home Audience 6 Normal levels of FSH and LH hormones during menopause: what threatens increased and decreased levels. Why are LH FSH and prolactin needed in the human body?

Normal levels of FSH and LH hormones during menopause: what threatens increased and decreased levels. Why are LH FSH and prolactin needed in the human body?

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Normally, the body maintains a healthy hormonal status (G.s.) - a balance of hormones in which estrogens and androgens balance each other in the correct ratio for a given sex.

Hormonal status Women are determined by the following hormones:

Follicle stimulating hormone (FSH),
Luteinizing hormone (LH),
Estradiol (E-2)
Progesterone,
Prolactin,
Testosterone (total and free),
Sex hormone binding globulin (SHBG)
Dehydroepiandrosterone sulfate (DHEA-S).

Definition of G.s. allows you to identify hormonal imbalances, which is important for diagnosis various diseases and conditions of the body (violation menstrual cycle, infertility, hirsutism, acne, etc.).

A decrease or increase in the amount of hormones, as well as a decrease or increase in the sensitivity of receptors to them leads to endocrine diseases or pathological conditions.

1. Follicle-stimulating hormone (FSH) synthesized in the pituitary gland and stimulates the biosynthesis of estradiol. Determined to assess the function of the pituitary gland and determine the cause of hormonal imbalance. A decrease in FSH indicates dysfunction of the pituitary gland. An increase in FSH indicates ovarian pathology.

2. Luteinizing hormone (LH) synthesized in the pituitary gland, stimulates the synthesis of estrogen and testosterone, and also regulates the secretion of progesterone. Determined to assess the function of the pituitary gland.

3. Ratio of LH and FSH. Not only the absolute amount of LH and FSH is important, but also their ratio.
Normally, LH/FSH ranges from 1.5 to 2. A reading above this most often indicates polycystic ovary syndrome, which is often accompanied by hyperandrogenism.

4. Estradiol (E-2)- the most active estrogen, which is secreted mainly by the ovaries. Determined to assess ovarian function.

5. Progesterone- a hormone produced yellow body, which is formed in the ovary from the follicle after the release of the egg (ovulation). Not a large number of progesterone is also produced in the adrenal glands. Determined to assess ovarian and adrenal function.

6. Testosterone (T)- the main male sex hormone. In men, it is synthesized mainly in the testicles, in women - in the adrenal glands and ovaries. Testosterone levels are determined to assess adrenal and ovarian function.
In women, elevated testosterone levels can cause menstrual irregularities, infertility, acne, hirsutism (hair growth male type), etc. Reasons for increased testosterone: tumors of the ovaries or adrenal glands that produce this hormone, as well as polycystic ovaries.

It should be borne in mind that the content of the total amount of testosterone in the blood may not reflect the actual degree of androgenization, because The bulk of testosterone is biologically inactive because it is bound by blood proteins. This is the fraction of bound testosterone, which is about 98% total testosterone.
Thus, total testosterone (T) consists of 2 fractions: free and bound.

7. Free testosterone.

Free testosterone is the biologically active form and makes up less than 2% of total testosterone. In target tissues, it is converted into the most active form of testosterone - dihydrotestosterone (DHTS). It is this fraction of testosterone that determines the biological effects of androgens.
Important! Level free testosterone is a more informative indicator of androgenicity than the level of total testosterone.
Important! If testosterone levels are normal, but manifestations of hyperandrogenism (acne, seborrhea, etc.) are observed, then we can assume increased sensitivity testosterone receptors or increased amount these receptors.

8. Androgen/estrogens ratio in women it is normally 4/10, and with androgenization (seborrhea, hirsutism and acne) - 6-8/10.

9. Sex hormone binding globulins (SHBG). Determined to assess the active part of testosterone (free testosterone).
As mentioned above, the bulk of testosterone is inactive, because. is in a protein-bound state. About 20% is bound by albumins, 78% by globulins. The strongest connection is ensured with the help of steroid-binding globulins, the synthesis of which occurs in the liver.
The less SHBG in the blood, the more share free testosterone.
The concentration of SHBG in women is 2 times higher than in men, since their synthesis is stimulated by estrogens.

