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Hormonal health

Interview: New horizons in endometriosis diagnosis

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Winner of the Femtech World Menstrual Health Innovation Award 2025, Serac Healthcare, is aiming to revolutionise endometriosis diagnosis via a non-invasive diagnostic molecular imaging agent. Serac Healthcare chief executive, David Hail, speaks to FemTech World about the company’s mission to improve diagnostic timelines for the condition and empower women’s health.

Endometriosis affects more than 176 million women across the globe, causing chronic pelvic pain, painful menstrual cycles, painful intercourse, bloating and fertility issues.

Unfortunately, women are often waiting up to eight years to be diagnosed, often experiencing dismissal over their symptoms. 

 

While scans such as MRI can provide insights into whether or not a person has endometriosis, currently, official diagnosis of the condition is done through an invasive surgical procedure called a laparoscopy, where a camera is inserted into the abdomen. 

With no innovation in endometriosis diagnosis or treatment, Serac Healthcare is working to redefine how we diagnose the condition through its innovative non-invasive method. 

Serac Healthcare chairman, David Hail, tells Femtech World that Serac’s imaging agent has the potential to revolutionise diagnosis and empower the development of new drugs for the condition.

“We have a real excitement and a real passion about bringing precision medicine – nuclear medicine – to people,” says Hail.

“Nuclear medicine is a way of looking at physiological processes in the body, and is very often used to see active disease in the bodies of patients, which is different to other imaging techniques.”

Serac’s imaging agent – Tc-maraciclatide – which has been granted Fast Track Designation by the FDA, is a radio-labeled tracer that has been designed to bind to new blood vessel formation.

“That’s really important in a lot of inflammatory conditions,” explains Hail. 

For instance, with endometriosis, where cells from the endometrium grow outside the uterus, to be able to survive in that environment, they have to grow their own blood supply.

“That’s what we image. So, maraciclatide binds to this new blood vessel formation, which is called angiogenesis, and we can scan somebody, pinpoint that and see it. 

“That is also why it works in inflammatory arthritis – rheumatoid arthritis and psoriatic arthritis, which, incidentally, is also a disease predominantly of women. In fact, autoimmune diseases generally are more prevalent in women than men, but for rheumatoid arthritis, 70 per cent of patients with rheumatoid arthritis are women.”

Hail highlights that one in two women who go for fertility treatment have endometriosis, and that these women often discover they have endometriosis when they start fertility treatment.

“At the moment, the only definitive diagnostic test for endometriosis is surgery. We know there’s a several month recovery period from laparoscopic surgery. 

“In laparoscopic surgery, the surgeon can see the endometrial tissue and it is also a treatment – they can also take out the tissue, so having a definitive imaging agent that can visualize and diagnose the early stage of endometriosis is incredibly important. 

“It can change the whole care pathway for some women today. When there are eight years between a woman seeing a clinician and having a formal diagnosis – apart from the physiological damage – there is psychological damage, because quite often, women are told it’s just in their heads.”

Serac has carried out clinical studies on the imaging agent, with findings from the Phase II study, carried out by a team from Oxford University, demonstrating that it can visualise and diagnose the very earliest stage of endometriosis. 

“The very earliest stage of endometriosis is superficial peritoneal endometriosis (SPE) in which there are very small lesions,” explains Hail.

“Visualising this stage is really important because it is the start of the active disease, and therefore, there is the potential to intervene sooner.”

“Apart from the physiological damage and the psychological damage – there is real economic harm to the women involved. This happens at exactly the time when they are arguably at their most productive – in the early stages of their career and relationships. All these things that are negatively impacted by endometriosis.

“Our mission is about being able to bring something to the world that can make an impact on that.”

Beyond early diagnosis of the condition, Hail says that the agent may also contribute to research and the development of new drugs to treat the condition.

“This is also really important for developing new disease modifying drugs – drugs that actually get to the underlying disease, as opposed to masking them,” says Hail. 

“We know that the treatments available today are not perfect – such as hormones, an example of which would be the contraceptive pill which mimics pregnancy. We know there are potential side effects from these hormonal therapies, as indeed there are from the ‘pill’.

“There are people trying to develop new disease modifying drugs, but to prove a drug works in endometriosis, you have to choose pain as an endpoint.

“There’s lots of variables that can affect pain and there isn’t a direct understanding of the relationship between the endometriosis itself and pain. The only alternative to prove that your new drug actually works and actually reduces the burden of endometrial lesions is surgery – in fact, two blocks of surgery. 

“It is very difficult to run clinical trials around that for all sorts of reasons. So potentially, having this imaging agent is an alternative way to prove that your drug is actually doing what you hope it will do.”

The outline for a Phase III study has now been agreed, and Hail says that the agent being granted fast track designation in the US highlights the FDA’s recognition of the need for innovation in endometriosis care. 

“Women’s Health generally, but endometriosis in particular, is an underserved area,” says Hail.

