Condition Guides
Clinical knowledge,
made accessible.
Every guide is cited from primary literature and NICE guidelines. Not a blog post. Not a symptom checker. Actual clinical knowledge — written clearly, for women who deserve real answers. Launching in full September 2026.
Affects 1 in 10 women · NICE NG88
PCOS
Polycystic Ovary Syndrome
PCOS is one of the most common hormonal conditions in women of reproductive age, yet it takes an average of over 2 years to diagnose. It is not just about irregular periods — it affects metabolism, mood, skin, hair, fertility, and long-term cardiovascular risk.
🔍Key symptoms
- Irregular, infrequent, or absent periods
- Excess hair growth (hirsutism) on face, chest, or back
- Hair thinning or loss from the scalp
- Acne or oily skin
- Weight gain or difficulty losing weight
- Darkening of skin in body creases (acanthosis nigricans)
- Mood changes, anxiety, or depression
- Difficulty conceiving
❓Why it's often missed
Many GPs only look for one diagnostic criterion — polycystic ovaries on ultrasound — when the Rotterdam criteria require two of three: irregular cycles, elevated androgens, or polycystic ovarian morphology. Women with regular periods can still have PCOS. Symptoms are frequently attributed to lifestyle, stress, or normal variation rather than investigated hormonally.
💬What to ask your GP
- Can I have a full hormonal blood panel including LH, FSH, testosterone, and fasting insulin?
- I'd like to be assessed using the Rotterdam diagnostic criteria — can we discuss whether I meet them?
- Can I have a pelvic ultrasound to assess for polycystic ovarian morphology?
- I'm concerned about insulin resistance — can we discuss this?
- If PCOS is confirmed, what are my long-term cardiovascular and metabolic risks?
🩸Recommended blood tests
LH and FSH (and ratio)
Elevated LH:FSH ratio is a hallmark of PCOS
Free and total testosterone
Elevated androgens are a key diagnostic criterion
DHEAS
Adrenal androgen — elevated in PCOS
Fasting insulin & HbA1c
Assesses insulin resistance — present in up to 70%
Prolactin & TSH
Rule out other causes of irregular periods
AMH
Often elevated in PCOS — supports diagnosis
Source: NICE Guideline NG88 — Polycystic ovary syndrome: diagnosis and management (2023). Rotterdam ESHRE/ASRM Consensus 2003. Teede HJ et al., International evidence-based guideline for the assessment and management of polycystic ovary syndrome, Human Reproduction, 2018.
Affects 1 in 10 women · NICE NG73 · Average 7 years to diagnosis
Endometriosis
The condition medicine keeps missing
Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus — on ovaries, fallopian tubes, the bowel, and beyond. It causes chronic pain, heavy periods, fatigue, and fertility challenges. Despite affecting 1 in 10 women, diagnosis takes an average of 7 years.
🔍Key symptoms
- Painful periods (dysmenorrhoea) — severe enough to affect daily life
- Chronic pelvic pain — not just during menstruation
- Pain during or after sex (dyspareunia)
- Pain during bowel movements or urination, especially during periods
- Heavy or irregular bleeding
- Fatigue, particularly around menstruation
- Bloating ("endo belly")
- Difficulty conceiving
❓Why it's often missed
Painful periods are normalised in healthcare. Women are frequently told period pain is "just how it is" and prescribed painkillers rather than investigated. Endometriosis cannot be diagnosed by blood test or standard ultrasound alone — laparoscopy is required for definitive diagnosis, which delays the pathway further. Symptoms overlapping with IBS, anxiety, and other conditions also lead to misdiagnosis.
💬What to ask your GP
- My pain is severe enough to affect my daily life — I would like this formally investigated for endometriosis
- Can you refer me to a gynaecologist with a specialist interest in endometriosis?
- I would like a transvaginal ultrasound as a first step — understanding this cannot rule out endometriosis
- Can you document my symptoms and this request in my notes today?
- I am aware that NICE NG73 recommends referring women with suspected endometriosis
🩸Recommended blood tests
CA-125
May be elevated — not diagnostic alone but supports clinical picture
Full blood count
Checks for anaemia from heavy bleeding
Ferritin
Iron stores — often depleted with heavy periods
CRP
Inflammatory marker — may be elevated in active disease
Source: NICE Guideline NG73 — Endometriosis: diagnosis and management (2017, updated 2023). Zondervan KT et al., Endometriosis, New England Journal of Medicine, 2020. Endometriosis UK patient guidelines.
