Signs of Infertility in Women: What to Know and What to Do Next
Not getting pregnant can leave you with more questions than answers. If you’re wondering whether something deeper might be going on, this guide breaks down the key signs of infertility in women — and what you can do about it.
Author
Tassia O’Callaghan
Reviewed by
Kayleigh Hartigan
19 min read
Spotlight:
- Infertility is defined as not getting pregnant after 12 months of regular unprotected sex — or after 6 months if you’re 36 or over. [1]
- The only definitive sign of infertility is not conceiving. But some underlying health conditions that impact fertility (like PCOS, endometriosis or thyroid issues) can show up with their own symptoms.
- Around 1 in 7 couples in the UK experience fertility difficulties, but most will conceive within a year — especially if the woman is under 40. [1]
- You don’t need to wait a year to get support. If something feels off — irregular periods, heavy bleeding, pelvic pain or other changes — testing early can offer clarity and save time. [1]
What is classed as infertility?
Infertility is when someone has trouble getting pregnant despite having regular unprotected sex. For medical purposes, it’s usually diagnosed after 12 months of trying without conceiving — or after 6 months if you’re 36 or over. [1]
There are two main types:
- Primary infertility: when you’ve never been pregnant before
- Secondary infertility: when you’ve been pregnant in the past, but are now having difficulty conceiving again
Infertility doesn’t mean pregnancy is impossible — but it may mean something’s getting in the way. That could include issues like irregular ovulation, blocked fallopian tubes, endometriosis, or age-related decline in egg quantity or quality. In some cases, there’s no clear explanation — this is known as unexplained infertility.
From our Matching Tool data, at least one underlying condition is present for around 40% of users. The most commonly reported are polycystic ovary syndrome (12%), endometriosis (12%), insufficient egg reserves (13%), adenomyosis (6%), fibroids (6%), tubal blockages (4%) and other uterine problems (1%). Almost a third of users also tell us that underlying conditions are an important factor when choosing a clinic.
Support is available. Whether you’ve just started trying or have been at it for a while, there are tests and treatments that can help you understand your options and move forward.
What are some signs of infertility in women?
Infertility often goes unnoticed until you’ve been trying to conceive for a while without success — but there are signs and symptoms that can signal something’s worth looking into sooner.
Spotting these signs early can help you take action before you even start trying for a baby, or in the early stages of your TTC journey. That way, if it does take longer than expected, you already have answers — and possibly treatment options — lined up.
If you’ve already been trying for a while, these signs are still important. They’re worth mentioning to your doctor, as they could point to a possible cause of infertility that’s diagnosable — and in many cases, treatable.
It’s worth noting that these symptoms aren’t exclusive to fertility problems. Some may be linked to the start of perimenopause, where hormone levels start to fluctuate in the years before menopause. Others — like unexpected weight changes, fatigue, or persistent bloating — may relate to wider health concerns, including thyroid disorders, autoimmune conditions, or (rarely) cancer. That’s why it’s important to treat your body’s signals seriously and speak to your doctor if something doesn’t feel right, whether or not you’re trying to conceive.
These aren’t signs of infertility itself (which is defined only by not conceiving), but they can signal an underlying condition worth investigating — especially if you’re already trying to get pregnant, or planning to soon.
