What does follicle stimulating hormone mean. What affects FSH? FSH indicators at different periods of the cycle and life

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 reproductive organs and 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 flow continuous 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 molecule has the same structure, but differences in one of the subunits does not allow the use of a substance of animal origin in 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 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 differs according to the days of the 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 and the luteal phase begins when hormonal level affects the corpus luteum formed at the site of the follicle. It synthesizes a large number of progesterone, which suppresses the principle feedback hormone production in the pituitary gland. If pregnancy does not occur, the corpus luteum regresses, steroids decrease, and FSH begins to cycle again.

Average 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;
• delay 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.

FSH analysis is necessary for differential diagnosis 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 treatment tactics. Also, the analysis is necessary to control the hormonal therapy of certain diseases.

In order for the results of the study to be reliable, it is necessary to observe certain rules preparation. 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 prior to 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 this mean?

It is easy to understand this, based on knowledge about 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 normal indicators consider 25.8-134.8 mIU / ml.

Signs of changes in hormone concentration

Increased concentration

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

Early thelarche and menarche

AT childhood it will be a symptom of precocious puberty. Thelarche - secondary sexual characteristics in the form of hair growth on the pubis and in armpits considered noma from 9 years old. 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 testicular feminization occurs when there is a congenital lack of sensitivity of tissues to androgens, while susceptibility to estrogens is preserved. Therefore, a false male hermaphroditism: the external genitalia are formed according to female type but no uterus and ovaries. At mild degree 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 formations 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 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. At elevated level 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 sea ​​fish rich in omega-3 fatty acids. It is recommended to normalize your weight: in case of obesity, lose at least 10% overweight, with a lack - get better.

Treatment for elevated levels of follicle-stimulating hormone depends on the cause:

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

A thorough examination of the body for hormones is carried out by people preparing to become parents, in the treatment of infertility and many other diseases. Studies are important for cosmetic problems: early wrinkles, sagging skin, baldness. What is follicle-stimulating hormone, be sure to understand even before the treatment process. Why is FSH important for health, how to properly test for hormones, in which cases does the amount of sex hormones increase or decrease? What is the follicular phase? You will learn in detail and accessible about the entire “kitchen” of the body in the article.

What is the FSH hormone

Follicle-stimulating hormone, aka follitropin, aka FSH, is a substance that is responsible for a person's sexual maturation and his ability to reproduce. In women, this hormone stimulates the development of the follicle responsible for the maturation of the egg and the formation of estrogens, i.e. female sex hormones. In men main function This hormone helps in the creation of spermatozoa.

Norm FSH

Determining the amount of FSH - important point problem identification reproductive system. Deciphering the analysis is somewhat difficult, because the concentration of follitropin in the blood is constantly jumping. Even its quantity is affected emotional condition person and time of day! In women, the day of the menstrual cycle matters.

Although for children, the indicators of hormones are relative. The level of follitropin rises immediately after birth. Then it drops sharply: at six months - in boys, in a year or two years - in girls. The amount of hormones rises again before the onset of puberty. In addition, FSH is not allocated constantly, but in separate "ethers" - once every 3-4 hours. During this period, the maximum concentration of follitropin occurs, which is also reflected in the results of the analysis.

Reference values ​​for FSH, like other blood tests, vary from laboratory to laboratory. The calculation of hormones depends on technologies, methods and reagents. Pay attention to the norms indicated on the forms with the result of the analysis. Below are the most average indicators of hormones. So if your data on follicle-stimulating components is higher or lower than those given - do not panic! In any case, only the doctor makes the conclusions.

Among women

The volume of “seething” of the follicle-stimulating hormone inside the woman’s body depends on the age, the day of the menstrual cycle, the onset of menopause. At follicular phase within the norm, it is 2.45-9.47 mU / ml, during ovulation - 3.0-21.5. In the interval between ovulation and menstruation, i.e. into the luteal phase of the cycle (in other words, the phase corpus luteum) – 1.0-7.0. Premenopause (transition period): 25.8-134.8; postmenopause, or menopause: 9.3-100.6.

