Glossary
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Adenomyosis
Adenomyosis is a condition where the lining of the womb buries into the muscular wall of the womb. The condition is not life threatening but can severely impact and diminish a person’s quality of life. There is no cure, but there are various treatment options to try and relieve the associated symptoms, ranging from pain management medications to surgery.
It is worth noting that adenomyosis is different from endometriosis, although they share some similarities. In endometriosis, the endometrial tissue grows outside the uterus, while in adenomyosis, it grows within the uterine muscle. However, it is possible for a person to have both adenomyosis and endometriosis simultaneously.
Source: NHSinform
Ablation
Endometrial ablation is a surgical procedure to alleviate heavy menstrual periods by removing the uterine lining. It is not recommended for those planning future pregnancies. The surgery, which aims to reduce excessive bleeding, is not considered a major surgery. It is not a form of contraception and it has associated risks and considerations.
Source: Bupa UK
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Blastocyst
A blastocyst is a cluster of cells that forms from a fertilised egg, about 5–6 days after fertilisation occurs. The blastocyst implants in the inner lining of the uterine wall, eventually becoming the embryo and then the foetus. Blastocysts are particularly important for IVF, where they are graded by health-care providers based on their shape, maturity, cell number, and density, to determine which embryos are most likely to lead to a pregnancy.
Source: Cleveland Clinic
Body Mass Index (BMI)
Body Mass Index is a technique that uses an individual's height and weight to assess whether they fall within the range of what is considered a 'normal' healthy weight. The resulting number is used to categorise individuals into different ranges, such as underweight, normal weight, overweight, or obese. Despite its widespread use since its development in the 1830s, the BMI method has drawn criticism for its oversimplified approach to gauging overall health. This is because it overlooks critical factors such as a person's race, gender, and even their muscle mass and fat percentage.
Source: Medical News Today
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A chemical pregnancy refers to an early miscarriage that typically occurs before the fifth week of pregnancy. At this early stage, a pregnancy might be detected by an at-home pregnancy test or a blood test but would not be visible on a scan. Often, individuals experiencing a chemical pregnancy may not have been aware of their pregnancy initially and might mistake the miscarriage for a delayed period.
Source: Tommy’s
Chemical pregnancy
Clomid
Clomid, a common medication for treating infertility in women, helps stimulate ovulation in those with irregular menstrual cycles or ovulation problems. It's often the first choice for those dealing with polycystic ovary syndrome (PCOS) and similar conditions. Usually taken orally for a specific time during the menstrual cycle, it encourages the release of hormones necessary for ovulation, boosting the chances of getting pregnant.
Source: St Mary’s Hospital Department for Reproductive Medicine
The IUS (intrauterine system), also known as the "coil," is a small T-shaped device that is inserted into the uterus. It releases the hormone progestogen, providing contraceptive protection. The IUS can also help alleviate symptoms of conditions like endometriosis and adenomyosis by reducing the severity of periods or stopping them altogether. It is important to consult with a healthcare professional to determine if the IUS is suitable for individual needs.
The non-hormonal coil, also known as the copper IUD (intrauterine device), is a small T-shaped device inserted into the uterus to prevent pregnancy. The copper alters the cervical mucus, which makes it more difficult for the sperm to reach into the uterus. It is highly effective, lasts for several years, and does not contain hormones. It does not protect against STIs (sexually transmitted infections).
Source:
Coil
The contraceptive pill, also known as the birth control pill or oral contraceptive pill, is a medication taken orally on a daily basis to prevent pregnancy. It contains synthetic hormones, typically a combination of oestrogen and progestin (aka the combination pill) or progestin alone, which work to inhibit ovulation, thicken cervical mucus, and thin the lining of the uterus. In addition to its contraceptive effects, the pill is often prescribed by healthcare professionals to manage reproductive health conditions, as it can help alleviate symptoms that are aggravated during a regular menstrual cycle.
Source: NHS
Note: The combined oral contraceptive pill is not a curative treatment for conditions like endometriosis and polycystic ovary syndrome (PCOS). However, it can be used as a management option to alleviate symptoms associated with these conditions.
Combined contraceptive pill
Emergency Contraceptive Pills (Morning-after pills):
These pills are taken after unprotected intercourse or contraceptive failure to prevent pregnancy. They contain a high dose of hormones and should be taken as soon as possible after intercourse.
