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Round up: Restoring immunity in menopausal women with HRT and more
Femtech World explores the latest research developments in the world of women’s health.
Phase 2 trial of non-hormonal endometriosis treatment completed
Hope Medicine has completed a global Phase 2 study evaluating the safety and efficacy of non-hormonal endometriosis treatment – HMI-115.
HMI-115 is a monoclonal antibody that blocks the prolactin receptor, and is a potential first-in-class treatment for endometriosis.
This study included 108 female patients with surgically diagnosed endometriosis in the US, Poland and China.
According to the company, the treatment demonstrated statistically significant improvement of endometriosis associated pain.
HMI-115 was well-tolerated with no treatment-related serious adverse events.
Specifically, at the end of the study treatment, the least-square-mean dysmenorrhea pain score was reduced by 42 per cent in the 240 mg q2w group, compared to that of the baseline.
The least-square-mean non-menstrual pelvic pain score was reduced by 52 per cent.
These reductions are statistically significant. No typical peri-menopausal symptoms were reported.
There were no significant changes in menstrual patterns, bone mineral density and sex hormone levels including estradiol, LH, FSH and progesterone.
Lan Zhu, director of gynecology at Peking Union Medical College Hospital and leading investigator of the study, said: “HMI-115 relieved endometriosis pain in women without disturbing their sex hormones.
“It can potentially shift the treatment paradigm.
“We will be able to treat women without menopausal side effects or even infertility.”
Nathan Chen, CEO of Hope Medicine says that the company is now communicating with key regulatory agencies, including FDA and NMPA, to finalise the Phase 3 protocol and to initiate global Phase 3 studies.
Hormone replacement therapy may help restore immunity in menopausal women
Hormone replacement therapy (HRT) may help reverse changes in the immune system caused by menopause, potentially booting immune health, a new study has found.
The research reveals new evidence that menopause significantly alters women’s immune system, increasing their vulnerability to infections.
The study is the first detailed analysis of how ageing and sex differences influence monocytes, a key group of immune cells that act as the body’s first responders to infection.
Analysing blood samples, the team found that after menopause, women develop more inflammatory types of white blood cells called monocytes, which are less effective at clearing bacteria.
These changes were linked to lower levels of complement C3, an immune protein that helps monocytes engulf and destroy harmful microbes.
In contrast, men of the same age did not show these changes, suggesting menopause has a uniquely disruptive effect on female immunity.
To test whether hormone therapy could influence this decline, the researchers studied peri-and post-menopausal women taking HRT.
They found that these women had healthier immune profiles, with fewer inflammatory monocytes and stronger infection-fighting ability as compared to age-matched controls.
Levels of complement C3 in their blood were also higher in those taking HRT, bringing them close to the immune status of younger women.
HRT is already prescribed to manage symptoms, but this study suggests it may also help maintain immune health and reduce infection risk in later life.
The researchers caution, however, that more work is needed to confirm whether HRT reduces real-world infection rates, and to understand how different formulations or delivery methods affect the immune system.
The authors caution that while the findings are promising, the study does not mean HRT should automatically be prescribed for immune health.
More research is needed to confirm whether women taking HRT have lower infection rates in real-world settings, and to investigate how different types and route of HRT administration may affect the immune system.
New imaging technique helps us understand how eggs mature and ovaries age
The ticking of the biological clock is especially loud in the ovaries — the organs that store and release a woman’s eggs.
From age 25 to 40, a woman’s chance of conceiving each month decreases drastically.
For decades, scientists have pointed to declining egg quality as the main culprit.
But new research from UC San Francisco and Chan Zuckerberg Biohub San Francisco shows that the story is bigger than the eggs: The surrounding cells and tissues of the ovary play a crucial role in how eggs mature and how quickly fertility wanes.
Understanding these changes may hold the key not only to extending fertility, but also to improving health.
The risks of many age-related diseases rise after menopause or ovary removal, and slowing ovarian aging could help reduce these risks.
