Normal FSH levels in women. Follitropin or FSH hormone in women: what is it, causes of excess and lack of an important substance

The hormonal system in women is a clear vertical with the main center of regulation in special areas of the brain - the hypothalamus and pituitary gland. Substances are synthesized and accumulated there, which then enter the bloodstream and stimulate the production of sex hormones. The latter, in turn, regulate the work of the reproductive organs and are responsible for general state organism.

Biochemistry of hormones

The hypothalamus is the main center that controls the secretion of all hormonal compounds. In its cells, gonadotropin-releasing hormone, aka gonadoliberin, is formed. Once in the cells of the anterior pituitary gland, it stimulates the secretion of follicle-stimulating and luteinizing hormone. But it does not proceed in a constant mode, but cyclically. In women in the follicular phase of the cycle every 15 minutes, and in the luteal phase and in pregnant women after 45 minutes.

Interesting fact. Gonadoliberin is affected by melatonin, which is synthesized during sleep. An increase in daylight hours and a period of wakefulness leads to a decrease in the inhibitory effect of melatonin and an increase in the function of the gonads. This is especially noticeable in the spring.

The synthesis of follitropin is inhibited by the protein substance inhibin. The follicle-stimulating hormone itself is a glycoprotein consisting of two subunits. In humans and animals, most of the molecule has the same structure, but the difference in one of the subunits does not allow the use of a substance of animal origin for medical purposes. It is obtained from the urine of menopausal women for medicinal purposes.

What FSH is responsible for in women is reliably known:

  • increase in estrogen;
  • conversion of androgens to estrogens;
  • regulation of the menstrual cycle.

Follitropin is also secreted in men, only its influence extends to the maturation of spermatozoa.

Phases of the cycle and the concentration of hormonal compounds

The concentration of sex hormones in the blood serum varies by day monthly cycle. From the first day of bleeding, the beginning of the cycle and the follicular phase, or estrogenic, are counted. During this period, there is an increase in follicle-stimulating hormone. At the same time, the concentration of estrogen increases. Under the influence of follitropin, a dominant follicle is released in the ovaries on the 5th day of the cycle, it is he who goes through all the stages of maturation, and the egg becomes ready for fertilization. The influence of estrogens extends to the uterine mucosa - proliferative processes intensify in it, microvessels and the thickness of the epithelium grow. This prepares the uterus for a possible pregnancy.

The peak of the release of FSH and LH corresponds to the rupture of the follicle membrane and the onset of ovulation. The follicular phase ends, the luteal phase begins, when the hormonal level is affected by the corpus luteum formed at the site of the follicle. It synthesizes a large number of progesterone, which inhibits the production of hormones in the pituitary gland according to the feedback principle. If pregnancy does not occur, the corpus luteum regresses, steroids decrease, and FSH begins to cycle again.

On average, the monthly cycle lasts 28 days, 14 of them are allocated for the follicular phase. In girls, the content of folliculin is low until the onset of puberty.

FSH tests

There are indications when it is necessary to take an analysis for follicle-stimulating hormone to make a diagnosis or search for the cause of the pathology:

  • infertility;
  • delayed or premature puberty;
  • lack of sexual desire;
  • endometriosis;
  • pituitary tumors are questionable.

The analysis allows you to determine the phase of the menstrual cycle and the period of menopause. In girls, follicle-stimulating kinin rises at night during puberty. This allows you to accurately diagnose the beginning of the restructuring of the body and determine its timeliness.

Analysis of FSH is necessary for the differential diagnosis of primary or secondary hormonal disorders. If the cause is in the sex glands, then a primary violation of hormonal regulation is established. If there is a pathology of the pituitary gland, then these are secondary disorders.

Venous blood sampling for FSH analysis

In isolation, the definition of FSH is rarely used. Often it is determined simultaneously with luteinizing kinin, which helps to establish the diagnosis of infertility and choose the tactics of treatment. Also, the analysis is necessary to control the hormonal therapy of certain diseases.

In order for the results of the study to be reliable, certain preparation rules must be observed. A few days before the test, in agreement with the doctor, stop taking hormonal drugs. Severe physical activity and emotional stress can also skew the results and should be avoided during the day before the study.

The analysis is handed over on an empty stomach. The studied material is venous blood. Do not eat or smoke for 3 hours before the test.

In women, the rate of follicle-stimulating hormone depends on the age and day of the cycle. For the study, FSH is prescribed from day 3 of the cycle to day 6 inclusive. In some cases, a study is carried out at the end of the cycle, on days 19-21.

Normal indicators during menstruation and up to day 6 are 3.5-12.5 mIU / ml. At this level, FSH lasts up to 14 days with a cycle of 28 days. At the time of ovulation.

Follicle-stimulating hormone increased or decreased - what does it mean?

To understand this is simple, based on knowledge of the normal cycle. From the 13th to the 15th day, ovulation occurs, while the concentration of the hormone reaches 4.7-21.5 mIU / ml. Then comes the luteal phase, in which the follicle-stimulating hormone drops to 1.2-9 mIU / ml.

If the examination is carried out in order to establish the causes of infertility, then both spouses pass the tests. Men do not have fluctuations in the level of follitropin during the month, so blood can be taken for them on any day. Normal values ​​are at the level of 1.5-12.4 mIU / ml. Also, for the diagnosis of infertility, the ratio of FSH and LH is taken into account.