10. Free androgen index (ISA) is calculated to estimate bioavailable testosterone as follows: divide the T concentration by the SHBG concentration and multiply by 100.
Its excess indicates that the level of biologically available testosterone is increased due to increased production of male sex hormones by the adrenal glands or ovaries. ISA increases with acne, hirsutism, baldness, obesity, hypofunction thyroid gland, polycystic ovary syndrome.

11. Dehydroepiandrosterone sulfate (DHEA-S) is an androgen that is synthesized by the adrenal cortex, and its level is an indicator of the activity of the adrenal glands in the synthesis of androgens. The hormone itself is weakly active, however, in peripheral tissues it converts to active forms androgens - testosterone and dihydrotestosterone. Because DHEA-S is not produced in the ovaries, then an increase in its level indicates increased production androgens by the adrenal glands. That. DHEA-S is determined to determine the cause of hyperandrogenism: high level hormone levels indicate the predominant formation of androgens in the adrenal glands, low - in the gonads.

12. Prolactin- a hormone produced by the pituitary gland. Ensures normal development and function of the mammary glands and milk production in women. It is present in the blood in small quantities, and during pregnancy and lactation its concentration increases significantly.
Elevated levels may indicate diseases such as polycystic ovary syndrome or a pituitary tumor - prolactinoma.
Prolactin stimulates the formation (secretion) of androgens in the adrenal glands and at the same time blocks the formation and secretion of gonadotropic hormones and steroid hormones in the ovaries.
An increase in prolactin levels may be accompanied by an increase in the amount male hormones, DHEA-S and corticosteroids, as seen in women with acne and hirsutism (hair growth on the face and chest).

13. 17-hydroxyprogesterone– an intermediate steroid, a precursor of steroid hormones - cortisol, androgens and estrogens. Synthesized by the adrenal cortex and gonads. Determined to exclude congenital dysfunction of the adrenal cortex (adrenogenital syndrome).

An increase in 17-hydroxyprogesterone indicates a deficiency of the enzyme that promotes the conversion of 17-hydroxyprogesterone into cortisol. This produces an increased amount of testosterone.

Important! Standards for different hormones differ in different laboratories depending on the test systems used and the units of measurement. Therefore, when interpreting the results, you need to rely on the reference values indicated on the form.

LH, FSH, estradiol, testosterone, prolactin, DHEA sulfate - the concentration of these hormones in the blood is determined using an appropriate analysis. Women are recommended to conduct such a study in case of menstrual irregularities, infertility, excess weight, hirsutism (male pattern hair), acne (or acne), or taking any oral contraceptives. The main indicators that give a complete picture of hormonal female status- This is follicle-stimulating hormone FSH, LH, prolactin, estradiol, testosterone, as well as DHEA sulfate (dehydroepiandrosterone sulfate). The main methods used to determine hormonal concentrations in the blood are ELISA ( linked immunosorbent assay), as well as chemiluminescence immunoassay (CHLA).

What role do hormones play? Ratio of LH to FSH. Norm and deviations from normal indicators.

Every person knows that hormones play an exceptional role in maintaining the functioning of the human body. They utilize sugar, regulate general temperature bodies, influence the formation of antibodies to infections, affect the level blood pressure, and are also responsible for a person’s ability to procreate. In addition, hormones perform numerous other significant functions. Today we will dwell in detail on two hormones - FSH and LH, the ratio of which sets the rhythm for the organs of the reproductive system, creating a harmonious and unique melody of reproductive health.

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In order for a person, regardless of his gender, to be capable of normal conception, 3 levels of the endocrine system must certainly work harmoniously and correctly in his body: two of them are located in the brain (doctors often combine them into a single pituitary-hypothalamic system), and the third is the ovaries or testicles themselves. At each individual level, their own hormones are produced, actively interacting with each other, maintaining the required concentrations of each other.

