Hormonal health
Research roundup: Overcoming EGFR-targeted therapy resistance in breast cancer, and more

Femtech World explores the latest developments in women’s health research – from overcoming EGFR-targeted therapy resistance in breast cancer to understanding obesity’s role in triple-negative breast cancer, and more.
EGFR-targeted therapy resistance in breast cancer
Researchers have reviewed current research on why Epidermal Growth Factor Receptor (EGFR)-targeted therapies often fail in breast and head and neck cancers.
The article explores how cancer cells evade these treatments by activating alternative survival pathways and offers an in-depth look at the molecular barriers to EGFR inhibition, providing insights that could inform the development of more effective and durable treatments.
EGFR is a critical protein that regulates cell growth and survival, and it is frequently overexpressed in breast and head and neck cancers. Although therapies targeting EGFR showed early promise, resistance has become a significant challenge.
In breast cancer, resistance mechanisms include the movement of EGFR from the cell surface into the nucleus, where it promotes DNA repair, as well as ligand-dependent activation that helps tumour growth despite therapy.
The review describes how tumour cells in these cancers commonly activate other receptor tyrosine kinases (RTKs), such as MET, AXL, and RON, to continue growing even when EGFR is blocked.
By analysing these resistance mechanisms, the authors highlight combination therapies from current research that target EGFR and other key molecular pathways.
Strategies such as dual inhibition of EGFR and MET or blocking inflammation-driven survival signals may enhance treatment outcomes.
Several clinical trials are evaluating these approaches in patients.
For example, in breast cancer, combinations of EGFR inhibitors with chemotherapy and immune checkpoint inhibitors are being tested to improve responses, particularly in triple-negative breast cancer.
These efforts aim to overcome resistance and provide more effective treatment options for patients with EGFR-driven tumours.
The review also emphasises the necessity of identifying biomarkers to predict which patients are most likely to benefit from EGFR-based therapies.
Screening women with diabetes for intent to conceive at every doctor visit
Adverse pregnancy outcomes such as miscarriages or birth defects are common in individuals with pre-existing diabetes and are often related to modifiable factors such as maternal high blood sugar and body mass index (BMI).
With this in mind, a new, joint guideline released by the Endocrine Society and the European Society of Endocrinology (ESE) has recommended that women with diabetes receive proper preconception care.
This includes access to emerging diabetes technology and therapeutics to manage their blood sugar before, during and after pregnancy.
Screening women of reproductive age who have diabetes for intent to conceive at every reproductive, diabetes and primary care visit helps ensure they get the appropriate preconception care and reduces health risks.
Care suggestions from the guidelines include screening by asking all women with diabetes of reproductive age about intent to conceive at every reproductive, diabetes and primary care visit; timing delivery before 39 weeks for pregnant individuals with diabetes as the risks associated with continued pregnancy may outweigh those of early delivery; discontinuing anti-obesity medications called GLP-1s prior to pregnancy; and, avoiding prescribing metformin in pregnant individuals with preexisting diabetes already on insulin.
Further suggestions include using diabetes technology, recommending hybrid closed loop systems for pregnant individuals with type 1 diabetes; and suggesting that women with diabetes use contraception until they are ready to become pregnant.
Premenstrual symptoms linked to increased risk of cardiovascular disease
A new study has revealed that women diagnosed with premenstrual symptoms have a slightly increased risk of developing cardiovascular disease later in life.
Premenstrual symptoms include premenstrual syndrome (PMS) and the more severe form, premenstrual dysphoric disorder (PMDD).
The study followed more than 99,000 women with premenstrual symptoms for up to 22 years, comparing their health with women without these symptoms – both in the general population and by comparing them with their own sisters to take into account hereditary factors and upbringing.
The results show that women with premenstrual symptoms had about a 10 per cent higher risk of developing cardiovascular disease.
When the researchers also looked at different types of cardiovascular disease, they found that the link was particularly strong for heart rhythm disorders (arrhythmias), where the risk was 31 per cent higher, and for stroke caused by a blood clot, where the risk was 27 per cent higher.
Even after the researchers took into account other factors such as smoking, BMI and mental health, the link between premenstrual symptoms and increased disease risk remained.
Research has not yet identified the cause of this link, but the researchers behind the study suggest three possible explanations.
One is that women with premenstrual symptoms may have a disrupted regulation of the renin-angiotensin-aldosterone system (RAAS), which controls blood pressure and fluid balance in the body, among other things.
The second is that these women have increased levels of inflammation in the body, which is a known risk factor for atherosclerosis and other heart problems.
Finally, it may be because women with premenstrual symptoms may have metabolic abnormalities, which are linked to an increased risk of both stroke and heart attack.
Obesity’s role in triple-negative breast cancer
Among the various subtypes of breast cancer, triple-negative breast cancer (TNBC) stands out due to its aggressive nature and poor prognosis.
It is characterised by the absence of three critical hormone receptors: oestrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2, which are common targets for breast cancer therapies.
Consequently, TNBC lacks targeted treatment options, relying primarily on conventional cytotoxic therapies, often referred to as chemotherapy in which drugs kill or damage cancer cells.
This limitation contributes to the subtype’s high recurrence rates and significantly lower survival rates compared to other forms of breast cancer.
Researchers have now discovered that exosomes, messenger nanovesicles that carry proteins, RNA, and other molecules to other cells, that are released into the blood by different organs and tissues in obese, insulin-resistant models, carry signals that turn otherwise slow-moving TNBC cells into highly mobile, invasive cells.
This is the first time a study has shown that exosomes from an obese, diabetic environment directly cause this aggressive change in TNBC, and that Rho-proteins (molecular switches that turn “on” or turn “off” signal transduction pathways) play a key role in driving the change.
According to the researchers, by revealing how obesity-driven exosomes push aggressive breast cancer to spread, they hope to unlock new blood tests and drug targets, like Rho-protein inhibitors that stop this deadly process.
“These findings support the development of clinical tests to quantify obesity-derived exosomes in patient plasma as noninvasive biomarkers of metastatic risk, allowing earlier identification and tailored management of aggressive TNBC,” said corresponding author Gerald Denis, Shipley Prostate Cancer Research professor and professor of pharmacology, physiology and biophysics.
“Ultimately, our goal is to improve survival and quality of life for patients facing both metabolic disease and hard-to-treat cancers.”
Fertility
Weight loss jab shows early promise in improving PMOS fertility

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.
Menopause
Apple Health adds menopause and perimenopause tracking

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.
Hormonal health
Iron deficiency in women: The tiredness everyone normalises

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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