Decreased FSH - about the causes of impaired hormone production in men and women

The pituitary gland of the brain produces tropic hormones. They stimulate the work of peripheral endocrine glands. One of these tropic substances is follicle-stimulating hormone (foliculotropin, FSH).

This complex chemical compound affects the formation, development and function of the genital organs in women and men.

Structure and secretion of the hormone

FSH is a two-chain molecule. The hormone contains 85% amino acids and 15% carbohydrates.

The release of this substance into the blood is influenced by three factors:

GnRH of the hypothalamus (stimulates);
genital inhibin (suppresses);
estrogens and androgens (suppress).

In adults, estrogens and androgens have the maximum effect on gonadotropins. The level of folliculotropin is regulated by sex steroids according to the feedback principle. The less androgens or estrogens, the more FSH is released from the pituitary gland.

In the female body, the level of follicle-stimulating hormone directly depends on the phase of the menstrual cycle. The hormone is released in high concentrations in the first two weeks after the onset of menstruation. During the follicular phase, its concentration constantly increases. Peak secretion occurs in the days before ovulation. Then, when the mature egg is released into the lumen of the fallopian tube, the FSH level decreases.

Once pregnancy occurs, follicle-stimulating hormone remains suppressed. Its level begins to increase only a few months after birth.

In women after menopause, the concentration of follicle-stimulating hormone ceases to change cyclically. Its blood level is always high. This is because the pituitary gland continues to stimulate the ovaries. But egg maturation does not occur, since the gonads after menopause lose sensitivity to FSH.

In men, follicle-stimulating hormone is produced evenly. No secretion peaks or noticeable decreases in hormone concentrations are observed. In old age, FSH increases in men. This is a natural reaction of the endocrine system to the aging of the body.

Action of FSH

Follicle-stimulating hormone is responsible for a person's ability to reproduce. It supports the functioning of the reproductive system.

The effect of FSH on the female body:

stimulates the growth of follicles in the ovaries;
increases estrogen levels;
provokes the conversion of testosterone into estrogens;
promotes ovulation;
regulates the beginning and end of menstruation.

Follicle-stimulating hormone is no less important for the male reproductive system.

His role:

promotes the development of seminiferous tubules in the testicles;
stimulates the formation of mature sperm;
regulates the functioning of Sertoli cells in the testes.

Both an increase and a decrease in FSH leads to impaired reproductive function. The level of the hormone changes in diseases of the gonads (ovaries, testes), pituitary gland and hypothalamus.

What factors lead to low or high FSH?

Low and high levels of FSH reflect the dysfunction of the reproductive system. When the value is outside the normal range, various violations are likely. Most often, changes in the norm lead to infertility.

An increase in follicle-stimulating hormone occurs when:

premature ovarian depletion (early menopause);
underdevelopment of the gonads;
endometrioid cysts;
uterine bleeding;
pituitary tumors (adenoma);
surgical removal of the ovaries or testicles (castration);
inflammation of the testicles;
testicular feminization syndrome;
alcohol abuse.

Low FSH occurs in patients with:

secondary hypogonadism;
Sheehan's syndrome;
prolactinoma;
polycystic ovary syndrome;
obesity.

In addition, the concentration of the hormone in the blood is affected by hormonal contraceptives, some other medications, traumatic brain injuries and other factors.

When a healthcare provider evaluates a patient with abnormal FSH levels, they will evaluate all possible causes of the imbalance.

Norm folliculotropin

The exact limits of normal FSH values may vary slightly between laboratories. They depend on specific technologies, methods and reagents in the medical institution.

Follicle stimulating hormone is usually measured in international units mU/ml.

The norm for children depends on age and gender. In girls under one year old, the norm should be from 1.8 to 20.3 mU/ml. Further, up to five years, the concentration of the hormone falls within the range of 0.6-6.2 mU/ml. By school age, this figure decreases to 4.5 mU/ml and remains stable until the onset of puberty.

In male infants it should be below 3.5 mU/ml, in preschool boys - less than 1.5 mU/ml, in primary schoolchildren - up to 3 mU/ml.