The team set out to profile what normal ageing looks like in the ovaries of mice and humans.
First, they developed a new three-dimensional imaging technique that allowed them to visualise eggs in the ovaries without having to slice the organs into thin layers, as had been done before.
In mice that were the equivalent of 30 to 40 human years, they observed a dramatic drop in both immature resting eggs that are waiting in reserve and in growing eggs that are beginning to mature for ovulation.
And just like women in their 30s, the mice did not conceive easily with in vitro fertilisation (IVF).
When the scientists extended their 3-D imaging to human ovaries, they uncovered an unexpected finding: Eggs are not evenly scattered throughout the ovary.
Instead, they cluster in “pockets” surrounded by egg-free zones. With age, the density of eggs within these pockets declines.
“This was a surprise, we assumed eggs would be distributed more evenly based on what we see in the developing ovary,” said Laird, who is a Biohub investigator and a member of the Eli and Edythe Broad Center for Regeneration Medicine at UCSF.
“These pockets suggest that even within one ovary, the environment around an egg may influence how long it lasts and how well it matures.”
Next, the researchers teamed up with Neff’s group at the Biohub to study what genes were active in ovary cells as they aged.
Ovarian tissue from humans is hard to come by, and eggs are large and incredibly fragile.
So, instead of using standard miniature devices that separate and tag cells to sequence their active genes, the group painstakingly isolated individual eggs by hand to separate them from other cells.
After studying nearly 100,000 mouse and human cells, they identified 11 major cell types found in the ovaries, including one surprise: Glia, a type of support cell typically associated with nerves and most extensively studied in the brain, were in the ovaries.
At the same time, the study revealed that sympathetic nerves, the same nerves involved in the “fight or flight” response, form dense networks in ovaries that become even more dense with age.
When the researchers ablated these nerves in mice, the animals had more eggs in reserve but fewer that matured, suggesting the nerves help decide when eggs start growing. Together, the observations on glia and sympathetic nerves suggest a new role for the nervous system in ovarian health.
Other support cells called fibroblasts also changed with age, triggering inflammation and scarring in the ovaries of women in their 50s, years earlier than such scarring appears in organs like the lungs or liver.
“This all points to a brand-new line of inquiry about how nerves, blood vessels, and other cell types communicate with eggs,” Laird said.
“It tells us that ovarian ageing is not just about the egg cells but about their whole ecosystem.”
The new roadmap of healthy ovaries over time offers a starting place to ask how ovarian aging changes in different situations.
The team is already launching studies probing whether some drugs could change the timing or speed of ovarian aging, she said.
Ultimately, they hope to uncover ways to slow or delay ovarian aging, to impact both fertility and other diseases, like cardiovascular disease, which are common in women after menopause.
“The fountain of youth may actually be the ovary,” said Eliza Gaylord PhD, a postdoctoral fellow at UCSF who is co-first author of the study.
“Delaying ovarian ageing could promote healthier aging overall.”
Hormonal birth control can influence emotions and memory
A new study shows that hormonal contraceptives appear to shape how women experience emotions in the moment and how they remember emotional events later.
Researchers compared women using hormonal contraceptives with women who were naturally cycling.
Participants viewed positive, negative and neutral images while applying different emotion regulation strategies, such as distancing, reinterpretation or immersion, and later completed a memory test.
Women on hormonal contraceptives showed stronger emotional reactions compared to naturally cycling women.
When they used strategies like distancing or reinterpretation, they remembered fewer details of negative events, though their general memory remained intact.
In other words, they could recall the overall event but not all of the specifics. That gap may actually be helpful, allowing women to move on instead of replaying unpleasant details.
Strategies like immersion boosted memory for positive images in both groups, making happy moments stick more clearly.
The findings add weight to a question many women have had but few studies have answered: How does birth control affect not just the body but the mind?
