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The initial endocrine evaluation includes testing for levels of TSH and free T4, prolactin, LH, FSH, estradiol (E2), and anti-Müllerian hormone (AMH). [9] FHA patients may display a combination of the following: FSH concentrations that are normal but lower than LH levels, low or low normal LH, E2 <50 pg/mL, and progesterone <1 ng/mL. [6]
Menopause, also known as the climacteric, is the time when menstrual periods permanently stop, marking the end of reproduction. [1] [6] [7] It typically occurs between the ages of 45 and 55, although the exact timing can vary. [8] Menopause is usually a natural change related to a decrease in circulating blood estrogen levels. [3]
The most common reason for high serum FSH concentration is in a female who is undergoing or has recently undergone menopause. High levels of FSH indicate that the normal restricting feedback from the gonad is absent, leading to an unrestricted pituitary FSH production. FSH may contribute to postmenopausal osteoporosis and cardiovascular disease ...
Persistently high LH levels are indicative of situations where the normal restricting feedback from the gonad is absent, leading to a pituitary production of both LH and FSH. While this is typical in menopause, it is abnormal in the reproductive years. There it may be a sign of: Premature menopause
Testing serum LH and FSH levels are often used to assess hypogonadism in women, particularly when menopause is believed to be happening. These levels change during a woman's normal menstrual cycle, so the history of having ceased menstruation coupled with high levels aids the diagnosis of being menopausal.
The diagrams below take inter-cycle and inter-woman variability into account in displaying reference ranges for estradiol, progesterone, FSH and LH. Levels of estradiol (the main estrogen), progesterone, luteinizing hormone and follicle-stimulating hormone during the menstrual cycle. [88]
If a uterus is present, LH and FSH levels are used to make a diagnosis. [13] Low levels of LH and FSH suggest delayed puberty or functional hypothalamic amenorrhea. [13] Elevated levels of FSH and LH suggest primary ovarian insufficiency, typically due to Turner syndrome. [13] Normal levels of FSH and LH can suggest an anatomical outflow ...
[2] [3] GnRH induces the secretion of the gonadotropins, follicle-stimulating hormone (FSH) and luteinizing hormone (LH), from the pituitary gland. [2] [3] The secreted gonadotropins travel through the bloodstream to the ovaries and trigger the secretion of estrogen and progesterone in fluctuating amounts during each menstrual cycle.
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