In men

In the male body, follitropin promotes the development of the seminiferous convoluted tubules, where the gums - spermatozoa - mature. It enhances spermatogenesis and helps "drive" testosterone to the epididymis, which contributes to the "correct" maturation of gametes. The level of the hormone immediately after the birth of a boy briefly rises and after six months drops sharply. Then, before the onset of puberty, it grows again. Indicators for adult men: 0.96-13.58 mU / ml.

The ratio of LH and FSH

FSH is produced in the anterior pituitary along with another hormone - luteinizing (luteotropin, LH, lutropin). Substances work in a complex, providing the ability to procreate, so it makes no sense to consider data on the amount of one without assessing the performance of the other. From the 3rd to the 8th day of the cycle, the concentration of follicle-stimulating hormone is less than luteinizing hormone by 1.5-2.0 times. In the first couple of days, the ratio of LH to FSH is less than 1, which ensures the maturation of the follicle. In tandem with LH and FSH, other sex hormones work, for example, progesterone with prolactin.

High FSH

An increase in the amount of hormones is a serious signal for health workers to look for health problems. It must be remembered: the concentration of follitropin increases and naturally - normally this happens during premenopause. Along with a progressive increase in FSH levels, other symptoms are then observed: the ovarian follicular apparatus is sharply depleted, and estradiol is lowered. This several times reduces the likelihood of becoming pregnant and bearing a child.

Causes

In women, FSH is elevated with a pituitary tumor, alcoholism, pathological exposure to x-rays, cysts and bad job ovaries. In men, there is a lot of follicle-stimulating hormone with inflammation of the testicles, an increased level of androgens, i.e. male sex hormones, pituitary tumors, alcohol abuse, kidney failure and acceptance of certain chemicals.

How to reduce

Reduce the level of pathologically high FSH after the cause of its increase is revealed. For example, with x-rays, the amount of the hormone returns to normal on its own within 6-12 months. In other cases, the work of doctors is aimed at adequate therapy primary disease, as a result of which the amount of follitropin decreases automatically.

Low FSH

Often, people who are inattentive to their health do not even know about problems with the hormonal background. As a result, it is often detected during laboratory research appointed for other reasons. And vice versa, when a person is concerned about issues that at first glance are not related to medicine, he solves them with the help of doctors. For example, FSH levels are below normal:

• with a decrease sexual attraction;
• with a decrease in the growth of wearable hair;
• in case of accelerated appearance of wrinkles;
• with infertility, impotence;
• atrophy of the reproductive organs;
• delayed puberty in children.

Causes

A decrease in the level of FLG, as a rule, is caused by:

• significant body weight, i.e. obesity;
• tumors of the pituitary gland, ovaries or testicles (testicles);
• hypogonadism - a consequence of a complex of various syndromes that reduce the activity of the gonads;
• hypopituitarism - associated with the process of reducing the activity of the pituitary gland, which is the main link in the process of producing FSH, caused by trauma, tumor, surgery on the pituitary gland;
• deficiency or increased activity of 5-alpha reductase, an enzyme that in the human body converts testosterone into active form- androgen dihydrotestosterone;
• Kallmann's syndrome (Kalman's syndrome) - very rare hereditary disease(as a rule, it manifests itself in men, although it also occurs in women), in which puberty is completely absent and the sense of smell is lost;
• in women - neoplasms and lesions of the ovaries with cysts, impaired activity of the hypothalamus, mental disorders, anorexia, prolonged fasting;
• Sheehan's syndrome - the death of a part of the pituitary cells that occurs after significant blood loss during childbirth or abortion;
• in men - pituitary insufficiency, age-related androgen deficiency.