1. Irregular, long, or short periods
A regular cycle doesn’t have to be exactly 28 days — anywhere between 21 and 35 can be normal. But if your periods are unpredictable, frequently skipping or showing up without pattern, it could be a sign of a hormone imbalance. Conditions like PCOS or thyroid dysfunction can disrupt ovulation, which is key for getting pregnant. [2,3,4]
You might even notice bleeding between periods, which could (although rare) indicate an infection, like chlamydia or gonorrhea — the good news is that both of these infections are treatable with a simple course of antibiotics. [5]
Cycle changes like these can also signal the start of perimenopause — the transitional phase before menopause — when hormone levels naturally begin to fluctuate. This is more common from your late 30s or 40s onwards, but it can happen earlier too. [6]
2. Regularly long (34+ days) menstrual cycles
Having consistently long menstrual cycles — typically longer than 35 days — can be a sign that you’re not ovulating regularly, which may make it harder to conceive. This is often linked to conditions like polycystic ovary syndrome (PCOS), where hormonal imbalances disrupt the cycle. Longer cycles are more likely to be anovulatory (meaning no egg is released), which can lower your chances of getting pregnant. [7]
3. Regularly short (<25 days) menstrual cycles
If your cycle is consistently on the shorter end of the spectrum (less than 25 days), emerging research could be linked to earlier menopause — but more research is needed. [8]
It could also point to a luteal phase defect — when the luteal phase is less than 10 days, instead of the average 14 days — which can impact the implantation of a fertilised egg. [9]
4. No periods at all
Missing the odd period due to stress or intense exercise isn’t uncommon. But if you haven’t had a period for several months, your body might not be ovulating. It’s worth speaking to your GP to explore why. [10,11]
In some cases, missing periods can be a sign of perimenopause or early menopause — especially if you’re over 40 or noticing other changes like hot flushes, disrupted sleep, or mood shifts. If you haven’t had a period for 12 consecutive months, it may be a sign that menopause has begun. But whatever your age, it’s worth investigating, as absent periods can also be linked to treatable hormonal conditions like thyroid dysfunction or premature ovarian insufficiency (POI). A simple set of tests can help clarify the cause and support your next steps. [6]
5. Painful or heavy periods
Severe period pain, heavy bleeding, or both can be more than just a rough cycle. They may be signs of conditions like endometriosis, pelvic inflammatory disease (PID), or fibroids, which can impact fertility. If your period regularly disrupts your daily life, don’t ignore it. [12,13,14]
6. Pain during sex
Painful sex is often dismissed or normalised — but it shouldn’t be. It can point to underlying conditions like PID, fibroids, or endometriosis, both of which can affect your ability to conceive. [12,13,14]
7. Unexpected weight changes
If your weight is fluctuating significantly — especially without any changes to your diet or exercise — it could be linked to a hormonal imbalance. Hormones like insulin, cortisol, and thyroid hormones play a big role in both metabolism and ovulation. Conditions like PCOS, thyroid dysfunction, Addison’s disease, or high prolactin levels can all affect your weight and your ability to conceive. Whether you’ve noticed unexplained weight gain or loss, it’s worth bringing up with your doctor — especially if it’s happening alongside other symptoms. [2,4,15,16,17,18,19]
8. Excess facial hair or hair thinning
Hair changes are one of the more visible signs of hormone imbalance. If you’re noticing new coarse hair on your face, chest or back (also known as hirsutism), or thinning hair on your scalp, it could be a sign of elevated androgens (male-type hormones). These symptoms are common in PCOS, which can disrupt ovulation and make it harder to get pregnant. [7,20,21]
9. Fatigue
Feeling constantly drained — even after a full night’s sleep — might not just be stress or a busy lifestyle. Ongoing fatigue can point to thyroid dysfunction, endometriosis, adrenal imbalance (like Addison’s disease), or iron deficiency, all of which can impact fertility. If you’re exhausted all the time, your body might be asking for help. A simple blood test could reveal something worth treating — not just for fertility, but for your overall health. [4,12,17,22,23,24]
10. Severe acne
A few spots around your period is one thing — but persistent acne or oily skin could point to a hormonal imbalance. High androgen levels (often seen in PCOS) can lead to persistent, painful acne, and may also interfere with ovulation. If over-the-counter treatments aren’t helping, it’s worth getting your hormone levels checked. What’s showing up on your skin could be a clue to what’s happening with your cycle. [2,25]
11. Recurring vaginal discomfort or infections
Vaginal soreness, itching, or unusual discharge could be signs of an untreated infection or PID. Some sexually transmitted infections (like chlamydia or gonorrhoea) can damage the reproductive tract if left untreated, even if they’ve caused no obvious symptoms before. [5, 13,26]
12. Feeling colder than usual
If you’re often reaching for an extra layer while everyone else seems fine, it might be more than just personal preference. Feeling unusually cold — especially alongside other symptoms like fatigue, weight changes, or brain fog — can be a sign of an underactive thyroid (hypothyroidism). [4]
Your thyroid plays a key role in regulating your metabolism, energy, and hormone balance — including the hormones needed for ovulation. When thyroid hormone levels are low, your cycle may become irregular, or ovulation may stop altogether, making it more difficult to conceive.
