The Effect of Grooming Products on Male Fertility

Written by Melanie Brown BSc (Hons), MSc. Reviewed by Dr Phoebe Howells for OVUM. 

An OVUM note: 

This piece focuses on the impact of grooming products on sperm health. Throughout, Melanie refers to "men" as shorthand for anyone who produces sperm, including transgender women, non-binary people, and those using donor sperm as part of their journey. Sperm health matters across all paths to parenthood.

 What Is “Male Grooming”?

Nowadays, grooming is a routine part of daily life for many men, for example using fragranced body sprays, fake tans, aftershave and beard oils. There are even fragranced grooming products specifically designed for direct application to the testicles. But as awareness of fertility health grows, a reasonable question follows. Could these products affect sperm health, testosterone levels and ultimately, male fertility?

Can Male Fertility be Impacted By Products?

The short answer is that some ingredients found in everyday personal care products may contribute to a ‘cocktail effect’ of chemical exposure that is worth reducing, especially for men who are trying to conceive. 

Current evidence points less to a single product and more to cumulative exposure to endocrine-disrupting chemicals such as phthalates, parabens, solvents, heavy metals, preservatives, plastic compounds such as Bisphenol A (BPA), formaldehyde, pesticides and PFAS, aka ‘Forever Chemicals’. These are a large group of man-made chemicals whose structures prevent them from breaking down in the environment or the human body. Several human studies have linked exposure to these chemicals to reduced hormone signalling (meaning the chemical messages your body sends are not getting through as well as they should), lower sperm counts, poorer sperm motility and quality, and sperm DNA damage. For example, anything labelled ‘parfum’ or ‘fragrance’ can technically contain a multitude of different chemicals, including phthalates. 

The strongest concern is not that a beard oil or aftershave will directly make a man infertile, but that repeated exposure to a mix of certain endocrine-disrupting chemicals may, over time, affect male reproductive health. For example, a major review in Fertility and Sterility, drawing on multiple human studies, found strong human evidence linking phthalate exposure with negative male reproductive outcomes. This included disruption to hormonal balance and negative changes to sperm count, motility, and morphology. 

Diethyl Phthalate is a common constituent of products that contain “fragrance” or “parfum”, which can consist of any of approximately 4,000 other chemicals used by the fragrance industry to formulate scents in toiletries and grooming products. More recent reviews have reached similar conclusions; for example, a 2026 systematic review of 38 human studies found associations between phthalate exposure and reduced semen quality. However, human studies can be difficult to interpret because there are many other factors at play, so it is difficult to isolate a single factor as the ‘cause’. In other words, the risk is plausible and supported by a growing body of research, but there are many other factors as well that influence male fertility, and we cannot blame male infertility on grooming products alone. 

Should Men Trying To Conceive Change Their Grooming Routine?

For most men, awareness is key, and the sensible approach is to reduce risk. If you are trying for a baby, it makes sense to choose simpler products with fewer unnecessary chemicals and fragrances, and, where possible, swap to products that may help lower that chemical burden.

 Practical ways to lower potential risk

• Shop for certified organic or "clean beauty" labels. When shopping for certified organic products, look for the Soil Association COSMOS symbol rather than just the word "organic" on the label. The term organic is unregulated for beauty products in the UK, meaning it can appear on packaging even when only a small fraction of the product's content qualifies. COSMOS certification guarantees no phthalates, no synthetic fragrances, and no parabens.

• Read the labels; look out for phthalates, parfum, fragrance, parabens, and mineral oils. See The Chem Trust website also has a useful plain-English guide to the specific chemicals worth avoiding in grooming and personal care products, including parabens, PFAS and synthetic fragrances, with practical tips on how to spot them on a label. 

• Consider downloading the Yuka app on your phone, which scans the barcodes of food, cleaning, and cosmetic products to decode and rate their ingredients based on their impact on your health and the environment.

• Choose fragrance-free or lightly scented male grooming products where possible, and try not to layer multiple fragrance-heavy personal care products every day. Use only the amount you need, when you need it. 

• Look for anything on this list on a product page or ingredients list: parfum, fragrance, diethyl phthalate (DEP), butylparaben, propylparaben, methylparaben, ethylparaben, formaldehyde, DMDM hydantoin, triclosan. 

Key Takeaways:

• Male grooming is unlikely to be the single reason for fertility problems, but it may be one small and often overlooked part of a bigger exposure picture. Sperm take about 90 days to make. Changes you make now show up in a test in three months, not three weeks.

