The FSH and LH test contains 1 test with 2 biomarkers.
Brief Description: The FSH (Follicle-Stimulating Hormone) and LH (Luteinizing Hormone) test is a laboratory test that measures the levels of these hormones in the blood. FSH and LH are important hormones involved in the regulation of the reproductive system and play a crucial role in the menstrual cycle and fertility.
Also Known As: Follicle Stimulating Hormone test, Follitropin Test, Luteinizing Hormone Test, Lutropin Test, Interstitial Cell Stimulating Hormone Test, ICSH Test
Collection Method: Blood Draw
Specimen Type: Serum
Test Preparation: No preparation required
When is a FSH and LH test ordered?
An FSH and LH test may be ordered in the following situations:
Evaluation of Reproductive Function: Healthcare providers may order an FSH and LH test to assess reproductive function and investigate issues related to fertility, menstrual irregularities, or problems with sexual development.
Infertility Workup: For individuals experiencing difficulty in conceiving, an FSH and LH test can help determine if hormonal imbalances are contributing to infertility. It provides valuable information about the functioning of the ovaries or testes and aids in identifying potential causes of infertility.
Monitoring of Fertility Treatments: Individuals undergoing fertility treatments, such as ovulation induction or assisted reproductive technologies, may require regular monitoring of FSH and LH levels to assess the response to treatment and guide adjustments in medication dosages.
What does a FSH and LH blood test check for?
FSH and LH are hormones linked to production and the development of eggs and sperm in both men and women. FSH and LH is measured in the blood.
The pituitary gland produces FSH and LH. The hypothalamus in the brain, the pituitary gland, and hormones generated by the ovaries or testicles all work together to control FSH and LH production. The hypothalamus secretes gonadotropin-releasing hormone, which causes the pituitary to secrete FSH and luteinizing hormone.
During the follicular phase of the menstrual cycle, FSH and LH increases the growth and maturation of eggs in the ovaries in women. The menstrual cycle is divided into two phases: follicular and luteal, each lasting approximately 14 days. During this follicular phase, FSH triggers the follicle's synthesis of estradiol, and the two hormones collaborate to help the egg follicle develop further. A surge of FSH and luteinizing hormone occurs near the end of the follicular period. Shortly after this burst of hormones, the egg is released from the ovary. The hormones inhibin, estradiol, and progesterone all help the pituitary gland regulate the quantity of FSH released. FSH also improves the ovary's ability to respond to LH.
Ovarian function declines and eventually quits as a woman matures and approaches menopause. FSH and LH levels rise as a result of this.
FSH induces the development of mature sperm in men's testicles, as well as the production of androgen binding proteins. After adolescence, men's FSH levels remain rather steady.
FSH levels rise early after birth in infants and children, and then quickly fall to low levels by 6 months of age in boys and around 1 and half years of age in girls. Before puberty and the development of secondary sexual characteristics, FSH levels begin to rise again.
The production of too much or too little FSH and LH can be caused by disorders affecting the brain, pituitary, ovaries, or testicles, resulting in infertility, irregular menstrual cycles, or early or delayed sexual development.
Lab tests often ordered with a FSH and LH test:
Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH) are key hormones in the regulation of the reproductive system in both men and women. Tests for FSH and LH are often part of an evaluation for fertility issues, menstrual irregularities, or suspected disorders of the reproductive system. When these tests are ordered, several other tests are typically included to provide a comprehensive assessment of reproductive and general health. Here’s an explanation of these tests:
- Purpose: Estradiol is a form of estrogen, the primary female sex hormone, which plays a crucial role in the menstrual cycle and fertility.
- Why Is It Ordered: In women, estradiol levels provide insight into ovarian function and are important in evaluating menstrual irregularities, menopause, and fertility. In men, estradiol is important for sexual function and bone health.
Testosterone (Total and/or Free):
- Purpose: Testosterone is the primary male sex hormone but is also important in women’s health.
- Why Is It Ordered: In men, it helps assess testicular function and is key in evaluating hypogonadism and infertility. In women, elevated testosterone levels can be a sign of conditions like polycystic ovary syndrome (PCOS).