In girls and women of childbearing age, the folliculotropin level varies according to the phases of the menstrual cycle.

If the analysis is taken during the follicular period, then the norm falls within the range of 1.37-9.9 mU/ml. On the days of ovulation, this figure is 6.2-17.2 mU/ml. If you take a hormone test in the luteal phase of the cycle, then its concentration should be from 1 to 9 mU/ml.

For women of reproductive age, the balance between the gonadotropins FSH and LH is extremely important. The level of the first of them is normally always 1.5-2 times higher. When follicle-stimulating hormone becomes relatively abundant, this ratio increases.

In the case when FSH exceeds LH by 2.5 times or more, then the following are likely:

ovarian depletion (approaching menopause);
polycystic ovary syndrome;
FSH-secreting pituitary adenoma.

In women after menopause, FSH normally increases. Its level reaches 19-100 mU/l.

In young men under 20 years of age, the concentration of the hormone in the blood is 0.4-10 mU/ml. In adult men after 21 years of age, this figure falls within the range of 1-12 mU/ml.

This hormone is determined along with a number of other parameters (LH, prolactin, sex steroids, etc.) This allows the doctor to get a holistic picture of the patient’s health.

The hormone is examined:

for infertility;
with irregular periods;
with uterine bleeding;
in the absence of ovulation;
with spontaneous abortion;
with endometriosis;
with polycystic ovary syndrome;
with decreased libido;
with impotence;
for chronic inflammation of the reproductive system;
with retarded growth and development of children;
with premature puberty.

How to donate hormones

In men, in children, in women after menopause or with amenorrhea for another reason, in pregnant women, FSH is determined on any day of the month.

To get accurate results, it is necessary to limit physical and emotional stress 2-3 days before blood collection. On the day of the test, it is recommended not to smoke (at least 60 minutes before the test). The night before, you should limit fatty foods to your menu. It is also necessary to abstain from alcohol. Blood is donated for FSH strictly on an empty stomach. Any food, sweet drinks, coffee and tea should be excluded for 8-12 hours. It is best to come for analysis in the morning (from 7 to 11).

Extremely important for women of reproductive age. It, paired with luteinizing hormone, creates the conditions for conceiving a healthy baby. As the name implies, FSH affects the development of follicles in which eggs ready for fertilization are placed. The hormone is generated by the pituitary gland, a gland at the base of the brain that receives commands to produce the substance from the hypothalamus. If FSH is elevated, it is necessary to find the cause of the deviation from the norm.

For men, follitropin is important because it promotes the development of seminiferous tubules, which transport sperm towards the egg. The hormone has other functions related to preparation for conception. A deviation in the content of a substance from the norm can mean a serious pathology in the body, even a malignant tumor.

Functions of FSH

In women, the hormone:

promotes egg maturation;
stimulates the production of estrogens, incl. estradiol;
affects the frequency of the menstrual cycle;
The health of a woman’s internal genital organs depends on it.

In men FSH:

stimulates tubule growth;
has a positive effect on testosterone production;
promotes the formation of viable and dynamic sperm;
The correct development of the male genital organs depends on the substance.

Normal helps a woman during the period of breastfeeding a baby to avoid another pregnancy while the first baby is too small and the mother has not recovered from the previous birth.

FSH norm

Excessive FSH levels may indicate a disease that needs urgent treatment. The acceptable amount of a substance is determined differently in women and men. In fertile men, it is constant. In women, the norm depends on the phase of the menstrual cycle. In the first 14 days, during the formation of follicles and maturation of the egg, the level of FSH in the body is high, during the period of ovulation its content reaches a maximum, and in the luteal phase the amount of the hormone is quite low. Then everything is repeated, and at the same time the normal level of follicle-stimulating hormone in a woman changes accordingly.

In women, at the beginning of the cycle, follicles develop under the influence of the hormone. Then the growth of only one, dominant follicle begins, containing a mature egg, ready for the ovulation phase, where conception is likely. The follicle produces estradiol, the task of which is to prepare the uterine mucosa for conception. During the ovulation phase, the follicle ruptures at the command of the pituitary gland and the formation of the corpus luteum. It produces progesterone, and the egg moves through the fallopian tubes to the uterus.