Source: NHS
Cycle
The menstrual cycle starts with the onset of menstruation and ends just before the next period. Typically lasting between 23 to 35 days, a "normal" cycle consists of four distinct phases: menstruation, the follicular phase, ovulation, and the luteal phase. Throughout this cycle, hormonal fluctuations orchestrate the processes involved in thickening the uterine lining, maturing eggs, triggering ovulation, and eventually shedding the uterine lining if pregnancy does not occur. It is important to remember that individual cycles may vary in length and characteristics, and factors such as age, stress, and medical conditions can influence the regularity of the menstrual cycle.
Sources:
NHS
Better Health Channel
Cysts
Ovarian cysts, fluid-filled sacs that grow on the ovary, are quite common, often remaining unnoticed until they cause discomfort or pain. Generally, if they aren't linked to underlying health issues like endometriosis, ovarian cysts don't typically pose long-term health concerns. In many instances, they vanish without any noticeable symptoms. However, if they rupture, which is usually harmless, they can cause sharp, severe pain. Although ovarian cysts can be asymptomatic, they may lead to pelvic pain, discomfort during intercourse, and irregular periods with changes in blood flow. While many cysts go away on their own, some might need medical attention, like medication or even surgery, depending on the situation.
Source: NHS
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Decapeptyl
Decapeptyl is a hormonal therapy drug which belongs to a group of medicines called gonadotrophin-releasing hormone agonists. These drugs work by reducing your levels of oestrogen and progesterone, putting you in a temporary menopausal state. Decapeptyl is administered by injection into the buttock area, and is commonly used to treat endometriosis and adenomyosis, control problematic vaginal bleeding, shrink fibroids, and treat PMS. Most women who take the drug will experience hot flushes and night sweats, and other common side effects include headaches, vaginal dryness, reduced bone density, and difficulty sleeping.
Sources:
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Embryo
An embryo is the initial stage of development for a baby in the mother's uterus. This term is used to describe the unborn child up to the end of the seventh week after conception, after which it is referred to as a foetus.
Source: Britannica
Endometriosis
Endometriosis is a chronic condition in which tissue similar to the lining of the uterus, called the endometrium, grows outside the uterus. This misplaced tissue can be found in various areas of the body, most commonly in the pelvic region, such as on the ovaries, fallopian tubes, and the outer surface of the uterus. However, it can also occur in other locations.
Endometriosis affects women of reproductive age and can cause a range of symptoms, including pelvic pain, painful periods (dysmenorrhea), pain during intercourse (dyspareunia), heavy or irregular menstrual bleeding, and infertility. However, the severity of symptoms can vary widely among individuals.
Although there is no cure for the condition, which is estimated to affect around 10% of women in the UK, there are treatment options available to manage the symptoms. These include pain medications, hormonal contraceptives, and surgical interventions.
Diagnosing endometriosis can be challenging, often taking an average of 7 years due to the similarity of symptoms with other conditions like irritable bowel syndrome (IBS). If you suspect you have endometriosis The Menstrual Health Project & BeYou has developed a diagnostic toolkit you can utilise and share with your GP. Familiarising yourself with the NICE guidelines on endometriosis and referring your GP to these can also be helpful in facilitating diagnosis and appropriate management.
Sources:
NHS
WHO
Royal College of Nursing
Excision
Laparoscopic excision is a surgical procedure performed through keyhole incisions to remove visible endometriosis tissue. It is considered the gold standard treatment for managing symptoms associated with endometriosis. During the procedure, a surgeon uses specialised tools to precisely cut away the endometriosis lesions, aiming to completely remove the affected tissue. This surgical approach can help alleviate pain, improve fertility, and enhance the overall quality of life for individuals with endometriosis. It is typically performed by gynaecological surgeons with expertise in treating endometriosis.
Source: North Bristol NHS trust
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Fallopian tube
A fallopian tube is a slender, tube-like structure that connects each ovary to the uterus in the female reproductive system. In a typical female reproductive tract, there are two ovaries and two fallopian tubes, positioned on either side of the uterus. The primary function of the fallopian tubes is to provide a pathway for an egg to travel from the ovary to the uterus. After an egg is released from the ovary during ovulation, it enters the fallopian tube where it can be fertilised by sperm.
Source: National Cancer Institute
Fertility
Fertility is one's ability to conceive a child. Infertility describes someone, who despite having regular unprotected sex, has not yet conceived a child. According to the NHS, about 84% of all couples will conceive naturally within a year if they have unprotected sex 2-3 times a week, but for those who have not conceived within a year, the likelihood of them conceiving naturally is 1 in 4.
There are multiple reasons why someone might struggle with infertility, such as poor sperm quality, lack of regular ovulation, and blocked fallopian tubes - but in many cases, the cause is simply unknown.
If you are struggling to conceive, see your GP. They can order a set of tests to check sperm quality, egg count, and whether you are indeed ovulating. Depending on your results, they might suggest certain interventions and ask to run another set of tests at a later date or refer you straight to a fertility specialist, who will help you determine the right course of action.