Luteinizing hormone LH and follicle-stimulating hormone FSH are produced in the pituitary gland (the second level of the system). This small organ is located on the lower surface of the human brain, near optic nerves. Special cells that produce these hormones are called gonadocytes, the activity of their work directly depends on the ratio of stimulating gonadoliberins, as well as inhibitory gonadostatins, which are produced by the hypothalamus. Both follicle-stimulating and luteinizing hormones are protein molecules, the point of application of which is the cells of the testicles and ovaries. But the effect of hormones on them is slightly different.

Let's talk in more detail about the hormones LH and FSH. Their ratio is an extremely important indicator. IN early age The pituitary gland produces these hormones, thereby maintaining their ratio to one another. From the moment a girl begins menstruating, the ratio of LH and FSH changes, with preference given to LH. The ratio of LH to FSH is approximately the following: 1.3 – 2.2 to 1.

It must be said that during the postmenstrual pause, the concentration of follicle-stimulating and luteinizing hormones stops their cyclical fluctuations, and the ratio of LH to FSH can change greatly. The FSH norm is 30 – 128 mIU/ml, and the LH norm can vary between 19 – 73 mIU/ml. The human body does not always work accurately and correctly, so any deviations can trigger the appearance of unpleasant consequences, that is, diseases.

Throughout its entire life, the human body produces many hormones, the level of which affects its performance. The ratio of FSH and LH is especially important for the female body. Let's take a closer look at what these hormones are and what they are responsible for. What is their norm in the body and the consequences of insufficient production.

Hormones in our body are produced throughout life and are responsible for many processes. The mental and emotional condition person. Proper production of the hormones prolactin, estradiol, FSH, LA promote conception. They are also able to maintain the balance of the entire multi-level system.

Hormones in our bodies are produced in several stages. Responsible for them endocrine system and sexual, both in female and male bodies.

These hormones are closely related to each other, and their insufficient quantity leads to an imbalance in the body and affects health. On initial stage two very important hormones LH and FSH are produced.

FSH – “follicle stimulating hormone” affects the genital organs and their development. Due to FSH, follicles in the ovaries grow and develop in the female body. After the onset of the follicular phase, the egg is released from the ovary. In women, the period of the follicular phase may differ, it depends on the physiology of the body.

In men, due to the hormone FSH, the seminiferous tubules grow. Indicators that affect the amount of testosterone in male body.

LH – “luteal hormone” secreted by the pituitary gland (in the brain). Due to it, the final stage of egg maturation occurs in the female body, after which ovulation occurs.

In the male body, LH promotes an increase in globulin. As a result, the hormone testosterone penetrates well into the testes, which contributes to the maturation of the sperm cell and increases its level in the blood.

In addition to the above hormones, there is one that is equally important and necessary for the development of reproductive organs - estradiol.

This female hormone, which is formed in the adrenal glands, ovaries and placenta. The hormone estradiol is primarily responsible for the normal development of a woman’s genital organs, and is also necessary, like the above, for childbirth.

Why do you need to get tested: What hormones are tested?

As a rule, when a woman has problems conceiving or is planning a pregnancy, the doctor sends her to take tests for these hormones. They allow you to identify pathology in the body and promptly prescribe necessary treatment. There are many factors to check the body:

Problems with conception.
Menopause.
Suspicions of ovarian diseases.
Development of the pituitary gland.
When monitored during hormonal treatment.
Various genetic abnormalities.

Men are also subject to FSH and LH testing, this occurs in the following cases:

Not the possibility of conception.
Retarded development of the sexual sphere.
Testicular dysfunction.
Treatment with hormonal drugs.

In addition, to reveal the full picture, a woman may be required to take an additional test for estradiol and prolactin. Since the entire female body is interdependent on each sex hormone. And to identify a specific reason, for example, the inability to conceive, there is a need to check all hormones: FSH, LH, prolactin, estradiol and their relationship to each other.

Ratio of FSH to LH: Hormone norm

To determine the ratio of hormones to each other, blood serum is checked. Throughout the menstrual cycle, hormone levels may fluctuate. The cycle is divided into three phases, each phase has its own specific number of days before and after.

