical professionals. They helped me to look at my life with a "whole-body approach’ lens - and bit by bit, I began to understand what was causing stress, anxiety, and exhaustion. I rebuilt my life based on my new needs - I needed space, nature, a job that kept my stress levels down, a better sleep routine, and to drink more water. Chronic stress, poor digestion and bad eating habits, blood sugar swings, and years of pushing through were quietly stacking up. My hormones weren’t the problem; they were reacting to everything else.

​The process wasn’t instant, nor linear. There were waits, moments of self-doubt, and times I questioned whether I was being “dramatic.” But learning to advocate for myself, asking better questions, seeking second opinions, and letting go of one-size-fits-all solutions - changed everything.

​If you were to ask me how I felt now, it wouldn’t be perfect, and I don’t chase that idea anymore. I have a much deeper understanding of my body, far fewer symptoms, and a sense of trust that I never had before. If there’s one thing I hope readers take away, is that feeling off doesn’t mean you’re broken; the real answers come from listening deeper, not louder.

MC's Approved Products To Help Your Hormone Balancing Journey

If you're here, chances are you or someone you know is navigating life with PCOS. It’s a condition that affects millions of women worldwide, including around 1 in 10 of us here in the UK.

Despite more women speaking openly about it - including high-profile names like Victoria Beckham and Frankie Bridge, as well as health advocates such as Dr Hazel Wallace and Grace Beverley - many of us still spend years searching for answers to our symptoms.

In fact, a recent all-party parliamentary report found that it takes an average of four years to receive a diagnosis, with two-thirds of those diagnosed given no resources to help manage their symptoms.

That’s why conversations about the lesser-known aspects of PCOS matter more than ever. And recently, new research has highlighted an area that’s rarely discussed: its potential impact on posture.

A study published in Nature earlier this year suggests that women with PCOS may be more prone to an increased curve in the lower spine (known as lumbar lordosis), alongside a forward rotation of the pelvis, commonly referred to as an anterior pelvic tilt.

As someone living with PCOS, this research made me sit up - literally. I’ve often wondered why my lower back has such an exaggerated curve and why my abdomen protrudes more than many of my friends. And though, as a health writer, I'm sceptical of terms like “PCOS belly” which swirl on social media, this suggestion of a scientific link between PCOS and posture struck a chord.

I’m not alone. Rosa, 26, from London, also has both PCOS and an anterior pelvic tilt. “I struggle to sit in the same position for long periods,” she explains, “and regularly experience low back pain, especially around ovulation.”

So, can PCOS really affect the way your pelvis sits, and if so, is it something we should be concerned about? I ran the research past leading gynaecologists and pelvic health specialists to find the answers.

For their thoughts, keep scrolling. Below, you’ll find an expert-backed guide to pelvic tilts, PCOS, and how to manage the discomfort that can come with them. For more support in managing the condition, check out our explainer on PCOS, guides to endometriosis symptoms, PMDD symptoms and PMS symptoms, plus a doctor's guide to how to advocate for yourself in medical settings.

New Research Points To A Link Between Posture And PCOS. But Does It Matter? Experts Weigh In.

What is a pelvic tilt?

In simple terms, your pelvis isn’t supposed to sit bolt upright like a stack of books. It naturally tilts forward or back, depending on your anatomy and muscle balance. But if that tilt is exaggerated, it can change how your spine, hips and pelvic floor function, and sometimes how they feel.

“A pelvic tilt describes the angle at which the pelvis sits relative to the spine and legs,” says pelvic pain specialist, Dr Sonia Bahlani. “When this alignment shifts forward (anterior tilt) or backward (posterior tilt), it alters the curve of the spin, and can impact posture, muscle balance, and how the pelvic floor, lower back and hip function.”

“Think of it like a bowl of water,” suggests women’s health physiotherapist, Sarah Tyler. “In a neutral posture, the bowl stays level. In an anterior tilt, it tips forward and spills the water.”

The experts are clear that everyone has some degree of pelvic tilt. “It’s a part of normal posture,” confirms urogynaecologist Rhiannon Bray. “But the degree to which your pelvis tilts can affect how the spine, hips and core muscles work together.”

So, what did the new research find?

The new study is small but fascinating. Researchers looked at the pelvic alignment of 95 women aged 25 to 35, some with PCOS and some without. None of the participants had given birth, which is important because studies show that pregnancy and birth can significantly influence pelvic alignment.

Within the study group, clear trends emerged. Women with PCOS had a significantly greater anterior pelvic tilt and a more pronounced lumbar lordosis (the deep curve in the lower back). In other words, their pelvis tended to tilt forward more, which could influence posture and the way forces travel through the spine and pelvis.

So, what does this mean in practice? Sexual health specialist Dr Shirin Lakhani explains. “The study suggested that there may be a correlation between those with PCOS and those who experience pelvic tilts and that hormonal imbalance, chronic inflammation and reduced muscle strength often seen in those with PCOS may contribute to these postural changes.”

What do the experts think of the findings?

While the study was small, experts agree it highlights an important point: PCOS may affect the body in ways that go beyond hormones, including how our muscles function and how our posture develops.

“PCOS itself doesn’t directly cause pelvic tilts, but it can influence the factors that contribute to them,” explains Dr Bahlani. Many people with PCOS experience “hormonal imbalances that lead to changes in fat distribution, abdominal weight gain, and insulin resistance,” she says. “These shifts can put extra pressure on the front of the pelvis, tighten the hip flexors and lower back, and over time may encourage an anterior pelvic tilt and a deeper lower back curve.”

Dr Bahlani also points to “chronic inflammation, reduced muscle strength, and altered pain perception” as important factors. “All of these can affect how your muscles are recruited and your posture over time.”

Still, the experts caution against jumping to conclusions. “This was a very small population of women - 52 in the PCOS group, all of a similar BMI, none of whom had given birth” says Tyler. “More research is needed before we can say these findings apply to the wider PCOS population.”

Is a pelvic tilt a problem?

So, if women with PCOS may be more prone to a forward-tilted pelvis, does that automatically mean something is wrong? The short answer, according to the experts, is no.

“It’s a myth that an anterior pelvic tilt is automatically bad for you,” says Bray. “Some degree of forward tilt is completely normal - it’s how the spine, pelvis and hips stay balanced. Problems only arise when that tilt is excessive or linked with pain, muscle weakness or pelvic-floor symptoms.”

In other words, the tilt itself isn’t the enemy. Issues only appear when the tilt itself becomes exaggerated or starts affecting other parts of the body.

For women with PCOS, these effects on the surrounding muscles and pelvic floor may feel more pronounced. Bray explains it’s not that the tilt is inherently worse, but that hormonal and metabolic factors can influence muscle tone, inflammation, and how the body handles load. When an anterior pelvic tilt is excessive, “it can change how forces travel through the lower back, hips, and pelvic floor,” she says. “For women with PCOS, who may already have differences in muscle function and metabolism, the combination of hormonal and mechanical factors can make these symptoms more noticeable.”

So, is a pelvic tilt something to panic about? No. But if you’re experiencing lower-back niggles, bladder pressure, or pelvic-floor symptoms, and you have PCOS, it could be one piece of a bigger puzzle.

What should you do if you're worried about your pelvic tilt?

If you’re experiencing lower-back soreness, pelvic heaviness, or urinary urgency, and you have PCOS, it could be worth exploring whether a forward-tilted pelvis is playing a role. Experts recommend starting with a women’s health physiotherapist.

“The first step is understanding what might be happening in your body,” explains Bray. “A specialist women’s health physiotherapist can assess how your pelvis and lower back are aligned, the strength and coordination of your core and pelvic floor muscles, and the flexibility of your hips and hamstrings.”

It’s also important, she reminds us, to look at pelvic tilt within the bigger picture of PCOS. “Hormone balance, inflammation, muscle mass, fitness, and lifestyle all influence posture. The goal isn’t to ‘fix’ posture but to support your body so it can function efficiently.”

She recommends:

1. Strengthening and stretching your muscles

“Strengthen your core, glutes, and hamstrings to stabilise the pelvis and ease pressure on the lower back,” says Bray. “Stretch tight hip flexors and front-thigh muscles to reduce the forward pull on the pelvis.”

2. Visiting a pelvic physiotherapist

“Physiotherapy can help you to become more aware of your natural posture and teach balanced movement patterns, rather than forcing a rigid stance,” she adds.

3. Consider your sleep, stress and nutrition

“Adequate protein and vitamin D support muscle health, while quality sleep and stress management reduce inflammation and improve overall movement efficiency,” says Bray.

While many of these strategies can be done at home, the experts are clear that you shouldn’t hesitate to ask your GP for a referral if you are worried about pelvic pressure, heaviness, urgency, or incontinence.

“Ultimately, posture is dynamic,” concludes Dr Bahlani. “There’s no ‘perfect’ position, but supporting your hormonal, muscular, and nervous systems together is what promotes long-term pelvic health.”

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I'm willing to bet that constipation is something every one of us has dealt with at some point in our lives, but the reluctance to talk about bowel movements remains strong. However, it's far more common than most of us realise, and can have some devastating effects.

"Constipation is very common, affecting around one in seven adults in the UK at any given time," says Dr Anisha Patel, GP and bowel cancer survivor and educator. "It’s more frequent in women than men, and tends to become more common with age. Studies suggest that up to a third of adults over 60 experience constipation regularly, while younger women often notice it around menstrual cycles, pregnancy, or menopause due to hormonal changes."

A word of warning, however: "Although occasional constipation is normal, persistent constipation (lasting more than three weeks) should always be checked by a GP to exclude any underlying causes such as thyroid problems, medication side effects, or bowel conditions," says Dr Patel.

Someone who struggled with constipation is Holly Brooke, who was impacted so heavily by her experience that she decided to create a supplement with the aim of easing constipation and its symptoms. This is where WE ARE. REGULAR was born - the inspiration and process for which she discusses below.

Plus, I spoke to Registered Associate Nutritionist Laura Jennings and Dr Patel about causes, symptoms, and methods of improving constipation that are easy to implement for anyone having difficulty.

And if you've found yourself with other queries - like how to boost gut health, whether you should take probiotics, or even which foods cause bloating, be sure to check out our other expert-led guides.

Struggling with regularity? Your guide to the best constipation treatments

What are the common causes of constipation?

"Constipation is incredibly common and can affect anyone at any age. It occurs when the bowel doesn’t move as frequently or as easily as it should," explains Dr Patel. "Common causes include low fibre intake (96% of the UK population are eating the recommended 30g of fibre a day), not drinking enough fluids, a sedentary lifestyle, and ignoring the urge to open your bowels.

"It can also be linked to stress, changes in routine (such as travel), or hormonal fluctuations, for example, around menstruation, pregnancy, or menopause. Certain medications (like iron tablets, painkillers, antacids, or antidepressants) and underlying medical conditions (such as thyroid problems, Parkinson's, diabetes or irritable bowel syndrome) can also contribute."

What are the symptoms to look out for?

Symptoms of constipation typically include "infrequent bowel movements (fewer than three times per week), straining, passing hard or lumpy / peels-like or rabbit dropping-like stools, or feeling that your bowel hasn’t emptied completely," says Dr Patel. "You might also experience bloating, abdominal discomfort, or a general sense of sluggishness.

"However, if constipation lasts more than three weeks, or if it’s associated with unexplained weight loss, unexplained fatigue, tummy pains, blood in your stool, or a change in your normal bowel pattern, it’s essential to see your GP to rule out anything more serious."

When it comes to a gut-related problem that could be triggering your constipation, nutritionist Jennings notes the slightly different warning signs to be aware of. "Two evidence-based red flags to watch for are blood in your stool (red or black/tarry) and unintentional weight loss, both of which warrant prompt medical review.

"Also see your GP if you have a new, persistent change in bowel habit (constipation, diarrhoea, or alternating) lasting more than three to four weeks, night-time gut symptoms that wake you, or signs of anaemia (marked fatigue, dizziness, pallor). Severe or ongoing abdominal pain, fever, or vomiting are additional reasons to seek urgent care. Persistent bloating is also a sign that there might be some dysbiosis (imbalance in gut microbes where unfavourable bacteria outweigh beneficial bacteria)," she explains.

Where to start with treating constipation

"Once any underlying causes have been excluded, the foundation of managing constipation lies in lifestyle and dietary changes," says Dr Patel. Jennings agrees, noting it is a good idea to "raise fibre slowly. Build toward 25 to 30 g/day from foods (oats/whole grains, beans/lentils, veg, fruit, nuts/seeds). Increase over one to two weeks to reduce gas and bloating," she says.

Both note the importance of drinking plenty of fluids and staying active. "Move after meals," says Jennings. "A five to ten-minute walk after breakfast and dinner boosts colonic motility. Aim for daily activity overall."

Finally, both Dr Patel and Jennings recommend creating a regular toilet routine. "Sit after breakfast (gastro-colic reflex is strongest), don’t ignore the urge, and use a footstool to straighten the anorectal angle - less straining, easier passage," says Jennings.

"If these measures don’t help, fibre supplements, stool softeners, or gentle laxatives can be used," says Dr Patel.

My journey with chronic constipation

I spent my entire adult life in and out of doctors surgeries

I’ve never wanted to be "normal" more than I have with my bowel habits. I remember visiting a GP at 18 when I finally plucked up the courage to speak to someone. I spent my entire adult life being in and out of doctors, specialists, trying every test imaginable, every diet imaginable - whether it be FODMAP or excluding gluten and dairy - stool tests, blood tests, supplements. You name it, I've tried it.

I spent a lot of my life being told I had IBS, but with little explanation as to what that meant. I was the girl who pooed once a week at best, and once, I went two weeks without any bowel movement. It was debilitating.

Often, on a Friday evening at 6 pm, when I was clearly relaxing for the weekend, I would poo. Yet despite all of the tests, no one was able to give me answers. It was evident I just had a slow-moving gut; your gut-brain connection is so strong, and for me, stress was a big contributor to my constipation. I did all the things you’re meant to, plenty of water, fibre, exercise, fruit and vegetables - I lived a healthy lifestyle, but nothing really got things moving.

When I finally became regular, I felt like a cloud had lifted

The biggest worry was being constantly told that this was "normal", and that there wasn’t a huge amount to be done about it apart from laxatives, avoiding certain foods and more kiwis (I mean, please?!). This held me back from living life to the full. I was always so envious of people with healthy bowel habits - and yep, bowel envy is a thing.

I would minimise my portions, because I was in fear of eating too much and it just sitting in my gut. The impact of toxins sitting in your gut has huge mental health impacts: the brain fog, feeling subpar, lack of energy, and mood swings. When I finally became regular, I felt like a cloud had lifted; I couldn’t get over how much better in myself I felt in so many ways.

My lifestyle now

That's why I decided to launch WE ARE. REGULAR. Selfishly, at the time of deciding to launch, I was taking 30 supplements a day and spending hundreds of pounds to be regular. I’d discovered a concoction of ingredients that was making me regular - Magnesium Citrate, Vitamin C, Peppermint, plus many more - but 30 supplements a day isn't sustainable or affordable.

I knew so many constipated women. Everybody has a constipated friend. Whether it is chronic constipation like my own or intermittently impacting women at certain times of their cycle or life, constipation and bloating affect us all, and I just knew I wasn’t alone. Above all, I was on a mission to just help women feel better.

Taking WE ARE. REGULAR in the morning works really well for me. I like to have a morning poo as it just sets my day off right - if there’s a day I don’t poo, I feel the impact. It’s packed full of ten good-for-you ingredients, the Vitamin C is great for energy, and the Barley Grass is what gives it that green look, but is full of fibre. I’m a huge believer in the power of antioxidants and botanicals, so no matter what, I know if I take it, I’m having a good day.

Finally, I am now a regular girl. I never thought I’d be able to say that, but pooing regularly is such a game-changer. My mood, my mental clarity, my energy - I’m no longer asking myself if I'll get caught out or need to go at an inconvenient time, because when you’re irregular, you will have to go at any given moment (even if that moment is minutes before a friend's wedding). You never know when the opportunity will come again. I’m no longer living anxiously, wondering when the next time will be, as I know it will be soon.

I have become so attuned to my body through this process. Over the years, I’ve learnt what does and doesn’t help. I avoid certain foods such as gluten and dairy as they really impact my gut motility. I take electrolytes to stay hydrated, because despite how much water you drink, sometimes it’s the absorption of it that is the problem, and electrolytes help with that. Eating as whole foods as I can, lots of fruit and vegetables and minimal fats.

We’re all different, and I’ve learnt that it takes time to listen to your body and understand what works for you.

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I started to process the waves of pain I was experiencing with diary entries - streams of words scribbled between agonising pulses.

It’s a strange thing to feel betrayed by your own body. To fear the pain, but fear people's disbelief even more. The pain hits first. Then the fear. And then the all-too-familiar thought - what if they don’t believe me again?

For nearly a decade, despite regular visits to my GP practice where I detailed the pain I was experiencing, no one seemed to listen. It took several years before anyone floated the term "endometriosis," a female health disease that affects around one in ten women worldwide. For context, that's roughly 450 million globally, and an estimated 1.5 million in the UK.

As Dr Raj Arora, a GP and women’s health specialist, explains, “Endometriosis is a chronic condition where tissue similar to the lining of the uterus grows outside it - most commonly in the pelvis, but sometimes on the bladder, bowel, or even nerves in the legs. These cells behave like those in the womb, thickening and bleeding each month, which can lead to inflammation, pain, and scarring.”

Despite it being actually quite a “common” chronic condition, diagnosis remains painfully slow. Recent data from Endometriosis UK shows the average wait time to be diagnosed has now reached eight years and ten months - the longest for any illness. And, despite being a condition that costs the UK economy more than £8.2 billion a year in healthcare, the women struggling with the disease are all too often left to slip through the cracks.

For many years, I was one of them. But eight years, six different hormonal pills, four operations, and the coil later, and I finally feel at one with this condition, and confident that I know how to tackle it, and most importantly, how to live with it.

I’ve also learned that I’m far from alone, and that understanding endometriosis starts with unlearning everything we’ve been taught to tolerate. Here’s what I wish I’d known from the start.