In the first 2 weeks of the cycle, FSH is elevated in women and should range from 3.5 to 12.5 mIU/ml. During ovulation, FSH levels are highest, rising to 25 mIU/ml. In the luteal phase, the volume drops to 1.7 – 9.0 mIU/ml. When a woman reaches the age at which menopause occurs, the content of the substance increases to 150 mIU/ml.

In adult men, the level of substance content in the body varies depending on the individual ability to conceive, from 0.7 to 11.1 IU/ml.

Exceeding the norm

First of all, the FSH hormone is elevated in a woman (if it has reached a volume of 40 mIU/ml) when the woman has lost the ability to conceive. An increase in FSH levels can signal diseases:

menstrual irregularities;
improper development of the gonads;
the onset of premature menopause;
the FSH hormone is higher than normal if an operation was performed to remove the ovaries in a woman or the testicles in a man;
tumor disease of the pituitary gland;
renal pathology;
ovarian depletion;
increased production of the male hormone testosterone in women;
X-ray irradiation;
treatment with hormonal or other medications that affect the production of FSH;
alcohol abuse;
FSH in women increases due to smoking habit;
a genetic disease when 1 chromosome is missing or damaged.

Since there are many reasons for increased levels of the hormone, you need to pay attention to additional symptoms of the disease.

In relation to children, it makes sense to observe their puberty, whether it occurs on time, or whether there is an advance or lag behind the schedule. If elevated FSH is detected in a woman, it means that she may experience interruptions in her periods, or they may stop altogether. Uterine bleeding may also occur. An additional symptom is frequent miscarriages. Men may experience decreased potency and lack of sexual desire.

A reduced amount of the hormone may indicate tumor diseases of the pituitary gland or hypothalamus. Hormone production is reduced in obesity. A deficiency of the substance is observed with multiple ovarian cysts.

High FSH may indicate prolactinoma - a benign tumor of the pituitary gland, stimulated by increased levels of prolactin. If the presence of this disease is detected at an early stage, it can be treated with medications without resorting to surgery.

Diagnosis and treatment

To determine the volume of FSH in the blood, a venous blood test is taken on an empty stomach in the morning. The rules for preparing for the test are standard: do not eat or drink on the day of the test, do not take medications or alcohol on the eve of the test, avoid physical activity and stress the day before and on the day of blood donation. You can't have sex the day before. Women need to come to the laboratory 4–7 days after the start of their period.

If the analysis shows that the hormone is elevated, additional research must be carried out. Often doctors immediately prescribe an extensive blood test for hormones to look at the levels of LH, sex hormones and the state of the endocrine system as a whole. Sometimes the doctor may refer the patient for ultrasound, MRI and other diagnostic procedures.

How to reduce FSH? Treatment may include hormone replacement therapy, which increases levels of other hormones. Since follitropin and sex hormones are related according to the law of feedback, to reduce the substance, sometimes it is enough to drink drugs that stimulate the production of sex hormones. You cannot prescribe hormonal medications containing estradiol and medications that stimulate the production of hormones to yourself, as this is dangerous to health. The doctor decides whether it is possible to take a hormonal drug.

When the increase in the hormone is affected by x-ray irradiation, no treatment is carried out. As a rule, the substance returns to normal 6 – 12 months after the fact of irradiation. If the reason for the decrease in follitropin lies in excess weight, the doctor may refer the patient to a nutritionist who will recommend a weight-loss diet to increase the volume of the substance.

If the deviation from the normal amount of follitropin is caused by pathology of other organs, it is necessary to treat the underlying disease. If a tumor of the ovaries or pituitary gland is detected, surgery may be required. In any case, if you have done a paid test yourself and found an increased FSH value, you need to consult a specialist for interpretation of the results and treatment. Your doctor will tell you how to lower FSH.

With the help of follicle-stimulating hormone or FSH, a woman’s body regulates the functioning of her reproductive system. Therefore, if its level is elevated, then this may indicate not just a hormonal imbalance, but rather serious pathologies that lead a woman to infertility.