In the follicular phase - consisting of the beginning of the cycle and up to two weeks.
In the ovulatory phase, the process of hormone production can occur on the 12th or 14th day.
Luteal phase – the remaining days of the cycle.

The relationship of hormones to each other is revealed only on certain days of the menstrual cycle. In the follicular phase, a blood test is taken in the morning on an empty stomach from days 7 to 9, and in the luteal phase on days 22, 23, 24 of the cycle. So, the ratio of FSH and LH should normally be in the following values:

Based on these standards, the doctor checks the woman’s actual results, and in this regard can identify pathology, this may relate to the reproductive function of a woman or man, and also relates to the endocrine system.

For pregnancy to occur, it is important correct ratio hormones LH and FSH. For woman reproductive age The normal ratio is LH//FSH – 1.3//2.5 to 1.

If there is a deviation of at least 0.5, then this is already a violation in the body. And then a test is prescribed to check other hormones, such as prolactin, for example, or extradiol. Because their relationship to each other is completely interconnected.

Deviation from the norm: what threat does it pose?

If the initial tests revealed a deviation from the norm. To diagnose the disease, the doctor will write a referral for additional testing. It will be more extensive, since all hormones will have to be checked, these will include FSH, LH, prolactin, extradiol, testosterone.

The blood sample will be examined by ELISA, which can give an informative result regarding the relationship of these hormones to each other. If after this a deviation is detected, depending on the increase or decrease, various diseases are diagnosed.

The ratio of FSH to LH is greater than normal and can be caused by the following pathologies:

Ovarian cyst.
Ovarian failure.
Uterine bleeding.

It is worth noting that the test rate is higher than normal during menopause, this normal phenomenon, and there is no pathology.

Underestimated analysis results may be: physiological norm, or characterized by the following deviations:

Weak periods.
Inability to conceive.
Underdevelopment of the mammary glands.
Lack of libido

What factors influence deviation from the norm?

The relationship of homones to each other, their relationship and the normal values of hormones such as prolactin, estradiol, FSH, LH, is mandatory for the full functioning of the body. There are many factors that can disrupt the rhythm of the body.

One of the most common causes of disorders in the female reproductive system these days is a malfunction in the ratios and total amount of hormones. And therefore, if such a pathology is suspected, any doctor will refer his patient for appropriate tests. In most cases, such hormones include prolactin, estradiol, progesterone, LH and FSH (their ratio) and many others. Only a doctor can competently evaluate the results obtained and prescribe the correct course of treatment. However, for most women it will be interesting to know, for example, what does the situation mean when LH and FSH are elevated?

Hormones LH and FSH: their norms and relationships with each other

Follicle stimulating hormone (FSH) is secreted by the pituitary gland (as well as LH) and has big influence for the work of the gonads, their normal functioning. Female body produces it with cyclical constancy, while the first phase of the menstrual cycle is noted slight increase its quantity (units/l) in the blood. The FSH hormone in women is responsible for the formation and further development of eggs that develop as part of the follicle. This structural component of the ovary consists of follicular cells, which during the growth of the egg and under the influence of FSH produce estrogen, which blocks the production of follicle-stimulating hormone.

It is worth noting that the level of this hormone, for example, before menopause is almost ten times less than in the postmenopausal period, and during pregnancy it decreases to almost undetectable levels. However, some people have individual characteristics, affecting the level of FSH: physical exercise, smoking, fasting, obesity, exposure to x-rays, contact with lead, etc. For FSH, the norm in women is:

4-10 U/l for the 1st phase of the cycle;
10-25 U/l for ovulation;
2-8 U/l for the 2nd phase of the cycle;
18-150 U/l for menopause.

An increase in the level of this hormone compared to standard indicators speaks of possible neoplasms in the pituitary gland, renal failure, alcohol addiction, endometrial cyst, ovarian failure, side effects some medicines. A reduced level is a sign of pregnancy or hypofunction of the pituitary gland or hypothalamus. If FSH is elevated, treatment is selected by the doctor individually and only after the causes of the increased hormone levels in the blood have been definitively clarified.