“We think it is so important to bring something to the world that’s going to make a real difference to 50 per cent of the population of the planet – we really need to do something about it, and that’s what we’re trying to do. 

“Early diagnosis of endometriosis is important because it allows physicians to provide timely, effective treatment, and the best treatments that are available.”

The Femtech World Menstrual Health Innovation Award 2025 is sponsored by Clue. See all our winners here.

Fertility

Weight loss jab shows early promise in improving PMOS fertility

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A weight loss jab may improve fertility outcomes in women with PMOS, early findings from an ongoing clinical trial suggest.

The proof-of-concept analysis found that injectable semaglutide may offer reproductive benefits while also addressing obesity and metabolic dysfunction.

It is the first report to examine how injectable semaglutide may improve reproductive outcomes in women with PMOS while also addressing obesity and metabolic dysfunction.

The work forms part of the ongoing RESTORE clinical trial.

Melanie Cree, professor at CU Anschutz and first author of the report, said: “Women with PMOS frequently face a frustrating choice between treatments that target reproductive symptoms and those that address metabolic health.

“Our early findings suggest injectable semaglutide may have the potential to improve both, offering a more comprehensive approach to care.

“This medication is incredibly promising when someone responds with 10 per cent weight loss.”

The trial is examining whether semaglutide can restore ovulation and improve reproductive health in adolescents and adults with polyendocrine metabolic ovarian syndrome, known as PMOS.

PMOS, formerly known as polycystic ovary syndrome or PCOS, is a hormone and metabolic condition linked to irregular periods, raised testosterone levels, infertility risk, obesity and increased cardiometabolic disease.

Cardiometabolic disease refers to conditions linked to the heart and metabolism, such as heart disease, high blood pressure and type 2 diabetes.

Existing treatments, including metformin and hormonal contraceptives, often do not fully address reproductive and metabolic complications at the same time.

The analysis focused on participants aged 12 to 35 who lost at least 10 per cent of their body weight during treatment.

Researchers said reproductive improvements appeared earlier than expected, prompting them to report preliminary findings while the wider study continues.

Cree is also a paediatric endocrinologist at Children’s Hospital Colorado.

Endocrinologists are doctors who specialise in hormones and hormone-related conditions.

Cree said: “What makes this work particularly important is that it focuses specifically on women with PMOS receiving injectable semaglutide.

“Although GLP-1 medications have transformed obesity treatment, there remains a significant need for rigorous data examining how these therapies affect fertility and reproductive function in this population.”

The RESTORE study is evaluating semaglutide treatment in girls and women with PMOS and obesity.

Its broader aim is to determine whether weight loss and metabolic improvements can restore ovulation and improve reproductive outcomes.

Ovulation is the release of an egg from the ovary, a key part of the menstrual cycle and fertility.

The authors said the findings are from an early proof-of-concept analysis and that larger, longer-term studies will be needed to confirm whether the reproductive benefits last.

The findings suggest injectable semaglutide may become a treatment option for women with PMOS seeking improvements in both metabolic and reproductive health, if future studies confirm the results.

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Menopause

Apple Health adds menopause and perimenopause tracking

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Apple announced menopause and perimenopause tracking for its Health app at WWDC 2026, with symptom logging and cycle alerts for some users.

The update expands the app’s cycle tracking beyond fertility and menstrual periods.

If logged cycle patterns suggest a user may be experiencing perimenopause, the app will send a notification prompting a conversation with a doctor.

However, this perimenopause-specific cycle deviation notification is only for users aged 40 and over and is not intended to replace a doctor’s diagnosis or treatment.

Stacey Ford, Apple’s vice-president of OS management, said users will also be able to log menopause and perimenopause symptoms in the Health app.

Educational content will also be available to help users learn more about these life stages and understand changes in their bodies.

Every year, about 2 million women enter perimenopause, the stage before menopause when levels of the hormone oestrogen decline.

According to a February 2025 survey involving 4,432 participants aged over 30, more than half of women aged 30 to 35 experienced moderate or severe perimenopause symptoms.

The findings suggest perimenopause does not affect only older adults.

About 6,000 women in the US enter menopause every day, according to the Society for Women’s Health Research.

Given the number of women affected by perimenopause and menopause, the update broadens the Health app’s scope.

The app launched in 2019, meaning it has gone seven years without these women’s health tracking features, which could help users better understand their bodies and prepare for informed conversations with doctors.

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Hormonal health

Iron deficiency in women: The tiredness everyone normalises

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Article produced in association with Spital Clinic

Feeling permanently tired has become so normal for so many women that most of us have stopped questioning it. But one of the most common reasons behind it is also one of the easiest to miss – and one of the most satisfying to fix.

The tiredness that gets explained away

There’s a particular kind of tired that a lot of women simply live with. The mid-afternoon slump that no amount of coffee touches. Needing an early night and still waking up flat. Putting it all down to work, kids, stress, age or hormones – anything except a cause you could actually do something about.