The FSH rate in menopausal women is significantly different. During this period, the ovaries cease to function, the concentration of estrogens decreases, which leads to a response increase in follicle-stimulating and luteinizing kinins. For women during menopause, 25.8-134.8 mIU / ml is considered normal.

Signs of changes in hormone concentration

Increased concentration

The interpretation of the results of the study is associated with the clinical picture of a particular patient. The concentration of follicle-stimulating hormone above the norm is observed in various pathological conditions.

Early thelarche and menarche

In childhood, this will be a symptom of precocious puberty. The appearance of thelarche - secondary sexual characteristics in the form of hair growth on the pubis and in the armpits is considered a noma from the age of 9. Even later, the mammary glands increase and only then comes the first menstruation. The appearance of these early signs suggests precocious puberty, which can be confirmed by testing for follitropin.

Primary ovarian failure

It is observed in (premature menopause), when a woman under 40 does not produce enough estrogen, the follicles do not mature, and ovulation stops. This condition develops after severe stress, autoimmune and infectious diseases, and also if produced. Radiation and chemotherapy, alcohol abuse are damaging to the ovaries and also lead to their insufficiency.

Ovarian neoplasms and congenital chromosomal pathologies

And also lead to an increase in FSH levels. The same condition is observed in congenital chromosomal pathologies:

  • Shereshevsky-Turner syndrome;
  • Swyer's syndrome.

In both cases congenital pathologies The chromosomal apparatus leads to underdevelopment of the ovaries, which means an insufficient level of sex steroids. Violated puberty, the girls remain sterile.

In boys, testicular failure, and hence elevated FSH, occurs with congenital chromosomal pathology - Klinefelter's syndrome. Isolated syndrome of testicular feminization occurs when there is a congenital lack of tissue sensitivity to androgens, while estrogen sensitivity is preserved. Therefore, false male hermaphroditism develops: the external genitalia are formed according to the female type, but there is no uterus and ovaries. With a mild degree of the syndrome, the external genitalia will be male, but spermatogenesis and virilization are impaired, which is manifested by infertility. The level of FSH in this case will correspond to the female, which is considered an increase in concentration for men.

Presence of tumors

Tumors also lead to a change in follitropin. Malignant tumors in the lungs can directly secrete their own hormone. And tumors of the pituitary and hypothalamus increase the secretion of FSH due to additional stimulation.

endometriosis

In women, it also leads to an increase in FSH. An increase in kinin is considered normal only during menopause.

Reduced concentration

A decrease in FSH levels can occur in the following cases:

  • polycystic ovary syndrome;
  • pituitary insufficiency and dwarfism;
  • Sheehan's syndrome;
  • gonadoliberin deficiency - a congenital condition Kallman's syndrome;
  • tumors of the ovaries, testicles in men, adrenal glands, which produce an excess of estrogens and androgens;
  • anorexia or starvation, debilitating diets;
  • hemochromatosis.

Hormone levels by phase of the menstrual cycle

In what cases can the results of the analysis be incorrect?

In some cases, the results of the analysis may be distorted under the influence of external factors. receiving radioisotopes, hormonal drugs, pregnancy, MRI and smoking before the study will distort its results. Incorrect blood sampling, which leads to hemolysis, will also give incorrect test results.

The following drugs increase FSH:

  • Bromocriptine;
  • Danazol;
  • Tamifen;
  • Hydrocortisone;
  • Ketoconazole;
  • Metformin;
  • Tamoxifen;
  • Biotin.

Reduce follitropin drugs:

  • anabolic steroid;
  • anticonvulsants;
  • prednisolone;
  • corticoliberin;
  • combined .

If a low result is obtained during the study, then such an analysis is repeated. Due to the cyclic release of the hormone, it is possible that the analysis was taken during a period of reduced concentration. With an increased level of follicle-stimulating hormone, it is not necessary to repeat the analysis.

Ways to influence FSH

For the onset of pregnancy, a normal concentration of hormones is necessary.

How to increase follicle stimulating hormone without medication?

You need to rethink your lifestyle and diet. The diet should include a sufficient amount of green vegetables and seafood, as well as marine fish rich in omega-3 fatty acids. It is recommended to normalize your weight: if you are obese, lose at least 10% of excess weight, if you are underweight, get better.

Treatment advanced level follicle-stimulating hormone depends on the cause:

  • With an excess of prolactin, drugs are prescribed to reduce it (Bromocriptine).
  • With tumors of the pituitary gland, surgical treatment is performed with the removal of the pathological focus. Ovarian cysts are treated medically or surgically. Treatment for endometriosis depends on its size and location. It is possible to take drugs that cause medical castration (Zoladex, Buserelin) and subsequent surgical removal of foci that have survived. Or only surgical treatment is used.
  • With ovarian failure and impaired puberty, an increase in FSH can be corrected by hormone replacement therapy, when synthetic estrogen preparations are prescribed in combination with progesterone. The same treatment is used for.

In men and women, the work of the reproductive system is regulated by the hypothalamic-pituitary region of the brain. It is in the central endocrine glands that gonadotropic hormones are produced that stimulate the ovaries or testicles.

reproductive system

The human reproductive system functions on the principle of feedback (positive and negative). Its three levels (hypothalamus, pituitary, gonads) have a constant influence on each other.