Luteinizing hormone (LH) stimulates the production of progesterone in women. It is produced cyclically, but unlike FSH, its peak concentration occurs during ovulation and the second phase of the menstrual cycle. This feature must be taken into account when examining women of reproductive age. Doctors are especially interested in the ratio of LH and FSH, because it determines the possibility and ability of fertilization - normally it should be in the range from 1.5 to 2. If this indicator rises above 2.5, then this indicates polycystic ovary syndrome, neoplasms in the pituitary gland (not necessarily malignant) or ovarian depletion.

Other hormones

In addition to FSH and LH in the blood of a girl/woman in in good condition contains a number of other hormones in appropriate concentrations, whose influence is also immutable. These include, for example, prolactin. This substance, secreted by the pituitary gland, is important for physiological processes mammary gland maturation. In addition, this hormone suppresses the production of sex hormones, and its concentration increases after sexual intercourse, during sleep and after physical activity. Unlike FSH or LH, prolactin reaches its peak concentration in the blood during pregnancy and lactation.

Also normally present in the blood is the hormone estradiol, which is produced by the ovaries. Its concentration increases as the follicle grows and reaches its maximum before the release of the egg, after which it decreases. This is why LH, FSH and estradiol are closely related. In addition to the listed hormones, they are also important for women reproductive system TSH, total and free thyroxine, progesterone, cortisol and others.

To determine the causes of hormonal imbalance, as well as clarify questions such as “are the FSH and LH levels normal in this particular case or not?” It is most effective to contact the appropriate specialists. They are waiting for you at our clinic in Arkhangelsk. Their high qualifications and long-term work experience will help draw conclusions from the analyzes as accurately as possible. Trust them, and then your health will be in good hands. Be attentive to various suspicious manifestations of your body and do not get sick!

The basis of human health is a high-quality endocrine system, because with the coordinated work of hormones, everything in the body is maximally focused on full life and its continuation.

With a stable healthy endocrine status, problems with certain organs, skin, blood vessels, well-being and reproduction are less likely to occur.

In order to promptly correct any problems that have arisen hormonal disorder, you should carefully assess your health and know which hormone is responsible for a particular function in the body.

Thus, the hormones FSH, LH and prolactin are most often recommended to be assessed in the case of female and male infertility. When to get tested for these hormones and why, read on.

Regarding the assessment hormonal status In order to avoid unnecessary and expensive tests, it is recommended to clearly formulate the problem that has arisen, since each hormone has its own role and routine diagnosis FSH hormones, LH, prolactin and testosterone are not indicated.

Laboratory diagnostics are required:

at clinical picture violations hormonal levels(impaired growth, development, problems with general health, hair loss, excessive hair growth, low or overweight);
for infertility;
with recurrent miscarriage;
before appointment hormonal drugs for the purpose of contraception.

At clinical manifestation hormonal imbalance it is necessary to focus on a specific problem. For example, if you are overweight or underweight, thyroid hormones and insulin are taken, plasma glucose is assessed, and if you have masculine physiology or male-pattern hair growth, a woman needs to take hormones in accordance with the phases of the cycle.

Guess hormonal problem female infertility after a year of unsuccessful attempts to have offspring, it is possible with an irregular menstrual cycle and/or lack of ovulation (ovulation within three cycles not confirmed by tests, ultrasound and basal temperature).

In this case, the woman donates prolactin, FSH, LH and thyroid hormones by day of the cycle, in some cases also estradiol and androgens (usually 17-CS). Often, if there is a disturbance in the production of thyroxine by the thyroid gland, it is enough to correct this with a drug - and all other hormones will also return to normal.

Male infertility can be assumed with low sperm count. Then from the hormonal spectrum you need to look at FSH, LH, prolactin, testosterone and thyroid hormones.

In case of miscarriage, it is necessary to evaluate the woman’s progesterone level in the second phase of the cycle and thyroid hormones. This is enough if the woman has a clear menstrual cycle and has confirmed ovulation by any of the methods.