How to boost

Firstly, to increase the level of follitropin, a diet is prescribed, which includes dark green and sea vegetables, ginseng, foods containing a large amount of natural fatty acids. Secondly, to mandatory recommendations includes the normalization of body weight, including through changes in lifestyle and sports. Shows massage of the lower abdomen and thumb. Oddly enough, to increase FSH levels, you need to reduce stress. During overstrain, both physical and mental, our body releases hormones that suppress the production of follitropin.

To help you - proper food, adequate sleep, hot baths, sports, yoga and a good psychotherapist. All of these recommendations are important, but usually not the only therapy. The main treatment will be prescribed by a doctor! Therapy will depend on the result of all studies performed (extended blood test for hormones, blood for biochemistry, sometimes ultrasound, CT, MRI and even X-ray) and after diagnosis. For a tumor or cyst, you will need surgical intervention, in case of problems with female hormones, estrogen and progesterone hormone replacement therapy will help.

How and when to take an analysis for FSH

How to prepare for a blood test, what day to take it, do I need to abstain from sex before this? Patients have many questions. For a blood test for follitropin:

• prepare a list of all medications, not just hormonal ones, that you take for your doctor;
• wait 4 - 7 days of the cycle, men do not have to wait for anything, except for the working hours of the laboratory;
• come to the test hungry;
• for three days, stop doing active sports and sex;
• an hour and a half before the test, do not smoke if you are dependent on this addiction;
• 15 minutes before going to treatment room in some way that is familiar to you, calm your brain and relax.

Follicle-stimulating hormone (follitropin or FSH), produced by the cells of the anterior pituitary gland, regulates the functioning of the gonads. In the body of women, it is responsible for the growth and maturation of follicles in the ovaries, and in the body of men it takes part in the process of maturation of spermatozoa in the testes.

Follicle stimulating hormone in the female body

1. The concentration of FSH in the blood and its functions depend on the phase of the menstrual cycle. Throughout this period, the ovarian hormones - estradiol and progesterone - control the concentration of FSH by the pituitary gland according to the feedback principle.
2. In the follicular phase, FSH stimulates the development dominant follicle in the ovary and the maturation of the egg in it. Together with luteinizing hormone (LH), FSH triggers the production of the hormone estradiol by the follicles, and also promotes the conversion of testosterone into estradiol. In the middle of the cycle, the maximum release of FSH occurs along with sharp rise LH level, due to which the follicle bursts and the egg is released into abdominal cavity. All these functions of FSH in the follicular phase of the cycle help the corpus luteum in the luteal phase to produce a sufficient amount of the hormone progesterone.
3. At the beginning of the menstrual cycle, FSH levels are higher than at last days follicular phase. Its maximum value is observed in the middle of the cycle, and after ovulation, the level drops again. An increase in the concentration of FSH and its excess of the values ​​​​of the follicular phase is observed only before menstruation. At the same time, throughout the cycle, the concentration of FSH in the blood of women is significantly lower than the concentration of LH.

Determining the level of FSH is one of the important tests to detect pathologies of the reproductive system. Therefore, the doctor may prescribe a study of the concentration of the hormone in the blood when:

• absence
• miscarriage
• menstrual irregularities
• uterine bleeding
• endometriosis
• decreased sex drive
• chronic inflammatory processes in the genitals
• hypofunction of the gonads

Follicle stimulating hormone in the male body

1. In the body of men, FSH contributes to the development and functioning of the testes and seminiferous tubules, and also enhances spermatogenesis. It stimulates the synthesis of androgen-binding protein in Sertoli cells and helps to "deliver" testosterone to the epididymis - this contributes to the proper maturation of spermatozoa. It also depends on FSH normal function testicular tissue and the production of the hormone estradiol by Sertoli cells.
2. According to the feedback principle, testosterone affects the hypothalamus and pituitary gland, helping to reduce the synthesis of FSH. In addition, inhibin secreted in the seminiferous tubules also affects the level of FSH.
3. A study of the level of FSH in men is usually recommended to diagnose hypofunction of the gonads and (especially with oligo- or azoospermia), as well as with a decrease in sexual desire and impotence.