Tropic hormones of the pituitary gland are produced under the control of:

  • inhibin;
  • gonadoliberin;
  • androgens and estrogens.

Sex steroids are secreted by the ovaries or testicles. If the concentration of these substances in the blood falls, then the synthesis of tropic hormones increases in the brain. Conversely, when there is a lot of estrogens or androgens, the formation of gonadotropins in the pituitary gland is suppressed. The hypothalamus stimulates the anterior pituitary gland to produce FSH and LH via GnRH. Suppresses the synthesis of follicle-stimulating hormone and inhibin (a product of the seminiferous tubules of the testis or ovarian cells).

Tropic hormones of the reproductive system

Tropic pituitary hormones for the reproductive system:

  • follicle-stimulating (FSH);
  • luteinizing (LH).

Each of these hormones has its own task in the body of men and women.

Biological action of FSH:

  • supports the growth of follicles in the ovaries;
  • triggers the proliferation of granulosa cells in the follicles;
  • increases the synthesis of the aromatase enzyme, which converts testosterone into estrogen;
  • increases the production of estradiol;
  • improves the sensitivity of the maturing egg to LH;
  • acts on the Sertoli cells in the testicles;
  • triggers the process of spermatogenesis in men.

The function of LH is to increase the concentration of testosterone in the blood in men. In women, this hormone is responsible for ovulation and an increase in progesterone levels in the 2nd phase of the menstrual cycle.

Gonadotropins are produced in the anterior pituitary gland. FSH is released into the blood in a pulsed mode. The pause between peaks of concentration reaches 2-4 hours. The level of FSH during an impulse release is 1.5-2 times higher than the average. The peak lasts about 15-20 minutes.

Gonadotropins in adult men are synthesized in a stable rhythm. Their concentration in the blood of FSH and LH is always approximately equal. Small seasonal fluctuations in concentration are observed. In the summer months, FSH levels in men are higher than in spring, autumn and winter.

In women of reproductive age, the hormones LH and FSH are secreted into the blood cyclically. It is their uneven secretion that helps maintain fertility. Due to the decrease and increase in the concentrations of LH and FSH, the maturation of the egg occurs and the phases of the menstrual cycle change.

When to donate blood for FSH

The study of gonadotropic hormones is indicated for women:

  • with primary and secondary infertility;
  • in the absence of ovulation according to tests and ultrasound;
  • when choosing oral contraceptives;
  • to control hormonal treatment of gynecological problems;
  • to determine the ovarian reserve;
  • for the diagnosis of menopause;
  • when diagnostics of the phase of the cycle is needed;
  • with violations of the menstrual cycle by the type of amenorrhea or oligomenorrhea;
  • with habitual miscarriage;
  • in girls with precocious puberty;
  • in girls with delayed puberty;
  • with a delay in physical development;
  • patients with polycystic and / or endometriosis;
  • with dysfunctional uterine bleeding;
  • patients with chronic inflammatory diseases uterus and appendages.

Men can also be assigned this analysis.

  • decreased sexual desire;
  • erectile dysfunction;
  • male factor of infertility;
  • growth retardation and impaired sexual development.

Blood for FSH is usually taken in a comprehensive analysis for sex steroids and gonadotropins. To see complete picture, the doctor needs to know the level of FSH, LH, prolactin, testosterone, estradiol, progesterone, etc. If necessary, the examination is supplemented with instrumental methods: ultrasound, tomography, etc.

Preparation for analysis


In women, the day of the menstrual cycle is of great importance for the level of FSH. If the doctor has not recommended otherwise, then the blood should be donated at the very beginning of the first phase. It is permissible to carry out the analysis from the 2nd to the 7th day of the cycle, but it is preferable from the 2nd to the 4th.

If a woman has menopause, amenorrhea in reproductive age, or an irregular cycle, then the study can be performed on any day.

In men, FSH is determined on any day.

For preparation it is necessary:

  • exclude heavy physical activity for 3 days;
  • stop smoking 1 hour before blood sampling.

The analysis should be taken on an empty stomach (8-14 hours after dinner). The preferred time for blood sampling is between 8 am and 11 am.

FSH norm

The analysis is interpreted by the doctor. FSH is measured in international units (mU / ml).

The norm for FSH in boys of the first year of life is considered to be up to 3.5. From 1 year to 5 years, this figure should be less than 1.5. At the age of a boy from 6 to 10 years old, with the physiological development of FSH, it is less than 3. In adolescents of 11-14 years old, the hormone should be in the range from 0.4 to 6.3. In boys 15-20 years old, FSH is considered normal from 0.5 to 10. Adult men have hormone levels from 1 to 12.

In girls, FSH is on average higher. In the first year of life, it can be up to 20.3, then up to 5 years - up to 6.1, and further up to 10 years - no more than 4.6. In older girls before menarche, FSH can range from 0.2 to 8.8.

In girls with the onset of menstruation and in adult women, the hormone is most dependent on the phase of the cycle.

Norm for FSH:

  • first phase 1.37-9.9;
  • ovulation 6.17-17.2;
  • second phase 1.1-9.2.