Emotion regulation and memory are tied to mental health outcomes such as depression, and this research suggests hormonal contraceptives may influence those processes in subtle but meaningful ways.
The researchers plan to expand the work by studying naturally cycling women across different menstrual phases and by comparing types of hormonal contraceptives, such as pills versus IUDs.
Elation Health has acquired Aster, a women’s health EHR startup created by sisters Fifi Kara and Dr Lailah Kara-Newton.
The deal, announced on 3 June 2026, will see Aster’s team join Elation Health as the company expands development of what it describes as the first agentic operating system for primary care.
An EHR, or electronic health record, is a digital system used by healthcare providers to store and manage patient information.
Aster was founded by Kara and Kara-Newton as an AI-native EHR platform for women’s health providers.
Elation Health said the acquisition would allow Aster to learn from its expertise in AI agents and support development of its agentic operating system for primary care.
Kyna Fong, co-founder and chief executive of Elation Health, said: “The Aster team impressed us with their vision and creative inventions to support independent practices.”
Fong said Elation, like Aster, was founded by siblings who wanted to change the healthcare system.
She added: “That shared north star means they understand what we’re building and why it matters. It was clear right away they would significantly add to our capabilities.”
Kara has spent 10 years creating consumer and business-to-business products across the UK, Europe and the US, and recently supported Meta’s Health & Fitness team, according to Aster’s website.
Kara-Newton previously worked as a hospital doctor in the NHS across medical and surgical specialties, including breast surgery, general surgery, emergency medicine and obstetrics and gynaecology.
Aster launched in 2023 after raising US$2.8m from Zeal Capital Partners, Cornerstone Ventures, Octopus Ventures and others.
Kara, Kara-Newton and Aster’s chief technology officer, Nacho Vazquez, will all join Elation.
Kara said: “From the moment we met Kyna Fong, Ashley Rogers, and the Elation leadership team, it was clear we were aligned on what matters most: that clinicians deserve truly incredible software that brings joy back to their practice. Together, we can now bring that vision to millions of primary care patients across the country.”
The sisters said their work was shaped by Kara-Newton’s first pregnancy, when undiagnosed pre-eclampsia led to an emergency caesarean section and neonatal intensive care admission for her son.
The founders said they wanted to build technology that could help prevent similar outcomes for other women.
The acquisition comes amid continued concern over maternal health inequalities in the US.
In the US, Black maternal mortality remains alarmingly high, with rates nearly double those of white women, and experts point to unequal access to care, implicit bias and fragmented approaches to care.
A four-week Pilates programme may improve heart, metabolic and stress measures in previously sedentary women, a small study suggests.
Pilates is a mind-body form of exercise that has been linked to better fitness, balance, posture, muscular endurance, mental wellbeing and quality of life in different groups.
Built around breathing, concentration, control, precision, centring and flow, Pilates is already used in physiotherapy, rehabilitation and preventive health. The new study looked at whether a structured four-week programme could affect cardiovascular, metabolic, body and stress-related measures in sedentary adult women.
The longitudinal study included 30 sedentary women split into two age groups, 30 to 40 and 50 to 60.
All participants completed a standardised, supervised Pilates programme lasting four weeks, with three sessions a week lasting 50 to 60 minutes.
Researchers measured resting heart rate, systolic and diastolic blood pressure, body mass index, abdominal circumference, fasting blood glucose and serum cortisol at the start and end of the programme.
Systolic and diastolic blood pressure are the top and bottom readings in a blood pressure test. Cortisol is a hormone linked to the body’s stress response.
The four-week Pilates programme was linked to improvements in cardiovascular, metabolic, body and neuroendocrine measures, although not every change reached statistical significance within each age group.
In the younger group, significant reductions were seen in heart rate, blood pressure, body mass index and fasting blood glucose after the intervention.
The reduction in blood pressure after the programme was significantly greater in the older group than in the younger group.
Older participants also showed a greater reduction in glucose and cortisol levels after the intervention than younger participants.