Norms and possible causes of violations of FSH synthesis

Normally, the concentration of FSH is (mU / l):

• for women (by cycle phases)

1. Follicular (1 - 12 days) - 2.8-11.3
2. Ovulatory (12 - 16 days) - 5.8-21
3. Luteal (from 16 to the onset of menstruation) - 1.2-9

• for men

1. The level of the hormone in the blood should be from 1.37 to 13.58.
2. These standards may vary depending on the standards and methods of research of the laboratory in which the analysis was performed.
3. An increase in the concentration of FSH in the blood can be observed with:

A decrease in FSH levels is noted with:

• hypothalamic causes of amenorrhea
• central form hypofunction of the gonads
• Sheehan's syndrome
• pregnancy
• Simmonds disease
• Denny-Morfan syndrome
• hyperprolactinemia
• polycystic ovary syndrome
• obesity or starvation
• surgical interventions
• some medicines

The production of FSH is closely related to LH, estradiol, testosterone and progesterone, so the simultaneous study of the concentration of these hormones is more indicative. So, when making diagnoses related to the work of the reproductive system of women, doctors sometimes also focus on the ratio of LH and FSH:

• normal before puberty, the ratio is 1: 1
• a year after the onset of menstruation, the ratio is 1.5: 1
• two years after the onset of menstruation to menopause, the ratio is 1.5-2: 1

If the ratio of the levels of these hormones is 2.5 or more, we can assume:

• polycystic ovary syndrome
• ovarian exhaustion
• pituitary tumor

As a rule, in order to obtain reliable test results, women with a preserved menstrual rhythm are advised to donate blood on an empty stomach on the 3rd-5th day of the menstrual cycle, or in accordance with the recommendations of a doctor. Men can take FSH any day. Before the study, sports activities should be stopped 3 days before the examination, fatty foods and alcohol should be excluded the night before, and smoking should be avoided 1 hour before blood sampling.

Remember that only a doctor can correctly interpret the results of the study.

Among the studies that are prescribed to women, the analysis of hormones occupies a central position. It helps to evaluate the work of the organs of the reproductive system, to identify existing deviations. So, a reduced FSH hormone can cause problems with.

What is FSH

Follicle-stimulating hormone (FSH) is a biological compound that stimulates the growth and maturation of follicles (in women) and spermatozoa (in men). This hormone belongs to the group of gonadotropic hormones - it is produced in the anterior pituitary gland, like prolactin, the luteinizing hormone. Their action is directly related to procreation. With a long absence of conception, infertility is suspected, a hormone test is one of the first studies prescribed by a doctor.

Hormone FSH - what is responsible for?

As noted above, FSH is produced in both male and female bodies. At the same time, the effect exerted by the hormone on the body is somewhat different. So, in males, FSH activates:

• testicular growth;
• development of the seminiferous tubules;
• protein synthesis that regulates spermatogenesis.

Telling patients what the follicle-stimulating hormone is responsible for in women, doctors call its following main functions:

• processing into estrogens;
• growth and development of follicles in the ovaries;
• production .

It should be noted that this substance is intensively synthesized only with the onset of puberty and throughout the entire fertile period. In infants, the hormone levels rise briefly and then fall rapidly. A repeated increase in the concentration of FSH is noted before the onset of puberty. With insufficient concentration of this compound in the blood of a teenager, the process of puberty slows down, which requires medical attention.

FSH analysis

Blood for FSH is taken from the cubital vein. The analysis is carried out in morning time. The nurse takes the blood sample, places it in a sterile tube, labels it, and sends it to the laboratory. Based on the results of the study, it is possible to determine the level of violations in the work hormonal system and evaluate the need for hormone replacement therapy. In the primary forms of pathology, they speak of a violation in the work of the gonads themselves. Secondary pathologies, accompanied by a change in the concentration of FSH, are associated with the work of the hypothalamic-pituitary system.