- Purpose: Progesterone is a hormone that prepares the uterine lining for pregnancy and helps maintain early pregnancy.
- Why Is It Ordered: To evaluate ovulation and luteal phase function, especially in women experiencing infertility or menstrual irregularities.
- Purpose: Prolactin is a hormone produced by the pituitary gland, primarily known for its role in lactation.
- Why Is It Ordered: Elevated prolactin levels can interfere with the normal production of FSH and LH, leading to menstrual irregularities and infertility.
Thyroid Function Tests (TSH, Free T3, and Free T4):
- Purpose: To assess thyroid function, as thyroid disorders can impact reproductive hormones.
- Why Is It Ordered: Both hyperthyroidism and hypothyroidism can cause menstrual irregularities and affect fertility.
Sex Hormone Binding Globulin (SHBG):
- Purpose: SHBG binds to sex hormones, affecting their availability in the body.
- Why Is It Ordered: Abnormal levels of SHBG can influence the levels of free hormones, affecting reproductive function and symptoms.
Dehydroepiandrosterone Sulfate (DHEA-S):
- Purpose: DHEA-S is an androgen precursor produced by the adrenal glands.
- Why Is It Ordered: Elevated levels can contribute to androgen excess in women and may be indicative of adrenal gland disorders.
Hemoglobin A1c (HbA1c) and Fasting Glucose:
- Purpose: To assess blood sugar control and screen for diabetes.
- Why Is It Ordered: Diabetes and insulin resistance can affect hormone levels and reproductive health.
Anti-Müllerian Hormone (AMH):
- Purpose: AMH provides an indication of a woman’s ovarian reserve (egg supply).
- Why Is It Ordered: To assess fertility potential, especially in women considering fertility treatments or experiencing early menopause symptoms.
These tests, when ordered alongside FSH and LH, provide a detailed picture of an individual’s reproductive hormonal balance, helping to diagnose and manage conditions related to fertility, menstrual health, and overall endocrine function. The specific combination of tests depends on the individual’s symptoms, sex, and medical history.
Conditions where a FSH and LH test is recommended:
An FSH and LH test is helpful in the evaluation of the following conditions or diseases:
Menstrual Irregularities: Irregular menstrual cycles, including absent or infrequent periods, can be indicative of hormonal imbalances. Measuring FSH and LH levels can help identify the underlying causes of these irregularities.
Polycystic Ovary Syndrome (PCOS): PCOS is a hormonal disorder characterized by enlarged ovaries with multiple cysts and irregular menstrual cycles. An FSH and LH test, along with other hormone tests, can aid in diagnosing PCOS and guiding appropriate treatment.
Premature Ovarian Insufficiency (POI): POI refers to the loss of ovarian function before the age of 40, resulting in reduced fertility or early menopause. Measuring FSH and LH levels can help confirm the diagnosis of POI and evaluate ovarian reserve.
Hypogonadism: Hypogonadism is a condition characterized by insufficient production of sex hormones, leading to reproductive and sexual health problems. An FSH and LH test can assess the functioning of the gonads (ovaries or testes) and aid in diagnosing hypogonadism.
How does my health care provider use a FSH and LH test?
Healthcare providers use the results of an FSH and LH test to:
Evaluate Reproductive Function: Abnormal levels of FSH and LH can indicate issues with ovarian or testicular function, helping healthcare providers identify potential causes of infertility or reproductive disorders.
Guide Fertility Treatments: FSH and LH levels provide information about the response to fertility treatments, allowing healthcare providers to adjust medication dosages or timing to optimize outcomes.
Monitor Hormonal Therapy: For individuals receiving hormonal therapy, such as in cases of hormone replacement therapy or assisted reproductive technologies, regular monitoring of FSH and LH levels helps ensure appropriate hormone balance and treatment efficacy.
