"How an at-home hormone test finally gave me a diagnosis – after a decade of pestering my doctor"
“So, when are you going to have children?” — it’s an (unwanted) question that many women will have been asked, usually by a distant relative at a family function. And for those, like me, who have concerns about their fertility, it’s one that can be not just uncomfortable but almost impossible to answer.
I knew something was wrong long before getting a PCOS diagnosis, but like so many women taking on the battle of healthcare in the UK, I had to wait 15 years for it to be confirmed — and fork out hundreds of pounds in the process, in order to find a consultant who finally acknowledged that my bleeding through my clothes and onto seats was not “fine.”
After spending years dealing with constant bleeding, debilitating migraines and frequent fainting, I left my GP armed with birth control, under the impression that it would give me my quality of life back. In truth, it did – for a bit. But stopping my periods altogether was the only way I could function, and that’s hardly a sustainable solution.
An ultrasound scan (also private, btw) revealed that I was again “fine,” but I knew the hair that now grew out of my chin had other ideas.
Ill-advised that I couldn’t take a hormone test whilst on birth control, I tried to put it to the back of my mind ‘for later.’ But when I hit 28, married and mortgaged, I couldn’t bat off my concerns about the future anymore. A voice in the back of my head often reminded me that I needed to get real answers, and that I’d need to stop taking the pill if I wanted to try for a family — and there will never be a good time for that.
When I discovered the 'Rotterdam' criteria (on Instagram, of all places) — the diagnostic tool for PCOS (Polycystic Ovary Syndrome) — I knew that I had enough of the symptoms to warrant a diagnosis (note: even with a clear ultrasound). But after years of being fobbed off by doctors, all of whom insisted everything about my heavy and prolonged periods was “normal”, I feared trying to push it again with a GP. But I still wanted the answers that a hormone test would provide. Part of me still wondered if I was having a massive overreaction, given that is what I'd been told for years by people who know a lot more about women’s health than I do.
So, I decided to order an at-home hormone test from the internet.
Hertility Health: An honest review
I discovered Hertility Health during one of many frantic Google searches at 3am — which, interestingly, I later found out is the website’s most active time according to co-founder, Dr Helen O’Neill.
So, alongside many others, I spent the dark of night researching how I could find out more about my hormones without having to sacrifice my beloved birth control — less of the judgement, please: birth control is the best option some of us have — and I found Hertility.
Hertility promised everything I wanted: a home hormone test, birth control or not, no waiting lists, a 10-day turnaround on results and clinicians to speak to once the results came in. Could I really get the answers I’d waited over 10 years for in just 10 days?
To get the ball rolling, I had to complete an online health assessment in which I ticked off my symptoms, gave information on my sexual history, periods and lifestyle, and ‘declared’ my choice of birth control. The information you give during this questionnaire instructs what you’ll be tested for — and anything you can’t be tested for depending on your chosen contraception.
Can you use Hertility whilst using hormonal contraception?
If you’re using hormonal birth control, yes it will impact what you can test, but that doesn’t have to be the end of the road on your quest for answers.
“You can absolutely still take a Hertility test whilst using hormonal contraception,” explains Dr Helen O’Neill, Founder of Hertility Health and Lecturer in Reproductive and Molecular Genetics.
“We’ll still be able to test for anti-mullerian hormone (AMH), thyroid stimulating hormone (TSH) and free thyroxine (T4) which will give you an insight into your ovarian (egg) reserve, risk of PCOS and general hormone health.”
The doctor adds that depending on your symptoms, lifestyle, menstrual cycle and medical history, additional hormones, such as testosterone and prolactin, may also be looked at to check for other conditions that could affect your reproductive health.
“However, as hormonal contraception influences the levels of your cycling hormones (luteinizing hormone (LH), follicle-stimulating hormone (FSH) and oestradiol), we don’t test these on hormonal contraception as the results would not be reflective of your normal levels,” Dr O’Neill explains. “Hormonal contraception might [also] temporarily lower AMH levels, so we would recommend retesting 3 months after coming off hormonal contraception to understand any changes to ovarian reserve.”
I opted for a nurse home visit to carry out my blood test. Thanks to my history of dangerously low iron levels (also not normal, btw), I’ve fainted during many a blood test and this felt a safer option. For those more comfortable with it, you can take your own fingerprick blood sample at home.
The nurse was a dream – he was calm, gentle and understanding – and the process was quick and easy (the blood was taken from my arm as opposed to a fingertip, while I laid on my sofa), he packaged and posted the sample for me, and my wait for information began.
What can Hertility test for?