In women, after the cessation of the menstrual cycle, there is a sharp increase in the level of FSH in the blood. The hormone in this period of life is in the range from 19 to 101.

For women, not only the FSH level itself is of great importance, but also its ratio with LH.

So, the LH / FSH ratio:

  • equals 1 before menarche;
  • equal to 1-1.5 after 12 months from the beginning of the menstrual cycle;
  • equal to 1.5-2 in a woman of childbearing age.

The ratio is disturbed when ovarian function is impaired.

Deciphering the results of the analysis


Elevated and insufficient levels of FSH occur in different clinical situations.

A high score indicates:

  • primary hypogonadism;
  • true depletion of ovarian reserves;
  • genetic syndromes (Svaer, Shereshevsky-Turner);
  • testicular feminization;
  • follicle persistence;
  • endometrioid ovarian cyst;
  • glandular pituitary tumor, etc.

Low FSH happens with.

The main center of the human hormonal system is located in the brain. The hormone FSH (follicle-stimulating) is responsible for a number of processes in the body. Hormonal concentration is not constant, it fluctuates during the monthly cycle.

The role of FSH in the body

Follicle-stimulating hormone plays a huge role in the body. Let us consider in more detail what this substance is responsible for in women.

  • follicle maturation.
  • Working out.
  • Ovulation.
  • The breakdown of androgens.
  • cycle regularity.

The follicle stimulator is also produced in men, it affects the process of maturation of spermatozoa.

Phases of the cycle and the hormone FSH

The start of the beginning of the cycle begins from the first day of menstruation. First comes the estrogen (follicular) phase, in which estradiol and related substances increase their presence in the blood. In the ovaries on the 5th day of the cycle, a dominant follicle is produced, which gradually matures.

The maximum release of FSH and LH (luteal hormone) occurs when the follicle bursts and ovulation occurs. At this time, the luteal phase of the cycle begins, when the corpus luteum has the main effect. The cycle lasts 21-36 days, two weeks are given for the follicular phase. Before the onset of menarche, the FSH content is low, as in menopause.

Hormonal level

Tests for the content of follicle-stimulating hormone are needed for an accurate diagnosis and finding out the cause of the patient's pathologies. Analysis for FSH is necessary for the following conditions.

  • Infertility.
  • Repeated miscarriages.
  • developmental delay.
  • Weak or absent libido.
  • , problems with menstruation.
  • Endometriosis.
  • Neoplasms in the pituitary gland.

Based on the results of the analysis, you can determine the period of menopause or the phase of the cycle. During puberty, the amount of follicle stimulator increases slightly at night. This helps to diagnose changes in adolescence. Analysis is needed to diagnose hormonal imbalance in the body. If it turns out that FSH has a normal level, then the problem is hidden in the gonads. In the pathology of the pituitary gland, the follicle stimulator is increased or decreased.

Separately, blood sampling for FSH is rarely prescribed, more often together with LH. This allows you to identify the cause of infertility and choose the right therapeutic strategy.

Sometimes the hormonal level will be found out as a control marker in the treatment of certain diseases. In order for the results of the analyzes to be accurate, it is important to comply with some requirements.

A week before blood sampling, by prior agreement with the doctor, you need to stop drinking oral contraceptives and some other drugs. Powerful physical activity and psycho-emotional tests will definitely affect the results.

Therefore, two days before the tests, you need to relax physically and mentally. The sampling of biological material is carried out on an empty stomach. Only the blood of their veins is subject to research. 8-12 hours before the analysis, you can not eat. Smoking is also prohibited for at least three hours before blood donation.

The rate of analysis depends on the age, the day of the cycle and even the time of day. Usually the doctor indicates that you need to donate blood strictly from the third to the sixth day. Sometimes studies are carried out from the 19th to the 21st day. Each endocrinologist has a table according to which decoding is carried out. You can also look at it below. Indicators are considered normal on days 1-6 of the cycle from 3.5 mIU / ml to 12.5 mIU / ml. At this level, the body keeps until the very ovulation. If the female cycle is standard and is four weeks, then the decrease begins on the 15th day.

Norm FSH

Ovulation in a normal 28-day cycle occurs on days 13-15, FSH reaches its peak value in the range of 4.7-21.5 mIU / ml. After ovulation, the body is restructured, when hormonal balance is achieved due to the maximum functioning of the corpus luteum. At this time, the follicle stimulator drops to its minimum value in the range from 1.2 mIU / ml to 9 mIU / ml.

FSH indicators at different periods of the cycle

If the doctor's task is to find the causes of infertility in a married couple, then the husband and wife are examined. In the male half of the population, the follicle stimulator remains approximately at the same level for a month. The norm in men is always at the level of 1.5 mIU / ml to 12.4 mIU / ml. For diagnosis, you need to additionally know the amount of lutein in the body.

The norm of the hormone in menopause in women is very different from its values ​​in the reproductive period. In menopause, the ovaries do not work, the level of the hormone estradiol drops dramatically. In menopause, the normal value of the follicle stimulator increases. Depending on the laboratory and the reagents available there, indicators in menopause are indicated in the range of 25.8 mIU / ml-134.8 mIU / ml.

FSH levels at different periods of life

High FSH

The doctor deciphers the result only on the basis of an analysis of the overall clinical picture of a particular woman. It takes into account her age, health status, medications taken and even mood. An increase in FSH is observed under strictly defined conditions that are well studied.