Average age of menopause: 51 · NICE NG23 · Under 10% feel informed
Perimenopause &
Menopause
Menopause is confirmed after 12 consecutive months without a period. Perimenopause — the transition — can begin years earlier and is often dismissed or misdiagnosed. Fewer than 10% of women feel adequately informed about menopause by their healthcare provider.
🔍Key symptoms
- Hot flushes and night sweats (vasomotor symptoms)
- Irregular periods — changing frequency, duration, or flow
- Mood changes, anxiety, irritability, or low mood
- Brain fog and difficulty concentrating
- Sleep disturbance
- Vaginal dryness and urinary symptoms (genitourinary syndrome)
- Joint pain and muscle aches
- Changes in libido
- Heart palpitations
❓Why it's often missed
Perimenopause can begin in the late 30s or early 40s — many women and GPs do not expect it this early. Psychological symptoms are frequently attributed to anxiety or depression and treated with antidepressants before hormonal causes are investigated. NICE NG23 states that for women over 45, menopause should be diagnosed clinically — blood tests are not required and can be misleading due to fluctuating hormone levels.
💬What to ask your GP
- I believe my symptoms may be perimenopausal — can we discuss this?
- I would like to discuss HRT as a treatment option and understand the evidence
- I understand that NICE NG23 says I do not need blood tests for diagnosis if I am over 45 — can we proceed on clinical grounds?
- If HRT is contraindicated, what alternatives exist?
- What are my long-term cardiovascular and bone health risks related to menopause?
🩸Recommended blood tests
FSH and oestradiol
Elevated FSH and low oestradiol support menopause diagnosis — but results fluctuate in perimenopause
TSH and free T4
Rule out thyroid dysfunction which mimics many menopause symptoms
Testosterone
Low testosterone causes fatigue and low libido — treatable with testosterone therapy
Full lipid panel
Cardiovascular risk increases significantly post-menopause
Source: NICE Guideline NG23 — Menopause: diagnosis and management (2015, updated 2019). British Menopause Society guidelines. Baber RJ et al., IMS Recommendations on women's midlife health and menopause hormone therapy, Climacteric, 2016.
Leading cause of death in women · ESC Guidelines 2021
Cardiovascular Health
in Women
Cardiovascular disease is the leading cause of death in women worldwide — yet it remains systematically underdiagnosed and undertreated. Women present with different symptoms than men, are less likely to be referred for cardiac investigations, and have historically been excluded from clinical trials.
🔍Female-specific symptoms
- Chest pain — often described as pressure, tightness, or burning rather than the classic "crushing" pain
- Shortness of breath — may occur without chest pain
- Fatigue — unexplained and persistent
- Jaw, neck, back, or arm pain — not always on the left side
- Nausea or vomiting
- Palpitations
- Dizziness or lightheadedness
- Silent ischaemia — heart disease without classic symptoms
❓Why women are under-served
Cardiovascular symptoms in women are more often attributed to anxiety, panic attacks, or musculoskeletal causes. Women are less likely to be given aspirin, statins, or referred for coronary angiography compared to men with equivalent symptoms. Menopause significantly increases cardiovascular risk — oestrogen is cardioprotective, and its decline accelerates atherosclerosis, lipid changes, and hypertension.
💬What to ask your GP
- Can you calculate my QRISK3 cardiovascular risk score?
- I would like a full lipid panel — not just total cholesterol
- My symptoms may be cardiac rather than anxiety-related — can we investigate this properly?
- Given that I am post-menopausal, I would like a proactive cardiovascular risk assessment
- I would like my blood pressure monitored regularly and my results explained to me
🩸Recommended blood tests
Full lipid panel
LDL, HDL, total cholesterol, triglycerides, non-HDL
HbA1c and fasting glucose
Diabetes is a major independent cardiovascular risk factor in women
CRP (high-sensitivity)
Inflammatory marker — cardiovascular risk predictor
Full blood count
Anaemia increases cardiac workload
TSH
Thyroid dysfunction affects cardiovascular risk
Source: ESC Guidelines on Cardiovascular Disease Prevention in Clinical Practice (2021). Regitz-Zagrosek V et al., Sex and gender differences in cardiovascular disease, Nature Reviews Cardiology, 2022. British Heart Foundation — Women and Heart Disease Report 2019.