Analysis also found significant links between cardiovascular, metabolic and neuroendocrine changes.
In the younger group, this was particularly seen between heart rate and blood pressure responses.
In the older group, it was particularly seen between changes in body mass index and fasting glucose.
The findings suggest Pilates could be a useful multidimensional exercise approach for cardiometabolic health and stress regulation in previously sedentary women.
The researchers said the larger reduction in blood pressure seen in the older group may reflect a higher cardiometabolic burden at the start, leaving more room for improvement after the programme.
The greater reduction in fasting glucose and cortisol in older participants may similarly suggest that people with higher baseline metabolic and neuroendocrine dysfunction could benefit more from structured exercise such as Pilates.
Although Pilates is known to improve body composition through energy use, neuromuscular activation and support for healthier habits, the researchers said the fall in body mass index over four weeks is unlikely to be explained by Pilates alone.
They noted that participants were also told to avoid alcohol, sugar-containing products and sugar-sweetened drinks during the intervention, which may have contributed to the change.
In the younger group, the link between heart rate and blood pressure suggested coordinated cardiovascular responses after Pilates.
The researchers also found that cortisol appeared to be linked to blood pressure and body mass index, suggesting stress-related changes may be tied to cardiovascular and body regulation after the intervention.
In the older group, the link between body mass index and fasting glucose highlighted the relationship between body fat and metabolic regulation.
A positive link between blood pressure and body mass index in this group also suggested that improvements in vascular regulation may be associated with reductions in body mass.
Overall, the findings suggest Pilates-related physiological changes may involve interconnected cardiovascular, body, metabolic and neuroendocrine mechanisms, with different response patterns by age.
The study has important limits. It did not include a non-exercise control group, so it cannot prove Pilates directly caused the changes.
The sample size was also small, which limits how far the findings can be applied more widely.
The authors also noted that cortisol was measured using a single fasting morning sample, which limits conclusions about broader hypothalamic-pituitary-adrenal axis regulation, the system involved in the body’s stress response.
They said larger studies with longer follow-up will be needed to confirm whether Pilates causes these physiological changes over time.
Article produced in association with Spital Clinic
AMH has become one of the most-requested blood tests in private women’s health. The number it gives back is useful, but only when it is read in context.
AMH testing in the UK has gone mainstream over the past few years. Home-testing kits sell it as a snapshot of “your fertility”.
Private clinics include it in screening packages. On social media, individual AMH results are now routinely treated as a verdict on whether a woman will be able to have children.
That reading isn’t accurate. Anti-Müllerian Hormone (AMH) does carry useful information, but only inside a wider clinical picture.
Looked at on its own, it produces a lot of unnecessary anxiety, and often hides the questions that matter more.
What AMH measures
AMH is a hormone produced by the small follicles in the ovaries, the ones that haven’t yet been recruited for ovulation. Because these follicles are relatively stable across the menstrual cycle, the test can be done on any day, without needing to be timed to a period.
A higher AMH level tends to indicate a larger pool of these follicles. A lower level suggests the pool is smaller. That, broadly, is what the result shows.
The HFEA, the UK’s independent regulator of fertility treatment, describes AMH as an indicator of ovarian reserve, while making clear that fertility test results of this kind “are not guaranteed” as a predictor of fertility outcomes.
Put simply: AMH is a count of what is there. It says nothing about how well the body will use it, and it cannot predict if or when conception will happen.
Where AMH fits in a modern fertility assessment
In current UK private practice, AMH is rarely tested in isolation. A meaningful fertility assessment will pair it with a fuller hormone profile (FSH, LH, oestradiol, prolactin and thyroid function), along with markers such as Day 21 progesterone, vitamin D and rubella immunity where relevant.
This is the structure used in a trying-to-conceive screening, and there is a reason for it: each of these tests answers a different question that AMH on its own cannot.
It is this combination, not the AMH number on its own, that gives a clinician enough information to say anything meaningful about an individual’s reproductive picture.