Keen to read more about endometriosis symptoms, endometriosis diagnosis, or how to adjust to living with endometriosis? Keep scrolling.

I’ve Long Struggled With Debilitating Endometriosis Symptoms – 7 Things I Wish I’d Known Sooner

1. Painful periods aren’t normal - full stop

For years, I wore my pain like a badge of honour. Doubled over in the bathroom, unwrapping my next heat pad, still turning up to work because that’s what I thought strong women did. Bad cramps felt like a tax on being a woman, something everyone warned me about, so I learned to accept them.

But the truth? Any pain that makes your vision blur and your body fold in two isn't normal.

Research from Vall d’Hebron University Hospital in Barcelona found that endometriosis pain causes measurable changes in the brain’s pain-processing pathways, proof that this isn’t “just bad period pain,” but a chronic, neurological condition that rewires how the body experiences pain.

“It’s one of the biggest misconceptions,” continues Dr Arora. “While mild discomfort can be normal, pain that stops you functioning, affects your ability to work, socialise, or prevents you from standing isn't something to normalise. Nothing about heavy bleeding, pain during sex, nausea, and pain outside of your menstrual cycle is normal.”

Generations of women have been taught to endure pain in silence, partly because severe period pain is still dismissed as routine. If there’s one thing I wish I’d known sooner, it’s that enduring agony isn’t strength. It’s silent. And it’s time we stopped mistaking one for the other.

2. Symptoms don’t play by the rules - your experience is valid

Ironically, there’s limited knowledge about endometriosis, yet endless noise around period pain and what women should expect. For as long as I can remember, I was told my pain was nothing out of the ordinary - just a simple part of womanhood, something to be endured.

We assume that because period pain is so universal, everyone’s endometriosis symptoms must also look the same. When mine didn’t match up to exactly what I’d read online, the intrusive thoughts began. "Maybe this is just what I have to live with?", I thought to myself. Or even worse - "Maybe I’m making it up in my head?".

“Symptoms can vary enormously,” explains Dr Arora. “Some experience severe period pain, others fatigue, digestive issues, or pain in the back or legs. There isn’t a universal pattern, and severity doesn’t always reflect the extent of the disease. Not all medical professionals are trained to recognise these symptoms, so don’t hesitate to ask for a referral to a women’s health specialist.”

It took me years to realise that pain doesn’t have to fit a pattern to be real. Endometriosis doesn’t follow the rules, and neither should the way we talk about it. Your symptoms are valid. Full stop.

Living with endometriosis can be difficult, but it is doable, and there is support out there for you.

3. Diagnosis delays aren’t your fault - but you can advocate for yourself

Before my diagnosis, I treated endometriosis like an exam with everything riding on it. I devoured research papers, watched every TED Talk, and covered every inch of Endo YouTube. Confidence and stubbornness became my tools. The better I could explain what was happening, the harder it was for the system to dismiss me. My first consultation taught me that if I wanted to be heard, I’d have to treat the appointment like an episode of Medical Mastermind.

One thing I wish I’d known sooner: you’re allowed to ask for a second opinion. I used this rule whenever advice contradicted my research. I once spent four hours in an appointment I’d waited a year for - exhausting, but empowering. It taught me the value of holding my own and trusting my instincts.

“You must become your own pain detective,” says Dr Olivia Ahn, doctor and co-founder of Fluus. “Given the long waits, meticulous data is your best tool. Track everything - pain, fatigue, triggers - and insist on a referral to an endometriosis specialist, not just a general gynaecologist. While you wait, be your own advocate: make health-first choices that reduce inflammation, from the products you use to the foods you eat. Education and self-advocacy go hand in hand.”

We can’t control the waiting lists, but we can control how we care for ourselves in the meantime. Knowledge isn’t just power, it’s protection. Keen to know how to advocate for female health conditions? Read our guide here.

4. There’s no one-size-fits-all treatment

I used to believe surgery was the only way forward - that once the tissue was removed, life would fall back into place. But the fact of the matter is, treatment for endometriosis isn’t linear. Sadly, there are no “fixes”; it’s about managing a chronic condition with patience in abundance and the right mix of tools.

“Physiotherapy helps you increase body awareness by looking at everything that can be affected - pelvic floor tension, bloating, bladder sensitivity, fatigue, or pain during sex,” explains Anna Wooley, physiotherapist and pelvic health specialist. “A big part of our role is listening. So many women don’t feel heard, but understanding your own body is powerful. When you know what makes symptoms better or worse, you can tailor your exercise, nutrition, and daily habits to support recovery. Don’t suffer in silence; there’s help out there.”

Claire Mills, founder of Core LDN and pelvic health specialist, adds: “Physiotherapy can reduce pelvic pain by easing muscle tension and improving mobility, but it’s most effective as part of a multidisciplinary approach - surgery, hormonal therapy, nutrition, and emotional support all play a role.”

If only I’d have known sooner, pelvic health, physiotherapy and physical movement aren’t niche fixes, but a foundation for long-term management.

5. Nutrition can be a game-changer

I was blissfully unaware of how much what I ate could influence my symptoms: the fatigue, the bloating, the brain fog. Like most, I used to treat nutrition as an afterthought, something totally unrelated to my diagnosis. But, with endometriosis, food can actually be one of the most powerful tools for managing inflammation, supporting hormones, and easing the daily discomfort.

Another thing I didn’t know: endometriosis isn’t just a reproductive condition, it’s deeply connected to the immune system, inflammation, and how our bodies metabolise hormones. As Hannah Alderson, registered nutritionist and hormone specialist, explains, “Endometriosis is an oestrogen-driven inflammatory condition, and what we eat can directly affect how much oestrogen circulates and how efficiently the body clears it. The goal nutritionally is to calm that cycle - lowering inflammation and supporting the body’s ability to metabolise and eliminate excess oestrogen.”

Her advice is refreshingly simple: eat anti-inflammatory fats like omega-3s from oily fish, flax, and chia seeds; fill your plate with cruciferous vegetables like broccoli, kale, and sprouts to support liver detoxification; and prioritise fibre and fermented food to keep your gut microbiome healthy - key for clearing excess oestrogen. Reducing ultra-processed foods, refined sugars, and trans fats can also quieten the inflammatory response that drives pain and fatigue.

Alderson adds, “It’s not about restriction, but nourishment - building every meal around protein, healthy fats and colourful fibre to stabilise energy and calm hormonal chaos.” She reminds us that nutrition sits within a wider lifestyle framework - stress, sleep, movement and all-around joy all influence hormone balance and symptom flares.

Research backs this up. A 2020 study linked Omega-3 intake to reduced endometriosis pain. Keen to read more? Our expert-led feature on the anti-inflammatory diet explores how small, sustainable changes can improve overall quality of life.

6. It’s a whole-body condition - not "just" a reproductive one

Before I bettered my understanding of the condition, I naively assumed endometriosis only affected periods and that the pain level was directly linked to my menstrual cycle. Now I know it can touch everything - digestion, energy, even breathing.

“Endometriosis is systemic,” says Dr Arora. “It can involve organs like the bladder, bowel, or even lungs. These cells can grow anywhere, and understanding it as a full-body condition changes how we treat it.” Research supports this: a 2021 review published by the National Library of Medicine described endometriosis as a systemic disease, noting it affects metabolism in the liver and adipose tissue, alters brain gene expression and leads to widespread inflammation

If I’d have known this sooner, I wouldn’t have treated each symptom in isolation. Digestive issues, chronic fatigue or shortness of breath weren’t separate problems; they were parts of the same story. Endometriosis doesn’t stop at the pelvis, so neither should the way we address it.

7. Mental health support is essential - and you’re not alone

There’s the pain, and then there’s the emotional toll. The guilt, frustration, and exhaustion of battling to be believed can weigh just as heavily as the physical symptoms. For years, I carried both, albeit not so silently, thinking that surviving the pain meant surviving everything else too.

“Chronic pain conditions affect the nervous system,” explains Dr Arora. “Over time, this can heighten anxiety, fatigue, and stress. Addressing mental health through therapy, mindfulness, or support groups can help calm that cycle and improve overall well-being.”

But what’s helped the most hasn’t been medical intervention; it’s been connection. Hearing other women say, "Yes, me too," has transformed isolation into solidarity. Communities such as Kuratd Studio and Endometriosis UK have provided me with a safe space to share experiences, exchange advice, and feel seen.

Bottom line?

Endometriosis is a complex, highly unpredictable, and at times, unforgiving condition. But knowledge changes everything, and it turns our own doubts into self-advocacy and isolation into connection.

Healing isn’t linear, and it isn’t solitary. If I’d known all this sooner, maybe I’d have spent less time surviving it and more time living through it. Now, at least, I finally am.

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Trigger warning - this article discusses infertility and IVF

Jennifer Aniston has opened up about her decades-long fertility struggles in a candid new interview. The Friends star, who detailed her 'challenging' IVF journey for the first time in 2022, elaborated on the difficulties she faced privately while being subjected to endless criticism for being child-free during both her marriages, and in the wake of her divorces. In 2016, while married to Justin Theroux, Jen An penned an op-ed for HuffPost where she responded to pregnancy rumours stating that she was 'fed up with the sport-like scrutiny and body shaming that occurs daily'.

In a new interview for Harper's Bazaar, Jennifer explained why she finally decided to correct the narrative. She told the publication: "They didn’t know my story, or what I’d been going through over the past 20 years to try to pursue a family, because I don’t go out there and tell them my medical woes. That’s not anybody’s business. But there comes a point when you can’t not hear it – the narrative about how I won’t have a baby, won’t have a family, because I’m selfish, a workaholic. It does affect me – I’m just a human being. We’re all human beings. That’s why I thought, 'What the hell?'"

Jennifer married Brad Pitt in 2000, and during their relationship she was often the subject of pregnancy speculation and body-shaming. When the couple divorced in 2005, she was then accused of prioritising work over starting a family. But over the course of two decades, The Morning Show star had been quietly undergoing unsuccessful rounds of IVF. Sharing why it suddenly felt important for her to share her story, Jennifer explained: "Because I knew a lot of women at the time who were trying to have kids, who were dealing with IVF. So it did feel like it was not only for myself, but for any women who were struggling with the same issue."

In an interview with Allure magazine, Jen An discussed feeling the same pressure during her second marriage to Justin Theroux. The couple were together for seven years, but divorced in 2018. Once again, she faced accusations of prioritising work over motherhood when their relationship ended. She told the publication: "God forbid a woman is successful and doesn’t have a child. And the reason my husband left me, why we broke up and ended our marriage, was because I wouldn’t give him a kid. It was absolute lies. I don’t have anything to hide at this point."

If you have been affected by anything discussed in this article, The Fertility Foundation can provide support to those seeking advice.

My painful periods weren’t the only reason I left my full-time job at a magazine in 2023 to go freelance, but I’d be lying if I didn’t say they were a major factor. With few other options available to me, I realised that I couldn’t go on forcing a round peg into a square hole: full-time work without flexibility, while living with abnormal periods, was burning me out. And so, I turned to self-employment to give me the flexibility I needed.

Since then, I have been shaping my work around my cycle, keeping the worst three or four days free of in-person commitments, and building in room to work from the sofa when excruciating pain and heavy bleeding made normal office life impossible. Despite working in women-dominated industries, I never felt period pain would be taken as a valid enough reason to miss work. Maybe this was projection or societal conditioning, but it became unmanageable. Covid lockdowns had shown me what flexible working could look like, and the thought of going back to commuting into an office every month while doubled over in pain felt unbearable. I should have asked for more flexibility or support, but, as we are primed to do as women, I didn’t.

When I first heard about Portugal’s new menstrual leave legislation, I felt hopeful. As of April 26th, employees who experience severe and disabling menstrual pain caused by endometriosis or adenomyosis can take up to three consecutive days of employer-paid leave per month. Spain led the way in 2023, passing similar legislation. Now, a new petition calling for the same in the UK is gaining traction, with over 60,000 signatures (it’ll need 100,000 signatures before making it to Parliament). However, after spending well over a decade trying to get my own PCOS diagnosis—and still awaiting further investigations into endometriosis and PMDD—my trust in systems to support women through gynaecological issues is low.

For women like me, a law like Portugal’s could be life-changing, but our optimism is peppered with doubt. Rebecca, a 36-year-old psychotherapist from London, describes being unable to do anything but lie on the sofa with painkillers and a TENS machine during her period. She’s apprehensive about what this leave could look like in practice: “I imagine this leave could be used in the way sickness leave is now: it’s there, but management doesn't like it when you take it. It could be yet another reason misogynists give for not hiring women,” she says. Her concern is not misplaced. The Guardian reported that in the 11 months immediately following Spain’s menstrual leave becoming law, it was taken just 1,559 times.

Others see it as an overdue recognition of women’s health. Samantha, a civil servant from the North East, says paid menstrual leave would have reduced stress in her early career: “Trying to schedule my period on my days off and making up excuses for calling in sick was exhausting. Knowing I could just take time off would have helped my mental health.” Alexia, 32, a clinical research practitioner in London, agrees: “Paid menstrual leave would mean I wouldn’t have to push through a full workday while dealing with endometriosis pain. It’s about health, not privilege.”

Experts back them up. Dr Sula Windgassen, a leading health psychologist, believes menstrual leave could be transformative: “A policy like this improves workplace accessibility for those with debilitating chronic illnesses. It reflects a sense of truly valuing employees, which actually enhances productivity. It’s a win-win.” But she warns that long diagnosisdelays—seven to nine years on average—mean too many would miss out unless access is widened.

Changing policy, though, isn’t enough. Menstrual care in the UK lags in research funding, education, and workplace culture. The burden falls heaviest on marginalised groups: working-class people and people of colour. A 2024 report found one in ten people with periods had been told not to talk about them in front of others, with Asian and Asian British people among the most affected. Furthermore, research from ethical period care brand TOTM has found that 94% of people with periods said period pain has disrupted their working day, and over half don’t feel comfortable discussing periods at work.

Menstrual leave won’t solve every problem, but it’s a crucial first step—and long overdue. The government must act swiftly to make it a reality. Yet true change requires more than policy alone; broader cultural shifts are essential, driven by education and awareness, to genuinely improve the lives of women living with painful periods.

Finally, women's health issues are becoming more visible. We're seeing dialogue opening up around topics from PMDD to endometriosis, all-important research funding being granted, vital studies being progressed, and answers finally being reached.

That said, there's still a long way to go - which is why it's been so encouraging seeing world-famous celebrities with global reach open up about their own personal female health struggles in the past few years. Because while it shouldn't be the case, it's always more impactful when celebrities speak out about their experiences.

Take tennis royalty Venus Williams, as an example, who recently opened up about her struggles with uterine fibroids in our fifth Marie Claire UK Women in Sport issue. Not only did she detail the debilitating pain they caused her for decades before her eventual diagnosis in 2016, but the heavy menstrual bleeding and severe discomfort she dealt with while making history on the tennis court.

Quite how she did it defies belief - but sadly, she's far from alone. English singer and songwriter FKA Twigs and Oscar-winning actor Lupita Nyong'o have also spoken out about their struggles, with Nyong'o revealing on Instagram that she had 30 fibroids removed in 2014 - the same year she won the gong for 12 Years A Slave.

And it's not just celebrities, either. Research (such as this study, published in the journal BioMed Central) shows that between 70 and 80% of women will develop uterine fibroids by the age of 50, with cases rising. Yet relatively little is known about the causes and symptoms of these benign growths, and we'd bet a few of you had never even heard of the common female health condition before today.

Below, we've spoken to top experts to debunk exactly what uterine fibroids are, how they occur, what the most obvious symptoms are, plus what to do if you reckon you may be struggling yourself. Whatever you take from this article, do know this - you're not alone, and you will get the help you need.

For more on the female health conditions we should all know more about, don't miss our expert-led guides to the symptoms of PCOS, symptoms of endometriosis, and symptoms of PMS, here, not to mention the perimenopause and early menopause symptoms, here.

As Venus Williams. FKA Twigs and Lupita Nyongo reveal their uterine fibroids diagnoses, experts explain the symptoms

What are uterine fibroids?

Given that they're so common, it's surprising that so few of us know what uterine fibroids actually are; so, let's put that right. Also known as leiomyomas or myomas, fibroids are growths of varying sizes found on the uterus.

"Uterine fibroids, also known as leiomyomas, are non-cancerous growths that develop in or on the uterus (womb)," shares Dr Sophie Strong, lead consultant gynaecologist from The Pelvic Pain Clinic at The Whiteley Clinic. "These clusters of muscle and tissue can vary in size from a few millimetres to very large masses that can significantly change the shape of the uterus. While they’re incredibly common, affecting up to eight in ten females by the age of menopause, many people are unaware that they have them or have even heard of them."

Although little is known about why fibroids develop, we do know that our risk increases as we head towards menopause, with black women disproportionately affected, too.

"Fibroids are very common, particularly in women of reproductive age, and often develop during the years leading up to the menopause," says Dr Suzanne Wylie, GP and medical adviser for IQ Doctor. "Some women may have only one fibroid, while others may develop multiple growths. Depending on their size and location, whether within the uterine wall, on its outer surface, or projecting into the cavity, fibroids can present differently, and symptoms may vary."

What causes uterine fibroids?

While the specific causes of uterine fibroids aren't fully known or understood, there are some risk factors to be aware of.

"The exact cause of uterine fibroids is not fully understood, but their growth appears to be linked to the female hormones oestrogen and progesterone," shares Dr Wylie. "Fibroids tend to grow during the reproductive years when hormone levels are at their highest and often shrink after the menopause when hormone levels decline."

As touched on above, race and ethnicity play a part, with women of Black, African or Caribbean descent being at greater risk of developing the growths.

"Genetic factors also play a role, as fibroids can run in families," continues Dr Wylie. "Additionally, certain lifestyle and health factors, such as obesity, early onset of menstruation, and being of Black African or Caribbean descent, are associated with a higher risk of developing fibroids."

All this being said, much more research is needed into uterine fibroid risk factors.

What are the symptoms of uterine fibroids?