Usually a girl develops according to a certain pattern. First, her armpit and pubic hair begin to grow, and the mammary glands increase. Normally, this happens at the age of nine or fourteen. A little later, menarche begins - the first menstruation. If hair growth, breast growth and menstruation begin before the age of nine, the child should be shown to a pediatric gynecologist. The first diagnosis that the doctor suspects in such a situation is premature maturation. To confirm the diagnosis, the child will be sent to donate blood to the level of FSH. In such a situation, it will be elevated.

The second diagnosis, accompanied by an excess of FSH, is ovarian exhaustion. Usually the ovaries begin to deplete after the age of forty, but sometimes it happens earlier. In this case, they talk about premature menopause. In women with early menopause, little estradiol is produced, the follicles do not have time to mature to the desired stage, and ovulation does not occur.

The early onset of menopause cannot be considered a physiological phenomenon. Usually this happens after a lot of stress, as a result of an infection or an autoimmune disease. The reason may be a surgical operation to resect the ovary.

Cancer treatment with chemotherapy, abuse alcoholic drinks also negatively affects the condition of the ovaries, causing their early insufficiency.

Ovarian neoplasms or congenital genetic diseases can cause increased follicle-stimulating hormone. Congenital anomalies of the chromosome set cause underdevelopment of sex hormones, puberty is disturbed, the woman remains infertile. In boys, high FSH occurs with a congenital anomaly, the male genital organs develop along female image but unable to bear children.

Tumors necessarily affect most of the hormones in the body. Malignant tumors in the lungs produce the hormone themselves. Neoplasms in the brain also increase the secretion of hormones several times. Some benign tissue growths also lead to excess production of FSH. An increase in this hormone is normal only at the age when a woman has already gone through menopause.

Low FSH

A decrease in the level of the hormone occurs with the following diseases and conditions.

  • Polycystic ovaries.
  • Weak pituitary function.
  • Gonadolirerin deficiency.
  • Insufficient blood supply to the fetus during childbirth.
  • Neoplasms in the ovaries.
  • Tumors in the adrenal glands.
  • Lack of weight.
  • Rigid diet.
  • Excessive accumulation of iron in the body.

Errors in analyzes

Sometimes the results of laboratory studies are erroneous, they are distorted under the influence of external circumstances. Such circumstances include taking some hormonal and some other pills, radioisotope substances.

Distorts the result of the patient's pregnancy, smoking before analysis, conducting magnetic resonance imaging on the eve. The mistake of a nurse who incorrectly performed blood sampling leads to hemolysis and incorrect results.

Taking a number of anabolic steroids and hormones, anticonvulsant pills reduces the amount of FSH. Therefore, at low hormone levels, the analysis is always repeated after a detailed questioning of the patient. Hormones are produced in the body cyclically, so the collection of materials could be carried out at the peak of the reduced concentration. With a high hormone, the analysis is not duplicated.

How to influence FSH

When preparing for pregnancy, a woman is important. FSH can be increased without medication if the decrease is not critical. In such situations, the endocrinologist recommends reconsidering nutrition and lifestyle. For the normal functioning of the hormonal system, greens and seafood must be present in the diet. To replenish the body with fatty acids, it is necessary to add sea fish to the diet.

The doctor will definitely recommend to reset excess weight. Reducing weight even by 5-10% will lead to a significant improvement in health. Excessive thinness is also harmful to the female body, it becomes common cause hormonal deficiency.

The treatment regimen for elevated FSH depends solely on the causes of the pathology.

  • If the cause is an excess of prolactin, then a drug is prescribed to reduce the follicle-stimulating hormone.
  • Neoplasms of the pituitary gland need surgical treatment in order to remove pathological tissue growths.
  • Cysts in the ovaries are treated in two ways: by the appointment of hormonal drugs or by surgery.
  • Endometriosis is treated in different ways, the choice of method depends on the localization of the pathological process. Surgical curettage of the uterine cavity is often used. Drugs for pharmacological castration may be pre-administered, after taking the medication, the remaining foci of endometriosis are removed.
  • If ovarian failure has led to a developmental delay, then high FSH is treated by correcting with replacement therapy. Synthetic estradiol is usually prescribed together with progesterone or its analogues. A similar treatment is carried out with an early menopause.

The FSH hormone is essential for the normal functioning of the entire body. To make sure that the cause of the disease was a lack or excess of this hormone, you need to donate venous blood. According to the results of the examination, the doctor will prescribe treatment.

A balanced diet, moderate exercise and peace of mind will help restore balance as quickly as possible. Rigid diets, obesity, physical inactivity and bad habits harm women's health and greatly complicate treatment.

The state of health of a woman largely depends on hormones: in early years sex hormones stimulate the development of female characteristics and reproductive functions through cyclic menstruation.

In addition, menopause may be accompanied by unpleasant symptoms, which in some cases require.

An active role in these processes is played by luteinizing (LH), follicle-stimulating hormones (FSH), progesterone and estrogens. Closer to the age of 40, the first signs of menopause appear, expressed by changes in the hormonal background and a slowdown in the production of estrogen by the ovaries due to a decrease in their egg reserves.