Often, an FSH hormone test is prescribed to confirm a presumptive diagnosis. Indications for appointment may include:

• early;
• delayed sexual development;
• suspicion of infertility;
• endocrine diseases;
• early onset of menopause.

When to take FSH?

A study on any hormones is carried out in the morning. A prerequisite for blood sampling is an empty stomach. In this case, the study in men can be carried out on any day, however, for women, the analysis time is great importance. Before prescribing an FSH analysis on which day of the cycle to donate blood, doctors always specify individually. Optimal time for the implementation of the study is the 4-6th day of the menstrual cycle. However, in some cases it may be another day.

The analysis is always carried out in the morning. Optimally - from 8 to 11 hours. It's connected with periodic fluctuations FSH levels in the blood. To obtain reliable results, the patient must strictly follow the recommendations issued by the doctor the day before. This will avoid re-testing.

FSH analysis - preparation

In order for an FSH blood test to reliably indicate the level of the hormone in the blood, a number of rules must be observed. So, three days before the appointed time of analysis, it is necessary to completely exclude physical activity, training. It is highly undesirable at this time to expose the body to stress and nervous tension– such situations affect the level of hormones in the blood. Just before donating blood, you also need to calm down. Smoking is prohibited 3 hours before the procedure. Other training features include:

1. The last meal should take place 3 hours before the study, preferably on an empty stomach.
2. Two days before the analysis, stop taking hormonal drugs, after agreeing the cancellation with the doctor.

For an objective result, doctors often carry out three blood samplings. This is due to the fact that the hormone FSH is released into the blood in portions. Three samples are taken with an interval of 30 minutes. Then, the concentration of FSH in each sample is evaluated and the average value is calculated, which is indicated in the conclusion issued to the patient.

FSH is normal

The concentration of FSH, the norm in women depends on several factors. Among them, the age of the patient and the phase of the menstrual cycle are decisive. Doctors always take these parameters into account when evaluating the result of the analysis.

In some cases, an analysis for FSH in men may also be prescribed. The concentration of this hormone in the blood of males is less subject to fluctuations. The main factor determining the level of the FSH hormone in a man's body is age. When evaluating the results of the study, doctors rely on the following norm values: 1.37–13.58 mU / l.

FSH - the norm in women by age, table

Follicle-stimulating hormone, the norm in women does not have constant values, is produced in the body with the onset of puberty. reproductive system throughout the reproductive period is subject to cyclical fluctuations. Directly the level of sex hormones determines the ability of the female body to bear children. Their correct concentration ensures the normal functioning of the gonads, reproductive organs. So, FSH hormone (the norm for women is shown in the table above) varies depending on three main factors:

• period of the menstrual cycle;
• the age of the patient;
• period of pregnancy (trimester).

The ratio of LH and FSH

AT integrated assessment the work of the reproductive system, establishing the reasons for the lack of conception, at the same time, a study of the level of LH and FSH is prescribed. Comparison of the concentration of these two hormonal substances helps to determine the degree of fertility of the female body. Under this term, reproductive specialists understand the ability of the female body to reproduce.

The ratio of the concentrations of FSH and LH (luteinizing hormone) allows you to get the fertility rate. It should be borne in mind that the level of hormones in the blood is determined directly by the age of the patient: the older the woman, the lower the body's ability to conceive. The change in the ratio of FSH and LH in the norm should occur as follows:

• before puberty - 1: 1;
• after menarche - 1.5: 1;
• 2 years after the first menstruation and before menopause - 2:1.

When the ratio of LH and FSH reaches 2.5:1 or higher, the following pathologies may develop:

• polycystic ovaries;
• pituitary tumor;

The hormone FSH is elevated - what does it mean?