Hypothyroidism is common, especially in women between 30 and 50, and it’s treatable with daily medication. If you’ve noticed you’re colder than usual and TTC is on your mind (now or in the future), speak to your GP about getting a thyroid function test. It’s a small step that could make a big difference.
13. Regular constipation or pain when going to the bathroom
Regular constipation or pain when passing stool or urine can be a sign that something’s not quite right — and in some cases, it may be linked to fertility. Conditions like endometriosis can affect the bowel or bladder, leading to discomfort, especially around your period. Fibroids may also press on nearby organs, causing similar symptoms. An underactive thyroid, which can interfere with ovulation, often includes constipation as a common symptom. [4,5,12,13,14,26]
14. Brain fog and difficulty concentrating
If you’re feeling mentally foggy, struggling to focus, or noticing that your memory isn’t as sharp as usual, it could be more than just stress or poor sleep. Difficulty concentrating — sometimes called “brain fog” — is a recognised symptom of both hypothyroidism (an underactive thyroid) and Addison’s disease, two hormone-related conditions that can disrupt ovulation and affect fertility. [4,17]
These conditions often develop gradually, and symptoms can be easy to overlook or attribute to other things. But your brain and your reproductive system are both influenced by hormonal balance — so if you’re finding it unusually hard to concentrate, especially alongside fatigue or cycle changes, it’s worth speaking to your GP. A simple blood test could help identify what’s going on, and early treatment can support both cognitive health and fertility.
15. Low mood or depression
Persistent low mood or feelings of depression can sometimes be a sign that your hormones are out of balance — and certain hormonal conditions linked to low mood can also affect fertility. Addison’s disease, for example, can cause mood changes due to disrupted cortisol levels. Left untreated, this hormonal disruption may lead to missed periods or reduced ovulation. Low mood is also common in other conditions that impact reproductive health, and because these symptoms often develop gradually, they can be easy to dismiss. [4,17]
16. Dry skin and hair
Skin and hair changes can sometimes be more than surface-level. If you’re experiencing unusually dry skin or brittle, thinning hair, it could be linked to a hormonal issue affecting your reproductive health. These changes are often associated with reduced levels of certain hormones that also play a role in regulating the menstrual cycle and supporting ovulation. While dry skin and hair can have many causes, if they appear alongside other changes in your cycle, mood, or energy levels, they may be worth investigating. [4]
17. Hoarse voice
A voice that’s become raspy, croaky, or hoarse — and stays that way — might seem like a minor irritation. But when it lasts beyond a cold or feels like your new normal, it could be a subtle signal from your thyroid. The thyroid gland sits at the base of your neck, close to your vocal cords, and when it’s underactive, it can lead to swelling and changes in your voice. Because thyroid hormones are also vital for regulating ovulation and the menstrual cycle, a hoarse voice that lingers could be one of several signs that your hormones — and fertility — may need a closer look. [4]
18. Regular abdominal pain or lower back pain
Persistent discomfort in your lower abdomen or back might not always feel connected to your fertility — but it can sometimes point to underlying reproductive health issues. Conditions like fibroids, which are non-cancerous growths in or around the uterus, and pelvic inflammatory disease (PID), an infection often caused by untreated STIs, can both cause chronic pelvic or back pain and impact your ability to conceive. These symptoms are often subtle or mistaken for normal cycle-related pain, but if they’re recurring or interfering with your day-to-day life, they deserve attention. [5,13,14,17,26]
19. Dizziness
Feeling lightheaded or dizzy on a regular basis could be your body’s way of flagging a hormonal imbalance that may also impact fertility. One possible cause is Addison’s disease, a condition where the adrenal glands don’t produce enough essential hormones like cortisol and aldosterone. These hormones help regulate blood pressure and fluid balance, and when they’re low, dizziness — especially when standing — can occur. Addison’s disease may also lead to irregular or absent periods, making it harder to conceive. [17]
Fertility Test: What It Is, What It Costs, and What It Tells You
From hormone checks to sperm analysis, we break down the most common fertility tests.