Gradually, menstruation comes less and less, the endometrium in the uterus is no longer updated due to a drop in the level of progesterone, the mucous membranes become thinner, and the genitals decrease in size. Such a restructuring also affects the synthesis of LH and FSH, which in general is very reflected in the general well-being of women in the menopause.

Climax and its phases

The physiological process, when in a series of age-related transformations of the female body, the processes of gradual cessation of reproductive and then menstrual functions prevail, is called menopause, which in Greek means “ladder” or “step”.

It takes place in 3 stages:

  1. premenopause. It starts at the age of 40-50 and lasts about a year and a half, during which conception is still possible, because. the eggs, although less often, still mature, and menstruation passes with an increasing interval and with less blood loss and duration. In between they may appear. Ovulation before menstruation occurs less frequently, then stops. Menses still come for a while, but they soon disappear. The second period of menopause comes.
  2. Menopause is the year after the end of the last menstrual period. The activity of the ovaries and other genital organs ceases. Pregnancy is no longer possible. high risk of osteoporosis, cardiovascular disease, diabetes And .
  3. Postmenopause- the final period of menopause, which lasts until the end of life. At that time menopausal symptoms are no longer observed, and high levels of FSH and LH tend to decrease.

How to delay the onset of menopause, read.

How do female hormone levels change?

By the time of the onset of the first phase of premenopause menopause, the reserve of eggs in the ovaries laid down in the embryonic period of the future girl is depleted, the level of female sex hormones estrogen decreases significantly, first to a minimum limit of 50 pg / ml, and then to 6 pg / ml. Progesterone, which is responsible for the state of the uterine mucosa, also decreases to the lower limits of 0.64 nmol / l (and even lower).

FSH

Follicle-stimulating hormone in menopause is a hormone produced by the pituitary gland, in women it is actively involved in the growth and maturation of follicles in the ovaries, stimulates the release of specific female hormones estrogen. In men, it controls the maturation of spermatozoa.

Its values ​​are not constant, they increase in the middle of the menstrual cycle, during ovulation, they are especially high at the onset of menopause. During pregnancy, the level of substances is inhibited by the corpus luteum hormone - progesterone. According to the dynamics of FSH growth in that phase of the menstrual cycle, when its values ​​are maximum, one can judge the approach of menopause.

The reproductive mechanism is built on the tandem of the pituitary gland and the ovaries. When the resources of the ovaries are depleted, and they produce estrogen more economically, the pituitary gland seeks to stimulate it by increasing the production of FSH. This is observed when approaching and onset of the first phase of menopause.

Meaning of indicators

As menopause approaches, the level of FSH in the ovulatory phase of the cycle increases every month. So, if in young age this figure corresponded to 10 mIU / l, then in a year it can double, and during menopause it triples or quadruples.

Tendencies to increase in FSH values ​​persist in the first and second phases of menopause, when it can reach up to 135 mIU / l. And then the level of the hormone decreases somewhat, remaining, however, stably high.

Norm

The norm of FSH during menopause in its different stages is different. In the initial phase, it is minimal and does not exceed 10 mU/l. At this time, fluctuations in the indicator during the menstrual cycle are still observed: at its beginning it is 4-12 mU / l, during ovulation it increases by 2-3 times, and in the luteal period it again decreases to a minimum.

At menopause, the level of estrogen compared to childbearing age is halved, and the concentration of FSH in the blood increases by 4-5 times. This is considered normal. For several years after the last menstruation, this FSH indicator remains at the level of 40-60 mU / l, and then gradually decreases. If this does not happen, then they talk about the pathological processes of the body.

What threatens high and low levels

Elevated FSH levels are observed in the following cases:

  • Reception of a number of medications: statins, antifungals and agents for the normalization of insulin in diabetes.
  • Bad habits (smoking, alcoholism, coffee addiction).
  • With infectious diseases.
  • During stress.
  • With a low level of estrogen in the blood due to endometriosis, pituitary or ovarian tumors.

A significant decrease in FSH levels is associated with high content in the blood of estrogen, the causes of which are:

  • The use of glucocorticosteroids, oral contraceptives, anabolics, hormonal drugs.
  • Pregnancy.
  • Hypofunction of the hypothalamus or pituitary due to a tumor.
  • Polycystic ovary.
  • Anorexia or starvation.
  • Hereditary disease with impaired iron metabolism in the body.
  • Obesity.

A high level of FSH indicates the onset of menopause, and a low level is often found in malignant tumors.

How to normalize?

During premenopause, a gynecologist-endocrinologist prescribes drugs to mitigate the accompanying symptoms and facilitate the body's adaptation to hormonal changes. These are low estrogen and progesterone combination products.. Moreover, if a woman's uterus was removed, then only medications estrogen based.

Read about all the pros and cons of hormone therapy for menopause.

In addition, to increase the level of FSH, a diet containing foods that cause cholesterol synthesis is prescribed.:

  1. Meat, fat, liver.
  2. oily fish
  3. Butter.
  4. Greens, nuts, fruits.

Useful infusions based on non-hormonal phytoestrogens: cimicifuga, flax, soy, hops.

Hops - natural estrogen, beer based on it, considered a female drink that helps normalize hormonal levels.

How to treat menopause symptoms folk remedies, read also .