• The most evidence-based takeaway is this: men do not need to abandon grooming, but choosing fewer, lower-chemical, lower-fragrance products is probably a good idea when you are trying to conceive. Reducing the use of fragranced products can be cheap, easy, and reasonable. Some other practical ways to reduce exposure include choosing organic, fragrance-free products. 

• Human evidence is strongest for phthalates and pesticides. For most other endocrine disruptors, it remains limited and inconclusive. The phthalates with the strongest evidence against them, DEHP, DBP and BBP, are already banned from UK cosmetics. DEP is not, and it hides inside “parfum”. Parabens as a mixture are associated with lower sperm concentration, count and motility. The cumulative daily load is the plausible risk, not any single product.

Alcohol and fertility: do I need to give it up?

Written by Melanie Brown BSc (Hons), MSc. Reviewed by Dr Katherine Joseph. (January 2026) for OVUM

“Do I need to give up alcohol?”

This is one of my most frequently asked questions when I talk to my clients about how good nutrition can help both male and female fertility. Do I have to stop drinking? I feel very sympathetic here as I love my glass of wine at the end of a long week! And most of my clients are in their thirties and forties, and when you cannot drink at all, for whatever reason, it can be incredibly difficult for your social life and very annoying and often upsetting when people ask you if you are pregnant because you have refused a drink. 

Unfortunately, there are so many variables associated with drinking alcohol that the research is very difficult to do to ascertain exactly how much alcohol affects fertility. The type of alcohol, the strength, the amount, the frequency, whether you smoke as well, eat healthily, if the partner also drinks and how much are all important factors in determining cause and effect.

So, the short answer is:to be completely safe, if you are trying to conceive, the NHS recommend that women (note: nothing about men) should abstain altogether, as there is no set ‘safe’ limit; and women may become pregnant without realising, when the effects of alcohol may be more damaging to the developing foetus.

How does alcohol affect female fertility? 

Alcohol can affect ovulation, hormone balance and egg quality. Many women report increased sensitivity to alcohol, for example, when they are pre-menstrual. Studies have shown that heavy intake (defined as >6 drinks/week of alcoholic beverages) in the luteal phase and ovulatory sub-phase is associated with reduced odds of conception Moderate intake( defined as 3–6 drinks/week) during the luteal phase was also associated with reduced fertility.

• Hormonal imbalance, leading to irregular or absent ovulation can occur due to alcohol’s disruption of the hormonal control system (The HPO axis). This system regulates ovulation, and therefore, disruption of this can negatively impact ovulation.

• Reduced egg quality with frequent or heavy intake due to oxidative stress. Alcohol increases oxidative stress in the body, which in turn can damage eggs (which are highly sensitive, particularly in the 3-4 months they are maturing). 

• Lower chances of implantation. This is because alcohol increases inflammation in the body, therefore impacting endometrial receptivity to implantation. 

• Increased miscarriage risk and risk to the baby’s health once pregnant. Once pregnant, the impact of alcohol on hormonal balance, inflammation and oxidative stress, as previously mentioned, may pose a risk to the health of the embryo. It is important to note that there is no set safe volume of alcohol exposure during pregnancy. 

How does alcohol affect male fertility

Alcohol mainly interferes with hormones and sperm quality.

• Lower testosterone, can reduce sperm production due to disrupting the hormone control centre (HPO axis). Testosterone is key for the creation of sperm, so this in turn impacts male reproductive health.

• Poor sperm quality via lower count, reduced motility, increased abnormal shape. This is due to alcohol increasing oxidative stress in the body, which can damage sperm cells.

• DNA damage in sperm  can also be caused by oxidative stress in the body and may affect embryo development.

• Erectile and ejaculation issues with heavier drinking. With alcohol being a depressant that interferes with many processes in the body, this can lead to erectile dysfunction concerns.

Heavy or chronic drinking has the strongest effect, but even regular “moderate” regular drinking can subtly reduce sperm health.

Practical tips

• Avoid going out just for ‘drinks’ with no food

• Eat something before you are tempted to drink. 

• Seek out pubs and bars that do cater for non-drinkers .Avoid places that expect you to just have fizzy water or lime and soda all night.

• There are some excellent alcohol-free beers on the market like Zed Pale Ale, Lucky Saint Zero and Guinness Zero alcohol, for example. There are also many alcohol free ‘spirit’ alternatives, some nicer than others! Try putting some in your bag in a little bottle, then buying a tonic water and adding your ‘shot’.