It is important to consult with a qualified healthcare provider to interpret FSH and LH test results in the context of an individual's medical history, symptoms, and other relevant factors. Treatment decisions are individualized based on the specific clinical situation, and the FSH and LH test results are used as part of a comprehensive assessment.
What do my FSH and LH test results mean?
FSH and LH test findings are frequently combined with those from other hormone testing estrogens, and/or testosterone.
A high or low FSH level as part of an infertility workup is not diagnostic, but it does provide some insight into the cause. A hormone imbalance, for example, can influence a woman's menstrual cycle and/or ovulation. To make a diagnosis, a doctor will take into account all of the information gathered during the examination.
- FSH and LH levels can assist distinguish between primary ovarian failure and secondary ovarian failure.
- Primary ovarian failure is associated with high levels of FSH and LH.
- Low FSH and LH levels are indicative of secondary ovarian failure caused by a pituitary or hypothalamic issue. Low FSH levels in the blood have been linked to an increased risk of ovarian cancer.
- Primary testicular failure causes high FSH levels. As shown below, this can be the result of developmental problems in testicular growth or testicular damage.
- Low levels are indicative of pituitary or hypothalamic dysfunction.
- Precocious puberty is defined by high levels of FSH and LH, as well as the development of secondary sexual traits at an extremely young age. This occurs far more frequently in girls than in boys. This abnormal development is usually caused by a problem with the central nervous system, which can have a variety of causes.
- Normal prepubescent LH and FSH levels in children who are showing signs of pubertal alterations could suggest a syndrome known as "precocious pseudopuberty."
- For children with delayed puberty, LH and FSH levels can be normal or below what is expected for children of their age.
Most Common Questions About the FSH and LH test:
Understanding the Test
What is the FSH and LH test?
The FSH and LH test is a blood test that measures the levels of follicle-stimulating hormone and luteinizing hormone in the blood. Both of these hormones play crucial roles in the reproductive processes in both males and females.
Why would someone need an FSH and LH test?
FSH and LH tests are often used when a person has symptoms of a hormonal or reproductive disorder or is having trouble getting pregnant. In women, these tests can help evaluate menstrual problems, fertility issues, or menopause. In men, they can help evaluate problems with the testes or pituitary gland.
Interpreting the Results
What do the results of the FSH and LH test mean?
The results are given in international units per liter (IU/L). For women, FSH levels can vary depending on the stage of the menstrual cycle, while LH levels peak around the time of ovulation. In men, levels of FSH and LH should be constant. Higher or lower levels than normal can indicate an issue with the reproductive system or pituitary gland.
How are the results of the FSH and LH test presented?
The results of the FSH and LH tests are typically presented as numerical values, given in international units per liter (IU/L).
About the Test
What factors can affect the results of the FSH and LH test?
Factors that can affect the results include age, sex, menstrual cycle phase (in women), stress, certain medications, and underlying medical conditions.
Understanding the Implications
What conditions can cause abnormal FSH and LH levels?
Abnormally high or low levels of FSH and LH can indicate several different conditions. These may include menopause, polycystic ovary syndrome (PCOS), ovarian failure, hypogonadism, pituitary disorders, and gonadal dysfunction.
What are the implications of abnormal FSH and LH levels?
Abnormal levels of FSH and LH may indicate an issue with the ovaries, testes, or pituitary gland. This could have implications for fertility, sexual development, and menstrual function.
Risks and Precautions
How do abnormal FSH and LH levels impact health?
Abnormal levels of FSH and LH can indicate an underlying condition that may impact health, especially reproductive health. For example, high levels can indicate ovarian failure in women or testicular failure in men, both of which can lead to infertility. Low levels can indicate conditions such as hypopituitarism or hypothalamic disease.
Dealing with Abnormal Results
What steps should be taken if the FSH and LH test results are abnormal?
The next steps depend on the specific results and potential underlying conditions. These could include further diagnostic testing, consultation with a specialist such as an endocrinologist or reproductive endocrinologist, or starting a treatment plan for the identified condition.
Interpreting the Test Results
What is the significance of elevated FSH and LH levels in the blood?