Infertility can be devastating. If you find that you struggle and need to talk to someone other than friends and family, ask your GP for a referral to NHS counseling or seek support via organisations such as the Fertility Network UK.
Sources:
NHS
Fertility Network UK
Fibroids
Uterine fibroids are non-cancerous growths that can develop inside the womb. They range in size; some are very small, whilst others can grow to become the size of a melon. Black women are more likely to develop fibroids and at an earlier age. Furthermore, black women are more likely to grow multiple and larger fibroids as well as experience more severe symptoms. Most people don’t experience any symptoms and fibroids will shrink and sometimes disappear on their own over time. But for some, fibroids can cause significant issues, both with pain and infertility and pregnancy complications.
In the cases where fibroids are impacting your quality of life, there are management and treatment options available to you. These include hormonal contraception, medications that can shrink the fibroids and surgeries.
If you suspect you have fibroids, see your GP straight away. In preparation, you can familiarise yourself with the NICE guidelines on fibroids and refer your GP to these. The British Fibroid Trust also has a lot of information on the condition itself and the various treatment options.
Source:
The National Institute of Health and Care Excellence
NHS
British Fibroid Trust
Follicles (ovarian)
An ovarian follicle is a small sac filled with fluid found within the ovary. Each ovary contains thousands of these follicles. As part of the menstrual cycle, one follicle will typically mature and rupture, releasing a single mature egg from the ovary. This process is known as ovulation and marks the fertile period when fertilisation can occur. The remaining follicles that do not mature will either regress or continue their development in subsequent cycles.
Source: Medical News Today
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Gestational diabetes
Gestational diabetes is a type of diabetes that develops during pregnancy in women who did not previously have diabetes. It usually disappears after giving birth. Like other types of diabetes, it causes high blood sugar levels that can affect both the woman’s pregnancy and the baby’s health. Most women with gestational diabetes have normal pregnancies with healthy babies, but it can cause complications such as a premature birth, the baby growing larger than usual, pre-eclampsia, and, more rarely, stillbirth. The chances of having problems related to the condition can be reduced by controlling blood sugar levels. This can be achieved by changing the diet and being more active, however, if these changes don’t work, medication is also available.
Source:
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HRT
Hormone Replacement Therapy (HRT) is a medical treatment to relieve some of the symptoms of menopause, by supplementing or replacing the hormones which are at lower levels during menopause. The two main hormones used in HRT are oestrogen and progesterone. In the early 2000s, there was a widespread scare around HRT, as it was reported that HRT could increase the risk of cardiovascular disease and cancers. The results of the study on which these claims were based have since been re-examined and new studies have been made, and it has been found that, when taking HRT at the time when menopausal symptoms typically present themselves (ages 50-59), the benefits far outweigh the risks.
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HyCoSy, short for Hysterosalpingo Contrast Sonography, is a specialised transvaginal ultrasound examination used to assess the condition of the fallopian tubes. Since these tubes are not easily visible with regular X-rays or ultrasounds, a contrast dye is injected into the fallopian tubes using a catheter. This process allows the tubes to become visible during the ultrasound scan.
Hysterosalpingo Contrast Sonography (HyCoSy)
Hysterectomy
A hysterectomy is a surgical procedure where the womb is removed. It is a major surgery and is often only considered when most other treatment options have been exhausted. Once you have had a hysterectomy you will go into menopause, your periods will cease, and you will no longer be able to get pregnant.
Source: NHS
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IUI, short for Intrauterine Insemination, is a fertility treatment where sperm is placed directly into a woman's womb. This procedure involves the use of a speculum to guide a thin, flexible tube called a catheter into the womb through the vagina. The sperm sample is then carefully passed through the catheter and into the womb.
IUI can be carried out during a stimulated or unstimulated cycle, which means that in some cases, individuals may receive hormones to encourage ovulation before the IUI procedure.
Source: NHS
Intrauterine insemination (IUI)
IVF
IVF (In Vitro Fertilisation) is a type of fertility treatment. During IVF, a person wishing to become pregnant will be given a course of hormonal treatments to stimulate egg production. Eggs will then be retrieved from the ovaries and fertilised with sperm in a laboratory. In cases where the sperm quality is particularly low, a procedure called ICSI (intracytoplasmic sperm injection) will be used. Here a single sperm is inserted into the egg, increasing the chance of successful fertilisation. If any of the eggs are successfully fertilised (becoming embryos), the best 1-2 will be transferred to the womb through the vagina. This typically happens about 6 days after the retrieval.