My advice if you are actively trying to conceive, or preparing for IVF

• Women: Best option is avoiding alcohol altogether

• Men: Aim for minimal intake -ideally ≤1–2 drinks/week (remember: sperm takes ~3 months to regenerate, so habits now matter later

The reassuring part

• Fertility often improves within weeks to months after reducing alcohol, especially if you have been used to drinking regularly

• Occasional drinks during celebrations are unlikely to cause long-term harm

• Consistency matters more than perfection

Key Takeaways

• Research has shown that alcohol may impact female fertility through disrupting hormone signalling, raising inflammation, and increasing oxidative stress. All of these have a negative impact on the health of your eggs and general reproductive function. 

• The impacts of alcohol are not isolated to women; male fertility can be negatively impacted by alcohol via lowering testosterone, damaging sperm cells, and potentially causing erectile dysfunction. 

• It can be really difficult to reduce or remove alcohol from your life. But I find it easier to tell my clients to think of alcohol reduction as part of a project; it is not going to be forever, and you will feel all the better for it. 

Dietary Advice for People Using GLP-1 Agonists (Ozempic, Mounjaro) For Pre-Conception Weight Loss.

Written by Melanie Brown BSc (Hons), MSc. Reviewed by Dr Phoebe Howells. (December 2025) for OVUM.

How weight can influence fertility outcomes. 

In UK guidance, adults are encouraged to keep waist less than half their height. In England, 29% of adults live with obesity and 64% are overweight or living with obesity, so this issue is widespread. 

Excess body fat, especially around the waist, is associated with insulin resistance, hormonal imbalances and inflammation; all of which negatively impact fertility. Evidence shows that obesity impacts the fertility of both men and women, being associated with a longer time to conception and higher chances of miscarriage and pregnancy complications. 

For example, a systematic review and meta-analysis of 21 studies found that female obesity (BMI greater than or equal to 30) was associated with significantly lower live birth rate following IVF compared to women of a BMI between 18.5 and 24.9. This also extends to men, with a meta-analysis of 50 studies reported that obesity (BMI greater than or equal to 30) was associated with an average reduction in all semen parameters in comparison with men with BMI less than 25.

What are GLP-1 Agonists?

GLP-1 agonist medications are effective tools for weight loss, which can be particularly beneficial for improving fertility for the right people, where weight is affecting your eligibility for IVF, or ability to become pregnant. Even though most of the emphasis is on a woman’s weight, male obesity is increasingly being linked with infertility, high DNA fragmentation and pregnancy complications for their female partner such as recurrent miscarriage and pre-eclampsia. So, they can be an incredibly effective tool to help people struggling with weight loss.

However, as these drugs significantly reduce appetite, and cause side effects like nausea and constipation, it is all too easy to skip breakfast, grab a bag of crisps for lunch and eat a half a diet ready meal for dinner. And yes, you will lose weight but at a considerable cost to your health. Everything from energy and focus, bone health, and your immune system to your hair, skin and nails, will be affected. And of course, that means your eggs or sperm will suffer too.

Please note: the NHS recommends that you do not try to get pregnant while taking GLP-1 medications, and that you have a ‘wash out’ period of 2 months prior to starting trying to get pregnant (so, you stop taking this for at least 2 months before you start trying to conceive). This is because the effects of these medications during this time are not yet known. For more information please visit the NHS site here. 

Core Principle: Nutrient Density Over Volume

Your goal is to eat smaller, more frequent meals packed with nutrition. Do not skip meals, as this can lead to nutrient deficiencies and is not recommended for reproductive health. Think of your meals as a miniature, well-balanced version of a standard healthy plate (see below). You have to plan for being on these drugs.

Managing Common Side Effects

Nausea: This is common initially. It's important to remember you are not ill and still need to eat. Opt for smaller, nutrient-dense meals and snacks rather than trying to eat a full meal.

Constipation: Reduced food and fibre intake can lead to constipation. To manage this:

• Ensure adequate fluid intake, because often thirst is also reduced.

• Consider supplementing with psyllium husks (a couple of teaspoons in water, followed by a second glass of water) to increase fibre and try to always have some vegetables and fats as well.

Building Your Nutrient-Dense Plate

Plan your meals objectively to ensure they are balanced. For each meal, ask yourself:

Where is my protein? 