Misconception 1: “A low AMH means natural pregnancy isn’t possible”
This is the misconception that causes the most distress, and it is consistently wrong.
Several large prospective studies of women in their 30s and 40s trying to conceive naturally have found that women whose biomarkers, including AMH, pointed to a diminished ovarian reserve were no less likely to conceive within twelve cycles than women with reassuring results.
That is why neither UK regulators nor national guidance treat AMH as a test that can predict natural fertility in women who have no known infertility issue.
The reason is simple. Natural conception only requires one good egg, released in a normal cycle, in the right window.
AMH doesn’t measure egg quality, and it doesn’t reveal whether ovulation is happening. A woman with low AMH may still ovulate every month with high-quality eggs.
A woman with high AMH (often the pattern seen in polycystic ovary syndrome) may not be ovulating regularly at all.
The NHS emphasises that age is the strongest single predictor of natural fertility. A 35-year-old with a low AMH and regular cycles is, on average, more likely to conceive naturally than a 40-year-old with a normal AMH and irregular ones.
If AMH comes back low for someone who is trying to conceive, the more useful question isn’t whether pregnancy is still possible (the answer is almost always yes), but whether there is reason to investigate the wider picture now rather than waiting twelve months.
Misconception 2: “A normal AMH means everything is fine”
The opposite assumption is just as risky.
AMH tells you about egg quantity. It does not tell you about:
- Egg quality, which is closely tied to age
- Whether ovulation is happening regularly
- Whether the fallopian tubes are open
- Whether there are structural issues such as fibroids, polyps, ovarian cysts or endometriosis
- Sperm parameters in a male partner
- Whether implantation will succeed
A reassuringly normal AMH at 38 still sits alongside age-related changes in egg quality. A slightly lower-than-average AMH at 28 may carry no real-world implications at all.
That is why no UK clinical body recommends AMH as a routine screening test for healthy women who have no fertility concerns. NICE’s fertility guideline, NG73, treats AMH as one component of a broader investigation, not as a verdict in itself.
Imaging is the natural counterpart to the blood test. A transvaginal pelvic ultrasound directly visualises the small follicles that produce AMH, the antral follicle count. It also picks up structural findings a blood test will never reveal, including ovarian cysts, fibroids, polycystic ovarian morphology, and abnormalities in the uterine cavity. A full ovarian reserve assessment normally includes both.
Where the AMH number actually matters
There are three settings in which AMH carries real, decision-relevant information.
Before IVF or egg freezing. AMH is one of the better predictors of how the ovaries are likely to respond to stimulation medication.
A higher AMH usually predicts more eggs collected per cycle, and a very low AMH may shape decisions about protocol or whether to bank cycles before treatment.
During a fertility investigation. If a couple has been trying for twelve months, or six months if the woman is over 35, AMH becomes part of a wider assessment that should also include ovarian ultrasound, a fuller hormone profile, semen analysis and an assessment of tubal patency.
As context for women planning ahead. Women who want to understand their reproductive options before they are ready to conceive (for example, ahead of a decision about egg freezing) can find AMH informative, provided it is interpreted alongside age, antral follicle count, and other markers, by a clinician who can place the number in context.
Reading the number properly
For anyone who has had an AMH test, three things make the result more useful:
- Pair it with age. A “normal” AMH at 25 means something very different from the same number at 38. Age is doing more work in the equation than the AMH value itself.
- Pair it with imaging. Ultrasound shows what is actually in the ovaries today, rather than relying on a single biochemical marker.
- Read it with a clinician. A number on a screen, with no context, no follow-up and no plan, is the worst way to use a test that, properly interpreted, can be very informative.
AMH is a useful tool. It just isn’t the headline it has often been turned into.
Disclaimer
This article is produced for informational purposes only and does not constitute medical advice, diagnosis or treatment. Clinical guidance referenced reflects published HFEA, NHS and NICE information available 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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