Interestingly, experts believe that the occurrence of fibroids may be even higher than reported, since they don't always cause any symptoms. However, those women who do experience the condition report a range of symptoms, from mild to debilitating. Let's take a look in more detail.

1. Heavy periods

By far the most common symptom of uterine fibroids is heavy periods, and by this we don't mean a few days of uncomfortable blood loss - we're talking changing pads every half an hour, frequent flooding and being unable to leave the house.

"A common symptom of fibroids is abnormal uterine bleeding," says Miss Mez Aref-Adib, consultant gynaecologist at London Gynaecology. "While symptoms depend on the location and size of the fibroids, most often submucous ones in the inner layer of the womb can cause bleeding problems such as heavy periods or bleeding in between periods. Sometimes the bleeding is associated with heavy clots and spasmodic pain, and can lead to iron deficiency and anaemia."

2. Severe cramps

Alongside heavy bleeding, you're likely also to experience severe cramping and pain. While some discomfort (an understatement if ever we heard one) is common during menstruation, fibroids can cause pain outside of your bleed, too.

"Fibroids can cause a feeling of heaviness and fullness in the pelvic area," explains Miss Aref-Adib. "Large fibroids can cause mass and pressure effects, and if they become larger, they can sometimes outgrow their own blood supply and can undergo what's known as central degeneration. In this case, they become extremely painful and can cause swelling.

"Additionally, depending on the position of the fibroid, they may also cause dyspareunia (pain during sex)."

3. Constipation and urinary issues

At this point, this is reading like a list of menstrual symptoms, but bear with us - there's a lot of overlap.

"Fibroids can press on the surrounding organs such as the bladder and bowel, leading to both urinary frequency and constipation," notes Miss Aref-Adib. "Occasionally, pressure on the bladder neck can lead to urinary retention, where women are unable to empty their bladders. Large fibroids can cause pressure on pelvic blood vessels, which can lead to swelling of legs, deep vein thrombosis and back pressure on the kidneys, too."

4. Fertility issues

It's important to note here that most uterine fibroids won't cause fertility issues, so if you've been diagnosed with them, try not to spiral.

"Symptoms often depend on the size, location, and number of fibroids," advises Eve Lepage, fertility nurse and reproductive health specialist at Clue. "For example, the fibroids that grow in the wall of the uterus (intramural fibroids) are more likely to cause infertility than those that grow outside of the uterus (subserosal fibroids)."

Dr Strong agrees, telling MC UK: "Some people experience fertility issues, particularly if the shape of the cavity of the womb, where a pregnancy would grow, is affected, but symptoms can vary widely from person to person. If you suffer from heavy periods which affect the quality of your life, constant pelvic pressure, frequent urination or difficulties in trying to conceive, it is important that you see your GP to discuss whether you could have fibroids."

Can uterine fibroids be treated?

There is some good news here. If fibroids are not causing unwanted symptoms, treatment usually isn’t necessary, but depending on the size, symptoms, and location, there are several treatment options available.

1. Hormonal treatment options

"Medical treatment options depend greatly on what symptoms you have," advises Lepage. "For example, paracetamol and ibuprofen are often used to manage pain. If you suffer from heavy bleeding, your doctor may prescribe you medication that helps reduce or stop the bleeding. These include:

• Oral contraception: the combined hormonal birth control pill
• Oral progestogen: a synthetic progesterone that helps reduce heavy periods
• Tranexamic acid: a medication that helps your blood clot, which reduces the amount of bleeding
• Hormonal intrauterine device (IUD): a small T- shaped device placed at the top of your cervix.

2. Non-surgical procedures

"When fibroids are still causing unwanted symptoms and medication has not helped, removing or destroying them through non-surgical and surgical routes may be an option," says Lepage.

These include:

• Uterine artery embolisation: a procedure where the blood vessels that supply blood flow to the fibroid are blocked.
• Endometrial ablation: a minor procedure that removes the lining of the womb to remove small fibroids, which can help with heavy bleeding.
• MRI-guided ablation: an MRI scan that uses laser or ultrasound energy to destroy the fibroid.
• Ultrasound-guided ablation: a newer technique that uses a sonogram and heat to destroy the fibroid.

3. Surgery

Surgery will usually be a last resort if other treatment options haven't been successful. Surgical procedure options include:

• Myomectomy: a surgery that removes certain types of fibroids from the uterus.
• Hysteroscopic resection of fibroids: a surgery that uses a small camera and instrument to remove the fibroid.
• Hysterectomy: a surgery that removes the uterus (only after other options have been unsuccessful).

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Put together any list of wellness buzzwords from the last few years, and chances are, "hormone balance" is right up there with "gut health", "glucose spikes", and "cycle syncing". Whether it's videos of raw carrot salads promising clear skin, viral seed cycling tutorials, or blood sugar hacks to beat the 3 pm crash, social media would have you think that balancing your hormones is a cure-all solution: unlocking better energy, clearer skin, improved digestion, and regular periods.

In many ways, the hype around hormone balancing is justified, with a growing body of science backing the connection between nutrition, blood sugar and hormonal health. Take this 2022 study, published in The Journal of Food Biochemistry, for example, which found that a diet rich in protein, anti-inflammatory foods and healthy fats positively influenced insulin and inflammation levels in women with PCOS (a common hormonal disorder affecting one in ten women in the UK). Or this research in the International Journal of Food Science and Nutrition, which found that limiting processed foods, prioritising quality sleep and engaging in regular physical activity can promote optimal hormonal function.

As someone who struggles with irregular cycles, I’ve become a fan of the simple “hormone-balancing hacks” shared by bioscientist Jessie Inchauspé (better known as the Glucose Goddess), whose blood sugar-stabilising tips have amassed 5.6M followers online. Working in an office four days a week, I knew I’d never commit to anything too complex, but just switching my sweet breakfast for something savoury? I can get on board. I’ve found myself staying fuller for longer, feeling more energised, and the dreaded afternoon slump is now a rare occurrence.

But in the last year, it feels as though the conversation around hormone balancing has shifted somewhat online. What began with nutritionists and dietitians sharing simple lifestyle and diet tweaks has turned into a wave of “what I eat in a day for hormone balance” videos, which at times look suspiciously restrictive, expensive, and anxiety-inducing.

For Hannah Alderson, Hormone Nutritionist and author of Everything I Know About Hormones, the concern is the lack of nuance within these videos. “The idea that what works for one individual will be right for another can be very misleading,” she explains. “Whilst there are common threads within hormone health, we are all individuals living unique lives, and our hormonal health should be approached with this in mind.”

Alderson reminds us that building a hormone-healthy environment shouldn’t be about fear or restriction. “There’s a difference between building a positive hormone environment and being told your body is broken if you don’t eat in a certain way. Our bodies aren’t a software system that needs to be hacked, and your hormones aren’t something to ‘fix’ – they’re something to support.”

So, how do we cut through the noise and get to the heart of what really matters when it comes to your hormones? To separate fact from fiction, we’ve enlisted the help of Alderson, alongside Women's Naturopathic Nutritionist and author of The Hormone Balance Handbook, Jessica Shand, to create your complete hormone-balancing bible.

Intrigued? Keep scrolling. And if eating for your hormones is something you’re keen to try, we’d suggest checking out Senior Health Editor Ally Head's review of Glucose Goddess hacks before heading to our nutritionist-approved guide to the best foods for hormone health. If recipe inspiration is what you’re after, our review of the best anti-inflammatory recipes is a must-read.

Keen to know how to balance your hormones? Top specialist experts share their take

What does it mean to "balance your hormones"?

With so much chatter around hormone health, it’s easy to nod along without fully understanding what’s actually going on beneath the surface. And I’ll be honest, even as a Health Writer who considers herself pretty in tune with her body, I’ve had moments where I’ve stopped and thought, hang on, what is a hormone, exactly?

“Hormones are chemical messengers produced by your endocrine glands - like your thyroid, ovaries, adrenal glands and pancreas,” explains Shand. “They’re responsible for regulating countless essential processes in the body, from metabolism and mood to energy levels, sleep, menstrual cycles, stress responses and reproductive health.”

So when we talk about 'balancing your hormones,' what we’re really getting at is helping those messengers communicate clearly and efficiently. “It’s about achieving an optimal level and interaction between various hormones in your body,” says Shand. “That’s what allows them to function smoothly and support your overall wellbeing.”

What both experts were quick to point out, however, is that it’s not about chasing some perfect number or keeping your hormones static. In fact, Alderson isn’t a fan of the word 'balance' at all. “While the goal is to feel balanced, aiming for ‘balanced hormones’ doesn’t send quite the right message,” she says. “Hormones are meant to fluctuate because they all have different roles and characteristics, that’s what keeps our systems functioning.”

Instead of chasing a fixed target, Alderson encourages us to focus on creating the kind of internal environment where our hormones can naturally do their job without disruption. Shand agrees. “Things like what we eat, how we move, how well we sleep, our stress levels, and even our exposure to environmental toxins all have a direct impact on our hormone levels. Balancing your hormones is not about perfect, static levels but rather about supporting your body in maintaining a healthy, adaptive range that suits your lifestyle and individual biology.”

What are the benefits of eating and moving for your hormones?

Research suggests that around 75% of women have experienced a reproductive health issue in the last year, which makes tuning into our hormonal health not just helpful, but necessary.

“Hormonal imbalances can be the cause of fertility challenges, abnormal menstrual cycles, persistent fatigue, anxiety, unexplained weight changes, poor sleep, skin breakouts and hair loss,” explains Shand.

And that’s just scratching the surface. “Everything from energy, mood, weight, digestion, sleep, your heartbeat, happiness and love is influenced by hormones,” adds Alderson. Put simply? When our hormones are well supported, we feel better.

But what’s actually going on behind the scenes to make us feel better? To help us get a little more granular, we asked Shand to break down the key benefits that come from supporting your hormones through nutrition and movement:

1. More stable energy levels

If you find yourself crashing mid-afternoon or reaching for a pick-me-up around 4 pm, you’re not alone, and your hormones might have something to do with it. “When hormones such as insulin and cortisol are balanced, we see a prevention of energy crashes and reduced cravings,” says Shand. The result? Steadier energy throughout the day, without the rollercoaster.

2. Better mood and mental clarity

Balanced hormones play a key role in regulating brain chemicals like serotonin and dopamine, which support emotional stability and mental sharpness. “Hormonal balance supports neurotransmitter function, reducing anxiety and enhancing focus,” says Shand.

3. Deeper, more restful sleep

Hormones like melatonin and cortisol play a major role in sleep quality. According to Shand, when they’re in sync, “you fall asleep easier, stay asleep longer, and wake up feeling refreshed.”

4. Weight management, if that’s your goal

Let’s be clear: weight loss isn’t the goal for everyone, and no one should ever feel pressure to change their body. But if a shift in body composition is part of your personal health goals, your hormones matter. “Stable insulin levels reduce fat storage, balanced thyroid hormones support metabolism, and lower cortisol helps prevent abdominal weight gain,” Shand explains.

5. Reduced PMS and smoother menstrual cycles

One in five women experiences PMS symptoms severe enough to impact daily life, but that doesn’t make it normal, and it’s not something you should just have to live with. “A hormone-friendly diet and regular movement can result in pain-free menstrual cycles, reducing cramps and PMS symptoms,” says Shand.

6. Greater resilience to stress

Movement is one of the most effective ways to regulate cortisol (your main stress hormone), Shand tells us, “whilst a nutritious diet helps to stabilise blood sugar, keeping your mood steady and helping you handle life’s challenges with greater ease.”

7. Fewer skin breakouts

If your breakouts tend to coincide with your cycle, you’re not imagining it. Shand explains that “hormonal stability, especially when it comes to androgens like testosterone, can help reduce breakouts and keep skin clearer.”

8. Improved fertility and reproductive health

Whether you’re trying to conceive or not, supporting reproductive hormones like oestrogen and progesterone is key. “Proper nutrition and regular movement promote healthy ovulation, which should be the goal of every cycle as it’s a vital sign of overall health,” Shand notes.

Who could benefit from "balancing" their hormones?

According to Alderson, the short answer is: pretty much all of us. “Whether you’re navigating PCOS, fertility, perimenopause or postpartum depletion, dealing with endometriosis, or simply want to feel less foggy and more energised, supporting your hormones is important at every stage of life,” she explains, reminding us that we don’t have to wait for something to feel ‘off’ before starting to pay attention to our hormonal health.

Shand agrees, highlighting that adopting a hormone-supportive lifestyle can be especially beneficial for women experiencing menstrual irregularities. This can include anything from “heavy periods, missed cycles or PMS,” she says. “Women with conditions like polycystic ovary syndrome (PCOS), endometriosis, or fibroids often see improvements in symptom management by supporting hormonal balance. Proper nutrition and lifestyle adjustments help regulate key hormones like estrogen, progesterone, and insulin.”

Hormonal health also becomes crucial when you’re thinking about starting a family. “For those facing fertility challenges, supporting hormones can help enhance monthly ovulation and optimise reproductive health, making conception more likely,” Shand explains. And this isn’t just relevant earlier in life. Women going through menopause can also benefit. “Symptoms like hot flashes, night sweats, and mood swings can often be eased by optimising hormone levels through diet and lifestyle changes,” she adds.

Is a diet and lifestyle tailored to balancing your hormones for everyone?

“While this way of eating and living can support almost everyone, it’s how you approach it that really matters,” explains Alderson, who reminds us that “if it becomes too rigid or fear-based, it can backfire.”

If you’ve ever been caught in the traps of diet culture, this will probably resonate. It’s all too easy for a healthy habit, especially around food, to slip into restriction and obsession. And when it comes to hormone health, that can do far more harm than good. As Shand points out, “Focusing too heavily on optimising health can become a stressor, particularly if someone starts to obsess over every bite. Ironically, this stress disrupts cortisol levels, which is the body’s primary stress hormone.”

It’s also important to remember that a hormone-supportive lifestyle won’t look the same for everyone, especially if you’re managing other medical conditions like diabetes. In these cases, it’s always best to check in with your doctor before making any significant diet or lifestyle changes aimed at balancing hormones.

2 simple hormone balancing recipes to try

1. Jessica Shand's Magnesium-rich Walnut Pesto Spelt Spaghetti

Serves 2

• 2 servings of spelt spaghetti
• Big handful of spinach
• 400g tin haricot beans, drained
• and rinsed

• 60g basil
• 30g flat-leaf parsley
• 60g walnuts
• 60g Parmesan
• 2 garlic cloves
• 125ml extra-virgin olive oil
• Juice of ½ lemon
• Pinch each of sea salt and freshly
• ground black pepper
• ¼ tsp dried chilli flakes

1. To make the pesto, place all the ingredients in a food processor and blitz.
2. Cook the spaghetti according to the packet instructions, drain and stir in the spinach, and haricot beans (or sub butter beans for your choice of protein, or prawns or chicken), along with the pesto, while the pasta is still hot.

2. Hannah Alderson's Lemon Chia Seed Pudding

Serves 1

• 60g rolled oats (gluten-free if needed)
• 2 tbsp chia seeds
• 1 tbsp ground flaxseed (optional but great for hormone support)
• Zest of 1 lemon
• Juice of 1⁄2 lemon
• 250ml unsweetened almond milk (or any milk of choice)
• 1 tsp vanilla extract
• 1⁄2 tsp cinnamon (optional for extra blood sugar support)
• 1tsp raw honey (optional, to taste)
• 2 tbsp Greek yoghurt or coconut yoghurt (for creaminess and added protein)

1. In a bowl or jar, mix the oats, chia seeds, flaxseed, lemon zest, and cinnamon
2. Stir in the lemon juice, almond milk, vanilla extract and sweetener (if using). Mix really well to avoid clumps
3. Cover and refrigerate overnight (or at least 4 hours) to allow the chia seeds and oats to soak and thicken
4. In the morning, give it a good stir and fold in the yoghurt
5. Serve with your favourite toppings, like berries for added texture and hormone-friendly nutrients

MC UK Approved Products To Help Your Hormone Balancing Journey

I think we can all agree that the world of nutrition has never been busier. Walk into any health food shop, scroll TikTok for 30 seconds, or listen to the latest wellness podcast, and you’ll be hit with a barrage of advice about adding more protein, eating for hormone balance, cutting out seed oils, or diversifying your gut microbiome. There's also noise on intermittent fasting paired with doctors warning you not to skip breakfast - confusing, right?

Though it's often well-intentioned, these messages make for a confusing landscape - and one which, if not trodden carefully, can lead you down a path of unintentional restriction.

As a Health Writer with a former career as a track and field athlete, you’d think I’d be across it all: fuelling my body “correctly”, ticking every so-called wellness box and training regularly. But the reality was quite different. You see, after years of underfuelling, my training caused me to lose my period at age fifteen. And over a decade later, I’m still battling to get it back.

My lost period was caused by a condition known as Relative Energy Deficiency in Sport, or RED-S. Also known as low energy availability (LEA), it occurs when the energy you burn through exercise outweighs the energy you take in through food. It’s a condition typically associated with professional athletes, but as dietitian Emily Vasquez, reminds us, “it can actually occur in anyone whose energy intake doesn’t meet the requirements of their energy expenditure.” With an ever-growing number of women taking up serious training (and yes, a marathon or HYROX competition is considered serious training), the risk of underfuelling has never been more of a mainstream issue.

While missing a period might seem like a convenient side effect of your hard training or busy schedule, it’s actually a major red flag from your body, and one with serious long-term implications. Research has shown that prolonged low energy availability can disrupt everything from metabolic rate and immunity to bone health and cardiovascular function, whilst the hormonal disruption caused by underfuelling has been shown in numerous studies to impact fertility, mood, and even gut health.

It’s very easy to fall into the trap of underfuelling, especially with so many confusing nutritional messages flying around, and you don’t have to be skipping meals or intentionally restricting either. While RED-S is often linked with disordered eating, it can also be due to not knowing how much you should be eating, not eating at the right time, being too busy to fit in a proper meal, or missing out on certain food groups.