LG

Luteinizing hormone (LH) is produced by the pituitary gland at the base of the brain. In women, it controls the maturation of the egg and ovulation, is involved in the formation of the corpus luteum and the secretion of estrogen in the ovaries. At ovulation, it reaches its maximum level in just a day.. And during menopause, trying (like FSH) to stimulate the female hormones estradiol and progesterone, the substance increases rapidly - compared to the childbearing period by 2-10 times.

How does the level change?

If a woman is still on her period, then the LH level (depending on the period of the cycle) fluctuates. In the first phase, it ranges from 2 to 25 mU / l, during ovulation its level increases 4 times, and in the luteal period it decreases to the minimum (0.6-16 mU / l).

If pregnancy occurs, which is possible only with premenopause, then its level is quite low. But during menopause, depending on how long the last menstruation took place, there is a significant increase in it, followed by some decrease. The dynamics and causes of LH fluctuations are exactly the same as described in the case of FSH.

The norm and what threatens its increased and decreased levels

The norm of LH during menopause in its different periods ranges from 5 to 60 mU / l. The maximum values ​​of this indicator are observed in the absence of menstruation in the menopausal phase. As in the case of FSH, it can stay at this level for several years until the body adapts to new conditions, and then gradually decreases to 20 mU / l.

But the absolute indicator of this hormone, especially in the initial period of menopausal changes, should also be compared with the value of FSH. It is considered normal if it is slightly behind the numbers of another hormone. If this is not the case, then they are not talking about menopause, but about pathologies: polycystic or ovarian depletion, tumors, kidney failure, and others.

Another significant increase in LH levels indicates such conditions:

  • Pituitary and ovarian dysfunction.
  • When you receive medicines(clomiphene, spironolactone).

And a decrease in the level of this hormone signals such pathologies or is a consequence:

  • Failure of the pituitary gland or hypothalamus.
  • Insufficiency of the corpus luteum.
  • Increased secretion of prolactin by the pituitary gland.
  • Obesity.
  • Anorexia nervosa or stress.
  • Bad habits.
  • Taking medications: digoxin, megestrol, progesterone.

How to bounce back

LH easily responds to any changes in the body. To normalize it, you need to stop smoking, alcohol abuse. You should eat a balanced diet, including in food all the minerals and vitamins necessary for the body.

NOTE!

Read also how to get rid of menopause symptoms.

What tests need to be done

To control the hormonal level of the body, a gynecologist-endocrinologist prescribes a comprehensive blood test. It is carried out on an empty stomach, 10 hours before that, you should refrain from eating, and a day before the procedure, stop smoking, alcohol, sexual intercourse and physical overexertion. The specialist at this time also cancels the use of hormonal drugs.

Usually these tests are taken at different phases of the menstrual cycle, the time of the greatest activity of each test substance is selected. With an irregular cycle, these procedures are repeated at regular intervals.

Age-related hormonal restructuring is a physiological process that lasts for a year, which cannot be avoided. A quantitative change in the level of hormones is purely individual and requires close monitoring, especially if these fluctuations are painful. Timely noticed deviations of female hormones from the norm will allow the doctor to determine their cause and prescribe the appropriate treatment.

Useful video

From the video you will learn about the effect of hormones on menopause:

In contact with

When identifying the causes of infertility, a blood test is always prescribed for the ratio of luteinizing and follicle-stimulating hormones. The ratio of LH and FSH gives the doctor information about existing problems and helps to determine next steps. Two analyzes must be taken in one menstrual cycle. The results obtained must be considered in combination. This type of study determines whether the amount of hormones is equal, or whether one prevails over the other.

The result of the analysis for the ratio of LH and FSH is an indicator of the activity of the organs of the reproductive system.

Follicle stimulating hormone

Follicle-stimulating hormone is also called follitropin. This substance is produced by the anterior pituitary gland. It performs the most important functions, regulating the work of the female reproductive system. FSH maintains the activity of the gonads, exerting a stimulating effect on them and promoting the growth of graafian vesicles, from which mature eggs are subsequently released.

The concentration of follitropin increases within a few days after the end of the next menstruation and determines the dominant follicle. This substance is responsible for the process of its maturation and growth.

Norm FSH

The result of the FSH test depends on the day of the cycle on which the blood was taken. An increase in the level of follicle-stimulating hormone occurs after the end of menstruation and until the moment when the dominant bubble reaches a size corresponding to 20-22 mm.

The norm for ovulation is the FSH index from 4.7 to 21.5 mIU / ml.

The optimal time to conduct an FSH test is the beginning of the menstrual cycle. The norm of FSH in the follicular (follicular) phase is considered to be from 3.5 to 12.5 mIU / ml. Please note that normal values ​​may vary in different laboratories.


This table shows the normal (reference) levels of FSH for men and women in different phases of the cycle.

luteinizing hormone

Another name for luteinizing hormone is luteotropin. Its production is carried out by the endocrine glands and the brain. The substance regulates the activity of the organs of the reproductive female system. The main purpose of luteotropin is to stimulate ovulation in the appropriate period, as well as to create optimal conditions for the attachment of a fertilized egg.

In women, luteotropin stimulates the synthesis of estrogens, while in men it enhances the production of androgens.