How can a woman tell if she is infertile?
The short answer? You can’t know just by guessing — medical testing is the only way to confirm infertility. But it’s absolutely valid to wonder when something doesn’t feel quite right.
You might notice irregular periods, skin or hair changes, persistent fatigue, or pain that seems to come and go without explanation. Chances are, one or more of these symptoms sound familiar — and annoyingly, they also happen to be classic PMS symptoms, or just part of life from time to time. That’s what makes things confusing.
What can really help is tracking your symptoms — not just if they happen, but how often, when, and whether anything seems to trigger them. Keeping a record gives you something concrete to bring to your GP or specialist, and helps build a clearer picture of what’s going on.
Fertility issues don’t always announce themselves with dramatic signs. Sometimes, they’re subtle patterns that only start to make sense when you step back and look at them over time. If you’re unsure or worried, testing can offer clarity — and with that, a clearer way forward.
How do you check if you are infertile?
If you’ve been having regular unprotected sex for a year (or six months if you’re 36 or over) and haven’t conceived, it’s time to speak to your GP. That’s the first step — because infertility can’t be confirmed based on symptoms alone. It needs medical testing. [1]
Your GP will start with an initial assessment, asking about your cycle, any past pregnancies or miscarriages, medical history, and lifestyle factors. They may arrange blood tests to check your hormone levels, screen for STIs, and refer you for an ultrasound to look at your ovaries, uterus, and fallopian tubes. If needed, you may be referred to a fertility specialist for more advanced testing, like tubal patency checks (using HyCoSy, X-ray, or laparoscopy), ovulation tracking, or ovarian reserve tests. If you have a partner, their fertility will usually be assessed too, through semen analysis and similar screening.
It’s worth knowing that access to NHS fertility testing can vary depending on where you live, as each ICB (Integrated Care Board) sets their own criteria. Some GPs might require you to meet certain conditions before referring you for tests. If that feels like a barrier — or if you want answers sooner — private fertility clinics are another route.
If you’re unsure where to start, our Clinic Match tool can help you find the right clinic for your needs, whether you’re going down the NHS or private route. It’s free, takes just a few minutes, and gives you personalised options based on your situation.
Can I check if I'm infertile at home?
You might have seen home fertility tests available from high street pharmacies or online platforms. These usually involve a finger-prick blood sample that’s sent to a lab to check hormone levels such as AMH (anti-Müllerian hormone) or FSH (follicle-stimulating hormone), with results typically returned within a few days.
While they may seem like a convenient first step, it’s important to approach these tests with caution. Hormone levels can vary throughout your cycle, and without a full clinical picture — including medical history, ultrasound scans, and additional blood tests — results can be difficult to interpret and, in some cases, misleading. At-home testing also carries a higher risk of contamination or error, which can affect accuracy.
We don’t recommend relying on these tests to understand your fertility. A clinical setting offers a more complete and considered assessment, helping you get clearer answers and guidance that’s grounded in your unique situation.
What causes infertility in women?