To understand why the follicle-stimulating hormone is elevated in the body, a comprehensive examination is required. This state does not pass without a trace and always causes concern among women. The first sign of an increase in FSH concentration may be uterine bleeding that have no connection with menstruation. In some cases, menstruation, on the contrary, is absent: amenorrhea is one of the symptoms of an increase in the level of FSH in the blood, with which women go to the doctor.

FSH is elevated - causes

When FSH is above normal in the follicular phase, the causes this phenomenon often associated with impaired hormone synthesis. This situation requires comprehensive examination. Among the pathologies in which FSH is elevated:

• ovarian exhaustion syndrome;
• pituitary adenoma;
• endometrioid ovarian cysts;
• Swaer's syndrome;
• dysfunctional uterine bleeding;
• kidney failure;
• smoking;
• taking certain drugs (Ketoconazole, Levodopa, Naloxone, Oxcarbazepine, Phenytoin).

FSH is elevated - what to do?

If the follicle-stimulating hormone is elevated in women, to determine the algorithm and features of therapy, full examination. In most cases, the elimination of the cause that caused the increase in FSH concentration leads to the normalization of the hormone level. The effectiveness of the therapy often depends on the time of visit to the doctor and the stage of the pathological process.

What is luteinizing hormone? It is also called luteinizing, luteotropin, lutropin and is classified as a peptide. This hormone is produced by the anterior pituitary gland. He plays very important role in ensuring the normal functioning of the reproductive system. In a woman's body, it works in conjunction with follicle-stimulating hormone (FSH). It stimulates the production of ovaries, which contribute to the onset of ovulation. In the male body, it affects the cells involved in the production.

What is luteinizing hormone (LH) responsible for? It plays an important role both in the body of a woman and in the body of a man. In the first FSH during the menstrual cycle promotes the growth of follicles. They, in turn, secrete a large amount of estrogen, among which it plays an important role. At the time of maturation of the follicle, the concentration of the latter becomes so high that it leads to the activation of work. As a result, the pituitary gland releases a large amount of luteinizing hormone and FSH into the woman's body. During this period, there is highest level these substances.

This process triggers ovulation, during which not only an egg ready for fertilization is released, but also a corpus luteum is formed in place of the remaining follicle. The latter secretes a large amount of progesterone, which promotes the growth of the endometrium for the successful implantation of the fetal egg. At this time, the level of a hormone such as LH is high.

This phenomenon is observed for 14 days, when support is needed for the existence of the corpus luteum (it is called the luteal phase). If pregnancy occurs during this time, this function takes over, produced by the embryo. LH in women also affects cells in the ovaries that produce androgens and other substances (precursors of estradiol).

Luteinizing hormone in men is a substance that affects the Leydig cells (located in the testicles) and promotes the production of testosterone. The latter is involved in spermatogenesis and is the main one in this process.

Hormone norms

Luteinizing hormone is secreted in varying amounts by the human body. LH norms in a woman are determined by her age, the phase of the menstrual cycle, or the presence of pregnancy. Usually in childhood, the concentration in the blood of this substance is negligible. For a child under 11 years old, the amount of a hormone such as LH is the norm from 0.03 to 3.9 mIU / ml, does not depend on gender. Only starting from puberty, its concentration changes depending on whether it is a boy or a girl. LH in men and adolescents who are over 11 years old reaches a concentration of 0.8-8.4 mIU / ml. This number remains stable and almost does not change.

When analyzing LH in the fairer sex, you can see that the concentration of this substance varies greatly depending on the phase of the menstrual cycle. Also, its increased level is observed during menopause. To understand what the result of luteinizing hormone tests means - up to 59 mIU / ml is considered the norm for women, you need to pay attention to the phase of the menstrual cycle (in mIU / ml):

• 1-14 days - 2.4-12.6;
• 13-15 day - 14-96;
• 16-28 days - 1-11.4;
• menopause period - 7.7-59. male body also reacts to aging by inhibition of reproductive function. After 60 years, LH is increased in men and its amount is more than 8.4 mIU / ml.