Worried that this could be you? Read on to discover the signs that you’re not eating enough, plus what you can do to solve it, from RED-S specialist nutritionists and dietitians. After more expert nutritional advice? Check out this guide to the common nutrition myths a dietitian recommends avoiding, plus balanced nutrition tips they swear by. We've also got explainers on what to eat before a workout, the benefits of mindful eating, and intuitive eating. Recipe hunting? Scroll through expert-approved Em The Nutritionist's recipes, healthy breakfast ideas, healthy snack ideas, and healthy smoothie recipes, here.

9 signs you're not eating enough, according to top wellness experts, plus how it might be affecting you

1. Poor recovery, fatigue and frequent injury

“When we are under-fuelled, the body has evolved to prioritise sending energy to the brain, lungs, heart and movement in order to keep us alive and functioning,” explains Sports Dietitian, Renee McGregor. “As a result, the body starts to switch off processes that it doesn’t deem essential for survival. One of the first signs of this is poor recovery between training sessions, which you may notice as increased muscle soreness, greater general fatigue, and a higher resting heart rate.”

McGregor goes on to explain that poor recovery between sessions can have a knock-on effect. “By going into each session fatigued, you increase your risk of injury and put your nervous system into a state of high stress.”

“Persistent tiredness can be another strong sign that your body is under-fuelled”, says Hannah Cartwright, nutritionist and co-founder of The Nourishu Method. “If the body doesn’t even have enough energy (from glucose, fats and protein) to power basic cellular functions, it will be challenging for you to exercise, work, or even think clearly.”

So, how might this show up in our lives? Well, as Cartwright explains, “this can feel like brain fog, sluggishness, or needing to nap often. Increased energy is often one of the first things people notice when they begin fuelling adequately again, with even small things like walking up the stairs starting to not feel like such a massive mission."

2. Performance plateaus

It’s not only recovery that’s affected by underfuelling, your performance can suffer too. “Think of it like driving a car with an empty tank,” explains Jonny Summer, specialist RED-S physiotherapist and clinical director at LDN Physio. “Athletes may notice intense fatigue mid-workout, dizziness, or an inability to hit usual performance markers.”

The danger, Summers explains, is that this drop in performance can cause us to train harder. “When you hit a new, poor performance baseline, it’s easy to feel pressure to start training more in the hope of improving performance, but this only causes further sinking into low energy availability. Instead, we need to focus on increasing calories, especially carbohydrates, to restore glycogen, whilst protein and fats will be critical for repair.”

McGregor also points out that you might not notice the body composition gains you were expecting from your training.“Instead of putting down more lean muscle mass as you would expect from a high training load, individuals with LEA may actually notice that their body actually holds onto more body fat because it is prioritising survival.”

3. Irregular or absent menstrual cycle

As someone who has lost her period, I’m always curious to understand what’s actually going on internally to have made them stop, which McGregor explains. “Placing the body under prolonged high stress, such as in the case of underfuelling, causes a communication network, known as the hypothalamic pituitary axis, to become down-regulated. This system is responsible for controlling our hormonal system, which is why we often see women experience changes to their menstrual cycle as a result of underfuelling.”

McGregor reminds us that it’s not just a total loss of periods which could indicate underfuelling. Any significant changes, such as more erratic cycles, lighter periods, as well as lengthened or shortened gaps between periods, could all indicate low energy availability.

“Missing just three consecutive periods can start to have a negative impact on bone health and thus puts individuals at higher risk of bone stress injuries, stress fractures, as well as recurrent ligament and tendon injuries,” she adds.

And as Vasquez points out, “it’s not just our bone health which is affected by missing periods. There’s also a number of other long term health effects, such as an increased risk of cardiovascular disease and infertility,” which is why it’s so important not to ignore the problem, and speak to a professional as soon as possible.

4. GI distress

According to McGregor, gut permeability (also colloquially known as a leaky gut) can be a consequence of low energy availability. “It’s common for individuals with low energy availability to experience more frequent bouts of gastric distress during activities, such as running. You may also notice IBS-like symptoms day-to-day, but this is actually caused by a phenomenon known as gastroparesis, or slow digestion. ”

Cartwright concurs. “It can feel ironic that someone who is under-eating would experience gut discomfort, and yet, slower metabolism means food can linger in the gut, causing bloating or constipation. Sometimes we cut out food, such as bread or gluten, because we’re struggling with IBS symptoms, when actually the problems are caused by under-eating, overexercise, high stress or food fears. Before anyone decides to eliminate a food group, I would always ask yourself if you could do with eating more, or eating more consistently.”

5. Sleep disturbance

Good sleep is important for anyone, but especially those juggling exercise, work and busy social lives. And yet, “when someone is underfuelling, their sleep patterns are often disrupted,” says Cartwright. “A lack of essential nutrients and calories can make it harder to fall asleep, stay asleep, or sleep through the early morning hours.”

According to Cartwright, carbohydrates are particularly important when it comes to sleep because they “play a key role in the production of melatonin, our primary sleep hormone. For someone not eating enough carbohydrates, melatonin synthesis can become impaired, which in turn affects sleep quality.”

6. Mood swings, anxiety and low mood

“The brain is an energy-hungry organ, and requires so many omega-3 and omega-6 fats to regulate thoughts and feelings, to concentrate and to memorise,” says Cartwright. “Without enough fuel, neurotransmitters like serotonin and dopamine can’t be created effectively. You might feel anxious, irritable, or low for no obvious reason - this is your brain's chemistry being thrown off by lack of nutrients.”

Summers agrees. “One of the first signs that the body is under-fuelled is a shift in mood. We start to notice heightened irritability, as well as brain fog, as the brain scrambles for energy.”

7. Food fixation

We all know the friend who’s excited for breakfast before they’ve even gone to bed at night, but, as Cartwright explains, there’s a big difference between a love of food and food restriction. “If you find yourself constantly preoccupied with thoughts about food, recipes, or what you’ll eat next, this can be a biological response to restriction. The body’s hunger hormones ramp up, and your brain becomes hyper-focused on finding energy. This is a common sign of energy deficiency, and isn’t a lack of willpower.”

She reminds us that “when our body feels safe and knows food is coming consistently, our brain will naturally not need to constantly think about it, plan out meals, seek out food and obsess over calories.”

8. Feeling cold all the time

“Food provides energy not just for movement but for maintaining body temperature”, explains Cartwright. “When your body recognises it is underfuelled, your core temperature may drop as part of the prioritisation of survival. At the same time, we see the thyroid slow down in response to low energy availability, which in turn reduces metabolic rate and heat production.”

9. Hair thinning or loss

And finally, if you notice hair thinning or loss, it could be a sign that you're under-fuelling. “Hair isn't vital for survival, so in times of energy deficit, nutrients like protein, iron, zinc, and biotin are diverted away from hair growth, causing shedding or thinning over time”, explains Cartwright.

Bottom line? Remember, even if you haven’t started to notice any of these signs, but still think you may be underfuelling, the best course of action is always to go and speak to your GP or, if possible, to a sports medical professional such as a RED-S specialist nutritionist or dietitian. This is because a lot of the signs of low energy availability take time to present themselves, as McGregor explains. “In a lot of cases, individuals actually often produce very good performances in the short term, but the issue is that the body cannot sustain this state, and as a result, the negative consequences of underfuelling start to occur after several weeks and months of low energy availability.”

MC-UK approved workout fuel

As a young woman of forty-four, menopause hadn’t even entered my vocabulary. I was slightly cocky about the fact that I thought I could easily crack out another couple of kids (even though I didn’t want to... talk about the arrogance of youth), so when it did happen, the perimenopause (again, a completely new concept to me) not only crept up on me but hit me like a train.

I wasn’t prepared for it. I didn’t even realise it was happening. And yet fast forward a few years and I’ve co-written a whole book about it. A book that went on to win Best Book of the Year at the British Book Awards.

Nothing has surprised me more. Not least because, sitting at that awards ceremony, I really didn’t feel like an author – I felt like a fake being there. But if a book about menopause can be chosen above literally thousands of other absolutely brilliant books to be recognised in that way, it tells us a lot about how much a guide to this phase of our life was – and still is – urgently needed.

There were lots of things that I wanted to do with Menopausing. I wanted it to be a really easy book to use. I wanted to put important things in big type on single pages, so that something would jump out at you and you’d go, "Oh, hang on, I’m going to stop here. I need to read that."

So many women – and men – still contact me with really touching messages about how the book has helped them, saying it struck a chord, and most importantly that it’s enabled them to find their stride and thrive at this stage of their life.

Luckily, conversations are continuing and changes are happening. The first edition of the book was published in 2022 and, from 2021 to 2022, 7.8 million items for hormone replacement therapy (HRT) were prescribed, a 35% increase from 2020 to 2021.

Then, from 2022 to 2023, 11 million items were prescribed, another 47% increase from 2021 to 2022. That truly is amazing because it suggests that word is getting out there and that the stigmas and misinformation around HRT are dissipating and women who can and want to take it are choosing to do so, and they’re able to access it.

And yet, while that is a big difference, it’s not enough. Socioeconomically, HRT usage is still heavily weighted towards the wealthy, and areas of greater deprivation in the UK have the lowest number of women being prescribed HRT. Why? Why is there still that barrier to access?

Pushing for workplace menopause strategies

Another brilliant step forward and something that I found really heartwarming is that lots and lots of businesses are getting really robust menopause strategies in place. I’ve done lots of talks in companies that are implementing different types of women’s health resources, such as menopause champions, flexible working, additional training or inviting a healthcare professional who is an expert in menopause or in women’s health issues to come into the workplace twice a month and women can get an appointment with them.

If you’re reading this, and changes aren’t being made in your company to support you, then suggest it. And to any business owners, please, please do the right thing. Feeling supported keeps your workforce happy and keeps it working more efficiently and that’s got to be a good thing for your business. You need your older women, you need their experience, and you need their talent, so please stop ignoring them and set up processes and strategies to respond to their needs. Otherwise, you’re going to lose them.

Overmedicalisation or steps forward?

In this country particularly, we educate, educate, educate, then progress is made and there’s a reaction or a backlash to that progress. There are amazing doctors and other celebrities doing brilliant things and using their platforms to get information about perimenopause and menopause out there, but somehow that education and empowerment seems to make people in certain camps nervous.

Plus, in the past year, there have been articles talking about the "overmedicalisation" of menopause, saying that most women should navigate menopause without the need for treatment and further, that overmedicalisation can lead to the disempowerment of women, presenting a negative picture of this point in our life.

What does it mean to say it’s over-medicalised? Why is making ourselves feel better a bad thing? We can’t sidestep the menopause. Roughly 75% of women will have some kind of symptoms ranging from slightly annoying to potentially life-threatening. And while it’s a relatively small amount of people that find it life-threatening, around 25% will find it incredibly debilitating and around 50% will find it a bit annoying.

I’m in this group and I really needed support and education to get myself through it. And when I did get myself to a better place with it, I thought, my god, other women need this information and this support, too. It can be a tricky period in our lives but if we have the information to understand it and make choices about how to cope with it, it’s easier.

What’s so, so sad about these claims of overmedicalisation is that they shame or embarrass women into not taking HRT. Women who might already be nervous about starting to take HRT are being made to feel worse for even contemplating it. To be made to believe you’re a weak person for wanting to help yourself feel better, or you’re going against nature, makes me really, really sad.

Because I know how this point in your life can feel. I know how lonely it can feel. And the fact is that taking HRT can really help you find the joy in your life again.

I’m not pushing HRT. I’m a massive advocate of freedom of choice - I want to educate, support and inform women to allow them to make their own choices. I just want to reframe the way that HRT is viewed by society because the more we talk about it, the less shameful it becomes. I want to demystify it so that women can decide whether to take it or not, based on facts rather than scaremongering or misinformation.

Encouraging open conversation

I wish we could all have an open discussion without arguing with each other and without organisations that deal with women’s health shaming us for a period in our lives that can be helped with medication if we need it. And I count myself as one of those people – I really needed it. And if women don’t want to take it – great. I just want us all to come together and talk about it sensibly, with an option for the women that really need it; an option for the women that can’t take it; and support for the women that don’t want to take it.

What I’d really love is for important groups, such as the British Medical Society (BMS), which does a brilliant job of educating the medical field, and the Faculty of Sexual and Reproductive Healthcare (FSRH), to use celebrities and other people with platforms. We want to help you get your message out there. Use us as amplifiers.

My menopause mission

In 2021, my documentary Sex, Myths and the Menopause – which lifted the lid on misinformation surrounding the menopause and examined the science and fear around hormone replacement therapy – aired on Channel 4. In the days that followed, something really unexpected and amazing happened. I have never ever presented a show that’s made so many people want to stop me in the street to talk about it. Not even Big Brother.

People spoke to me everywhere I went - on dog walks, in the supermarket, and just walking down the street. Some women were in tears sharing their stories of feeling invisible, marginalised and patronised. Some men and women telling me how much they'd enjoyed watching it with their partners, and how it had given them a better understanding of what their loved ones were going through. It was totally and beautifully overwhelming.

Those moments lit a fire in me and made me feel like I needed to do more – to reach more women. I don’t want women – or men – to hear about menopause from friends who are going through it. I would like every woman to know about perimenopause and menopause by the age of thirty, at least, so that they're prepared for it and are armed with the knowledge to face it head on.

The revised edition of Menopausing, by Davina McCall and Dr Naomi Potter, is out today. It's been updated to reflect the changes in the conversation around menopause and the treatments available, exploring and explaining the science and smashing the taboos related to perimenopause and menopause.

ADHD (attention deficit hyperactivity disorder) cases in women are rising at rapid-fire rates, but many are left wondering what took so long. Women’s health has historically been overlooked — we see it everywhere, from the recent revelation that tampons sold in the UK contain alarming levels of lead, arsenic and other toxic chemicals to a widespread lack of understanding of how symptoms differ between the sexes.

In fact, the growing surge in ADHD can largely be attributed to TikTok. Yes, social media has been leading the way in growing awareness of how ADHD presents in women and girls. Impulsiveness and hyperactivity (which is how ADHD typically manifests in young boys and men) have long been considered key symptoms, but thanks to a wave of social media videos—there are currently 3.4m #ADHD videos on TikTok—there’s a growing understanding of how the condition affects women and girls and how they experience and show ADHD. As such, prescriptions for women have increased five times in as many years.

While growing awareness is undoubtedly positive, should the support signposting not come from a medical practitioner rather than a social media platform? The ADHD Foundation estimates there are 750,000 women and 423,000 girls in the UK living with ADHD, while an investigation by the BBC suggests that for many parts of the UK, the backlogs for adult ADHD assessments could take at least eight years to clear.

It’s something that Dr. Janina Maschke, an experienced ADHD and Executive Functioning Coach and author of A Feminist’s Guide to ADHD knows all too well. Here, she recounts her own experience struggling with ADHD for years and explains why a lack of understanding is a feminist issue.

By Dr. Janina Maschke

“Have you ever felt that some tasks are difficult for you while others handle them effortlessly? I know I have. Ever since I can remember, I struggled with activities that seemed simple to others. In school, concentrating in the classroom felt impossible. While my classmates seemed to have no trouble focusing on the teacher’s words, my mind would always wander elsewhere. This continued through school and beyond, making me question what was wrong with me. I felt like I never quite belonged, but I never considered that it might be ADHD. When I thought of ‘ADHD’, I’d picture a young hyperactive boy, not a girl labelled as a daydreamer, too chatty or too slow. I never imagined that I could have ADHD.

Years later, while I was starting my PhD, and feeling overwhelmed by the workload, I stumbled upon a research paper on ADHD in women. At that moment, everything started to make sense. The descriptions and symptoms resonated deeply with my experiences, and for the first time, I felt understood. It was a revelation that brought both relief and a surge of questions. I spent hours trying to find help, support and someone in my area to diagnose me.

When I finally got an appointment after waiting months, I was advised to “just try harder.” It left me feeling even more frustrated and misunderstood. After fighting to be evaluated and finally receiving an ADHD diagnosis, my psychiatrist admitted he might have been biased about women and ADHD. This revelation was not just a personal insight but also highlighted a broader societal issue: the under-diagnosis of ADHD in women is inherently a feminist issue.”

“I witnessed firsthand how challenging it is for a woman to be heard and receive a proper diagnosis in a world designed for men. Women are three times less likely to receive an ADHD diagnosis. While men are, on average, diagnosed around the age of seven, women are typically diagnosed in their thirties. These figures are not just numbers; they represent countless women who struggle without understanding why. After experiencing this feminist issue firsthand, in true ADHD fashion, I dove headfirst into a rabbit hole of research, determined to understand everything about ADHD and why it seemed so hard for so many women to be listened to or receive a diagnosis.

One of the main reasons ADHD often goes undiagnosed in women is due to the stereotypical view of the disorder. Researchers studying ADHD have only recently started to look at girls and women rather than solely boys and men. This shift in research is crucial because it also highlights the different ways ADHD can manifest in females and brings attention to the unique challenges they face. Historically, the diagnostic criteria and treatment approaches have been primarily based on male presentations of ADHD, leading to girls and women being overlooked because their symptoms often manifest differently.”

“Society’s expectations of women—to be organised, attentive, and self-disciplined—compound the problem, making it even harder for us women to seek help or be taken seriously when we do. This societal pressure pushes women into masking their ADHD symptoms. Many of us with ADHD start masking unintentionally at a young age, simply wanting to fit in and make our lives feel easier. Masking involves hiding or compensating for our symptoms to appear more organised, attentive, and capable than we feel. Many of my patients (and me) started behaviours like over-preparation, perfectionism, people-pleasing, and creating external structures to manage daily tasks.

I would spend hours preparing for everything in life to ensure I wouldn’t forget anything and over-preparing for meetings and social events by creating detailed notes and backup plans. I engaged in a masking behaviour called ‘social camouflaging,’ where I carefully observed and mimicked the behaviours of those around me to fit in.”

“While these masking behaviours help avoid negative judgments and social stigma, they also prevent us from receiving the recognition and support we need. The emotional and psychological costs of masking are high, often leading to chronic stress, negative thoughts, overwhelm and burnout.