Following this, there is a 2-week wait, until you can take a pregnancy test or return to the clinic for a blood test to confirm whether or not you are now pregnant. If a pregnancy is confirmed you will be followed closely for the next few weeks to ensure everything is developing as it should.
Sources:
MayoClinic
NHS
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Menopause / Early menopause / Premature Menopause
Menopause is a natural part of the ageing process and usually occurs somewhere between the mid-forties and mid-fifties. In the UK, the average age to reach menopause is 51. Menopause is when a person stops having periods as a result of their ovaries no longer producing the same levels of oestrogen and therefore stopping ovulating. The term is used when you have not had a period in 12 months. The lead-up to this is called perimenopause.
During perimenopause, oestrogen levels can rise and fall sporadically, often causing irregular periods as well as other symptoms. Perimenopause can last a couple of months or several years.
Early menopause
Early menopause is when menopause occurs earlier than expected - before the age of 45. This can happen due to chromosome abnormalities, autoimmune disease, or following medical treatments such as chemotherapy, radiotherapy, or hysterectomy. However, in many cases the cause is unknown. Early menopause can be very upsetting, especially for someone wanting biological children - but a person might still be able to conceive through IVF.
Source: NHS
Premature menopause
Premature menopause, or early menopause, is when a woman's ovaries stop functioning and she stops having periods before the age of 40. It can happen for different reasons, such as genetics, autoimmune conditions, or certain medical treatments. Premature menopause can affect fertility and cause symptoms similar to those experienced during regular menopause, like hot flashes and mood swings. Treatment options, including hormone therapy, can help manage symptoms and reduce potential health risks.
Menstruation / Periods
See Cycle
Miscarriage
A miscarriage is a loss of pregnancy in the first 20 weeks. There are multiple reasons why miscarriage occurs and in most cases, there is nothing one can do to avoid a miscarriage. Often miscarriages happen when there are abnormal chromosomes in the foetus. Miscarriage is incredibly common, and people who have had one or more miscarriages often go on to carry pregnancies to term without complications.
Source: NHS
Myomectomy
A myomectomy is a surgical procedure aimed at removing fibroids from the uterus. It can be performed using two different approaches: laparoscopic and laparotomy. In laparoscopic myomectomy, a minimally invasive technique, small incisions are made in the abdomen, through which a camera and surgical instruments are inserted to remove the fibroids. A laparotomy involves making a larger incision in the abdomen to directly access and remove the fibroids. The choice of approach depends on factors such as the size, number, and location of the fibroids, as well as the surgeon's expertise and the individual's specific circumstances.
Source: British Fibroid Trust
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NICE
NICE (The National Institute of Health and Care Excellence) was established in 1999 as a response to calls for a national approach to decide what medicines and treatments the NHS should provide universally on the basis of what worked and was cost effective, as opposed to what is referred to postcode prescribing (where treatments available to you is dependent on where you live).
One of NICE’s core objectives is to publish guidelines on what is believed to be best practices for the diagnosis and treatment of a variety of conditions. But where some of NICEs recommendations are binding, such as which medicines should be paid for by the NHS, their guidelines are not.
Source: The National Institute of Health and Care Excellence
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Ovaries
The ovaries are two almond-shaped organs, placed on either side of the uterus. ‘Normal’ functioning ovaries release an egg during each menstrual cycle and release the hormones oestrogen and progesterone.
Source: NHS
Oestrogen
Oestrogen, also spelled as "estrogen," is one of the main female sex hormones. The hormone is produced by both males and females, but it plays a bigger role in the female body. The hormone, which is needed for puberty, the menstrual cycle, bone strength, and fertility, is mainly produced in the ovaries. Oestrogen also affects your brain and your heart, and it can help with bladder control. Oestrogen levels fluctuate throughout a woman's life, with higher levels during the reproductive years and a decline during menopause.
Source: Health Direct
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PCOS
Polycystic Ovary Syndrome is a condition that affects the ovaries and their ability to ovulate as ‘normal’. Due to abnormal levels of hormones, follicles develop on the ovaries, which fail to mature and release eggs during the menstrual cycle. Instead, they accumulate on the ovaries. It is estimated that the condition which can cause painful and irregular periods, excessive hair growth, insulin resistance, weight gain, acne, and recurring miscarriages, as well as other symptoms, affects as many as 1 in 10 women.
PCOS cannot be cured, but symptoms related to the condition might be managed through lifestyle changes, medications, and hormonal contraception.
Verity has published a series of booklets to support people with PCOS, which can be purchased through their website. Verity also runs meetup groups, where you can access peer support.
