Peri-Menopausal Panel Basic

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).

Thyroid Stimulating Hormone (TSH) test measures the amount of TSH in your blood which helps to find out if the thyroid gland is working normally or not. Low TSH levels indicate hyperthyroidism and high TSH levels indicate hypothyroidism.

In case of hyperthyroidism, the thyroid gland produces very high amounts of thyroid hormones (T3 and T4) and you may experience symptoms of weight loss, rapid heartbeat, tremors, sweating, anxiety, increased sensitivity towards heat, etc. In case of Hypothyroidism, there is a decrease in the production of thyroid hormones (T3 and T4) which may cause weight gain, fatigue, slow heart rate, increased sensitivity towards cold, depression, dry and thin hair, etc.

There is a feedback system in the body to maintain stable amounts of the thyroid hormones (T3 and T4) in the blood. TSH signals the thyroid gland to make and release the thyroid hormones (T3 & T4) into the blood when the level of thyroid hormones is low and can also signal the thyroid gland to lower the production of thyroid hormones when the level of thyroid hormones is very high. So, when the thyroid hormone (T3 and T4) levels decrease, the pituitary gland is stimulated to release TSH and this high TSH level, in turn, stimulates thyroid gland to release more thyroid hormone (T3 & T4) from the thyroid gland and the vice-versa happens when the thyroid hormone levels are very high.

Glycosylated Hemoglobin Test measures the percentage of glycosylated hemoglobin in blood which reflects the average blood glucose over a period of past two to three months (8 - 12 weeks).

Hemoglobin is the protein found in Red Blood Cells and is responsible for transporting oxygen. Of the different types of hemoglobin, Hemoglobin A is predominant. With the elevation of blood sugar levels, some glucose binds spontaneously to Hemoglobin A (this binding is called Glycosylation or Glycation) and remains bound for the complete lifetime of the RBC, which is 120 days normally. Higher the level of glucose in the blood, greater is the amount of it binding to Hemoglobin A. Hemoglobin A1c is the dominant form of Glycated Hemoglobin. As RBCs die and are replaced, Hemoglobin A1c is cleared and slowly replaced with non-glycosylated hemoglobin. Measurement of HbA1c level over a period of time gives an indication of the level of glucose in the blood over the specified period of time. This helps in the diagnosis of Diabetes and is useful for monitoring the effectiveness of measures taken to reduce blood sugar levels.

Estradiol test measures the levels of estradiol in blood. Estradiol is a form of estrogen hormone which plays an important role in the function and development of reproductive organs and in the formation of secondary sex characteristics in females. It regulates the menstrual cycle in women along with progesterone. Other functions of estrogen along with progesterone include the growth of breasts and uterus. Estrogen hormone is also found in men. It regulates growth and metabolism in both males and females. In men, estradiol is produced in testicles while in pre-menopausal women it is produced in ovaries. In postmenopausal women, estradiol is converted into estrone. Estradiol is present in high levels in non-pregnant and pre-menopausal women. Depending upon the age of the women and her reproductive status the values of estradiol varies. It is considered to be one of the good markers as regards to ovarian function.

At birth, the levels of estradiol are high but the levels fall within a few days and become minimal during early childhood. As puberty approaches the levels of estradiol rise. During the menstrual cycle, its levels vary depending upon the ongoing menstrual cycle phase. During menopause, the levels of estradiol fall as the production by ovaries decreases.