Embracing your authentic self, with all the quirks and challenges that come with ADHD, can be liberating. It allows you to seek genuine support, connect with others who understand, and focus on your strengths rather than hiding your struggles. The emotional toll of masking not only diminishes your quality of life but also obscures the need for proper diagnosis and treatment, perpetuating the cycle of struggle and concealment.

I’ve gained significant power and autonomy by transitioning from hiding my ADHD to openly discussing my experiences as a woman with the condition. Every time you share your story, it encourages someone else to speak freely as well. I hope my book, which explores the unique aspects of ADHD in women, helps others realise they’re not alone and that a fulfilling life is within reach. By sharing our experiences, we can break the stigma, support each other, and live authentically.”

Dr. Janina Maschke is an experienced ADHD and Executive Functioning Coach. She is the author A Feminist’s Guide to ADHD and she has a PhD in Psychology, MSc in Molecular Medicine and a background in Neuroscience.

I recently wrote about being unsure whether or not I want children, and while that’s still the case (God, give me a sign), there was another equally strong feeling that silently ran throughout that story, one I didn’t have the word count to explore. I also wasn’t sure if I wanted to go there.

The there I am referring to is the fertility cliff, the edge that feels like it’s crumbling underfoot. While I’ve always had a hang-up about ageing, my ideas around turning 35 were mainly informed by Sex and The City or, more specifically, Samantha’s rallying cry: “You’ve got to grab 35 by the balls and say, “Hey, World, I’m 35!”” Now, the terms whirring through my mind are “geriatric mother” and “advanced maternal age” - not exactly the call to arms I’d once held close, but they certainly drive home a point.

Ten years ago, The Washington Post published an article reassuringly titled “No, women’s fertility doesn’t ‘drop off a cliff’ at 35” - they ought to have done; their 1978 article “The Clock Is Ticking For The Career Woman” is credited with making ‘biological clocks’ mainstream. Naturally, it was a male author—Richard Cohen—who coined the phrase. Media history aside, my point is that a full decade ago, the Post attempted to right their wrongs and put the whole sorry story of the fertility cliff to rest, yet the myth pervades.

“Women’s health issues are often under-discussed and underreported due to a combination of historical and societal norms,” explains Karolina Löfqvist, Founder and CEO of Hormona. Years of women being blocked from clinical trials (stemming from the Thalidomide scandals), a perception of female hormones as naturally “messy”, and a lack of gender-based data in medical research (predictably, white, heterosexual males are predominantly assumed to be the standard norm for test subjects) have all led to universal misdiagnosis and misunderstanding of women’s health. Depressingly, only 2% of global medical funding goes towards researching women’s health.

The good news is we now have better access to healthcare, resources, and fertility testing, meaning that, as Löfqvist explains; our levels of health are significantly higher, and age is now a less influential factor in fertility levels. “There is no doubt that our ability to conceive declines as we get older, but it is still possible for those above 35 to conceive naturally or with medical assistance, assures Löfqvist.

According to the Office for National Statistics, the age at which both women and men have children has reached new highs (age 30.9 for women and 33.7 for men). Like record numbers of women my age, I entered my thirties in rented accommodation (technically, I turned 30 living with my mum, having barely made a dent in my student loan debt. I was also still scrabbling to land a full-time job in journalism - a notoriously tough industry to break into even before the media crisis. Now that I’m here, I feel resentful that instead of enjoying the fruits of my labour, I feel pressured to think about the fruits of my loins.

Like “geriatric mother”, another term being bandied around is “delayed adulthood.” The term explains how mid-Millennials like me have been held back by circumstances (like graduating into a recession). Decades of wage stagnation, increased debt and declining government support, plummeting home ownership levels, and the soaring cost of actually having a child (£166,000 for a couple and £220,000 for a lone parent) make parenthood feel like yet another unrealistic aim.

While I welcome the recognition, I find “delayed adulthood” offensive. Looking around, I don’t see a generation of avocado-eating Peter Pans; I see young people (I refuse to relinquish my youth status here) battling mounting debt with less and less support. We’re no less adults because circumstances have denied many of us home ownership and other traditional markers of ‘growing up’.

To me, the idea of “delayed adulthood” is as problematic as the 1980s’ concept of career women being ‘too selfish’ to have kids. “The pressure and demands on women in modern society has had a considerable effect on fertility,” says Dr Vikram Murthy, a Harley Street Dr and co-founder of Murthy Health. I would argue that the pressures of modern life also have a considerable effect on whether women want to have children—or can afford to—and that decision isn’t made easier by mounting pressure about so-called fertility cliffs.

“The cliff sounds very drastic, doesn’t it?” asks Sandy Christiansen, an embryologist and fertility coach. We know that fertility declines with age, but fertility is individual, she says, adding that there’s a lack of education about fertility. “Hormones and fertility are complicated to navigate, but with sexual education in schools tending to focus on sex itself and the menstrual cycle, we simply aren’t taught enough about other crucial areas of female health,” agrees Löfqvist.

When I wrote about being unsure if I wanted to be a mother, one of the most common responses I got from women was that they, too, were unsure and also didn’t want to spend hours agonising over a decision that might not be theirs to make. “I think the difficulty is there’s no true indicator of your fertility,” explains Christiansen. She says a lot of people are pushing AMH tests, but AMH is an ovarian reserve test that was developed solely to predict how you might respond to a hormone stimulation for IVF for egg freezing - “It’s not an indicator of your actual current fertility”. Christiansen tells me that people are doing these tests to find out how much time they have, but the tests are just a quick insight into what your fertility might be right now. Your ovarian reserve in no way predicts what your fertility is going to be like in three to five years.

Christiansen wants women to know that fertility is individual, so there’s no exact “expiration date”- another grim term that’s been doing the rounds. “In my view, and based on current scientific evidence, the notion of an “expiration date” for fertility is a complete myth,” argues Dr Amit Shah, a gynaecologist and co-founder of Fertility Plus. He thinks that “the fertility cliff is “somewhat of an over-exaggerated concept”. Instead, he recommends looking at things this way - fertility generally begins to decline gradually from around 30 (yikes) and continues to decrease as you get older. Shah says this decline is primarily due to the diminishing quantity of eggs and an increase in DNA damage associated with age. Basically, it's more of a gradual decline over time rather than a sharp drop-off. “Every woman’s fertility journey is unique, and there’s no one-size-fits-all timeline or expiration date,” insists Shah.

“There is no doubt that our ability to conceive declines as we get older, but it is still possible for those who are above 35 to conceive naturally or with medical assistance,” adds Löfqvist. She wants to debunk the myth that middle-aged women are infertile. Many of us are taught that the younger the woman is, the more fertile they will be, which has led to some harmful stereotypes that women should all be having babies as early as we can, she says, adding, “This is not the case!” While it is true that our fertility decreases as we age, it doesn’t mean that every woman in their 20s can fall pregnant easily, nor does it mean women in their 40s will never be able to conceive, explains Löfqvist. A lot of these numbers are based on national averages, so Löfqvist recommends focusing on making informed decisions and plans rather than “rushing into having a baby based on age”.

That’s easier said than done. As Christiansen, who worked for the NHS tells me, “If you have zero symptoms and no concerns about your fertility and you’re just curious, then there’s no free service for that.” So often, women are expected to make an informed decision without much information. “It’s a hard thing to try to make an informed decision when you don’t know a lot about it,” agrees Christiansen. In my own life, I've seen friends underestimate their mid-30s fertility, taking an “If it happens, it happens” approach, only to find, it happened too quickly. Shah would like to see better education around fertility, which he says is crucial for making the most informed and empowered decisions when it comes to family planning.

“We have a lot of questions, but not many answers,” adds Tess Cosad, founder of Béa Fertility, a clinical-grade at-home fertility treatment. She wants women to know that there is more than one way to start – and be – a family and that you can still get pregnant after 35.

Despite getting the sense that I have more time than I was worried about, I can’t help feeling that I’m still running out of it. My so-called selfish years—that stretch of time from late teenhood to early twenties when you’re free of responsibility—started later than most, and I’m resentful at the thought of cutting them shorter still. Maybe, if, like Christiansen suggests, we had a robust health strategy in place, which meant we understood more about fertility instead of how to not get pregnant, I’d feel more confident in my decision-making. Christiansen says there is a women’s health strategy being implemented by the UK Government, but she’s quick to add that it’ll be the next generation that will benefit. I can’t help feeling that again, my generation has been given short shrift. I sense a new term on the horizon…“Delayed geriatric motherhood”, perhaps?

Shortly after walking the red carpet at the Oscars last month, Olivia Munn opened up about her breast cancer diagnosis and explained that she underwent a double mastectomy in May last year. The X-Men: Apocalypse star shared a statement with her social media followers in the hope that her candid health update would 'help others find comfort, inspiration and support on their own journey'.

A few days later her partner John Mulaney shared a touching message about Olivia's diagnosis, and she also shared her support for the Princess of Wales just two weeks later when the royal spoke publicly about her own cancer diagnosis for the first time.

Now, Olivia has spoken in detail to People magazine about her diagnosis and treatment, as well as the emotional impact of a double mastectomy and why she was put into medically-induced menopause after surgery.

Discussing her double mastectomy, she told the publication that she struggled when saw her body post-surgery, explaining: "It was a shock. It was a shock to my system. I had such a hard time, I remember just looking in the mirror with [the doctor] and just having no emotion, just taking in what he was saying."

Adding that she 'absolutely broke down' when she got home after the appointment, Olivia went on to discuss the physical changes she has experienced since starting hormone suppression therapy in November. She began the treatment in order to induce menopause and reduce the risk of cancer recurring.

"I'm constantly thinking it’s hot, my hair is thinning, and I’m tired a lot," she said,

"I'm basically on a treatment of suppressing all my hormones, so I will go into menopause. And I will shut down all the hormone production in my tissue and my ovaries. And that's again, more problems. But I figured, as a woman, I can't escape menopause. So I'd rather just take it on now and tackle it head on."

Olivia has been widely praised for sharing her experience and raising awareness, with breast cancer charities responding to her post by urging people to familiarise themselves with the symptoms and to regularly attend screenings.

You can find more information and access resources and support from charities such as Cancer Research UK, Breast Cancer Now, and CoppaFeel!

This month marks Menopause Awareness Month, an entire month dedicated to raising awareness of the common - but also commonly under-discussed - women's health condition. So, as a leading menopause author, I decided to address one of the questions I get asked the most, which is hands down, which menopause supplements are worth your time and which, well, aren't.

See, I personally have a small row of jars lined up behind my laptop - a daily reminder to take the various vitamins and minerals that I believe are facilitating my personal perimenopause experience. I am well aware that we all ought to eat the sort of balanced diet that means supplements aren't necessary. In reality, I, like many of us, don't always manage that. (I once Googled, 'strawberry jam, vitamin C?').

So, what's the truth about menopause supplements? They're unquestionably useful in these super busy times, but they aren't magic. If something sounds too good to be true - "Get rid of all your symptoms and lose loads of fat" - then it probably is.

"We're all leading turbo-charged lives and diets aren't always optimal," says registered nutritionist Emma Bardwell, co-author of The Perimenopause Solution with Dr Shahzadi Harper. "But my view is that supplements are massively oversold to consumers."

However, she says that there's definitely a place for them in perimenopause and menopause. "Whatever you take needs to be well researched and based on genuine need rather than an alternative to a healthy lifestyle."

They are - don't forget - just supplements. Keen to read more about menopause and which supplements experts actually reckon can help ease your symptoms? Keep scrolling.

Menopause supplements: Your guide

Is there one best supplement for menopause symptoms?

Good question. "Always check that whatever you take won’t affect any medication you may be on," says BANT registered nutritionist Rayne Roberts at 360fitfood.co.uk. "Supplements can have contraindications, and there’s no guarantee that they will work for you."

Bardwell recommends that you have a personalised consultation with a registered nutrition professional. "When purchasing herbal supplements, look out for the THR stamp (Traditional Herbal Registration) to assure quality and safety, and remember that they can take a while to kick in."

"I have clients who see great results from things such as agnus castus and St John’s Wort for mood symptoms, and from isoflavones like red clover and sage for vasomotor symptoms like flushes and sweats."

10 nutritionist-approved supplements to have on your radar

1. D Vitamins

Best for: A Vitamin D boost.

Why the experts recommend? Bardwell says that it's impossible to make blanket recommendations about supplements, but there are a few basics from which most women will benefit. We should almost all be taking Vitamin D - the government recommends 10μg daily in autumn and winter.

"The darker your skin, the lower your levels are likely to be. Higher melanin acts like natural sunscreen to reduce vitamin D production," says Roberts.

"Sub-optimal levels have been linked with low mood, muscle aches, and pains and lowered immunity, all commonly suffered by menopausal women," says Bardwell. "Take alongside K2 which helps calcium absorption and bone mineral density."

2. B Vitamins

Best for: A Vitamin B boost.

Why the experts recommend? For those with low energy or who eat a vegan or vegetarian diet, a B complex might be helpful. "B vitamins can help with PMS-type symptoms as they help with hormone synthesis, and they are also vital for energy," explains Bardwell.

"There are eight B vitamins – including B12, B6, folate, and thiamine – and they work best taken together," says Rayne. Unless you’ve been diagnosed with a B12 deficiency, take a vitamin B complex."

3. Omega 3

Best for: Heart health.

Why the experts recommend? I eat plenty of oily fish, but for years I've also found a daily omega-3 capsule is excellent for my short-term memory. If I forget to take one for a few weeks, I notice.

We can't make omega-3 in our bodies, but it can help with cognition (brain fog, anyone?) as well as eyes, skin and heart health. 'If you are vegan or vegetarian, I recommend taking an algae oil like this Vim & Vigour by Bare Biology,' says Bardwell.

4. Creatine

Best for: Muscle mass.

"Creatine monohydrate has been researched extensively and can be very beneficial if you work out a lot," suggests Bardwell. "It helps with increased strength and power and muscle building as well as improving cognition."

It’s cheap, may help slow sarcopenia (loss of muscle mass) and you only need 3 to 5g daily to get benefits.

5. Magnesium

Best for: Improved sleep.

Why experts recommend? It's said that around 70% of us are deficient in magnesium, which can be enormously helpful for such menopausal symptoms as sleep and restless legs.

"Look for a glycinate variety (it will specify the type on the bottle) as it’s well absorbed, and aim for around 350mg a day. Similarly, if you’re one of the many peri or menopausal women with constipation, choose a citrate variety," says Bardwell.

6. Evening Primrose Oil

Best for: Breast pain.

Why experts recommend? "Evening Primrose Oil can be helpful for breast pain and is now recommended by the NHS," says Bardwell. Some studies have also shown that it helps with night sweats.

7. Femal

Best for: Night sweats.

Why experts recommend? "There are some interesting supplements for women who suffer from flushes and sweats but can’t or don’t want to take HRT," says Bardwell. Femal is made from grass pollen. Femarelle, on the other hand, is soya-based (but can’t be taken alongside tamoxifen or aromatase inhibitors).

8. Red Clover Extract

Best for: Hot flushes.

Why experts recommend? "Red clover is a source of natural isoflavones, otherwise known as phytoestrogens," says Rayne. "These mimic oestrogen in the body, with benefits to the heart, bones, and menopausal symptoms."

A 2021 meta-analysis of trials suggested that it appears to help with hot flushes, too.

9. Agnus Castus

Best for: Mood boosting.

Why experts recommend? Agnus castus is said to relieve general menopausal symptoms like hot flushes and low mood. There’s some positive clinical research, with benefits being noted most after four weeks, explains Rayne.

10. St. John's Wort

Best for: Reducing anxiety.

Why experts recommend? "St John's Wort is said to help reduce the feelings of anxiety which may occur in perimenopause or menopause by supporting the regulation of happy hormones such as serotonin," says Rayne. It may also play a role in reducing hot flushes.

Do be aware, though, that it can interact with other medications, including antidepressants.

Considering investing in some menopause supplements? Your need-to-knows

1. Always read what's on the bottle

You absolutely can have too much of a good thing, and non-soluble vitamins such as A and E can build up and cause problems. Don't exceed the RDA of anything.

2. Get tested

I recommend all women try to get some basic bloods done: ferritin (iron), B12, folate (B9) and vitamin D either with their GP or via a home testing kit such as Medichecks,' says Emma.

3. Try collagen

On a personal note, I swear by Ingenious Beauty Ultimate Collagen, £48, for a month's worth of capsules, which gives skin a youthful luminosity and promotes hair and nail growth. I used to have hair extensions for thickness...I don't need them any more.

This article has been updated to reflect current pricing and is part of Alice Smellie's monthly column, Discussing Menopause.

If you’re one of the 85% of women who wil go through menopause at some point in their lifetime, you might have some questions. Like, how do you know if you actually have it? What are the most common signs it's happening to you? And should you try hormone replacement therapy, otherwise known as HRT?

Before we get into it, know this: while menopause is likely something you can't avoid, it's also a perfectly natural stage of life for most women.

Luckily, there's a wealth of experts, resources and information out there now aimed at helping you through this stage of your life. Plus, thanks to celebrities like Davina McCall and expert committees, like the Menopause Mandate, campaigning tirelessly, the life phase is thankfully losing its stigma. But that doesn’t mean that we’re fully there yet – many would argue that we still have a long way to go in order to smash the taboo around the common yet not so commonly discussed topic.

Below, we caught up with three women who are trying to encourage greater conversation around the change, so if you're going through it yourself, you know you're not alone. Sara Matthews is a consultant gynaecologist, Dr Jan Toledano specialises in women's hormones at the London Hormone Clinic, and Jackie McCusker is a registered Nutritional Therapist.

Drawing on expert insight and their own lived experience, they share your need to knows about menopause, including the average age of menopause, how your skin changes during menopause, and the best menopause supplements, plus their top tips for thriving, not simply surviving, this stage of life. For your need to knows and more - keep scrolling.

This Menopause Awareness Month: your need-to-knows

What is the menopause?

First up - a definition of menopause for you. “It’s the age at which a woman has her last period,” explains Matthews. “For women in the UK, this sits at an average age of 51. At this point, there are no functioning eggs left in your ovaries.”