Protein is an essential component of all of your cells. This goes beyond being important for egg and sperm cells, including immune cells, red blood cells, muscle cells and everything that makes you, you. Maintaining protein intake is absolutely essential to preserve lean muscle. 

Good sources include: eggs, fish, chicken, meat, beans, lentils, chickpeas, nuts, seeds, milk, yoghurt and cheese and tofu.

If you are exercising, particularly strength training, consider adding a scoop of good quality protein powder to a smoothie or breakfast to meet increased needs without adding excessive volume. What makes a good protein powder? Less is more here; try to choose options that avoid lots of flavourings and additives. If in doubt, the less ingredients on the back of the pack, the better. 

Where are my healthy fats? 

Fats are vital for hormone production and the health of your joints, skin, hair, gut and mood. Do not opt for "low-fat" or "fat-free" products solely because of the calories, the key here is moderation.

Include sources like: avocado, nuts, and good quality olive oil. Full fat yoghurt, a slice of cheddar cheese, a sprinkle of sunflower and pumpkin seeds over breakfast or a salad and a drizzle of olive oil over salad, soup, and cooked vegetables.

Where is my whole-grain carbohydrate? 

These provide energy, B-vitamins and crucial fibre, which helps with digestion. Where people tend to make mistakes here are, the type of carbohydrate they are selecting and how much of it they include.  

Choose small portions (one or two dessert spoons) of: oats, wholemeal bread, brown pasta, or brown, black, or red rice. 

Where are my fruits and vegetables? 

These provide essential fibre, antioxidants, vitamins, and minerals. Ensure they are a part of every meal. Fibre-rich diets (wholegrains, legumes, vegetables, fruit) improve insulin sensitivity, reduce systemic inflammation, and promote a favourable gut microbiome, all factors that indirectly support reproductive health. 

In the UK, adults are advised to consume 30 g of fibre per day from a variety of plant foods. However, average intakes remain well below this level. Some fruits with high fibre per portion are berries and pears, while vegetables such as broccoli and Brussels sprouts are also particularly high in fibre.

Where are my fluids? 

Sometimes, GLP-1 agonist medications reduce both thirst and hunger, but it is vital to remember to stay hydrated. Dehydration contributes to constipation and headaches. Keep a bottle of water in your bag and a big jug on your desk. Set your phone to remind you to drink every few hours.

Essential Supplementation

Due to reduced food intake, you are at a higher risk of nutrient deficiencies (e.g., iron, B12, zinc, vitamin C). The following supplements are strongly recommended:

• A broad-spectrum multivitamin and mineral tablet.

• Omega-three fatty acids (e.g., a high-quality fish oil).

• Vitamin D: 1000 IU daily (a spray is a convenient option).

• Iron: This is particularly important for menstruating women to replenish iron lost during their period.

Key Takeaways

• Weight is something that needs to be considered when approaching fertility. This is due to the impact it can have on the health of both the egg and the sperm, as well as pregnancy complications later on. 

• Remember, these medications are designed to reduce hunger, not to stop you from eating. Your focus must shift to providing your body with the high-quality nutrition it needs to thrive, especially when you are trying for a baby. 

• GLP-1 agonist medications can be a useful tool for helping people struggling with weight loss, and in turn with fertility. However, it is important that you do not try to conceive until after the ‘wash-out’ period of these medications, as effects are not yet fully understood.

More Than Just a Numbers Game: Why Sperm Count Isn’t the Only Metric That Matters

Written by Melanie Brown. Reviewed by Jenny Wordsworth for OVUM.

When it comes to male fertility, the most commonly cited metric is sperm count.

It’s easy to understand why - numbers are straightforward, and for decades, semen analysis reports have placed a heavy emphasis on total sperm concentration. But actually, good sperm count is only one piece of a much larger puzzle. 

Evaluating male fertility by sperm count alone is like judging a marathon by how many swimmers show up at the starting line, without watching to see who crosses the finish line. Sperm have a tremendous job to do, swimming the equivalent of the English Channel, navigating obstacles, trying to put off the sperm behind them (yes, they are competitive!) and trying to penetrate the membrane of the oocyte (the egg). This cell is enormous compared to them, and it is extremely fussy about who it will let in. 

If you are trying to conceive, it's time to move past the myth that just having a sperm count equals fertility. Today, reproductive specialists may look at several critical factors beyond count: semen volume, sperm morphology (shape), motility (how sperm moves) and a separate test that looks at DNA integrity. These deeper measurements provide a far more accurate picture of a man's reproductive potential and are essential for diagnosing and treating infertility.

