Follicle Stimulating Hormone and Luteinizing Hormone-FSH and LH

Also Known as:       follicle-stimulating hormone and luteinizing hormone 

What is an FSH and LH test?

This test measures the luteinizing hormone (LH) and Follicle-stimulating hormone (FSH) levels in your blood. Your pituitary gland, a small gland underneath your brain, produces FSH and LH. The hypothalamus in the brain, the pituitary gland, and the hormones generated by the ovaries and testicles all work together to control the production of LH and FSH. FSH and LH are essential for sexual development and functioning, such as:

• In women, LH and FSH assist in regulating the menstrual cycle, stimulating the growth of the egg and its release (ovulation) from the ovary, and signal the ovaries to produce the hormone estrogen. 
• In men, LH and FSH levels do not fluctuate much normally, and they play their part in stimulating the testicles to produce testosterone, which is necessary for sperm production
• LH and FSH levels are typically low during early childhood and begin to rise a few years before puberty.

Many problems such as infertility, menstrual irregularities, early or delayed puberty, and low sex drive can also be caused by too much or too little LH and FSH levels in the blood.

What is the test used for?

To control sexual functioning, an LH test works in combination with another hormone called follicle-stimulating hormone (FSH).  These tests are used differently whether you are a woman, a man, or a child.

These tests are most commonly used in women to:

• Assist in determining the cause of infertility.
• Find out when ovulation (egg release) takes place; the time when you're most likely to conceive.
• Determine the cause of irregular or stopped menstrual cycles.
• Confirm that menopause (when a woman's menstrual periods have finished and she can no longer conceive) or peri-menopause (transition period before menopause) has begun. 

This test is most commonly used in men to:

• Assist in determining the cause of infertility.
• Find out why your sperm count is low.
• Find out why you have a low sex drive.

This test is most commonly used in children to diagnose early or delayed puberty.

If puberty begins before the age of nine in girls and before the age of ten in boys, it is called early puberty. 
Puberty is considered delayed if it has not begun by the age of 13 in girls and 14 in boys

Why and when do you need this test?

If you are a woman, this test may be required if:

• You have been trying for a year and have not been able to conceive.
• Your menstrual cycle is not consistent (irregular). 
• Your periods have stopped (menopause). You can use this test to identify if you have reached menopause or are in the perimenopause stage.

If you are a man, this test may be required if:

• After a year of trying, you haven't been able to get your spouse pregnant.
• Your sexual desire has been reduced

If you experience symptoms of a pituitary disorder, both men and women may require this test. Some of the symptoms stated above are included, as well as:

• Fatigue 
• Weakness
• Loss of weight
• Loss of appetite

An FSH and LH test may be required if your child does not appear to be commencing puberty at the appropriate age. Signs of puberty include:

• Breast enlargement in young girls
• Pubic hair growth
• Testicles and penis growth in boys
• Beginning of menstrual cycle in girls 

What kind of sample is required for the test?

A small needle will be used by a healthcare professional to obtain a blood sample from a vein in your arm.  A small amount of blood will be collected into a test tube or vial once the needle is inserted. When the needle goes in or out, it may sting a little. It usually takes less than five minutes to complete this process.

Do you need to prepare for the test?

If you are a woman who has not yet reached menopause, your doctor may suggest that you have your test at a specified point in your menstrual cycle. If there are any other special instructions to follow regarding additional testing, your health care provider will inform you.

Are there any risks to this test?

Having a blood test carries relatively little risk. You may experience little pain or bruising where the needle gets inserted, but most symptoms disappear quickly.

What do the test results mean?

Your results will differ depending on whether you are a woman, a man, or a child.

If you are a woman, elevated FSH levels could indicate that you:

• Have Primary ovarian insufficiency (POI): loss of ovarian function before the age of 40.
• Have been diagnosed with polycystic ovary syndrome (PCOS): a common hormone disease that affects women of childbearing age and is one of the leading reasons of infertility among women.
• Have Turner syndrome:  a hereditary condition that affects female sexual development, often causing infertility issues.
• Have started menopause or are in the premenopausal stage
• Have an ovarian tumor

If you are a woman, elevated LH levels could indicate that you:

• Are not ovulating. If you are of childbearing age, this could indicate an issue with your ovaries. If you're over 40, it is possible you have started menopause or are in the perimenopause stage.
• Have been diagnosed with polycystic ovary syndrome (PCOS): a common hormone disease that affects women of childbearing age and is one of the leading reasons for infertility among women.
• Have Turner syndrome:  a hereditary condition that affects female sexual development, often causing infertility issues.

If you're a woman, low FSH levels could indicate:

• Your ovaries are not producing enough eggs.
• Your pituitary gland is not functioning correctly.
• You have a problem in your hypothalamus ( a portion of the brain that regulates the pituitary gland and other vital bodily functions)
• You are underweight.

If you're a woman, low LH levels could indicate:

• Your pituitary gland is not functioning properly.
• You are suffering from an eating disorder.
• You are malnourished.

If you are a man, elevated FSH levels could imply one of the following:

• Chemotherapy, radiation, infection, or alcohol abuse may have affected your testicles.
• Autoimmune Disease
• Germ Cell tumor 
• You may have Klinefelter's syndrome: a hereditary disease (chromosome disorder) affecting male sexual development and may cause infertility issues. 

If you are a man, elevated LH levels could imply one of the following:

• Chemotherapy, radiation, infection, or alcohol abuse may have affected your testicles.
• Autoimmune Disease
• Germ Cell tumor 
• Failure to develop normal gonads
• You may have Klinefelter's syndrome: a hereditary disease (chromosome disorder) affecting male sexual development and may cause infertility issues. 

If you are a man, low LH and FSH levels may indicate 

• A disorder of the pituitary gland or hypothalamus 

High levels of LH and follicle-stimulating hormone (FSH) in children may indicate that puberty is about to begin or has already started. If this occurs before the age of nine in a girl or before the age of ten in a boy (precocious puberty), it could be an indication of:

• A condition that affects the central nervous system, e.g., central nervous tumor, meningitis, encephalitis)
• A brain injury or trauma 

Low levels of LH and follicle-stimulating hormone in children may indicate a delay in puberty. Puberty can be delayed due to a variety of factors, including:

• A condition affecting the ovaries or testicles.
• Turner syndrome affecting young girls.
• Klinefelter's syndrome in boys
• A chronic infection.
• Deficiency of hormone 
• An eating disorder 

Should you have any questions regarding your results, consult your healthcare provider.

Related Tests: 
Follicle-stimulating Hormone (FSH), Testosterone free, Progesterone, Estrogens, Androstenedione, Semen Analysis, Anti-Müllerian Hormone, Prolactin, Sex Hormone Binding Globulin (SHBG), Luteinizing Hormone (LH)