If pregnancies occur but are terminated after the 5th obstetric week, there is no need to diagnose other hormones in either the man or the woman.

Analysis of estradiol concentration levels

Estradiol is a female sex hormone responsible for in a general sense for feminization. At elevated level estradiol in men, infertility and female-type development are observed; in women, hormone fluctuations can also lead to disruption reproductive function, deterioration of skin and hair condition. Estradiol also increases in some types of oncology.

The analysis is indicated in conjunction with FSH (as well as LH and prolactin) for:

menstrual irregularities, menopause;
suspected neoplasm (from cysts to oncology) of the testicles, ovaries, uterus;
weight disorders (usually seen together with TSH and thyroxine);
female infertility;
male feminization.

Blood test for progesterone

Progesterone is a hormone produced by the corpus luteum of the ovary after the release of a mature egg. With high-quality ovarian function, progesterone is produced from 10 to 16 days in the second phase of the cycle, and also continues to be produced when pregnancy occurs.

Progesterone is naturally low in the first phase of the cycle before ovulation, and also drops 14-16 days after ovulation in the absence of pregnancy or when a damaged fertilized egg is implanted.

A progesterone test is indicated for:

miscarriage of the 1st trimester;
the length of phase 2 of the cycle is less than 10 days;
diagnosis of female infertility;
menstrual irregularities.

In men, a progesterone test has virtually no diagnostic value.

FSH analysis

Follicle-stimulating hormone is responsible for stimulating the maturation of germ cells in the body, and also primarily for sexual development. The initial period of spermatogenesis is due, in particular, to this hormone; in women, FSH helps the growth of the follicle with the egg, and when a critical value appears in the luteinizing hormone in the plasma, ovulation occurs.

men with poor performance spermograms, hypogonadism;
women with menstrual irregularities, suspected menopause, infertility, or lack of ovulation.

Changes in the level of FSH, LH, progesterone and estradiol in 1 cycle

Follicle-stimulating hormone largely depends on thyroid hormones, so diagnosis should be carried out in conjunction with these hormones. In addition, FSH assessment in women should be performed twice per cycle, without neglecting luteinizing hormone.

LH analysis

Luteinizing hormone is a hormone responsible in women for stimulating the growth of follicles with eggs, where its maximum concentration in plasma is trigger mechanism for ovulation, and in men the same hormone is involved in final stage spermatogenesis.

The assessment of this hormone is primarily indicated for both male and female infertility and does not depend on spermogram parameters. The hormone is assessed together with FSH, in women - twice per cycle.

Research rules

To correctly assess endocrine status, it is important to remember three points.

First, hormones are cyclical, and their secretion is optimally determined in the early morning from 8 to 11, at empty stomach, preferably avoiding stressful situations and excessive physical activity.
Secondly, hormones are affected by the drugs that a person takes - one-time or constantly, this is fundamentally important to take into account.
And the third point - a woman produces hormones cyclically, so assessing its amount on the wrong day of the cycle can lead to incorrect results, incorrect and potentially dangerous treatment!

Of course, if there is a serious disruption to a woman’s menstrual cycle, it is sometimes impossible to count the day, and only in this case all the required hormones are given at one time on one day (as in men).

Modern laboratories are equipped with marking of hormone concentrations by cycle phase, which greatly simplifies diagnosis even if there is an error in choosing the day of delivery.

However, to make a diagnosis, you should adhere to the rules of cyclical hormone donation:

on the 7th day after ovulation, progesterone is determined;
TSH and thyroxine do not depend on the day of the cycle, but it is optimal to conduct the study not during ovulation;
FSH and LH, depending on the purpose, are monitored either in the first 7 days, or twice on days 10-13 and on day 7 after ovulation;
estradiol, prolactin, testosterone during the follicular phase - on days 6-7 of the cycle.

Lactotropic hormone is produced in both female and male bodies. And possible consequences Let's look at it in the article.

Let's consider what are the reasons for increased progesterone levels in women.