Morphology: Structure Dictates Function

Sperm morphology refers to the size and shape of sperm. The ideal sperm has an oval head and a long tail, which helps it swim efficiently and penetrate the egg’s outer layer. Abnormally shaped sperm - those with large, misshapen heads or coiled, broken tails—may have trouble reaching or fertilising the egg.

The World Health Organization (WHO) considers a morphology rate of just 4% of your sperm to be normally formed or higher, to be within the fertile range, a surprisingly low standard. It means the majority of sperm can be imperfect, but if even a small fraction are structurally sound, fertilisation is possible. Still, poor morphology, known as teratozoospermia, can significantly reduce the odds of natural conception or even hinder assisted reproductive technologies (ART) like IVF.

Motility: The Marathon of Fertility

Sperm motility refers to how well sperm moves. Healthy sperm need to swim vigorously and in a straight line, to navigate the female reproductive tract, which is designed with multiple biological obstacles in order to further filter out the less sound sperm. 

 There are two main types of motility:

• Progressive motility: sperm move forward in a straight line or large circles.

• Non-progressive or immotile sperm: sperm that move in one small space or not at all.

Poor motility, called asthenozoospermia, means that there may be lots of sperm present, but they just cannot reach the egg. And while techniques like intrauterine insemination (IUI) and IVF can bypass some of these obstacles, very low motility often requires advanced interventions such as intracytoplasmic sperm injection (ICSI), where a single sperm is injected directly into the egg.

DNA Integrity: The Silent Factor

Perhaps the most overlooked aspect of sperm quality is DNA fragmentation. Even if sperm look healthy and swim well, their genetic cargo (the DNA they deliver to the egg) might be damaged. This is critical because poor DNA integrity has been linked to:

• Lower fertilisation rates

• Higher miscarriage rates

• Poor embryo development

• Failed IVF or ICSI cycles

DNA fragmentation can be caused by a varicocele (a varicose vein in your testicle), oxidative stress, infections, environmental toxins, age, and lifestyle factors such as smoking, recreational drug or alcohol use or poor diet. Sometimes, there is no specific cause identified. Male obesity may also be a risk factor. Unlike sperm count or motility, DNA integrity requires specialised testing, which may be used when couples experience unexplained infertility or repeated IVF failures.

A Holistic View of Male Fertility

It’s important to recognise that sperm health is multifactorial. A man may have a high sperm count but poor motility and morphology. Conversely, someone with a lower count might have excellent motility and DNA integrity, making natural conception entirely possible.

Moreover, the great thing is that male fertility is not fixed. Diet, exercise, sleep, alcohol consumption, and exposure to heat or environmental toxins all influence sperm health. Unlike eggs, which are fixed in number and decline with age, sperm are produced continuously. This means that with targeted lifestyle changes and medical intervention, sperm quality can often be improved within three months, the time it takes for sperm to fully develop.

Why This Matters

Understanding the full picture of sperm health empowers couples to make informed decisions. It can prevent months or years of frustration and unnecessary treatment. Too often, fertility assessments focus on the female partner, while the male factor is only superficially examined. In reality, male factors contribute to infertility in 40-50% of cases.

So next time someone mentions sperm count as the key metric, remember: fertility isn’t just about how many swimmers start the race - it’s about how many finish strong, with the genetic integrity needed to create a healthy embryo.

Final Thoughts

If you’re facing fertility challenges, insist on a comprehensive semen analysis that includes as many semen and sperm parameters as possible, including morphology and motility, and an examination of your testicles. If the sperm test looks ‘OK’ but there is still doubt over the cause of your and your partner’s infertility, ask for a DNA fragmentation test as well. 

Don’t accept “your count looks fine” as the end of the story. Reproductive science has advanced, and your family planning deserves more than a headcount.

Celebrity Save Our Sperm: Why is our Male Sperm Count so Low

As male fertility rates plummet, Russell Kane, Melvin Odoom and Ollie Locke unite in a ballsy attempt to increase their sperm count. Can they rise to the challenge and prevent spermageddon?

The Gut-Fertility Axis

Reviewed by Jenny Wordsworth for OVUM.

The Surprising Link Between Gut Health and Fertility

When most people think about fertility, hormones, ovulation, and reproductive health specialists typically come to mind. Did you know that your gut health might also play an important role? 