Often, though, that’s exactly what it is: a cause you could do something about. Low iron is one of the most common reasons women feel wiped out, and because it builds so gradually, it rarely announces itself. You don’t wake up one morning feeling different. You just slowly get used to running on less, until “exhausted” starts to feel like your baseline.

Why women are far more likely to run low

Iron is what your body uses to carry oxygen around in your blood. When levels fall, everything has to work a little harder to do the same job – which is why feeling tired is usually the very first thing you notice.

The reason this affects women so disproportionately is simple: periods. Every cycle carries a small iron cost, and over months and years that quietly adds up. Pregnancy adds to the demand too, when the body’s iron needs rise sharply.

But heavy periods are the big one – left unchecked, they can steadily drain your iron, which is why the NHS treats them as something worth looking into rather than just putting up with.

So if your periods sit on the heavier side, you’re not just dealing with the inconvenience in the moment – you may be slowly draining your iron stores at the same time, month after month.

The reassuring part is that heavy periods can be treated, so it’s worth having them looked at rather than soldiering on.

What low iron actually feels like

Tiredness is the headline, but it’s rarely the only clue. Low iron can show up as feeling breathless going up stairs you used to manage without thinking, a foggy, can’t-quite-focus feeling, looking paler than usual, or noticing your heart racing or thumping for no obvious reason.

Then there are the stranger signs people almost never connect to iron: brittle nails, more hair than usual collecting in the brush, restless legs at night, and – oddly – craving and crunching ice. On their own, each of these is easy to shrug off. Lined up together, they’re very often the same story.

Why it so often slips under the radar

Part of the problem is that none of these symptoms screams “iron.” They’re vague, they overlap with ordinary life, and they arrive slowly enough that you adjust without realising. Most of us are also remarkably good at minimising our own tiredness – we assume everyone feels like this, so there’s nothing to mention.

The result is that low iron can go unaddressed for years, not because it’s hard to find, but because nobody thinks to look. It’s a genuinely common, genuinely treatable issue that quietly chips away at how good you’re allowed to feel.

When “heavy” periods are actually heavy

Here’s the tricky bit: most women have no real benchmark for what counts as heavy, because the only period we ever experience is our own. A useful rule of thumb is needing to change a pad or tampon every hour or two, bleeding that lasts longer than seven days, or passing clots bigger than a 10p coin.

NICE frames it even more usefully: periods count as heavy if they’re getting in the way of your life – physically, emotionally or socially. You don’t have to measure anything. If you’re planning your week around your period, doubling up on protection, or it’s leaving you drained, that’s reason enough to take it seriously.

And the good part is they don’t have to be permanent. If yours have crept up over time, getting them under control is worth it in its own right – and it often tackles the iron problem at its source, rather than topping you up only to lose it again next month.

How you actually find out

You can’t tell your iron levels from how you feel. Plenty of women feel rough with results that look “borderline fine,” and some feel reasonably okay while their reserves are already running low.

The only way to know is a straightforward blood test that checks both your blood count and your ferritin – the marker that reflects how much iron you’ve actually got stored away.

Ferritin is the one that matters here, because it tends to drop first, before a standard anaemia test would flag anything as wrong. That’s exactly why a woman can be told her bloods are “normal” and still feel exhausted: the headline number looks acceptable, but the reserves sitting behind it have been running down for a while.

The good news: it’s very fixable

This is the part worth holding onto. Iron deficiency is one of the more rewarding things to put right. The NHS approach is usually a course of iron tablets over several months to rebuild your stores, paired with a source of vitamin C – even just a glass of orange juice – to help your body absorb them properly.

Alongside that, dealing with whatever’s causing the loss in the first place is what stops you ending up back at square one.

Most women start to notice the difference within a few weeks, often well before their levels are fully restored. The fog lifts, the stairs get easier, and the version of “normal” you’d quietly resigned yourself to turns out not to have been normal at all.

The takeaway

The exhaustion so many women treat as a fixed fact of life frequently isn’t one. Low iron is common, it’s quick to check, and it’s straightforward to put right – but only if someone actually looks for it.

If you’ve been tired for longer than you can remember, especially if your periods are heavy, it’s worth getting your iron checked rather than explaining it away for another year. Speaking to a GP is usually all it takes to get that started – and more often than not, the fix turns out to be far simpler than the months of tiredness would suggest.

Disclaimer: This article is produced for informational purposes only and does not constitute medical advice, diagnosis or treatment. Clinical guidance referenced reflects published NHS and NICE information as at May 2026. Individual circumstances vary; readers are advised to consult a qualified healthcare professional before acting on any information in this article. This piece was produced in association with Spital Clinic, which provided background clinical information for editorial purposes. Hyperlinks to external sources are included for reference only and do not represent an endorsement of any product, service or organisation.

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