Technically, if a woman has been without a period for twelve months, it can be referred to as the menopause, but not before that point, McCusker adds. “In the Western world, one year after your last period is when you're officially diagnosed as going through the menopause. Up until that point, you're in the peri-menopause. That’s the stage when our oestrogen and progesterone levels are beginning to drop." She herself experienced early menopause symptoms in her 30s.

What is the difference between menopause and perimenopause?

Put simply, the menopause is when your periods stop, while the perimenopause is the months (or years) before your period stops when hormones change and you start to have menopausal symptoms (like hot flushes – but more on that later).

Matthews goes on: "The perimenopause can pre-date the menopause by up to ten years when periods are still regular and hormone levels are "normal". Stereotypically, the ability to conceive will also be lost approximately two years prior to the last period.”

The perimenopause continues until you are considered “post-menopausal” (one year after your period stops). Perimenopause can last a long time, with some women saying they feel the menopausal changes in their late 30s. That said, it’s important to remember that not all women will have the same experience of the menopause. Some will experience the menopause suddenly or early, as a result of surgery or treatment for cancer, and some might not get symptoms at all.

What are some of the tell-tale menopause symptoms?

You start to experience symptoms in the perimenopausal stage, which can occur at different times for each individual as it’s all down to the changes in your hormones. “Progesterone will have already been depleted over the previous decade, so many women will have already gone through heavier periods and worse PMS symptoms,” explains Dr Toledano.

“Then, your ovaries stop producing oestrogen – the hormone that controls many functions of a woman’s body – and that’s when you may experience symptoms like hot flushes, low mood, vaginal dryness, poor memory and headaches. On top of that, testosterone also declines, which can cause low energy, libido, muscle strength and, in turn, confidence.”

What are common symptoms of menopause and perimenopause?

There are a whole host of symptoms that occur when you’re at this point, some more common than others.

According to Matthews, around 88% of women in the perimenopausal stage will experience hot flushes (or vasomotor symptoms, to give them the correct medical name). Women describe these flushes as an “intense heat”, commonly on the upper part of the body – think the neck, face and shoulders. Sometimes you might look a little pink in the cheeks and sweat, while other times you won't. They can last just a moment or a few minutes.

Other potential symptoms span:

• skin dryness
• vaginal dryness
• hot flushes
• forgetfulness
• depression
• low moods
• night sweats
• irregular periods
• anxiety
• heart palpitations
• panic attacks
• decreased libido
• joint paints
• brain fog
• skin rashes
• allergic reactions
• weight gain
• hair loss
• brittle nails
• needing to go to the loo more often
• increased urine leakage
• migraines or other types of headache
• acne
• breast tenderness
• difficulty coping at work
• relationship difficulties
• sleep deprivation
• exhaustion

“We have completely individual biochemistries,” explains McCusker. “One person’s menopause isn’t going to be the same as another person’s menopause. It’s genetics, diet, the amount of stress we’ve had in our lives, cultural differences, and so on.”

Dr Toledano agrees, saying, “All women experience the change in hormones differently. Some are debilitated and feel unable to function properly, while others barely notice this change at all.”

They add: “There is an idea that women must carry on through menopause with little complaining." However, this idea isn't a fair representation of the changes you're experiencing, she adds. “These changes can be devastating and often happen at a time of life when there are other changes too, such as children growing up and leaving home."

Nothing symptoms in yourself and feeling overwhelmed? Remember this: "All symptoms are preventable and physical changes reversible.”

How long do symptoms last?

This is not a straightforward question to answer, because the menopause is defined by the day twelve months after your last period. However, the length of time a woman experiences the perimenopause, or symptoms of the menopause, will vary considerably.

Unfortunately, nothing is set in stone. “There is no test that can indicate how long,” says Matthews. “Women can start symptoms up to ten years before their periods' stop, but recent research suggests that symptoms after the last period last an average time of 7.4 years.”

According to the NHS, symptoms can last for months or years, and can change with time. For example, hot flushes and night sweats may improve, and then you may develop low mood and anxiety. Some symptoms, such as joint pain and vaginal dryness, can carry on after your periods stop.

Should you see a doctor to confirm you are going through the menopause?

Matthews recommends that you do. “It is always useful to consult your GP about any symptoms that could relate to the menopause, no matter what age you are. A blood test to check your hormones will indicate whether you are one to two years from your last period, but you can still have symptoms long before that," she explains.

"If your hormone levels are fine and your periods regular, and your GP has ruled out other causes for your symptoms, then it would be useful at that stage to see a menopause specialist,” she goes on.

Find your nearest NHS or private menopause specialist on the British Menopause Society website (this lists NHS and private specialists).

What’s the best menopause treatment?

“All perimenopausal symptoms will improve with hormone replacement therapy (HRT),” says Matthews. “About ten years ago, HRT received bad press after a study suggested it significantly increased the risk of blood clots and breast cancer. The findings have now been refuted and safer HRT regimes have been developed.”

Dr Toledo agrees with HRT as a treatment, adding, “Topping up the hormones that are low is the best option. The fear instilled by those studies and the subsequent press frenzy still causes confusion for women. There is no increased risk of disease, and in fact, there’s a lower risk of many diseases with certain HRT.”

Ideally, you would get a top-up of both oestrogen and progesterone, as they balance each other out. By replacing oestrogen you are protected against heart disease, strokes, high cholesterol, diabetes and osteoporosis. It also helps to relieve hot flushes. There’s also the option of vaginal oestrogen, which prevents and treats vaginal dryness and urinary symptoms. Matthews recommends it to all of her patients from the menopause onwards, apart from breast cancer patients. Replacing progesterone can stop skin from being and feeling as dry and helps with cognition and sleep.

What are the benefits of HRT?

HRT is proven to be effective, and many say it’s life-changing – it remains the most effective treatment for hot flushes, night sweats, tiredness, insomnia, mood changes and poor memory.

Women wishing to start HRT should carefully discuss the benefits and risks of treatment with their doctor to see what is right for them, taking into account their age, medical history, risk factors and personal preferences.

Can lifestyle changes help menopause and perimenopause symptoms?

Changes to your lifestyle can also help you manage your symptoms. “A heathy diet and exercise, good sleep and doing things that make you happy all have a positive impact,” says Matthews. “Moderating alcohol intake, stopping smoking, taking control of your health will bring massive benefits. Cognitive behaviour therapy can help along with meditation.”

Dr Toledano couldn’t agree more: “Make healthy lifestyle choices, like a better diet, more exercise (especially weight-bearing exercise to keep your bones healthy), stop smoking, lose excess weight and cut down on alcohol. Meditation or cognitive behaviour therapy can also be really useful.”

Is there a recommended menopause diet?

As a nutritional therapist, McCusker works closely with women to help them rethink their diets to help with the symptoms.

“The female Asian population tend to have a better experience of menopause than women in the Western world, and one of the main reasons why is their diet. They tend to eat a very nutritiously dense diet of whole foods, legumes, and traditionally fermented soy, which contain phyto-oestrogens. These are natural plant oestrogens and can emit a mildly oestrogenic effect when your oestrogen levels are dropping severely during perimenopause."

Her advice? Have a look at your diet, look at the composition of your plate and make vegetables your hero. "50% of your plate should be vegetables," she recommends. "There should be good quality fat, no low-fat anything and good quality protein. Things like legumes, tofu, and fermented soy products are great, as are eggs and dairy thanks to being sources of calcium and protein.”

The main foods to be to mindful of are environmental oestrogens, otherwise known as zeno-oestrogens or endocrine-disrupting chemicals. These disrupt your internal hormone system, the expert continues. These come from things like plastic bottles, plastic wrapping and parabens in skincare. To avoid these, McCusker recommends buying organic where possible. “It’s about making small steps to lower your toxic load - for example, changing your washing up liquid to a more natural one.”

The bottom line: what else should I know about menopause?

Bottom line? “Firstly: do not blame yourself for how you feel,” reassures Dr Toledano. “Then, get help from your doctor to give you the hormones you need. It's simple - your body isn't making them anymore and the levels will need to be topped up."

She also advises avoiding oestrogen if you still have periods, unless this is supervised by a gynaecologist. "Only use progesterone at this stage," she adds.

“Be aware of the symptoms that can arise and seek medical help from your GP or a menopause specialist,” Matthews adds. “Don’t suffer in silence. Take a little time out to think about what is happening and how you can adapt your lifestyle to help. Little practical things like layering clothes and having a fan and some water in your handbag, cotton sheets and a cool bedroom can make all the difference.”

“Find a bit of joy every day,” recommends McCusker. “Although life can be really crap and terrible, find time to laugh, find something that makes your heart sing, that lifts you a little bit. Even in the darkest moments.”

If you feel you need more support or information, check out one of the following charities:

• Women's Health Concern
• Menopause Matters
• Daisy Network for premature menopause
• Menopause Café
• Queermenopause for people who identify as LGBT+

6 menopause products that'll make life a little bit easier

The below products are specifically designed to help women going through menopause.

UK abortion rights have been front and centre this week, with a controversial case seeing an English woman sentenced to 28 months in prison for inducing an abortion after the legal limit. 

Amid calls to reform the UK's 162-year-old abortion law and following on from the overturning of the landmark US Roe v. Wade ruling last year, UK abortion rights have been put under the microscope. 

In fact, women's organisations are advising that now is a crucial time to read up on UK abortion laws, your rights and how safe they actually are given the global wave of reproductive rights restrictions.

I'm a woman in the UK - what are my abortion rights?

UK abortion rights are not as simple as you might think, and while women do have access to free and safe abortions in this country, the act has not been fully decriminalised. This means that the right to an abortion is not protected by law and it is still technically considered a criminal act in the UK. 

The law does however provide exemptions from prosecution in certain circumstances, which is how UK women procure abortions legally today.

Women can access abortions legally if their situation fits the specific criteria stated in the Abortion Act, including their socio economic circumstances, their reasons for aborting and how advanced they are in their pregnancy. If however a woman's pregnancy does not fit the Abortion Act's criteria, an abortion is not a legal option.

This makes UK abortion law more restrictive than many countries in Europe, with 39 of its countries legalising abortion and making it a right on request.

UK abortion law

UK abortion law is rooted in the 1861 Offences Against the Person Act, a Victorian law that criminalised all abortions. According to the 1861 Act, anyone who self-aborted or performed an abortion on someone else was guilty of crime, and if convicted, faced a prison sentence.

The introduction of the Abortion Act in 1967 however provides exceptions to the 1861 law, allowing doctors to perform abortions on a number of specific grounds - most commonly if pregnancy would harm the mother's physical or mental health. 

This was prompted by a landmark UK case in 1938 where Dr Alex Bourne was acquitted of performing an illegal abortion for a 14-year-old girl who had become pregnant after being sexually assaulted.

The Abortion Act still stands today, providing an amendment to the 1861 Act that has still not been repealed, and underpins abortion law in the UK.

This means that abortion remains illegal if the conditions stated in the Abortion Act are not met, and that women can still face a prison sentence for illegally obtaining an abortion.

It is important to note however that prosecutions are not common. According to statistics obtained by the Observer under the Freedom of Information Act, police across England and Wales recorded just 67 cases of obtaining an illegal abortion in 10 years [ending April 2022].

Northern Ireland abortion law

Abortion in Northern Ireland is legal before 12 weeks, with the country voting to decriminalise the act in 2019. After 12 weeks, Northern Ireland follows the same abortion laws as the rest of the UK.

UK abortion legal requirements

The 1967 Abortion Act makes abortion legal before 24 weeks as long as it is performed by a registered medical practitioner at a medical facility recognised by the Secretary of State, and that specific criteria are met. This has to be authorised by two doctors "acting in good faith".

1967 Abortion Act

As quoted in the UK Public General Acts legislation

"Subject to the provisions of this section, a person shall not be guilty of an offence under the law relating to abortion when a pregnancy is terminated by a registered medical practitioner if two registered medical practitioners are of the opinion, formed in good faith—

(a) that the pregnancy has not exceeded its twenty-fourth week and that the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman or any existing children of her family; or

(b) that the termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman; or

(c) that the continuance of the pregnancy would involve risk to the life of the pregnant woman, greater than if the pregnancy were terminated; or

(d) that there is a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped."

UK telemedical abortion rights

Women in England and Wales are now able to permanently access early medical abortions at home.

If the pregnancy is less advanced than 10 weeks, telemedicine (abortion pills) can be a legal early abortion care service. 

Telemedical abortion was made available during the pandemic, with the House of Commons voting to permanently allow at-home abortion services in March 2022. This marked the biggest change to abortion care in the UK since 1967.

"New legislation will allow women to access pills for early medical abortion via a teleconsultation, and for both pills to be taken at home for gestation of up to 9 weeks and 6 days," read a press release from the Department of Health and Social Care.

How safe are UK abortion rights?

The right to abortion is not protected under UK law in England, Scotland and Wales. It is only in Northern Ireland that abortion has been decriminalised in the first 12 weeks of pregnancy, and protected by law.

The rollback of US abortion rights and its knock-on effect across the globe has therefore left many questioning the safety of UK abortion rights, and whether access could be restricted in future. Women's organisations have warned in response that until abortions are protected under UK law, the right to them is not safe.

"The devastating news from the US should serve as a reminder that we in the UK can never take reproductive rights for granted until abortion is treated like all other healthcare," warned Louis McCudden, Advocacy and Public Affairs Advisor for MSI Reproductive Choices UK, after the overturning of Roe v Wade.

“The 1967 Abortion Act, and our ability to end a pregnancy, lie in the hands of politicians, and over the past 10 years we have seen a number of parliamentary bids to restrict abortion safely and legally,” explained Katherine O’Brien, associate director at the British Pregnancy Advisory Service. “These groups have strong links with their US counterparts, and we would be concerned that they will escalate activity [now that] Roe v Wade is overturned.”

“At any given time, parliament could attempt to restrict women’s access,” another spokesperson for BPAS added, via the Independent. “Over recent years, a number of anti-choice MPs have sought to do just that, and we must be constantly vigilant.”

For more information on UK abortion rights, visit the British Pregnancy Advisory Service, MSI Reproductive Choices and NHS services.

A UK woman was sentenced to 28 months in prison on Monday for inducing an abortion after the legal limit. 

The mother of three pleaded guilty under the Offences Against the Person Act in March. 

The unnamed woman, now 44, took abortion pills in 2020 during lockdown as part of the "pills by post" service introduced during the pandemic after a remote consultation. She went on to deliver a foetus estimated to be between 32-34 weeks after taking the pills, reporting that she did not know how advanced her pregnancy was. The country's limit for telemedicine is 10 weeks.

She was charged with child destruction under the Infant Life (Preservation) Act 1929 at Stoke Crown Court, and faced a maximum penalty of life in prison. 

She is expected to serve the first half of her 28 month sentence in custody, after which she will spend the remaining half under license.

While the circumstances of this case have divided the public in the days since, it has brought to light the outdated abortion laws in this country (still in existence from 1861) and the urgent need for reform.

Women's rights activists and political leaders have been calling for parliament to overhaul the outdated laws, with the Women's Equality Party holding a march in London this weekend to call for abortion law reform and make this a catalyst for change. 

Taking place on Saturday 17th June at 1pm, the march will meet at the Royal Courts of Justice and finish at Westminster, calling for the full decriminalisation of abortion.

"Yesterday we heard the news that a woman has been sentenced to prison for over two years for an abortion outside of the legal time limits," announced the Women's Equality Party in a statement. "I think that everybody can agree that what happened in this case is tragic, but all that the intervention of the criminal justice system has done here is make it even more tragic.

"Criminalisation doesn't prevent women in crisis breaking the rules, it doesn't even reduce the number of abortions. All it does is deter women from seeking healthcare when they need it, and generate cruel verdicts like this."

The statement continued: "WE are calling for the full decriminalisation of abortion, and to be clear that is NOT to say we are calling for abortions without medical restrictions. Abortions can and should be regulated and managed like all other healthcare. It already is in countries like Northern Ireland and Canada.

"It serves absolutely no one to lock this woman up for years, or to separate three children from their mother. She was sentenced under a law that was written before women even had the right to vote - it’s long since time we brought it into the 21st century.

"Want to take action? March with us this weekend! Or if you can't make the protest, help us to flood the health secretary's phone line this Wednesday."

“It is a hangover from another era that our abortion laws are based not on healthcare considerations, but first and foremost criminal sanctions," Labour MP Stella Creasy stated after the sentencing.. “This case shows that the failure to address this has very real modern day implications. In the light of repeated attacks on women’s rights and the lack of compassion this case shows, its never been more urgent to ensure it is a formal human right of all women in the UK to access a safe, legal and local abortion if she chooses”.

"This sentence is cruel and utterly heartbreaking," added the Women's Equality Party on Monday. "No woman should go to prison for seeking healthcare. It is not in the public interest to rip her away from her children and imprison her. We must decriminalise abortion. Until then, women are at risk."

We will continue to update this story.

Prince William and Kate Middleton will be celebrating their 12th wedding anniversary next month. The Prince and Princess of Wales exchanged vows in 2011, and have since gone on to have three children, Prince George, Princess Charlotte and Prince Louis. 

However, one royal author has claimed that before the couple tied the knot, Kate 'had to take a fertility test' to ensure that she could have children. 

William and Kate met at university in 2001, and were close friends before embarking on a romantic relationship a couple of years later. They split briefly in 2007 but reconnected just a few months later, with the pair reportedly making a marriage pact during a make-or-break trip to the Seychelles. 

The late Queen Elizabeth II was said to be very impressed by Kate, and insiders praised her for her 'stoicism' during their short break-up - asserting that this cemented her future role as Queen Consort.

But according to Tom Quinn, when William decided he wanted to marry Kate, the Princess underwent a fertility test. 

In his book Gilded Youth: An Intimate History of Growing Up in the Royal Family, he writes: "These are always carried out to ensure a future Queen is able to have children. If Kate had not been fertile, there is little doubt the marriage would have been off."

He also goes on to allege that this is considered a common practice for women entering the royal fold, claiming that the late Princess Diana was subjected to similar treatment. 