Research shows that gut health doesn’t just affect digestion. The health of your gut is also deeply connected to hormone balance, inflammation, and reproductive health as well. And it’s not specific to women’s fertility alone. There is emerging evidence that the gut-testes axis is playing a big role in all aspects of quality sperm production.

Why Gut Health Matters For Male Fertility

The gut is home to trillions of microbes, bacteria, fungi, and other tiny organisms, collectively known as the gut microbiome. When the gut microbiome is balanced, it works to help keep your body running smoothly. But when it’s out of balance (a condition called dysbiosis), it can trigger a ripple effect that can impact fertility.  

Hormones

Those bacteria that live in your gut can even affect your testosterone, the main hormonal driver of male fertility. The relationship between the two is extremely complicated, involving hypothalamus-pituitary-gonad axis modulation, male hormone metabolism, insulin regulation, the immune system and the health of the gut.

Inflammation and sperm damage

Under normal conditions, the gut microbiome maintains a healthy relationship with the testes. Disruption of the gut microbiome, either by poor diet or disease, can initiate a chain reaction of testicular damage. This starts with the breaking down of the delicate gut lining, which then allows the leaking of pathogenic bacteria and their by-products of inflammatory chemicals into the bloodstream. Ultimately this exposes the testicles (along with the rest of your body) to chronic inflammation, high levels of oxidative stress, and eventual damage to the sperm-producing cells.

Nutrient Absorption

A healthy gut helps you absorb key nutrients like folate, zinc, and vitamin D. These nutrients are vital for sperm health. A high-fibre diet, and one rich in fruit and vegetables and especially those that contain compounds called polyphenols, feed out healthy gut bacteria. Conversely a diet high in fast, fried and ultra-processed foods feed the pathogenic bacteria. 

Everyday Gut-Friendly Habits That Support Fertility

Supporting your gut may also be supportive of your fertility journey. Some simple tips to consider:

• Eat more fibre: Fruits, vegetables, pulses and whole grains feed the “good” bacteria in your gut.

• Incorporate fermented foods: Yoghurt, kefir, and kimchi all introduce beneficial probiotics to the gut.

• Fruits and vegetables: Aim for between 20 to 30 different plant-based foods each week to diversify your gut microbiome, such as root vegetables and a variety of colourful fruits.

• Eat polyphenol-rich foods: Olive oil, nuts & seeds, berries, dark chocolate, broccoli, onions, garlic, apples, spices like turmeric and cinnamon, the more colours on your plate, the better.

• Staying hydrated: Water helps your digestive system process nutrients efficiently. 

• Stress reduction: Stress hormones can have a negative impact on gut health and potentially on fertility. Consider incorporating yoga, meditation, or walks in nature.

• Limit ultra-processed foods, fast fatty foods, and sugar: These can feed harmful bacteria and therefore worsen inflammation.

To Summarise

Gut health isn’t the magic solution to fertility challenges, but it is a powerful piece of the puzzle. In nurturing your microbiome, you’re not only improving digestion - you’re also creating a more balanced and nourished environment for your hormones, reproductive organs, and overall well-being.

When your gut is happy, your body is better prepared for the possibility of creating new life.

Endometriosis: ‘Women's Problems’ and Fertility Nightmare

March is always Endometriosis Awareness Month, but sufferers of this particularly complex and distressing condition are more than ‘aware’ of it. It hits full on every month, causing everything from pain on ovulation, to bad period pain, to excruciating period pain, often accompanied by diarrhoea, vomiting and fainting. Strong pain is incredibly debilitating and of course heavy bleeding may also cause iron loss and anaemia. I have just read a study looking at the economic burden of endometriosis, and suffice to say it costs a lot of money! And for my clients it is a huge risk factor for infertility. It is a very complex condition, probably genetic, involving the immune system; auto-immunity may play a role, hormonal, driven by oestrogen, and highly inflammatory.

But endometriosis is also widely misdiagnosed; after all teenage girls always exaggerate everything specially to get off games, “just take a painkiller and live with it, it’s all part of being a woman”, and the ultimate irony, “it’ll get better when you are pregnant”. Great, just what you want to hear. Women become enormously resigned to the pain, and it can take until there are fertility investigations for endometriosis to be diagnosed, never mind treated.

For those of you who are unsure what endometriosis actually is . . .

