Straight talk: Why we need to talk about hormones beyond reproduction

When we say hormones, we often think about the reproductive hormones testosterone and oestrogen. Very few know that hormones are, in fact, responsible for every function in our bodies.

Hormones are chemicals secreted by our glands in order to send “messages” through the bloodstream, simply letting the body know what to do to run smoothly. Indeed, they regulate growth, sex drive, reproduction and metabolism, but they are also integral to our digestive, immune, urinary, nervous, cardiovascular, respiratory and skeletal systems.

When it comes to hormonal fluctuations – during menstruation and beyond – experts agree that there is a big education gap. A report published by the female-founded cycle company Fewe found that, of the 2,000 participants interviewed, more than half believed the menstrual cycle was just one week long, while 90 per cent did not see a correlation between their hormones and their health. The same number did not consider management of hormones as an important way to improve their health and wellness.

“What really surprises me is that even us, as women, don’t understand our hormones,” says Sarah Bolt, founder of the biomarker tracking platform, Forth. “Often hormones are talked about in relation to reproduction, but they are so important to our everyday health.”

The lack of knowledge is even more prevalent in regard to perimenopause and menopause. “The two are used very much interchangeably,” Bolt explains. “We see more conversations around periods, but there’s still such a long way to go. Menopause is getting a lot of publicity at the moment, helped by figures like Davina McCall and her recent programme, but we know we need to do a lot more to educate women about the importance of their hormones, how they fluctuate and how they impact all areas of their health. It’s not just about having children.”

Her company, Forth, offers a full range of tests – from liver function tests to immune system, thyroid and hormone tests, providing detailed insights and advice on how to help your body perform to its best. MyFORM, a female hormone mapping test available to women who want to check if their hormones are fluctuating in the correct pattern, is one of them.

The test is suitable for women who want to check their fertility, identify or manage a hormone-related condition such as polycystic ovary syndrome (PCOS), but also for those wanting to check if their hormone network is healthy or for sportswomen who may be at risk of relative energy deficiency in sport (RED-S).

The idea behind the at-home test came after Sarah, working for the NHS, noticed how often women’s symptoms and hormonal imbalances were ignored. “Women were not being listened to particularly during perimenopause and menopause,” the founder tells me. “Our chief medical officer, Dr Nicky Keay, is an endocrinology specialist and she was frustrated because the tests at that time  were not able to capture whether a woman’s hormones were fluctuating in the correct pattern during the entire length of her cycle.

“I myself had been going through perimenopause and I listened to all of my friends going through it. Very often they weren’t being given the correct information by GPs or they ended up being put on antidepressants. So, we decided to look at how we could come up with a solution.”

By combining blood analysis and information about your cycle length, the hormone test mathematically maps how each of your four ovarian hormones fluctuate across your entire cycle and it gives you a detailed, personalised report with next step actions.

“Knowing that your hormones are fluctuating in the healthy correct pattern is important at any life stage and for general wellbeing,” Bolt points out. “So, our bigger goal is to educate women about these hormones and how important they are to their everyday well-being. We recognise those who are on fertility journeys, but we also look at women experiencing conditions like PCOS that they may not even know about.”

MyFORM can also be particularly useful for women who are doing a lot of exercise and who can develop relative energy deficiency syndrome that causes fatigue, low energy, disordered eating, menstrual dysfunction and low bone mineral density.

“Their periods just stop completely,” the founder says. “And that really starts to compromise their health. If you’ve got an imbalance in energy in and energy out, your body will start to go into survival mode. The test identifies if there is a drop in hormones and help you understand the relationship between those variations and how you feel.”

Once they order the blood test, women need to collect a sample on day 14 and day 21 of their cycle and then post it back to the company’s lab. The results are then available on their online account within two working days. Sarah says that women are very surprised when they get the results, because they’ve never been given this kind of information before. “They find it really insightful.”

She tells me that the next step is to expand Forth beyond the UK and develop “an ecosystem” that takes care of women’s health. “I’m also hoping to raise more awareness and help women spot some of the conditions that they might have,” the founder continues. “One of the things that women don’t realise is that the drop in their hormones can really impact their bone health. That is why athletes, for example, have a drop in their hormones and get more injury-prone, because their bone health becomes compromised. That is also why many women develop osteoporosis post-menopause.

“So, we want to open up this conversation because it’s just a natural part of women’s life. There’s nothing embarrassing. Why would it?”