Perimenopausal Package

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).

Ph, Serum measures the levels of inorganic phosphates in blood. It is critical in the production and storage of energy as it forms a part of the energy currency of cells (Adenosine tri, di, and monophosphates). It is also a structural component of DNA. It is essential in the functioning of nerves and muscles, and in the growth and maintenance of healthy bones. In blood, phosphates act as buffers to maintain the pH and electrolyte balance of the body.

The main source of phosphorus comes from diet. Once consumed, it is quickly absorbed by the digestive system. In the body, most of the phosphates are bound to calcium in the bones and teeth. Some of it is found in muscles and nerves, and a small amount is present in cells, where it forms a structural component of DNA. Very small amounts of phosphates are normally found in circulation, and these levels are measured with blood phosphorus levels.

Phosphate levels in the blood are maintained within its very narrow normal concentration range by excretion of excess phosphorus through kidneys. Phosphate levels are also dependent on the levels of calcium, Vitamin D and parathyroid hormone in blood.

The Lipid Profile Test typically measures the levels of total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. Other results that may be reported include VLDL cholesterol, non-HDL cholesterol, and total cholesterol to HDL cholesterol ratio.

Lipids are fatty acids which store energy for the body and play essential roles in cellular structure and cell signaling. Cholesterols and triglycerides are essential lipids, carried in the blood by lipoprotein particles made up of cholesterol, triglycerides, proteins and phospholipid molecules. The lipoprotein particles are classified according to their densities into High Density Lipoproteins (HDL), Low Density Lipoproteins (LDL), and Very Low Density Lipoproteins (VLDL).

Cholesterol is a fat-like substance formed in the liver, as well as obtained from dietary sources. It is found in all the cells and is an essential part of the structural framework of the cells apart from performing various vital body processes. However, excess cholesterol is harmful. Increased cholesterol in blood can cause it to get deposited on the inner walls of the blood vessels forming plaque.

Triglycerides are the commonest type of fat in the body. Triglycerides are obtained from dietary sources and form the stored fat in adipose tissues. Increase in triglyceride concentration can also give rise to cardiovascular diseases.

High Density Lipoproteins or HDLs are high density particles which help to reduce the chances of cardiovascular diseases by picking up and carrying lipoprotein particles of lower density to the liver for disposal.

Low Density Lipoproteins or LDLs are lipoprotein particles of low density which carry cholesterol to the tissues. Cholesterol carried by LDLs easily comes out of blood and get deposited on the inner walls of the blood vessels, increasing the chances of cardiovascular diseases.

Very Low Density Lipoproteins or VLDLs are lipoprotein particles of very low density which carry triglycerides to the tissues. Excess triglycerides in blood causes increase in VLDL particles which in turn again increases the chance of developing cardiovascular diseases.

Plaque deposition makes the lumen of the blood vessels narrower thereby preventing proper flow of blood and may stop the flow completely. Excessive plaque deposition can also cause the arteries to harden, giving rise to a condition called Atherosclerosis. Improper flow of blood prevents the supply of nutrients and oxygen to the vital organs and may cause heart attack or stroke.

Luteinizing hormone is associated with reproduction and ovulation. In females, it stimulates the release of an egg from the ovary. However, in males, testosterone production is dependent on LH. This test helps in measuring the amount of LH present in the blood.

 LH is produced by the pituitary gland, and its production is controlled by the hypothalamus, pituitary gland, and the hormones produced by the ovaries (in women) or testicles (in men).

 In premenopausal women, LH stimulates ovulation and the production of other hormones, estradiol, and progesterone. The menstrual cycle is divided into 2 phases, follicular and luteal phases, each of these last for about 14 days. Near the end of the follicular phase, there is a mid-cycle increase in follicle-stimulating hormone (FSH) and LH. This triggers ovulation. During the luteal phase, LH secretion stimulates the corpus luteum to start producing progesterone. At this point, FSH and LH levels get reduced, while progesterone and estradiol concentrations rise. If the egg is not fertilized, then the levels of these hormones fall after several days followed by the beginning of the next menstrual cycle. With the onset of menopause ovarian function reduces and eventually discontinues, which results in increased levels of FSH and LH.

 In men, LH stimulates Leydig cells in the testicles to produce testosterone. However, LH levels remain relatively constant in men after puberty. A high testosterone level provides negative feedback to the pituitary gland and the hypothalamus, thus decreasing the amount of LH secreted.

 In infants and children, LH levels rise shortly after birth and then fall to very low levels (by 6 months in boys and 1-2 years in girls). At about 6-8 years of age, levels again rise before the beginning of puberty and secondary sexual characteristics development.