There are many reasons why conception might not be happening as quickly as expected — and for around 1 in 4 couples, no specific cause is ever found (what’s known as unexplained infertility). But here are the most common identifiable reasons: [1,27]
Age:
Fertility naturally declines with age, particularly after 35, and becomes more significant approaching menopause. This affects both egg quantity and quality, and is the most common and universal factor influencing fertility over time. [28]
Lifestyle and risk factors
- Weight – being overweight or underweight can affect ovulation. [29]
- Smoking or vaping – affects fertility for men and women. [30,31]
- Alcohol – heavy drinking can impact ovulation and sperm health. [32]
- Environmental exposures – to certain solvents, pesticides or metals. [1]
- Chronic stress – can suppress hormones involved in ovulation and sperm production. [1]
Hormonal or ovulation-related causes:
- Polycystic ovary syndrome (PCOS) – can disrupt or prevent ovulation. [2]
- Thyroid dysfunction – both underactive and overactive thyroids can affect ovulation. [4,33]
- Premature ovarian insufficiency (POI) – when ovaries stop working before age 40. [34]
Structural or physical causes:
- Blocked or damaged fallopian tubes – often from pelvic inflammatory disease (PID), past infection, or surgery. [13,35]
- Endometriosis – tissue growing outside the womb can damage ovaries or fallopian tubes. [12]
- Fibroids – non-cancerous growths in or around the uterus that can affect implantation or block fallopian tubes. [14]
- Cervical mucus problems – can make it harder for sperm to travel through the cervix. [1]
- Scarring from previous surgery – especially pelvic or cervical surgery. [1]
Medication or drug-related causes:
- Long-term or high-dose NSAIDs – like ibuprofen or aspirin. [1]
- Chemotherapy drugs – can cause ovarian failure. [36]
- Certain antipsychotics and neuroleptics – may stop periods or disrupt fertility. [1]
- Spironolactone – fertility usually returns after stopping. [37]
- Illegal drugs – such as marijuana and cocaine, which can affect ovulation. [38]
Find the right IVF clinic for you
Choosing a clinic is one of the biggest decisions you’ll make. We’ll find the best options for you and arrange your pre-treatment tests, empowering you from this point onwards.
What are the chances of being infertile?
The chances of being infertile are lower than they often feel. Around 1 in 7 heterosexual couples in the UK experience fertility difficulties, but most people will conceive naturally within a year — especially if the woman is under 40 and having regular unprotected sex every 2–3 days. After three years of trying, the chances of conceiving naturally drop to around 1 in 4 in the following year. [1,39,40,41]
Infertility doesn’t always mean you can’t conceive — often, it’s subfertility, meaning your chances are reduced, not zero. Age plays a big role, with fertility declining more sharply from the mid-30s. Ovulation issues, sperm quality, tubal damage, and lifestyle factors like smoking, BMI, or STIs can all contribute. [28,41,42]
When to see a fertility specialist
You don’t have to wait 12 months to ask for help — especially if something doesn’t feel right. Whether it’s irregular periods, past health issues, a gut feeling that something’s off, or simply the emotional weight of waiting, trust yourself. Early testing can make a huge difference. It can save time, reduce uncertainty, and help you avoid the stress of unanswered questions later on.
Fertility challenges are medical — and they’re treatable. From hormone support to IUI or IVF, there are many routes forward depending on what’s going on. The first step is getting clarity. That might mean speaking to your GP and requesting investigations, or turning to a private clinic if you want faster access or more personalised support.
You can also use our Clinic Match tool to find the right clinic for your needs and priorities. And if you’re feeling isolated or unsure, know that you’re not alone. Our community is full of people who’ve walked this path — and we’re here to help you feel more informed, less overwhelmed, and genuinely supported.
Want to talk through your options with our team? Message us on WhatsApp using our chat in the bottom right corner or send us an email, and together, we can work out what’s best for you.
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