Delivering personalised female hormone health through an expert report system

I am passionate about helping women improve their wellbeing and quality of life through a better understanding of their personal female hormones. But every woman is different and it takes time for me to interpret and explain her results. It has been extremely exciting to work with technology experts at Forth to create an app that enables many more women to access my medical knowledge in a personalised female hormone health report

For the past 30 years I have been working with many women who come asking questions about their female hormone health. These some of the questions often asked:

  • Am I entering the perimenopause? Should I consider HRT?
  • Am I making the best lifestyle choices for my personal hormone health?
  • How can I better understand the interaction between my hormones and my sports performance?

Women are absolutely right to be asking these important questions. The answers can help optimise physical and mental health. Women also know that lifestyle behaviour choices influence their health. The key message is that hormones are the mediators between our behaviours and our health.

Out of all the hormone networks, the female menstrual cycle is the most complex. Furthermore, the timings and levels of female hormone fluctuations are highly individual to each woman. There is also individual variation in the way that each personal female hormone network pattern interacts with behaviours and impacts wellbeing.

The gold standard for measuring the four key female hormones (Oestradiol, Progesterone, Follicle Stimulating Hormone and Luteinising Hormone) is to perform a blood test. This can be done at home using a simple capillary finger prick kit.

What is my approach to answer these questions about hormone health for an individual woman?

I start by asking about some background details, including age, menstrual history, lifestyle and wellbeing. Next, we look over the blood hormone results and I explain what these numbers mean. When I look at a set of hormone results, I scan for patterns and biological meaning. This is bit like translating a complex piece of prose written in a foreign language, but it is a language in which I am entirely fluent and conversant with all the grammar and subtle nuances, because it is the language of hormones.

After explaining the hormone patterns, we discuss how these personal patterns tie into wellbeing and what is the best course of action to optimise hormone health through lifestyle behaviours and sometimes medication, where clinically indicated. After our discussion, I write a summary letter that includes a suggested evidence-based personal action plan.

If there were a way I could make the process of delivering a personalised hormone health report more efficient, I would be able to support more women with hormone health questions. This is where artificial intelligence techniques can help.

Personalisation of health through the clinical application of artificial intelligence techniques is revolutionising health care

The Chief Medical Officer of England outlines how access to personalised medicine can be extended through the application of artificial intelligence techniques, such as machine learning[1]. This revolution in healthcare is underway. Every month I attend webinars for medical doctors run by the world leading research group based at Cambridge University to discuss the latest developments in this exciting field of clinical medical artificial intelligence[2].

Artificial intelligence (AI) [3] is somewhat of a misnomer. The “intelligence” does not come from a sterile computer; human programmers collaborate with experts to write the software. By encoding the language of hormones, the computer is able to recognise patterns and then draw upon my medical knowledge to interpret the results in a personalised report, at lightning speed.

For me, this is “intelligence augmentation”: IA rather AI.

You might wonder how a sophisticated computerised system can increase personalisation of healthcare? Even the most experienced individual doctor does not have the time or expertise to mathematically interrogate all clinical and research data in their particular field of medicine. By working closely with mathematicians, doctors can augment their clinical expertise to identify the best management and treatment for an individual. The other big advantage of mathematically modelling medical data is that it is possible to perform extensively testing, by generating lots of “virtual” patients with their medical data to feed into the system.

How can an expert report system deliver a personal female hormone health report?

The Female Hormone MappingTM system produces a personal hormone health report that is exactly what I write for a woman I see in clinic. The only difference is that this is produced in a fraction of the time it would take me to “download” my medical assessment through typing up a clinic letter[4].

The starting point to delivering a personalised female hormone health report was to work closely with a mathematician with expertise in statistics and computer science AI techniques. To help me in my interpretation of menstrual cycle hormone results, I needed graphs to show the variation of an individual’s hormone network over a menstrual cycle. This makes it easier to pick out hormone patterns and compare to a “reference” group of women matched for cycle length, who are known to be ovulating.

The process of making an expert report library

The next step was to work on an expert report system in order to access a vast library of clinic letters currently stored in my brain. This library covers all possibilities of hormone network results for women over a range of ages and activity level. The mathematical model generated an enormous range of possible graphs from “virtual” hormone blood tests from women of different ages and exercise levels. I sat for hours, days and months to harness my 30 years medical experience into how I would explain and advise a “real” woman sitting in front of me with those particular personal characteristics and results. In other words, I downloaded my medical brain.

All these medical summaries with evidence-based advice were definitely not generated by “artificial” intelligence. Rather the expert report system acts as a very efficient librarian. Presented with the request for a particular book and a specific page in the chapter, the expert librarian retrieves the exact page written by me, the author of all the books in this hormone library.

Hormonal digital fingerprint

In practical terms, a woman can now create a personalised digital fingerprint of her menstrual cycle hormone network from just two finger prick capillary blood samples taken during a cycle. Together with her personalised hormone health report, she can empower herself with insights into her hormone health in order to make informed decisions to optimise physical and mental health.

Female Hormone MappingTM is a personalised hormone health report, available at your fingertips on a mobile app, that I have developed in partnership with Forth, the health tech company where I am Chief Medical Officer. Your personalised female hormone health report provides detailed personalised clinical medical explanation, commentary and evidence-based advice written by me and delivered by an expert report system. 

As pointed out at every webinar I attend on the medical application of AI for health, AI can never replace medical doctors. Any unusual results are passed to me for review. There is also the opportunity to book in and discuss your report in further depth with me.

Furthermore, as with any medical measurement, the true value lies in monitoring trends over time. So, repeating Female Hormone MappingTM will give personal feedback on whether the advised lifestyle behavioural changes have helped with wellbeing and female hormone network function. This monitoring process directs further informed decisions about next steps for lifestyle modification, or discussion about medication where clinically indicated.

Answering the questions about personal female hormone health

This new approach in assessing female hormone networks for individual women is proving a valuable clinical tool[5]. This enables me to answer the questions that women are asking and move away from generic advice to personalised evidence-based advice. Having these personal hormone health insights empowers women to make informed, personal decisions that will help each individual attain her personal best quality of life.

References


[1]Machine learning for individualised medicine” Mihaela van der Schaar, Annual Report of the Chief Medical Officer. 2018, Chapter 10. Health 2040 – Better Health Within Reach. Accessed 2021

[2] Van der Schaar M. Revolutionising Healthcare webinars for clinicians, Cambridge University 2021

[3] Artificial Intelligence AI council. UK Government 2021

[4] Keay, N. Fingerprinting Hormones St John’s College, Cambridge University 2021

[5] Keay N. Hormone Intelligence for Female Dancers, Athletes and Exercisers. British Journal of Sports Medicine 2021


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