It you suspect you have PCOS see your GP. Prior to your appointment, you can familiarise yourself with the NICE guidelines on PCOS.
Source:
NHS
MedlinePlus
POI
Premature Ovarian Insufficiency is a condition in which the ovaries stop working properly well before the expected age of menopause. This means that the ovaries may no longer release eggs regularly or produce insufficient hormones; oestrogen and progesterone. Some people are diagnosed with POI as early as their teenage years. The condition is also known as Premature Ovarian Failure, but it is thought that Premature Ovarian Insufficiency is a more accurate term as the ovarian function can fluctuate over time and people diagnosed with POI might still experience ovulation and periods, and 5-10% of people with POI will still be able to conceive. While POI is not reversible, treatments such as hormone replacement therapy (HRT) can help manage symptoms and support overall health.
Source: Daisy Network
PMDD
PMDD (Premenstrual Dysphoric Disorder) is an extreme form of PMS (Premenstrual Syndrome) that can have a severe impact on a person's mental health. Individuals with PMDD may experience intense mood swings, irritability, anxiety, depression, and other emotional symptoms in the days leading up to their period. Studies have shown that people with PMDD are at an almost seven times higher risk of suicide attempts and almost four times as likely to exhibit suicidal ideation, meaning that PMDD is very much a life-threatening condition and you need to seek help. If you're experiencing suicidal feelings and are worried you may act on them, you can call 999, go straight to A&E, or call the Samaritans for free on 116 123 to talk.
If you suspect you have PMDD, track your symptoms and talk to your GP. The International Association For Premenstrual Disorders (IAPMD) links to several helpful trackers you can use.
It might also be beneficial to acquaint yourself with the NICE guidelines on PMS and PMDD.
Sources:
Mind
Report: Suicidal Risk in Women with Premenstrual Syndrome and Premenstrual Dysphoric Disorder: A Systematic Review and Meta-Analysis
The National Institute of Health and Care Excellence
PMS (Premenstrual Syndrome) is the name for a combination of symptoms that a woman may experience in the week or two leading up to her period. It is a common condition which affects most women at some point. Symptoms include mood swings, feeling anxious or irritated, bloating or stomach pain, headaches, and breast tenderness. A number of treatment options are available for PMS, such as the contraceptive pill, dietary supplements, and antidepressants. The exact cause of PMS is unknown, but it is thought to be influenced by the hormonal fluctuations that occur during the menstrual cycle.
Sources:
NHS
Mayo Clinic
PMS
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Secondary Infertility
Secondary infertility is when someone is unable to conceive or carry a baby to full term, having previously conceived naturally and given birth in the past. This can be linked to fertility issues in either the male or female partner. Common causes of secondary infertility in women include mature age, endometriosis, and PCOS. In men, factors such as low sperm quality and low testosterone levels can contribute.
Source:
Semaglutide is a commonly prescribed medication for managing type 2 diabetes. It functions by regulating blood sugar levels in the body. Furthermore, a stronger dose of Semaglutide has gained approval for aiding weight management in individuals dealing with overweight or obesity and at least one weight-related condition. Administered via injection (once a week), it is typically complemented by a balanced diet and regular exercise. To learn more, it is advisable to consult a doctor or a healthcare provider. Some of the brand names for Semaglutide include Wegovy, and Ozempic.
Liraglutide, like semaglutide, is administered as a daily injection due to its shorter duration of action in the body. It is known by the brand names Victoza for diabetes management and Saxenda for weight management.
Source: London Obesity Clinic
Semaglutide and Liraglutide (Weight-Loss Injections)
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Vaginal atrophy
Vaginal atrophy, also known as atrophic vaginitis, is when the vaginal walls become thinner, inflamed, and drier as a result of a lack of oestrogen in the body. The symptoms include vaginal or vulval burning or itching, pain during intercourse, and lack of bladder control. It is a treatable condition, and various options are available, including hormonal and non-hormonal treatments, to alleviate the symptoms and improve the overall health of the vaginal tissues.
Source:
University Hospitals Sussex
NHS
Vaginal ring
A vaginal ring is a small, soft plastic ring that is placed inside the vagina as a birth control method. It releases a continuous dose of oestrogen and progestogen into the bloodstreamto prevent the release of an egg each month. It also thins the lining of the womb, making a fertilised egg less likely to implant itself, and it thickens the cervical mucus so that it is more difficult for sperm to move through the cervix. If used correctly, it is more than 99% effective at preventing pregnancy. It does not protect against STIs, so a condom may still need to be used. It may also ease premenstrual symptoms, and lead to lighter and less painful menstruation. Some temporary side effects include more vaginal discharge, breast tenderness, and headaches.
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