Elevated levels of FSH and LH in the blood can indicate several conditions, such as primary ovarian insufficiency or menopause in women and primary hypogonadism in men. It can also indicate certain types of pituitary tumors.
Understanding the Importance of the Test
How does the FSH and LH test assist in diagnosing disease?
The FSH and LH test is used to help diagnose disorders of the ovaries, testes, and pituitary gland, and can help determine the cause of infertility in women and men. It is also used to diagnose conditions such as polycystic ovary syndrome (PCOS) and pituitary disorders.
Discussion with Healthcare Provider
What do I discuss with my healthcare provider after receiving the FSH and LH test results?
Discuss the meaning of your results and what they could suggest about your health. Your provider may discuss potential underlying conditions, further testing that may be needed, treatment options, and next steps.
Relationship with Other Tests
How does the FSH and LH test relate to other hormone tests?
FSH and LH tests often are used in conjunction with other hormone tests, such as estradiol or testosterone, to provide a more comprehensive picture of reproductive function and hormonal balance.
How does the FSH and LH test complement other diagnostic tools?
The FSH and LH test provides specific information about reproductive hormone levels that other tests or diagnostic tools can't provide. This can complement information from other diagnostic tools, like imaging studies or physical exams, to help diagnose certain conditions.
The Test and Specific Conditions
Can the FSH and LH test help diagnose polycystic ovary syndrome (PCOS)?
Yes, the FSH and LH test can be useful in the diagnosis of PCOS. Women with PCOS often have a higher than normal LH to FSH ratio (often 2:1 or higher).
Can the FSH and LH test diagnose menopause?
The FSH and LH test can help to confirm menopause. Levels of FSH tend to rise and LH may rise somewhat during the transition to menopause.
Conditions That Warrant the Test
Why would a man need an FSH and LH test?
A man might need an FSH and LH test if he has symptoms of a hormonal imbalance, like erectile dysfunction, low sex drive, infertility, or abnormal breast growth. These symptoms could suggest an issue with the testes or pituitary gland, which the FSH and LH test can help evaluate.
Why would a woman experiencing fertility issues need an FSH and LH test?
A woman experiencing fertility issues might need an FSH and LH test because these hormones play key roles in the menstrual cycle and ovulation. Abnormal levels can disrupt these processes and lead to fertility issues.
Further Diagnosis and Treatments
What additional tests might be ordered if my FSH and LH levels are abnormal?
Additional tests will depend on your symptoms and medical history, but could include tests for other hormones like estradiol or testosterone, imaging tests like an ultrasound or MRI, or other lab tests like a complete blood count (CBC) or metabolic panel.
What are the potential treatments for conditions indicated by abnormal FSH and LH levels?
Treatments will depend on the specific condition indicated by the abnormal levels. Potential treatments could include hormonal therapies, fertility treatments, lifestyle changes, or surgery.
When during the menstrual cycle is the FSH and LH test most accurate?
For women, the FSH and LH test is often done on the third day of the menstrual cycle, as this can give the most accurate assessment of a woman's baseline levels of these hormones.
Can the FSH and LH test be performed post-menopause?
Yes, the FSH and LH test can be performed post-menopause. In fact, increased FSH and LH levels can help to confirm menopause.
What are the normal reference ranges for the FSH and LH test?
The normal reference ranges can vary by lab and by individual factors like age and sex. Generally, for women in the follicular phase of their menstrual cycle, normal FSH levels are around 3.5-12.5 IU/L and LH levels are around 2.4-12.6 IU/L. For men, normal FSH levels are around 1.5-12.4 IU/L and LH levels are around 1.7-8.6 IU/L.
Why are FSH and LH often tested together?
FSH and LH are often tested together because they work closely together in the body's reproductive system. The ratio of LH to FSH can provide useful information for diagnosing certain conditions, like PCOS.
Why does the FSH and LH test need to be timed correctly in women?
Timing is important in women because levels of FSH and LH fluctuate throughout the menstrual cycle. Testing at the right time in the cycle can provide the most accurate and meaningful results.
We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.