It is important not only whether the luteinizing hormone is elevated or reduced, but also its ratio with FSH. female body reproductive age should be characterized by an optimal proportion between these substances. The ideal LH to FSH ratio is 1.5 to 2. In little girls given value equals 1. A few months after the appearance of the first menstruation, the indicator gradually increases until it reaches the optimal level.

LH during pregnancy decreases and remains stable throughout the entire period of gestation, since there is no ovulation at this time.

When is it necessary to take tests?

The need for a blood test for LH is observed in the presence of the following problems:

• precocious puberty - both in boys and girls;
• delayed sexual development in adolescents;
• lack of menstruation in women ();
• significant lag physical development body;
• a small amount of menstrual flow that lasts less than 3 days;
• uterine bleeding of an unexplained nature;
• to determine the causes of male or female infertility;
• spontaneous abortion;
• establishing the causes of endometriosis;
• detection;
• excessive hair growth on the female body;
• decreased sex drive in men.

How is the analysis given?

Lutropin is carried out using venous blood. To obtain reliable result it is recommended to adhere to the following rules:

• before donating blood for hormones, it is forbidden to eat for 2-3 hours. Allowed to drink plain water, but without gas;
• 2 days before the study, it is necessary to completely stop taking drugs containing or thyroid hormones. In this case, it is best to consult a doctor to avoid any consequences for the body;
• the day before donating blood, it is forbidden to expose the body to excessive physical exertion. The same rule applies to emotional overstrain;
• 3 hours before hormone tests, smoking is prohibited.

Causes of high hormone levels

Luteotropin is elevated in women due to the following reasons:

• pituitary dysfunction, including hyperpituitarism;
• the presence of polycystic ovary syndrome;
• elevated levels of this hormone may indicate a violation of the kidneys;
• dysfunction of the sex glands (ovaries) or their complete absence;
• amenorrhea;
• taking certain drugs;
• the presence of certain hereditary disorders;
• development of menopause;
• the presence of tumors in the ovaries or pituitary gland (in men, formations may be in the testicles);
• premature puberty, if the analysis was done to a child;
• with endometriosis;
• with excessive physical activity, chronic stress, during fasting or following a strict diet.

Determination of low values

Low LH is determined in the following cases:

• determination of secondary insufficiency during the work of the gonads;
• the presence of tumors on the ovaries in women or testicles in men;
• violation normal operation hypothalamus or;
• development of galactorrhea-amenorrhea syndrome;
• the presence of anovulation;
• Kallman's syndrome;
• taking certain medicines containing progesterone, digoxin, estrogen and other substances that affect hormonal background person;
• a decrease in this hormone in the blood in men can be caused by atrophy of the gonads due to mumps, brucellosis, gonorrhea;
• anorexia;
• severe stress;
• delayed puberty.

Treatment

To find out how to lower or increase LH, you need to consult a doctor. He conducts an appropriate study of the state of the body, after which he prescribes treatment. Drugs are used that can normalize hormone levels and restore reproductive function men or women.

It is possible to reduce, or rather, correct the amount of lutropin, if drugs containing estrogens or androgens are used during treatment. When shown the use of funds containing ergot. Drugs such as cabergoline and bromocriptine are often prescribed.

Also often shown surgical intervention. The operation allows you to eliminate the tumors that are the cause of the violation.

Bibliography

1. Arterial hypertension in pregnant women. Is it just gestosis? Guide for doctors. Makarov O.V. 2006 Publisher: Geotar-Media.
2. Ascending infection of the fetoplacental system. Glukhovey B.I. 2006, Publisher: MEDpress-inform.
3. Neonatology: a national guide. UMO vulture medical education. Editor: Volodin N.N. 2007 Publisher: Geotar-Media.