To understand the danger of an increased level of FSH in a woman’s body, you need to know what it is in general and why it is needed in the body. From the name “follicle-stimulating” it becomes clear that it controls the process of maturation and release of eggs from the follicles. Those cells that, during fertilization, become embryos and subsequently people. The hormone is synthesized within the endocrine system, more precisely in the pituitary gland.

But FSH is not only a female hormone, although it plays an important role in a woman’s body. In men, it regulates the functioning of the seminiferous tubules, and it also helps sperm grow, as it produces testosterone. In a man's body, follicle-stimulating hormone is always at the same level, something around 10.1 IU/ml. But in women, its level constantly changes depending on many factors, such as age, or the moment in the cyclicity of menstruation. And for each such day and condition there is its own norm.

It is clear that follicle-stimulating hormone in a woman’s body is not the only one that controls the reproductive organs. It works in close relationship with prolactin, which is responsible for lactation, as well as with estradiol and progesterone, which perform their functions.

That is, the hormonal preparation of a woman’s body for conception and childbirth is a rather delicate and sensitive area. FSH levels are constantly changing depending on the approaching day of full maturation of the egg. After it has matured and escaped from the follicle, the FSH level drops sharply. From this moment on, the movement and further fate of the egg depend on other hormones. If conception occurs, the hormone level remains low until the birth of the child and another 2-6 months later. The cyclicity of its increase resumes along with the menstrual cycle.

FSH standards

Despite the constant cyclical nature of FSH levels and the large number of factors that make it up, scientists were able to determine the hormone norms for each category and woman on each day of her monthly cycle. This is necessary to identify pathologies based on deviations from the norm.

Here is what a table of normal FSH levels in women looks like:
Girls under 11-12 years old: 0.11-1.6 mIU/ml.
Woman at the beginning of the follicular phase: from 1.9-11.0 mIU/ml;
Woman during the ovular phase: 4.8 to 20.5 mIU/ml;
Woman during the luteal phase: from 1 to 9 mIU/ml;
Women during menopause: 30 to 128 mIU/ml;
Postmenopausal woman: 21.7-153 mIU/ml.

An increased content above the presented norms is considered a signal from the body that something is wrong with it.

Reasons for elevated levels

If the hormone is elevated, a woman cannot become pregnant. The level of the FSH hormone increases for the following reasons:

Dysfunction of the sex glands. Or their underdevelopment.
Presence of a cyst in the uterus.
Menopause that started too early.
FSH is elevated due to removal of the ovaries during surgery.
Inflammatory process in the ovary.
Development of a tumor in the pituitary gland.
FSH is high, in renal failure.
Increased levels of male hormone in the female body.
Hard gamma radiation.
Bad habits such as alcohol abuse and smoking.
FSH can be high due to certain medications, especially those containing hormones. For example, oral contraceptives.

Symptoms of an increase in the FSH hormone are primarily a violation of the cyclicity of menstruation. If elevated levels occur in a girl, she may stop growing and experience delayed puberty. In addition, a rather obvious symptom is a miscarriage; in this situation, there is no need to wait for this phenomenon to recur; you should immediately consult a doctor.

Diagnosis of the cause of elevated FSH

To diagnose the cause of an increase in FSH, it is not enough to take a test for the level of the hormone in the blood. You need to undergo a full examination by an endocrinologist, and take several more tests for the content of other hormones - prolactin, testosterone, progesterone, estradiol, and anything else that the doctor deems necessary to check in a given situation.

It is important to follow the rules for taking FSH tests, otherwise the measurement will be incorrect and the treatment will accordingly be prescribed incorrectly. Therefore, 3-5 days before the analysis, it is necessary to stop vigorous physical activity, especially sports. 3-4 days before the test, you should stop drinking alcoholic beverages and cigarettes. 12 hours before the test, you must stop eating. For 3 hours, you should calm down and try not to get nervous.

You also need to understand that few doctors will be able to make an accurate diagnosis based only on a one-time analysis. In any situation, he does 2 or even 3 analyzes, after which the results are compared. In addition, the doctor must know the exact age of the patient, her exact weight, and must also tell her at what age she began puberty.