It is defined as the presence of endometrial (womb/uterine) tissue that can grow anywhere in the pelvic cavity, outside of the endometrium and is responsive therefore to all the hormonal fluctuations of a monthly menstrual cycle. This tissue then induces a chronic inflammatory response causing the pain associated with the condition. Blood filled endometrial cysts known as ‘chocolate cysts’, may form on the ovaries and inflamed lesions cause scarring, which then tugs and pulls on the organs where the endometriosis has formed, like the ovaries, fallopian tubes, bowels and bladder.

How and why some women have endometriosis is a bit of a mystery. In terms of risk to health, as we have just mentioned, endometriosis affects fertility. The adhesions can cause scarring in the fallopian tubes, and they become blocked and the chronic long-term inflammation causes high levels of oxidative stress, free radicals that damage the cells of the ovaries, ovarian reserve and egg quality. It is speculated (but controversial) that high levels of cytokines and NK cells may also be associated with the potential autoimmune component of endometriosis as well. So, what to do about it? Well, researchers have identified several diet and lifestyle risk factors that may be involved.  So, when my clients come to see me, they are often on the way to IVF and this preparatory stage is very important.

Three months preparation is ideal, until egg collection, where we can reduce the inflammation to the developing follicles and give them a fighting chance. I usually recommend a very plant- based diet for my clients, with the only non-plant foods coming from a little chicken or turkey and fish and some eggs; the rest is from pulses, seeds and nuts and lots of vegetables. A little organic tofu is fine in my opinion, two meals a week is not going to cause harm, in fact the phytoestrogens in soy may even protect the cells from more pathogenic forms of oestrogen.  And one or two soya-based meals a week will not harm sperm either.

GLUTEN

There is now some good evidence linking gluten-avoidance with relieving some of the symptoms of endometriosis. And I do always recommend avoiding it, if possible. Gluten may ‘switch on’ oestrogen modulating genes, and some specialists recommend avoiding wheat in the second half of the cycle and during a period, as this also seems to alleviate pain. Nowadays, it is not so difficult to avoid it and it’s worth giving it a go.

DAIRY PRODUCTS

These are one of the food groups that I recommend cutting down on for my clients with endometriosis. Dairy products (probably due to both the oestrogens and the growth factors in milk) may play a role in driving the condition. But to be honest it’s hard to find evidence that supports this, which is why I recommend a little but low fat, dairy. So, try and have no more than one portion of low-fat organic dairy a day if you want to eat it. (not full fat for endo).

But if you are planning to do IVF, then the time to go with FULL fat dairy is from the beginning of stimulation, until egg collection. Those oestrogens and growth factors may have a positive effect on follicle and egg development.

RED MEAT

This is a food that I would recommend avoiding with endometriosis, mainly due to the presence of both dioxins (see below) and inflammatory compounds in meat. You may have it once a week, but ensure it is organic and lean.

DIOXINS

Dioxins are environmental chemicals and in early animal studies one in particular stood out called TCCD, which appeared to be very strongly associated with a worsening of endometriosis. But at the time hospital studies on humans failed to confirm this link. However, no we know so much about epigenetics, the way that genes are expressed (or not) according to environmental factors, the association between dioxin exposure and endometriosis in women with an individual susceptibility, appears to be a very real factor. This is all very well, but how can you avoid them? Well, it’s a bit difficult because these industrial chemical pollutants are everywhere, in our air, water and soil. But it is believed that 90% of human exposure comes from food, mainly fatty animal products (dioxins are stored in animal fat). 

And even common chemicals that we come in contact with every day are dioxins; chlorine is one, which is in everything from tea bags to sanitary products as bleach, so just go for unbleached like Clipper tea bags and organic sanitary wear. I always advise my clients not to use tampons, it seems so counterintuitive to the flow of blood, almost like blocking it and sending it backwards, increasing the painful contractions that are trying to get rid of it. But the research does not show that tampon use affects endo, in fact there is some that indicates that tampon use is helpful, I have no idea why myself! But I would suggest always using unbleached, as above, anyway. Or even better, washable organic cotton pads, which I think can be more absorbent than disposable towels. There are lots of different brands around.

Reducing all environmental chemicals is a good idea too; from parabens in toiletries, to the chemicals in cleaning products, scented candles, air fresheners, and plastics. Go BPA free with plastics; use glass bottles, reduce tinned foods, use a bamboo BPA-free sustainable take-out coffee/tea cup like Clipper. Eat organic as much as you can, especially whole grains, eggs, tomatoes and peppers and root vegetables, chicken and salmon (or wild).