Hertility screens for 18 common gynaecological conditions, including PCOS and endometriosis, by combining diagnosis criteria and clinical guidelines with clinicians' expertise and data modelling. What that means to mere mortals like us (i.e. not molecular geneticists) is that the initial online health assessment (which took five(!) years to build) is very carefully and deliberately crafted to screen you for these conditions in combination with your medical history.
Dr O’Neill says: “The software uses advanced technologies and has a 98-99% accuracy. This empowers our clinicians in their decision making, so they can decide if any further investigation is required and outline it in the patient’s report. This process can be as short as 10 days, so a big improvement from today’s average of some female health conditions which can take up to 9 years!”
The hormone result section of my report had arrows detailing where I sat on the spectrum of the different hormones I was tested for (AMH, thyroid health and androgen health — essential for diagnosing PCOS), along with what’s classed as low, in range, and high.
When I moved onto the explanation section, information was provided on what my results could mean and why. The analysis given isn’t excessive and it won’t give you a diagnosis, so if you don’t know what you’re looking for, a follow-up consultation with one of Hertility’s specialists will be helpful.
In terms of other next steps and insights from Hertility, it felt a bit automated. My suggested action was a pelvic ultrasound, which makes total sense, but I’d already had one — I get it, of course, but I felt a bit on my own with the results for a bit.
For me, having clear data showing my androgens were high, an important marker of PCOS, was enough to book in with a private gynaecologist (not affiliated with Hertility) for the final piece of the puzzle: a diagnosis. Hertility says that its report is designed to be taken to your doctor or a specialist afterwards, and judging by the reviews I spent hours reading, many people do.
The results
You can track your progress online (I was refreshing every half an hour tbh) and after nine days I got an email with my results.
They’re delivered in a report which you can log in and look at within a ‘virtual clinic’ which takes you through six stages: a doctor’s note, blood test results, explanations of them, analysis of what they might mean, suggested next steps and personalised insights.
My biggest worry — as strange as it may sound — was that my report would come back with nothing; that all my hormone levels were in range. That I’d be told again that my symptoms were normal and I would just have to live with them, accepting my fate as a diagnosed weakling who can’t cope with one of the most integral parts of womanhood.
But as soon as I read what the gynae who interpreted my results had written, that fear was alleviated: “There are some results and symptoms that I would recommend looking into further.” I breathed a sigh of relief — finally, I was being taken seriously.
How long does the Hertility process take?
Mine took two and a half weeks from ordering the test to accessing my results. This will depend on whether you take your blood yourself — you might be able to do it quicker than waiting for a nurse’s availability, for example.
What support is offered by the Hertility team?
A team of fertility experts are available for you to book in with after you receive your results, and the customer service team were great when I spoke to them about booking my blood test appointment (and again when I had to move it).
You can also book ultrasounds and follow-up appointments and treatments via Hertility.
How much does Hertility Health hormone testing cost?
The cost of a Hormone & Fertility Test is £149 (or you can pay in interest-free instalments).
The optional nurse visit was an extra £79 — this felt like a lot for a blood test but was ultimately worth it for me and if I did it again, I’d still take that option.
Plus, if you were to choose private in-clinic hormone testing, you’re likely to be looking at a lot more money for the same panel of testing. If you only need one hormone tested, an in-clinic route may better suit you, but for testing multiple hormones this is undoubtedly cheaper.
If you want to speak to a fertility advisor for help with your results and next steps, that will cost you an additional £39. You can choose this option when you purchase your test kit or go back and buy it as an extra service once you’ve got your report.
Hertility Health hormone testing: The verdict
Getting my hormones tested was potentially the best thing I’ve done for myself in my adult life. After over a decade of wondering and knowing deep down and never quite being heard, I have answers, and have been able to adapt my life to improve my health. As far as fertility goes, I’m not quite sure on that one yet, but I’m armed with info to help me make decisions.
If you think you know what data you need, Hertility is a great option. If you feel uneasy about the blood test, I would absolutely recommend a nurse visit, and ultimately information is power: whatever comes out of this test for you will be of use. But you may need to speak to someone afterwards, as it’s a bit tricky to interpret the impact of the results yourself (especially if you don’t have anything in particular in mind, I imagine).
If you’re expecting to see a diagnosis in your report, this isn’t likely. But it’ll give you the information to get one.
I absolutely would recommend Hertility. It was clear to me throughout the process that it had been designed by people like me, who genuinely understood. Information really can be power, and now I’ve been able to understand more about what my body is up to and what I can do about it. If you think something is up, go with your instincts. Most of the time we’re right, Dr O’Neill says — and I can vouch for that.
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