Treatment of elevated FSH levels

If the increased level of FSH is the result of bad habits, then restoring it is quite simple, just give them up. But if high FSH in the blood is associated with hormonal dysfunction, you will have to undergo drug treatment. The drugs usually used for this are hormonal, so only a doctor prescribes them.

If it turns out that the increased level of FSH was a consequence of gamma radiation, then no special treatment is carried out, since the level of the hormone normalizes on its own. This usually takes from 5 to 10 months. In this case, a woman must adhere to a certain diet, the diet of which contains foods rich in iodine. If conservative therapy does not help, then you have to resort to surgery. During this procedure, a tumor is removed from the pituitary gland, uterus or ovaries.

Responsible for the production of follicles in the ovaries of the fair sex.

It also promotes the synthesis of estrogens. Follotropin is intended to regulate the production of other sex hormones.

If this hormone exceeds the norm, the woman will need treatment. FSH can be reduced with the help of medications.

What does an elevated FSH level indicate?

An increase in follicostimulating hormone indicates a malfunction in the female body.

Often, when the amount of FSH increases, doctors suspect the presence of a tumor of the pituitary gland (gland of the endocrine system).

Elevated follotropin may also indicate the presence of endometrial cysts and ovarian dysfunction in the body.

Elevated levels of the hormone indicate problems with the body such as:

Lack of ovulation phase.
Stopping menstrual flow.
Presence of uterine bleeding.

Diagnostics

For diagnosis, you should consult a gynecologist. Healthcare workers refer the patient for a blood test.

Main stages of preparation:

Before donating blood, you are prohibited from taking hormonal medications, including contraceptives, for 24 hours.
2-3 hours before the test you should not smoke or exercise.
Blood is donated strictly on an empty stomach

Causes of elevated FSH in women

The level of follicostimulating hormone in the female body is not stable. It changes depending on the phase of the menstrual cycle.

The largest amount of follotropin is at the beginning of menstruation. It is at the beginning of the menstrual cycle that the body begins active preparation for the release of the follicle from the egg.

During menopause, elevated FSH levels are often observed. This occurs due to the fact that the ovaries do not respond to hormones that are produced by the glands of the endocrine system.

Therefore, there is an oversaturation of this hormone. This situation greatly affects a woman’s body during menopause. She feels worse and becomes irritable.

The main reasons for increased levels of follicle-stimulating hormone:

The onset of early menopause.
Surgery to remove the ovaries.
Kidney failure.
High level of male hormone in a woman’s body.
Exposure to X-rays.

The increase in FSH is greatly influenced by bad habits: drinking alcohol and drugs, as well as smoking.

The consequence of the occurrence of indicators above the norm may be Ullrich-Turner syndrome.

This disease is a congenital pathology characterized by an abnormal number of chromosomes.

FSH standards

In teenage girls, it ranges from 0.11 to 1.6 mIU/ml.

In women of childbearing age in the follicular phase (stage of the menstrual cycle), a level of 1.9 to 11.0 mIU/ml is considered normal.

The ovulatory stage is characterized by indicators from 4.8 to 20.5 mIU/ml. During the luteal phase (the final stage of the menstrual cycle), the norm ranges from 1 to 9 mIU/ml.

During menopause (menopause), the levels range from 30 to 128 mIU/ml, and during postmenopause, this ranges from 21.7 to 153 mIU/ml.

For IVF, the FSH norm is 1.37 – 9.90 mIU/ml.

How to lower FSH levels

In order to lower FSH, women are prescribed drugs that temporarily block the basic functions of the ovaries.

The duration of treatment depends on the level of the hormone. It can last from 3 to 12 months.

You can lower FSH with drugs such as:

"Buserelin."
"Carbamazeline".
"Danazol".
"Goserelin."
"Megestrol".
"Sesranol."
"Stanozol".
"Pimozide".
"Phenytoin."
"Toremifene."

Note!

Medicines should not be taken on your own initiative. All medications must be prescribed by an endocrinologist, gynecologist or reproductive specialist.

Decreased FSH

If FSH is low, this may be a consequence of fertilization of the egg. After conception, the level of this hormone decreases sharply.