In terms of supplements, omega three fatty acids are extremely anti-inflammatory and blood thinning, helping to reduce the painful clots. A plant compound called Resveratrol has been well researched for its benefits on endometriosis, as is N-Acetyl Cysteine and of course turmeric, or curcumin. And magnesium to help with the pain.

Exercise is beneficial, so don’t stop moving, even during your period. And sitting down all day is just terrible for endometriosis.

Heat from a hot water bottle or a hot pad that you just stick on under your clothes (From Boots), warm castor oil packs (a very old- fashioned remedy), herbs like agnus-castus and cramp bark (best sorted by a herbalist), acupuncture and reflexology also can really help.

And believe it or sexual intercourse during a period may actually be helpful; with both female orgasm and the highly anti-inflammatory compounds in semen called prostaglandins reducing the pain. I’ll leave that one with you! 

Think of this as a three-month preparatory time so those eggs can be the best quality they can be, and you may reduce the pain as well.

Covid-19 Vaccines & Fertility

View fullsize

PODCAST: Does a lack of sleep affect my fertility? with Fertility Podcast

This episode has a slightly unusual intro as I had to record it whilst driving, my recorder was safely stored in my glove compartment or whatever the bit in the middle is, by the handbreak.. it does affect the quality a bit, so I apologise. However I’m just back from Fertility Fest and needed to go and pick up my son and get this episode finished.. Hence the need to multi task. You’ll hear a quick chat from Jessica Hepburn from Fertility Fest who I did an insta live with after the session to day (Sunday 28th April) and I’ve lifted the audio, seeing Lives dissapear.. again a slight quality issue. I also wanted you to get to watch the Fertility Fight Club live stream which you can do so here 

Melanie Brown

Now onto my guest. Meet Melanie Brown, a fertility nutritionist and former guest on this podcast. I wanted to speak with Mel after I saw her post this on her instagram

So I wanted to know more. Now, this chat was back in January, so Mel does refer to it being dark in the afternoons and getting lighter (don’t get confused if you’re listening in April when I’ve released it).

Mel was keen to know about the effects of circadian rhythms on your fertility and whether it can affect it. We spoke about how it’s been known for a long time that shift workers, stewardess and pilots have menstrual irregularities and that there is a great deal of evidence that fertility is diminished. 

But what about the rest of us, working normal hours. Does it affect us? Well it seems it does.

The luteinizing hormone that surges mid-cycle is under the 24-hour body clock control so disturbances could affect ovulation and uterine receptivity. 

If implantation doesn’t happen, despite embryos being quality and blastocyst… everything is done to receive the embryo (scratch, washes then we need to start to consider the stress  on the body from  sleep deprivation affecting uterine receptivity

There was also discussion about TNF Alpha – related to Natural killer cells being linked to sleep stress pathway. 

Mel explained how she always recommend my clients use a SAD lamp as there is evidence that getting 20 min of natural daylight in the morning before 9am can have an extremely positive effect and can set your master clock

Did you know that IVF success rates are lower in the winter,  higher in the spring and summer

I think it’s also to do with you get up in the dark, go to work in the dark, artificial light and she spoke about 

Mel spoke about the benefits of melatonin and how in order to prepare to go to sleep, make sure you are not in a bright bedroom, checking your phone and then turning off the light and hoping to go to sleep

We spoke about Sleep Hygiene. Warm bed cold room… we evolved to sleep in cold temperatures having the heating on in the winter is bad for our sleep

We spoke about whether the sleep before midnight more valuable than after and how its the quantity of sleep. If you go after midnight you’re more likely to get less sleep

 The cut-off point for sleep damage is UNDER 6 hours

Did you know you can do SLEEP CATCH up at the weekend it’s been discovered you can… just do it for one night… it’s quite technical so have a listen to how Mel explains it, but do remember that sleep is our wear and repair time and we try and we might to get out of it… we can’t do it. Remember that the environment that interrupts our sleep, so use blackout blinds and earbuds.

Women with diminished ovarian research are 30 times more likely to have disturbed sleep? 

Mel gave great advice on how to approach sleep when you are going through IVF… sometimes it’s easier to think of it as a project. I know I did like it was a science experiment. Mel said ‘You have to think – I have to be in bed for at least 7 hours, so I have some spare time to get back to sleep and I’m not going to get anxious. It’s like school nights you’re getting as much sleep as you can. If you don’t get enough sleep something else will give – the immune system you have to take the best care of yourself and sleep is an essential part of that…”

Do have a listen to my previous chat with Mel about how a Mediterranean diet can really benefit male fertility here