Norma LH

The first phase is characterized by low levels of LSH, corresponding to 2.4-12.6 mIU / ml. Such parameters provide the desired concentration of estradiol for the growth of cells of the endometrial layer. An increase in the level of luteotropin is noted closer to ovulation and reaches a peak a few hours before its onset. Then the content of the hormone gradually decreases. At the same time, the source of progesterone in the luteal phase is activated.


This table shows LH norms for women (reference values) in different phases of the cycle.

Normal level LH for men 1.7 - 8.6 mIU / ml.

LH above normal: what does it mean

An elevated level of luteinizing hormone in the first phase often indicates either. But you should know that it is impossible to make a diagnosis on the basis of analysis alone. It is necessary to examine the patient in detail in order to exclude these pathologies.

Rules for testing for LH and FSH

It is necessary to donate blood for luteotropin and follitropin in several cases:

  • menstrual irregularities;
  • endocrine pathologies;
  • diseases of the organs of the reproductive system;
  • infertility.

The results of these analyzes alone are not very informative, so it will be difficult to determine what the essence of the problem is with their help. For this reason, doctors consider them together. It is necessary to familiarize yourself with the rules for donating blood so that the results are as correct as possible. Hormone levels are constantly changing, and you need to know which day to come to the laboratory. The most suitable time period is from the third to the fifth day of the menstrual cycle. Otherwise, the ratio will be distorted.


In order for the tests to show the most accurate result, you must strictly follow all the instructions before donating blood.

Before the study, you must adhere to several recommendations:

  1. Do not drink alcohol for a week before the test.
  2. Do not eat fatty foods, spicy, fried, salty.
  3. Avoid physical activity.
  4. Three days before the study, do not have sexual intercourse.
  5. On the day of blood donation, do not smoke and remain calm, as emotional overstrain can distort the results.
  6. After the last meal, at least six hours must pass before blood sampling.

For research, blood is taken from a vein. It is necessary to decipher the results based on the standards of the laboratory in which the analysis took place.

The normal ratio of hormones for conception

LH and FSH change their ratio throughout the entire monthly cycle. Immediately after the end of menstruation, the follicular phase begins. This period is characterized by the predominance of the substance responsible for stimulating the activity of the gonads. Up to 6-9 days of the cycle, an increased concentration of follitropin and a reduced level of luteinizing hormone are noted. When ovulation ends, the luteal phase begins. At this time, on the contrary, the amount of FSH is declining, and LH is increasing.


The graph shows how LH and FSH rise at the time of the release of the egg from the follicle at the end of the follicular phase. The normal ratio of these hormones to each other is shown to the right of the graph.

Until adolescence, the production of these hormones occurs in the same amount, therefore, their ratio is equal to one. After the appearance of the first menstruation, the level of luteotropin and follitropin gradually increases. After one year, the coefficient corresponds to 1.5, and after another year - 2.

If the reproductive system is working properly, then the ratio of luteinizing and follicle-stimulating hormones should be up to 2.5.

The sex glands function correctly with the optimal ratio of these substances. When abnormalities are detected, in particular with an increase in the production of these hormones, it is very important to take appropriate measures in a timely manner to reduce the concentration. Methods for solving the problem depend on the factors that caused the violations.

What does wrong ratio mean?

To establish the ratio of follitropin and LH, the indicators of luteotropin are divided by FSH. The results obtained should be in the range between 1 and 2.5. An increased coefficient always indicates the presence of pathological processes in the reproductive system.

Common causes of imbalance:

  • Early menopause.
  • benign tumors.
  • Androgen resistance syndrome.

It is important to understand that the results of the tests are strongly influenced by the mood of the patient, taking any medications, physical overstrain, etc. Therefore, preparation for the test must be approached responsibly.

Underestimated values ​​usually indicate the absence of ovulatory processes. If an increased coefficient is noted after the onset of menopause, then this is the norm.

Normalization of hormonal levels before conception

Preparation for the upcoming pregnancy involves a thorough examination of the patient, including blood tests for hormones. The correction method depends on how much the coefficient between follitropin and luteinizing hormone deviates from normal values. With excessively elevated rates, modern and effective methods of infertility therapy are used.

When planning conception, the hormonal system is put in order using the following means:

  1. Decreased physical activity.
  2. Application hormonal drugs to regulate the functioning of the ovaries.
  3. Establishing a sleep pattern.
  4. Measures to reduce weight (with its excess).
  5. Elimination of stressful conditions and situations.

Obesity is one of the worst enemies of the balance of hormones in the body, so you need to maintain a normal physical shape, eat right.

In addition, in the absence of a night's sleep, an imbalance often occurs, since most of the hormones are synthesized at night. The process of production of FSH and LH is inevitably disrupted, their ratio is not changing for the better.

The ratio of LH and FSH in men

These substances are produced not only in female body but also in men. But in men, these hormones perform other functions:

  • LH is involved in the production of testosterone and is also responsible for the production of seminal fluid.
  • ensures the normal functioning of the testes, promotes the development of sperm.

The ratio between follitropin and luteotropic hormone in men does not have of great importance. It is important only in the female body, especially when planning a pregnancy. The concentration of FSH and LH in men is determined individually.

The level of follitropin in the representatives of the stronger sex should correspond to the range from 1.5 to 12 mU/l, and luteotropin - from 0.5 to 10 mU/l.

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