Affects women 10× more than men · NICE NG145
Thyroid &
Autoimmune Dysfunction
Thyroid conditions are among the most common hormonal disorders in women — and among the most frequently missed. Symptoms overlap with many other conditions, and standard TSH testing often fails to capture the full picture, particularly in Hashimoto's autoimmune thyroiditis.
🔍Key symptoms (hypothyroidism)
- Persistent fatigue despite adequate sleep
- Weight gain that does not respond to diet or exercise
- Brain fog, poor memory, difficulty concentrating
- Cold intolerance — feeling cold when others are not
- Hair thinning or loss, including eyebrow thinning
- Constipation
- Dry skin and brittle nails
- Mood changes, depression, or anxiety
- Heavy or irregular periods
- Joint or muscle pain
❓Why it's often missed
Many GPs test TSH only. However, TSH can be within the "normal" range while free T4 is low, free T3 is poor, or TPO antibodies indicate Hashimoto's. The TSH reference range is also debated — some women remain symptomatic at TSH levels considered normal. Hashimoto's autoimmune thyroiditis is the most common cause of hypothyroidism in women and requires antibody testing to diagnose — which is not always performed.
💬What to ask your GP
- Can I have a full thyroid panel — not just TSH — including free T4, free T3, and TPO antibodies?
- I would like to be tested for Hashimoto's autoimmune thyroiditis specifically
- Even if my TSH is within range, I remain symptomatic — can we investigate further?
- Can we also check vitamin D, B12, and ferritin which are commonly deficient alongside thyroid conditions?
- If Hashimoto's is confirmed, how will this be monitored and treated?
🩸Recommended blood tests
TSH, free T4, free T3
Full thyroid function — TSH alone is insufficient
TPO antibodies (thyroid peroxidase)
Diagnoses Hashimoto's autoimmune thyroiditis
Thyroglobulin antibodies
Additional autoimmune marker
Vitamin D, B12, ferritin
Commonly deficient alongside thyroid conditions
Full blood count
Anaemia frequently co-occurs
Source: NICE Guideline NG145 — Thyroid disease: assessment and management (2019). British Thyroid Foundation patient guidelines. Chaker L et al., Hypothyroidism, The Lancet, 2017.
Affects up to 8% of women · DSM-5 & ICD-11 recognised condition
PMDD
Premenstrual Dysphoric Disorder
PMDD is a severe, hormone-linked mood disorder affecting up to 8% of women. It is distinct from PMS — symptoms are debilitating and cycle-linked, consistently occurring in the luteal phase and resolving after menstruation. It is a recognised condition in both DSM-5 and ICD-11 and is treatable.
🔍Key symptoms
- Severe mood swings — anger, sadness, or feeling out of control
- Marked anxiety or tension in the days before menstruation
- Persistent low mood or hopelessness in the luteal phase
- Irritability or anger that feels disproportionate
- Difficulty concentrating
- Fatigue and low energy
- Physical symptoms: breast tenderness, bloating, headaches
- Symptoms resolve within days of period starting
- Cyclical pattern — same timing each month
❓Why it's often missed
PMDD is frequently misdiagnosed as generalised anxiety disorder or depression and treated with standard antidepressants without investigating the hormonal pattern. The key distinguishing feature — that symptoms are cycle-linked and resolve after menstruation — is often not explored in a standard GP appointment. Women may also not connect their mood symptoms to their cycle without being asked specifically.
💬What to ask your GP
- I have been tracking my symptoms and they consistently occur in the week before my period and resolve within days of it starting — this suggests PMDD rather than generalised anxiety
- I would like to be assessed for PMDD using a symptom diary approach as recommended
- Can we discuss treatment options including SSRIs for the luteal phase only, hormonal therapy, or GnRH analogues?
- I would like a referral to a gynaecologist or reproductive psychiatrist with PMDD experience
🩸Recommended blood tests
Oestradiol and progesterone (day 21)
Assesses hormonal levels in the luteal phase
FSH and LH
Rule out other cycle disorders
Prolactin
Can cause mood and cycle disruption if elevated
TSH and free T4
Thyroid dysfunction can mimic and worsen PMDD
Vitamin D, B12, ferritin
Deficiencies worsen mood symptoms
Source: DSM-5 (APA, 2013) — Premenstrual Dysphoric Disorder diagnostic criteria. ICD-11 (WHO, 2022). ACOG Committee Opinion on PMDD. Yonkers KA et al., Premenstrual syndrome, The Lancet, 2008. IAPMD Clinical Guidelines 2022.