Quinn claims: "Diana complained in a brief encounter with the present author that she had in all innocence thought her premarital check-ups had to do with general health, only realising later on that she had actually been tested for fertility. 

"'I was so innocent I just went along with everything at that stage,' she said."

Quinn's book, which was released last month, 'interweaves exclusive testimonies from palace staff with historical sources' to examine how various members of the royal family's childhoods have impacted their adult lives. 

Menopause has finally been in the spotlight over the last few years - largely thanks to celebrities like Davina McCall and Penny Lancaster openly discussing their own menopause symptoms, encouraging other women to do the same, and petitioning for better rights. 

It seemed like things were moving in the right direction - just last year, the government appointed a female health minister and HRT began to be sold over the counter.

In July 2022, the Cross-Party Women and Equalities committee put forward twelve recommendations for menopause rights in the UK. This was after they published findings which concluded that the UK's lack of menopause support is currently causing the economy to "haemorrhage talent" by forcing women out of work.

Yet, sadly the proposal to change current legislation and protect women experiencing menopause was yesterday rejected by MPs.

Five of the twelve suggestions have been rejected outright, including the recommendation for menopause to be made a “protected characteristic” in the Equality Act. This would have made it illegal to discriminate against those who are struggling at work due to menopausal symptoms. 

So, why were the suggestions rejected? Well, it's thought members of parliament feared the proposal could discriminate against men.

The official response states that they wish to avoid “unintended consequences which may inadvertently create new forms of discrimination, for example, discrimination risks towards men suffering from long-term medical conditions." 

To add to the disappointment, one of the other ideas also rejected by the government was the large-scale menopause leave pilot, which they deemed unnecessary and called “counter-productive”.

One government spokesperson defended the move, saying they have "put women's health at the top of the agenda as part of the first-ever women's health strategy for England." 

"We are implementing an ambitious programme of work with the NHS to improve menopause care so all women can access the support they need," they continued.

What does this mean for you? 

Well, it's time to defend women's rights. The suggestions were designed to make sure women don't have to continue dropping out of work because of their menopause symptoms - rather, give them the support they need during one of the most difficult times in their lives.

It's essential that we support the movement until the necessary change is made. 

Speaking exclusively to Marie Claire UK about the move, Doctor Shirin Lakhani, who treats women with menopause symptoms at her clinic Elite Aesthetics, shares that it's "very disappointing". "The government has rejected five of the Women and Equalities Committee’s recommendations, [all of which were] aimed at giving working women more rights."

"Women should have access to the required education and treatments needed to successfully navigate menopause and, should they then require time away from work, be able to do so without discrimination," she continues. 

Did you know? Research by the Fawcett Society found that one in ten women aged between 45 and 55 have left employment because of their menopause symptoms. Plus, 14% of menopausal women say they have reduced their hours and 8% had not applied for a promotion.

“Women are crying out for help and need support," Doctor Lakhani continues. "Too many are leaving employment early because they cannot cope with menopausal symptoms and this is not good for society as a whole as we are letting talented women leave the workforce too early. It's not good for the economy."

We'll leave you with this - women of menopausal age (that's 45 to 54, FYI) make up 11% of all people in employment and 23 per cent of all women in employment in the UK. That's 3.5 million women. "Their importance should not be underestimated," adds Doctor Martin Kinsella. 

Discussing Menopause is back, my monthly column where I debunk common menopause myths and questions. This month, I'm examining the research on the link between exercise and menopause - keep scrolling for your need-to-knows. 

The best bit of the week, once I've dragged myself out of bed, is my Saturday morning run around the muddy lanes of Somerset. It's frequently wet, and sometimes so cold my fingers go numb, but running with friends gives me a post-exercise glow of energy (helped by excellent chat) that lasts all day. 

It's no revelation that exercise is good for us. But perhaps you don't realise that exercising now is banking better health for your future. When it comes to perimenopause and beyond, this is one investment that won't fail. 

"There are so many benefits," says Dr. Samantha Wild, Women’s Health Lead and GP at Bupa Health Clinics. "During perimenopause and menopause, exercise has been proven to reduce symptoms, particularly low mood, anxiety, sleep, and joint stiffness, and some studies say that it can reduce hot flushes and night sweats." (Read my explainer on when menopause starts, here). 

Long-term, studies have proven that it also helps to maintain bone, muscle mass, and heart health - so it's really a no-brainer.

Exercise and menopause: so, what's the link, really?

"Official guidelines recommend 150 minutes of aerobic exercise a week, as well as two resistance, or weight-bearing, sessions," says Dr Wild. 

This sounds like an awful lot in our already packed lives, but she suggests multitasking by, for example, running whilst wearing light ankle and wrist weights, and adding in squats, lunges, and curls. 

Her top tip? "Try and get to the end of the week having worked every muscle group twice."

Exercise boosts both body and mind

It's not just about your physical health, though - far from it. The link between exercise and mental health is another big reason to lace up your trainers. Exercise releases the feel-good hormones called endorphins - that's why you feel so great after a workout (smugness is a personal choice). 

One of the first symptoms of perimenopause, which can be as early as your late thirties, is often anxiety, low mood, and insomnia.

I love doing Pilates if I'm feeling stressed - it's also great for flexibility, muscle tone, and balance. Yoga expert Petra Coveney runs classes for peri to postmenopause. "We include specific practices tailored to cool hot flushes, calm your mind, ease insomnia, and reenergise," she says. "Menopause yoga is a holistic practice that supports bones, balance, heart and mental health."

Exercise improves bone health

Perhaps you feel too young to worry about osteoporosis, or thinning bones. But it's never too soon to consider bone health, and weight-bearing exercise is absolutely vital.

Weight-bearing means that you are working against gravity to stimulate calcium deposits - preventing bone loss, and even building new bone.

"In the seven to ten years post menopause you can lose as much as 20 percent of your bone density," says Dr. Karen Hind, director of clinical affairs at Medimaps Group. "Up to the age of forty, you can build bone mass with a good diet and exercise. During perimenopause, the goal is to maintain it."

The Royal Osteoporosis Society helpfully categorises exercise; low impact is brisk walking, medium impact is running and team and racket sports. High impact might include star jumps and basketball. 

Maintaining muscle mass is equally important - it goes down from around our mid-twenties. As well as supporting stronger bones, muscle mass is associated with general good health. "A big fear is bulking up," says personal trainer Kate Rowe-Ham, who creates workouts for menopausal women. 

"In reality, when you weight train, you're building lean muscle mass," she shares. If that's not enough reason to get going, remember that muscle burns more calories than fat, which improves the metabolism. 

"I find weight training is like meditation," adds Kate. "You're focusing so hard on what you're doing. It's a good way of switching off."

And you don't have to join an expensive gym with today's Zoom-enabled workouts. "You can do weight training just as easily at home."

Exercise is key for a healthy heart

Ready to get your heart pumping? "Oestrogen protects the heart, but postmenopause, twice as many women die from coronary heart disease as from breast cancer,"reminds Kate. 

"Aerobic exercise keeps blood pressure and cholesterol down, and also reduces the risk of diabetes," says Dr Wild. You don't have to go full lycra - she says that very brisk dog walking (so brisk that "you can't speak in sentences") counts. So does running, swimming, cycling, and tennis, and the British Heart Foundation also counts gardening and housework.

This is useful stuff. Next time I'm feeling resentful about cleaning the kitchen or running up and down the stair with clean washing, I'll remind myself that it's exercise!

Remember to focus on inner strength, too

In other words, don't ignore your pelvic floor. This vital area also needs a daily workout. "About 20 percent of young women wet themselves, but few talk about it," says physiotherapist Elaine Miller, who specialises in pelvic floor health.

"It can usually be cured with pelvic floor exercises (and if not, then physio). These are easy to learn, free to do and the only side effect is (probably) an improved orgasm!"

Her website provides the most comprehensive explanation I've ever found - "Take a deep breath in, sigh out. As you sigh out, #squeezeandlift your bum-hole. Hold it shut for a count of 10 seconds and keep breathing." 

You're welcome. 

Shop some of my go-to exercise aids

With around 13 million women in the UK currently going through the perimenopause or menopause and menopausal symptoms affecting more than 75% of women – the menopause brings with it a whole host of unpredictable symptoms; from fatigue and heart palpitations to anxiety and brain fog.

Put simply, the menopause is not just hot flushes. 

In fact, according to a report produced by the Fawcett Society, based on survey data commissioned by Channel 4 of over 4,000 women – the findings of which were featured in Davina McCall’s Sex, Mind and the Menopause documentary – 77% of women experience one or more symptoms they describe as ‘very difficult’, while 44% of women described three or more symptoms as ‘severe’. 69% say they experience difficulties with anxiety or depression due to menopause, 84% experience trouble sleeping and 73% experience brain fog.

Aside from these, further symptoms of menopause include; headaches, panic attacks, exhaustion, muscle pain, loss of libido, night sweats… the list goes on and on. Menopause symptoms are severely impacting most menopausal women – only a lucky few remain symptom-free – and we refuse to stay silent.

Here, three women share their varied menopausal experiences and hard-earned wisdom...

“My main symptom was horrendous joint pain”

“My menopause journey was a long and lonely one,” says Claire, 55. “I was in my early forties when it all began and, from the word go, I never had a hot flush or any of the ‘typical’ menopause symptoms so I never have thought it menopause related. My main issue, and symptom, has always been horrendous joint pain.”

“I remember waking up in the middle of the night with searing pain in two of my fingers. This quickly transferred into my elbows then knees and hips. Leaving me unable to walk, sit or stand, and in a dreadful state. My then GP was not particularly knowledgeable about menopause and never mentioned it. I was sent to endless consultants over a number of years and endured endless blood tests, CT scans and MRI’s. I was tested for Fibromyalgia, Arthritis, and Lymes Disease, to name a few… but everything came back normal.”

“In desperation, my then GP suggested I try HRT, I took it in tablet form but it made little difference. Knowing what I know today, I should have been on an alternative dose, or offered a gel or patches or maybe stronger HRT (Our GPs desperately need more training).”

“My physiotherapist (all the consultants I saw referred me back to physio) seemed to be the most help, and when I approached him at a particularly low point and asked him if I was terminally ill, he was mortified and said no, it was systemic. Each week I had different joint issues.”

“I changed GPs and she was empathetic and listened to my long story. She had me try different medications and strong anti-inflammatory tablets. I also took good quality supplements for sleep issues and anxiety. Exercise played a huge part, even though at times I could barely walk, I still went most days to the gym.” 

“Today, I’m in a much better place. I am now on transdermal HRT (gel and tablet progesterone) and my joints are 80% better. If only I had known then what I know now I wouldn’t have lost nine years of my life to menopause symptoms.”

“The menopause affected my mental health”

“I literally had every symptom going bar hot flushes,” says Kim, 60. “I had all the mental impact of the menopause which had a huge physical impact on my life because I was so lethargic and had no interest in anything.”

“My anxiety even affected my job, as I kept having panic attacks. I went from having all the confidence in the world to no longer being able to walk into a room full of strangers, so I had to quit my job as a makeup artist and start a business from home as I felt I couldn't even leave the house. Obviously, this financially hit me and my family too.”

“I tried my GP but they just wanted to prescribe anti-depressants, but that wouldn’t address the cause of the problem. I decided to do research into doctors who understand the menopause and could offer specialist treatment and that’s how I heard about the Online Menopause Centre.”

“I was diagnosed as being deficient in several hormones – DHEA, estrogen, testosterone and progesterone – and started biologically identical hormone replacement therapy, which is better tolerated than older forms of synthetic HRT. My anxiety gradually disappeared after six months of taking HRT, but my other symptoms stopped almost immediately. I felt like a completely different person mentally – I could relax more and deal with stressful situations much better. I also got my confidence back.”

“For me, the brain fog was the worst”

“My menopause ‘journey’ officially started at the end of 2020,” says Lucy, 52. “I had had hot flushes for a while and by summer 2021 I was on HRT and feeling a lot better. However, what I had not taken into consideration were the other symptoms that I can now attribute to the menopause. For me, the brain fog and joint pain.”

“I used to get out of bed and feel about 20 years older each morning – prior to this I would be pretty supple and happily getting ready each day. Now, it took me several minutes to stand up and shake out and stretch the worst affected joints (usually hip/knee/feet) to get them up and running (so to speak!)”

“I am someone who doesn’t love exercise but realises how good it is for me both physically and mentally. So I was going to the gym 5–6 times a week; a mix of static weight machines and treadmill (interval training). Initially, I thought the aches were side effects but as they did not get any better, and once the HRT had taken effect, I realised what the cause was.”

“For me, the brain fog has been not just frustrating but also very worrying. I began to question what was wrong with me, dementia? Old age? Until I did research and again the HRT kicked in. I still have my moments but it became so debilitating for run-of-the-mill tasks both in and out of work. Not only that, it scared and upset me. I was forgetting simple things, and berating myself for not remembering what I was supposed to be doing. My Google calendar became a sea of reminders.”

“Having been on HRT for over two years, I can honestly say it has been life-changing – I was also given the chance to ‘upgrade’ my treatment this summer with a more ‘tailored’ option – I am lucky enough that my local authority offered me a consultation with a specialist menopause GP – sadly the Lenzetto option she prescribed to me is not in stock enough to risk changing over, so I remain on the basic oestrogen tablets.”

Did you know that women are twice as likely as men to develop clinical depression or anxiety, and this is usually related to hormonal changes? Yes, that’s right, hormones have a direct impact on our moods and emotions thanks to our menstrual cycles, the types of contraception we may take, hormonal changes in pregnancy, and of course, the perimenopause and menopause. 

It goes without saying that feeling sad, upset or worried is part of being human (and totally normal), but during the perimenopause and menopause the definition of what’s ‘normal’ can change (thanks to our fluctuating hormones).

According to research conducted by Livi in April 2022, where 2,000 women in the UK were polled about their personal health experiences, perimenopause or menopause is currently women’s second biggest health concern (28%) following mental health (31%) – and these two often come hand in hand.

To better understand the link between menopause and mental health we caught up with two female health experts: Dr Victoria Manning, GP and advisor to the new menopause platform Issviva, where women can learn and share information about their menopause experience, and Dr Bryony Henderson, lead GP at Livi, the digital healthcare provider – who recently launched the Uneducated series exploring women’s health.

Drawing on expert insight, they share everything you need to know about the menopause and its impact on our mental health – plus, their top coping tips.

How do perimenopause and menopause impact our mental health? 

“During peri-menopause, our ovaries naturally produce lower levels of hormones including oestrogen, progesterone and testosterone to name a few,” explains Dr Manning.

“Reduced oestrogen for example,” adds Dr Henderson, “can affect your mood because of its impact on the levels of serotonin in your brain. Serotonin is a hormone that stabilises your mood and promotes happiness and wellbeing. When the levels of oestrogen go down, so do the levels of serotonin, which explains why you might feel closer to tears, a bit low or even depressed.”

These changing hormone levels can have a direct impact on your mental health, says Dr Manning. “It’s also worth noting that If you have a history of mental health issues, then you’re more likely to be depressed during menopause.”

And on top of the impact of hormonal changes, many women find that the physical symptoms of menopause have a negative impact on their mood, too. “It’s tough to walk around worrying about sudden hot flushes, to not getting the sleep you need, being unable to enjoy sex to the same extent and to get used to a new weight, for instance,” says Dr Henderson.

What mental health problems are most common in perimenopause and menopause?

Low mood and even depression are common symptoms of the menopause and they can impact you at any time, says Dr Manning, “anxiety, low mood, mood swings are all common symptoms during this phase. It’s normal to feel irritable and have less patience with family and friends”. 

Women often report feeling invisible to society, she adds, “and sometimes they even feel a sense of loss. These are all quite normal feelings but don’t be afraid to tell people how you’re feeling. There’s nothing to be ashamed of.”

The difficulties can be quite pronounced, says Dr Henderson, “and often seem to appear out of the blue, which can make them more difficult to deal with”. 

How many women experience some sort of mental health impact during menopause?

Research shows that 69% of women say they experience difficulties with anxiety or depression due to menopause. 

“Mental health difficulties during perimenopause and menopause are so widespread that some researchers have proposed a new term to describe them: ‘menopause distress’. The symptoms are described as significant and persistent, yet different enough to other depressive diagnoses to warrant their own label,” says Dr Henderson.

“Over the years of working as a GP and now aesthetics doctor, so many women have come to me with mental health symptoms which may or may not be a result of reaching the menopause,” adds Dr Manning. “Menopause symptoms can affect their whole life and it can have a huge strain on their mental health in particular. Relationships are often impacted and sometimes they experience problems at work too.”

When are you more likely to experience depressive disorders during menopause?

You are 2-5 times more likely to experience depressive disorders during perimenopause than during the late premenopausal years, says Dr Henderson. “For some, emotional exhaustion can make everyday tasks difficult.”

Midlife is also a time when many of us go through life-changing experiences and events, she adds. “Life stressors and adversity can contribute to mental health difficulties, which is why some types of therapy can help.”

“Often we find that women who have never experienced low mood before, start to feel incredibly low and that can be scary and confusing,” says Dr Manning. “Around 25% of menopausal women consider changing jobs or leaving work at this time. We all need to be acknowledging this is a huge waste and employers need to offer much more support for their menopausal workforce.”

“Menopause gave me anxiety for the first time in my life”

Louise*, 50, has been prone to anxiety throughout her life, but started to feel a new and different kind of ‘low’ around the age of 45. “I felt very anxious in situations where previously I had felt fine – busy shops, walking the dog, using public transport,” she says. 

“I saw my GP after about a year as I was really struggling, and he prescribed anti-depressants. I had never been on anti-depressants before and I started using a low dose – 50mg Sertraline – which definitely took the edge off for a few months, but my gut feeling was I knew it wasn’t the right treatment, so I weaned myself off them. 

“Through googling, I realised my symptoms were most probably due to major shifting hormone levels, so I sought out a private Menopause Specialist ANP (Advanced Nurse Practitioner) who had a clinic thankfully near to where I lived. After an initial discussion I started on an oestrogen supplement and my mood changed over time. Once again, and only based on a gut feeling, the mood shift felt more natural as I felt more back to myself rather than an anti-depressant which felt like it was masking my mood.”

