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Follicle Stimulating Hormone

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Follicle Stimulating Hormone (FSH) is a hormone associated with reproductive functions such as development of eggs in women and sperms in men. The FSH test is ordered in case of a variety of problems such as difficulty getting pregnant, menstrual irregularities, low sex drive, and early or delayed puberty.

The low levels of FSH may indicate decreased ovulation in women, reduced sperm count in men, problems at the level of the hypothalamus or pituitary gland. High levels of FSH, on the other hand can be indicative of loss of ovarian function and menopause. FSH works closely with another hormone called luteinizing hormone (LH) to control sexual functions. Hence, the LH test is frequently ordered along with the FSH test.

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What does Follicle Stimulating Hormone measure?

Follicle-stimulating hormone (FSH) is a hormone which is associated with reproduction and the development of eggs in women and sperm in men. This test measures FSH in the blood.

FSH is produced by the pituitary gland, and its production is controlled by a feedback system involving the hypothalamus in the brain, the pituitary gland, and the hormones produced by the ovaries or testicles. The Gonadotropin-releasing hormone (GnRH) from the hypothalamus stimulates the pituitary gland to release FSH and luteinizing hormone (LH; another closely-related hormone also involved in reproduction). FSH affects the growth and maturation of egg follicles in the ovaries during the follicular phase of the menstrual cycle. The menstrual cycle is divided into follicular and luteal phases, each phase lasting for 14 days. During the follicular phase, FSH initiates the production of estradiol by the follicle, and the two hormones work together in the further development of the egg follicle. Near the end of the follicular phase, the production of FSH and luteinizing hormone increases. The release of the egg from the ovary (ovulation) occurs shortly after this increased production of hormones. The hormone inhibin as well as estradiol and progesterone help control the amount of FSH released by the pituitary gland. FSH also facilitates the ability of the ovary to respond to LH. At menopause, ovarian function decreases and eventually ceases which results in increased levels of FSH and LH.

In males, the role of FSH is to stimulate the testicles to produce mature sperms and also promotes the production of androgen binding proteins. FSH levels are relatively constant in men after puberty than in women.

In infants and children, FSH levels rise shortly after birth and then fall to very low levels by 6 months in boys and 1-2 years in girls. Concentrations begin to rise again before the beginning of puberty and the development of secondary sexual characteristics.

Disorders affecting the hypothalamus, pituitary, and/or the ovaries or testicles can cause the production of too much or too little FSH, resulting in a variety of conditions such as infertility, abnormal menstrual cycles, or early (precocious) or delayed sexual maturation (puberty).

FAQs related to Follicle Stimulating Hormone

What are the causes of high levels of FSH in Children?

The start of puberty might be the cause for high levels of FSH in children.

What do low levels of FSH mean?

Low levels of FSH may indicate decreased ovulation in women, reduced sperm count in men, problems at the level of the hypothalamus or pituitary gland, which are the hormone control centers in the brain, and stress.

What other hormone tests may be required along with abnormal FSH values?

FSH levels are usually just one part of the puzzle a doctor has to work out. To gain a clearer picture, further tests are likely to be needed. Following tests may be advised by your doctor: Estradiol Luteinizing hormone Progesterone Testosterone

Can medicines have any effect on the levels of FSH?

There are certain medicines that can affect the levels of FSH. In order to prevent false readings, it is important for the individual to inform the doctor about all the medicines they are taking as they can alter the functioning of hormones. Medicines that could increase FSH levels include cimetidine, clomiphene, digitalis, and levodopa. Whereas, medicines that decrease FSH levels include hormone replacement therapies, oral contraceptives, and phenothiazines. Taking multivitamins that contain biotin or vitamin B7 may also affect the accuracy of the FSH test. Doctors usually recommend that a woman should not take these supplements for at least 12 hours before a test.

Are there any special preparation required for FSH test?

As such no special preparations are required. However, in case of women, menstrual cycle timing is noted so as to compare the range accordingly.

Can levels of FSH vary during different days of the menstrual cycle?

Yes, the FSH level can vary during the different phases of the menstrual cycle. Following are the normal range during different phases: Follicular phase: 3.1-7.9 mIU/ML Ovulation phase: 2.3-18.5 mIU/mL Luteal phase: 1.4-5.5 mIU/mL FSH levels can vary not only throughout the menstrual cycle but also from cycle to cycle. You can get a normal test value one month and an abnormal test value the next. Hence, to test basic fertility and to evaluate ovarian reserves, the FSH level is checked on day 3 of the menstrual cycle. The first day of the cycle is the day when the period begins. Reference range may vary from lab to lab* l range during different phases: Follicular phase: 3.1-7.9 mIU/ML Ovulation phase: 2.3-18.5 mIU/mL Luteal phase: 1.4-5.5 mIU/mL FSH levels can vary not only throughout the menstrual cycle but also from cycle to cycle. You can get a normal test value one month and an abnormal test value the next. Hence, to test basic fertility and to evaluate ovarian reserves, the FSH level is checked on day 3 of the menstrual cycle. The first day of the cycle is the day when the period begins. Reference range may vary from lab to lab*

Which factors can affect the FSH level?

The levels of FSH can get affected by conditions like uncontrolled thyroid disease, sex-dependent hormone tumors, ovarian cysts, and unusual vaginal bleeding. Moreover, medicines like birth control pills, cimetidine, clomiphene, digitalis, levodopa, phenothiazines as well as medicines used in hormone replacement therapies can also affect the levels. Similarly, medicines used in hormone replacement therapies can also alter the FSH levels. Multivitamins containing biotin or vitamin B7 may also affect the accuracy of the FSH test. It is generally advised that a woman should avoid taking these supplements for at least 12 hours before a test.

What do high levels of FSH indicate?

High levels of FSH can indicate loss of ovarian function or ovarian failure, menopause, polycystic ovarian syndrome, chromosomal abnormalities (e.g., Turner’s syndrome), and reduction in the production of good quality eggs and embryos for fertilization.

What are the causes of high levels of FSH in Men?

High levels of FSH in men may indicate Klinefelter’s syndrome, absence of testicles or impaired functioning of testicles, damage to testicles by a disease such as alcohol dependence, and testicular damage by treatments such as X-rays or chemotherapy.

Content created by

Dr. Swati Gupta (Anand)

MBBS, MD Lab Medicine

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Last Updated

25th Oct 2023