The reason FSH decreases during pregnancy is the fact that follotropin no longer needs to stimulate follicle development since fertilization has already occurred.

Reduced follicle-stimulating hormone indicates a malfunction of the pituitary gland. Also, FSH in women is often reduced due to and due to excessive body weight.

Other reasons for decreased follotropin levels:

Kallman syndrome.
Pituitary insufficiency.
Sheehan's syndrome.
Excessive production of prolactin by the body.
Ovarian tumor.
Simmonds' disease.

Hemochromatosis can also cause a sharp decrease in follotropin. This is a disease characterized by disorders of iron metabolism.

Drugs to increase FSH:

"Ketoconazole".
"Nafarelin."
"Naloxone."
"Nilutamide".
Pravastatin.
"Tamoxifen."

Conclusion

It is imperative to treat elevated levels of follicostimulating hormone. After all, this threatens a woman with infertility.

If the level is above 40 mIU/ml, the egg does not leave the follicle, therefore ovulation does not occur, so the fairer sex will not be able to get pregnant.

Video: High FSH levels

Changes in a woman's hormonal levels can be due to various reasons. Therefore, to maintain general health and when planning pregnancy, you should be tested for.

Follicle-stimulating hormone (FSH) is a hormone that is involved in the process of creating estrogen and accelerates the development of follicles in the ovaries in women. In the male body, follitropin is involved in the process of spermatogenesis. This hormone is produced.

With the onset of menopause, follicle-stimulating hormone levels increase, while estradiol production decreases.

The hormone is released into the blood every 1-4 hours. The duration of such a release is 15-20 minutes.

The main functions of follicle-stimulating hormone in the female body:

Increases estrogen production
Takes part in the conversion to estrogens
Affects ovulation
Regulates the menstrual cycle

More information about FSH can be found in the video.

Follitropin is important for the male reproductive system. The hormone in the male body performs the following functions:

Promotes sperm development
Responsible for the development of seminiferous tubules
Affects the production of estradiol

Follicle-stimulating hormone performs a reproductive function in both men and women. Therefore, both partners need to take the test.

Indications for testing

A test for follicle-stimulating hormone is prescribed in the following cases:

An increase in follicle-stimulating hormone in women may indicate the occurrence of the following pathologies:

Development of endometrial cyst
Pituitary tumor
Premature menopause
Turner syndrome
Swyer syndrome
Kidney failure
Problems conceiving a child

FSH concentrations higher than normal can be observed after surgery to remove one of the drugs, X-ray exposure, or adverse reactions when taking certain medications.

A woman with a high level of follitropin does not have menstruation, and uterine bleeding occurs regardless of the menstrual cycle.

An increase in hormones in men may indicate inflammatory processes in the genital organs or high levels of male sex hormones. If you are a woman or suffer from alcoholism, FSH in the blood also increases.

If the indicator is too high, it is necessary to undergo a full examination so that the doctor can assess the overall picture and prescribe quality treatment.

Low hormone levels

A decrease in the level of FSH in the blood may be the cause of excess weight, polycystic ovary syndrome, or associated with pathologies of the hypothalamus.

Quite often, hormone levels below normal affect the conception of a child, which is associated with dysfunction of the gonads.

A decrease in the hormone can be caused by various factors:

Poor nutrition
Working in hazardous conditions
Endocrine diseases
Stress

Low concentrations of the hormone in men indicate a lack of sperm or their complete absence, problems with potency or testicular atrophy. All this is due to pituitary failure.In women and men, against the background of low FSH concentrations, libido decreases, wrinkles appear, and body hair growth decreases.

To diagnose the disease, genital organs are performed, if necessary, CT or.After a series of examinations, treatment is prescribed. If FSH levels are high, hormone replacement therapy is prescribed. Taking into account how much the concentration deviates from the norm, the dosage of the hormonal drug is selected. The dose is increased gradually.

When the concentration of hormones decreases, a procedure is carried out, which involves taking medications that increase FSH.

It is possible to eliminate the problem and normalize the level of follicle-stimulating hormone, but it is important to follow all the doctor’s recommendations and take prescribed hormonal medications.