Louise’s anxiety made her feel very insecure about her relationships with family, friends and work colleagues. “In my low moments, I would question if I bought anything positive to any relationship. I’ve also read how many women feel they lose their confidence during the peri/menopause and I can resonate with that around my close relationships,” she says.

“I felt (and feel!) very impatient with my teenage children and often just wanted to be away from them – this has got better with HRT and exercise but I still feel they can trigger my emotions very quickly,” she adds. “My husband is wonderful and very understanding – we’ve talked a lot about the symptoms and their impact, however it’s without a doubt put a huge strain on us. I’ve been grumpy, resentful and my libido has essentially crashed. I just don’t want to be touched. My ANP prescribed me a testosterone gel to help and initially it worked for a few months but sadly, I’ve gone back to having a very low libido. I really worry about this and the impact on our marriage.”

But it’s not all doom and gloom – a combination of HRT and exercise has helped Louise to reclaim her mental health. “The HRT has definitely helped but I would say the biggest, positive contributor is exercise. I now do three gym sessions a week (HITT class, yoga and 30-minute swim), plus I walk the dog 4-5 time a week. For me, this really helps. I also drink less caffeine and alcohol and eat less sugar – but I’d never give them up completely, treats are crucial. I also make sure I spend minimum one evening a week with girlfriends.”

Of course, HRT – while great for many women – isn’t for everyone. Suzanne Boudier, 49, felt so low, she decided to develop her own supplement to help tackle menopause symptoms. “I’ve never experienced anxiety before and suddenly felt it in abundance,” she says. “Every noise made me jump, I didn’t want to drive our teenage kids anywhere as the thought of driving filled me with dread. Lash on depression, night sweats, weight gain, bloating, low energy, brittle hair, ageing skin… it was an unbearable existence. In all honesty, I was one of the one in four women who felt they simply couldn’t cope. If rock bottom had a basement, I got into a very dark and overwhelming place.”

Suzanne, like Louise, went to her GP and had hormone level blood tests which came back negative. “I felt left to my own devices,” she says. “I went privately for help and tried bio-identicals but they didn’t do anything for me.”

How did she reclaim her mental health? Diet, exercise, supplements and mediation. “Meditation was a big help with anxiety and also playing all my favourite 80s songs and music that really resonates with my soul – which sounds absolutely mad,” she says. “But listening to music or even watching films that feel familiar, safe and have some joyful associations, really helps lift mood too. I forced myself to go to concerts so I could lose myself in some of my favourite artists and took trips to the Kent coastline, as there’s nothing like a trip to the beach, rain or shine.”

“Menopause,” Suzanna says, “is really about throwing away any rule book and doing things your way, whatever works then do that. It forces you to go inwards, it makes you look at your life. Nap, sing, walk, swim, chat utter twoddle with a girlfriend, hang out in the garden with a book, try to focus on all the small joyful moments that each day brings, laughing with my daughters and keeping in mind that this is a rite of passage to a life without a menstrual cycle – I mean, how liberating is that.”

What should you do if you’re struggling with your mental health during menopause?

1. Book a GP appointment

Your first port of call should be your GP to explain how you’re feeling. “I know first-hand that so many women are fearful of going to their GP to discuss menopause symptoms and they often question whether it is something that's worthy of an appointment. If it bothers you, it’s worthy of a GP appointment,” says Dr Manning.

“Make sure you ask if there is a doctor or a nurse that specialises in menopause,” she adds. “If there is, then they'll likely have had some additional training and they should be up to date in terms of guidelines and treatments.”

Dr Henderson reiterates this: “Please do reach out to a doctor if your symptoms are impacting your mental health and remember you are not alone. Depressive symptoms are very common during perimenopause and menopause, and a doctor will be able to guide you through your options, including talking therapy, antidepressants, HRT or a combination.”

2. Log your symptoms

The best way to prepare yourself is to gather as much information as you can. “Read up about perimenopause so that you’re able to identify symptoms and know what to expect,” says Dr Henderson. 

“The GP is probably going to ask you lots of questions and will want you to provide quite a bit of detail,” says Dr Manning. “The GP will want to know about your symptoms, how long they've been going on, how they’ve changed over time, and if they fluctuate.” Dr Manning suggests keeping a journal or diary so you can note how often you’re feeling low and see if there is a pattern developing.

3. Talk to friends and family 

“Tell family and friends how you’re feeling – they can be a huge support during tough times,” says Dr Henderson.

“Just chatting with other people and hearing their thoughts tends to validate what you're going through and makes you feel less anxious,” adds Dr Manning. “I find with my patients that when they understand what they’re going through and they feel well-informed and ‘heard’ they tend to manage their menopause experience in a much more positive light. Understanding they are not alone or going crazy is important and there are some brilliant support groups out there, like Issviva which is a free website where you can learn about menopause and share your experience with others in a closed group environment. Talking and sharing is beneficial to your whole menopause journey.”

4. Consider HRT 

“Depending on your circumstances, your GP might prescribe HRT,” says Dr Manning. “My suggestion would be to try it for three months and if your mood improves, then great. However, if HRT doesn't make a difference, it might be a case of going back to the drawing board and actually digging down a bit deeper. The cause of this mood dip could be clinical depression so I would suggest trying an antidepressant for a few months. Again, if it doesn't work, you can eliminate it. Medicine is never as clear and simple as it requires a bit of investigative work.” 

5. Move your body 

“Stay healthy, this includes eating a well-balanced diet and regular exercise. Research shows that physical activity has a positive effect on both physical and mental health during perimenopause. It also releases endorphins and other feel-good hormones,” says Dr Henderson.

“Whatever stage of the menopause you’re at, exercise is undoubtedly beneficial,” says Dr Manning. “As your metabolism slows, many women report weight gain, so cardiovascular activity will help manage this. If you haven’t exercised for a while, I recommend starting with at least ten minutes a day of brisk walking (ensure your heart rate increases and you become slightly out of breath) and then introduce some strength training. This often helps you reduce body fat, strengthen your muscles and burn calories more efficiently. If you can exercise outdoors, do so, as this is proven to help improve your mood and help boost energy levels.” 

If you’re worried about your mental health during this time of change, book an appointment to speak to a doctor.

*name changed 

MPs have voted in favour of enforcing buffer zones, which will protect women from anti-abortion campaigners, in England and Wales. 

This means it will be a criminal offence to harass, intimidate, obstruct or threaten patients within a 150m 'buffer zone' of a clinic. By a hefty margin of 297 to 110, MPs backed the amendment to the Government's Public Order Bill with a margin of 297 to 110. Breaking the rules of the buffer zones could result in up to six months in prison. 

While telemedical abortion was made available during the pandemic, many women in the UK still visit abortion clinics, and are often met with campaigners outside handing out leaflets, holding distressing signs and sometimes even heckling those who are entering the clinics. 

Rebecca Minor, a gender specialist, explains that buffer zones is a positive - and integral - step for women's rights. 

"Those accessing care at abortion clinics are already embarking on an often painful decision-making and potentially traumatizing process. Pregnant people deserve to have a buffer zone that allows them unobstructed access to healthcare, a fundamental human right, without additional traumatic experiences. 

"We cannot turn back the clocks and prevent those unwanted or dangerous pregnancies, but we can control unnecessary harassment and emotional harm. Those with anti-abortion sentiments have plenty of other avenues to voice their concerns and tormenting people is not a requirement of free speech."

The amendment was originally proposed by Labour MP Stella Creasy, who said it was designed to protect, "women accessing a very specific type of healthcare”, as reported by the BBC.

She continued, "It does not stop free speech on abortion. It does not stop people protesting. It simply says you shouldn’t have the right to do this in the face of somebody – and very often these people are right up in front of people."

While this is clearly a step in the right direction, unfortunately, there's still a way to go before it becomes law during a lengthy process, including approval from the House of Lords.

Over in the US, there's little hope of buffer zones to protect women being introduced any time soon.

Leigh Ann Wheeler, a professor at Bingham University specialising in women, sexuality, social movements, explains, "The US Supreme Court addressed the issue of buffer zones around abortion clinics in 2014 and - even before it was stacked with Trump appointees - the nine-member court voted unanimously against laws that created buffer zones.

"The case was McCullen v. Coakley, and the Court reasoned that the First Amendment protects the free exchange of ideas in public spaces. Britain's Public Spaces Protection Order (PSPO) seems to take a different approach by protecting clinic staff and clients from harassment in public spaces. 

"First Amendment jurisprudence in the US has leaned toward protecting speech over protecting people in public spaces. Some feminists in the US have tried to create a right to be free from harassment in public spaces - see, for example, Stop Street Harassment and Right to Be - and state laws do offer some protection, but the First Amendment creates a pretty high bar against prosecution for harassing behaviour on public streets."

New UK Prime Minister Rishi Sunak announced the final few appointments to his cabinet on Friday, controversially making Maria Caulfield the new Minister for Women.

The alarming appointment has prompted backlash by women's rights groups and women's health charities, with Caulfield holding concerning views on abortion and reproductive rights in general. 

Caulfield, 49, voted against the legalisation of abortion in Northern Ireland, backed cutting the abortion time limit in the UK and opposed the recent vote on buffer zones around abortion clinics. She also used to be a member of the parliamentary "pro-life" group. 

To reiterate, she is now the Minister for Women - responsible for policy regarding gender equality and the advancement of women.

Caulfield's appointment has been widely criticised, with women's rights activists warning of the potential consequences, and urging members of the public not to be complacent.

"We are horrified that a clear opponent of abortion rights has been appointed minister for women," stated Harriet Wistrich, the director of the Centre for Women's Justice, via BBC.

“The vast majority of women want the right to choose. Her appointment signals a potential restriction on women’s reproductive rights, which in turn is an attack on women’s autonomy and freedom. We hope Maria Caulfield will keep her personal opinions on the issue of abortion to herself.”

Among those to voice their outrage were politicians, especially following Caulfield's recent interview defending her opposition to the buffer zone vote, which makes it illegal to harass women outside abortion clinics. 

"The definition of harassment is open to interpretation," Caulfield told BBC's Politics Live when questioned about her stance. "There's a possibility of someone going up to a woman who may be upset or distressed, offering them some comfort, that could then be accused of harassment and and face six-months in jail."

Taking to Twitter, Labour MP Diane Abbott responded: "Sunak’s new Minister for Women Maria Caulfield wants to limit a woman’s right to an abortion and now claims protesters harassing women outside abortion clinics are trying to 'comfort' them. Ridiculous appointment".

This news comes as reproductive rights are increasingly under threat worldwide, following the overturning of Roe v Wade by the US Supreme Court.

“The 1967 Abortion Act, and our ability to end a pregnancy, lie in the hands of politicians, and over the past 10 years we have seen a number of parliamentary bids to restrict abortion safely and legally,” explained Katherine O’Brien, associate director at the British Pregnancy Advisory Service. “These groups have strong links with their US counterparts, and we would be concerned that they will escalate activity [now that] Roe v Wade is overturned."

“At any given time, parliament could attempt to restrict women’s access,” another spokesperson for BPAS added, via the Independent. “Over recent years, a number of anti-choice MPs have sought to do just that, and we must be constantly vigilant.”

"You think what you see in America couldn't happen here?", tweeted Stella Creasy, MP for Walthamstow, following the overturning of Roe v Wade. "Then you don't understand who is organising in UK politics. No one thought American Supreme Court would ever overturn a right previously granted either... These attacks on women's rights won't stop. Be prepared."

So, what can we do on an individual level?

“The most important thing people in the UK can do to support abortion rights is to be loudly, unashamedly pro-choice,” Abortion Support Network founder Mara Clarke told the Independent.

“The anti-abortion population is less than 10 per cent of the UK’s population. We are the pro-choice majority, and we should speak often about not only abortion but about all reproductive health issues.”

We will continue to update this story.

You don’t have to have watched Bridgerton to know of Adjoa Andoh. Starring in one of Netflix’s biggest shows ever will, understandably, propel you into the limelight. But today, we’re not talking with Andoh about her role as Lady Danbury or even the highly anticipated release of season 3. Instead, we’re sitting down to talk all things menopause.

As No7’s menopause ambassador, Andoh wants us to know this isn’t your average celeb endorsement project (although she admits, of course, she does use and love No7’s Menopause Skincare Collection). “I don't do advertising stuff generally,” she caveats. This move for her isn’t about money or product, it’s about opening up conversation around a topic she feels needs more attention.

At 59 years old, Andoh is open about her experiences with perimenopause, menopause and post-menopause, revealing the thing that spoke to her most when the opportunity arose to work with No7 was the brand’s willingness to actually speak with women, take feedback on board and help shed light on the changes the body goes through. “Once you have the knowledge, you don’t give yourself such a hard time,” she says.

Sitting down with Senior Beauty Editor, Katie Thomas, here, Adjoa Andoh talks on her experiences of the stigma around menopause, discusses why open conversation on menopause in the work place could increase productivity and reveals the reasons why being armed with skin knowledge makes for a liberating menopause experience.

How did the menopause start for you?

"I would say, like most women, there was no starting date. Instead, it was more of an incremental shift. It was one that started with having very straightforward menstrual cycles and then the rhythm of them suddenly shifting. That was the early indication when I was in my late forties/early fifties. But the things I noticed more were the clichés you think aren’t true, but are—things like night sweats and erratic sleep. At a certain point you put all the dots together and think: So this is the menopause?"

How have you found your menopause journey so far?

"I do feel like we’re not well versed in our bodies and that things come upon women, which takes us by surprise. Particularly when it comes to menopause, we’re not prepped and no one wants to talk about it. There’s been a shame around it that implies when ‘the change’ happens, all bets are off, your life’s over and you’re a dried up husk. I think there’s something really fundamental and basic about writing women off once they’re no longer of childbearing value. It’s almost like saying because I’m not going to be giving anyone a baby anytime soon, I’ve lost all of my functions—my intellect, my curiosity, my appeal, my sexiness—it’s all gone because that was only there so that I could make babies. It’s not true. We don’t die at 60 anymore, there’s a whole load of life still to go.

"I suppose the biggest thing for me is just to say, it's just a change in my life, it’s just a new development. It’s going, this is the way I am and if you don't like it, go somewhere else. I'm not going to be anxious about who I am as a person anymore or whether I'm pleasing you, whether you think I'm suitable, good enough, or includable—I'm just gonna play on my own. I'm not going to be intimidated or squashed, or reduce myself in any way, I'm just going to embrace the whole of who I am. I think those sorts of changes also happen. "

Did you find that the menopause affected your work?

"[As actors] I think, generally, our work is affected just because of the preconceptions that people have about women who are older in terms of stories that are available to play. Although, I think that's starting to change now. Viola Davis is doing more work, and Leslie Manville is doing more work. People whose careers might have been written off are still working because life keeps going and life is still interesting.

"I've been pretty fortunate but I think just as women don't talk about menopause, we also still don't talk about childcare. There are all these things that go on in one's life, and everything needs to be taken into account. If I've been directing a show and someone's got [something going on with their kid] then I will tell them to come in when they can come in and we'll work around them. Why? Because that's part of life. I want a happy company of actors and other creatives, and if you're stressed about something that you should be dealing with, you're not going to work well. 

"I just feel like we work well when we acknowledge everything that's going on. Everybody's going through the same shit, so why are we all in denial about it? We should be supporting each other to be productive by being responsive and caring. So, in terms of the menopause and post-menopause, I think that big wraparound care needs to be happening in our work life, just as much as it should be happening with caring for elders or caring for children, or having a health condition or whatever it may be. It may look like it's a barrier to our working sufficiently well, but actually, it's just a part of life and it just needs to be woven into the work/life balance, I think."

Did you notice any menopausal changes in your skin?

"I've always been a great fan of moisturising. If you are of African heritage and you don't moisturise your skin, you will be thrown out of the club. You can't leave the house with ashy skin, it's against the law. I've also been blessed with fantastic genes. But I think I have noticed, even though I moisturise, that I need to moisturise more. There's a certain elasticity in the skin that starts to roll back as you go through the menopause, which makes perfect sense because you're losing oestrogen and that takes some of the elasticity of your skin. For me, I've found more water, more sleep, and less sugar have been really helpful. 

"What was really interesting to me about the new No7 range was that they bothered to spend time, over a number of years interviewing a huge cohort of women (of different races, different regions, different stages of menopause) to get their feedback on what they've noticed. It’s not a case of wanting to fight against a terrible thing that’s happening, it's just providing information. Once you have the information, you can choose how best you wish to address it. For me, a good moisturiser that's addressing the shifts in your skin is essential. I particularly like the No7 Menopause Skincare Nourishing Overnight Cream, £31.30."

Was there anything else that helped you through?

"I've had cancer, so the supplements that are available to most women who have gone through menopause to support the oestrogen quota in your body, which are supportive things, can also potentially support the return of cancer cells, so I can’t take that stuff. I couldn't take HRT (hormone replacement therapy), for example, and I couldn't take a homeopathic route or have red clover, but I do take sage which is fantastic. That's probably the only supplement I take in terms of something that's directly there to address menopause, although I do take other supplements like vitamin C and vitamin D. I'm vegetarian so I take vitamin B12 and black garlic—there's all sorts of things I take but they’re just to support my general well being. Although, I think when your body is shifting, you need to support your general well being."

Do you think women are armed with enough information on the menopause?

"No, I don't think we are. I don't think we factor it into the world. We think menopause is old. It's reduced. It's coming to the end of life. It's something you don't want to think about because you don't really think about your end when you're in the middle. But that's fiction because it is the middle for most women's lives. There's a whole chunk of decades still to go in which you can be embracing the freedom of menopause and embracing your confidence in who you are as a person. 

"It needs to be talked about so that it can't be used to undermine women in the workplace, and undermine their sense of beauty, their own agency in the world, their own intellectual curiosity or just their general fabulousness. I think women are hungry to know, and actually men should be hungry to know as well so that everybody is on the same page about what’s happening."