FSH LEVELS: WHAT YOU NEED TO KNOW
WORRIED ABOUT HIGH FSH LEVELS?Follicle Stimulating Hormone, commonly known as FSH, is one of many hormones that move through your bloodstream as “chemical messengers” to help regulate the functions of your cells and organs. FSH, is released by the brain's pituitary gland and plays a key role in the natural menstrual cycle. Its main responsibility is stimulating the growth of ovarian follicles.A follicle is a small cyst that contains an egg. FSH levels are lowest at the beginning of the menstrual cycle and then go up, helping a follicle to grow and the egg to mature. At this time, the follicles release estradiol. These higher levels of estradiol tell the pituitary gland to produce less FSH. Conversely, if you have fewer follicles, less estradiol is released, the pituitary gland never receives the signal that it has to cease producing FSH, leading to higher FSH levels.FSH is generally measured on days 2 or 3 of the cycle because that provides a more accurate reading of FSH levels before it increases rapidly during the ovulatory phase of the menstrual cycle.Elevated FSH levels impact fertility because they indicate that the ovaries are not producing as many eggs as they should be. High FSH levels can be a sign of a number of conditions, including:
- Premature ovarian insufficiency (POI)
- Polycystic ovary syndrome (PCOS)
- Age-related infertility
WHAT IS A NORMAL FSH LEVEL FOR WOMEN?Mildly raised levels between 10 and 15 miu/ml can be a wake-up call of diminished ovarian reserve. Over 20 may be a significant indicator of advanced ovarian aging. Normal FSH levels by age are considered to be the following.
The reference ranges slightly differ depending on the individual and the laboratory’s environment. Elevated FSH levels can be also connected to primary ovarian insufficiency (POI), a rare condition where ovarian function ceases before age 40.Keep in mind that the FSH levels won’t tell you whether or not you can conceive right away and are not a key indicator of the probability of having a baby. The levels can fluctuate from month to month depending on the patient’s individual environment. What FSH levels can tell you is your ovarian reserve. Nowadays, specialists put more weight on AMH levels (coupled with estrogen) for determining a patient’s fertility issues.
Before puberty: 0–4 IU/L
During puberty: 0.3–10 IU/L
Age 33 or under: less than 7.0 mlU/mL
Age 33-37: less than 7.9 mIU/mL
Age 38-40: less than 8.4 mIU/mL
Age 41 and over: less than 8.5 mIU/mL
After menopause: 25.8 to 134.8 mIU/mL
How Do FSH Levels Affect Fertility By Age?As women age, FSH levels increase in response to a natural decrease in egg quantity, known as the “ovarian reserve.” At the beginning of the menstrual cycle, FSH levels are at the lowest. The brain senses a low level of estrogen in the ovaries and signals the pituitary gland to make more of the FSH hormone. And then, follicles begin estrogen production which gives a message to the pituitary that there is a sufficient amount of FSH and to stop secretionContrary to this process, as women get older, the total number of eggs dwindles. So although the FSH induces follicles, it becomes harder to mature eggs in the ovaries. Thus, follicles produce less estrogen over time, which sends a signal to the brain that it has to make more FSH for ovulation.It is significantly important to note that a high FSH level is an indication, not a cause of reduced egg count. Furthermore, lowering a high FSH level won’t relate to boosting fertility. To put it another way, high FSH levels are a symptom of low fertility, not the cause.To understand a patient’s fertility comprehensively, fertility specialists have to diagnose it with AMH and estrogen, and so on.
CAN HIGH FSH LEVELS BE LOWERED?Women are born with all the eggs they will ever produce, so it’s important to understand there isn’t a way to create more eggs. It is possible to lower FSH levels using estrogen, the birth control pill, Lupron, etc. Those medications will suppress the high FSH level in a mechanism called negative feedback. However, a lower FSH level can’t guarantee your chance of getting pregnant and doesn’t change the ovarian reserve.
Are there lifestyle changes that can help improve FSH levels?Yes, it may be possible to improve FSH levels naturally, by:
- Maintaining a healthy weight
- Eating a healthy diet
- Exercising regularly
HOW ARE FSH LEVELS ARE IMPORTANT FOR IVF?High FSH levels indicate diminished ovarian reserve which means there are fewer follicles and their quality is low.FSH levels are used to evaluate whether in vitro fertilization (IVF) treatment or injectable fertility drugs could be effective. Women with high FSH levels are less likely to respond to fertility medications. Depending on how high FSH levels are, specialists will vary your IVF treatment because the cycles are moderately vulnerable to success.Still, high FSH levels don’t necessarily mean you can’t conceive with your own eggs. Your fertility specialist may still be able to find a solution based on your circumstances.
FSH levels and menopauseWomen typically go through natural menopause in their early 50s. Premature menopause, in which the women undergoes menopause before 40, happens to approximately 1 % of women. Early menopause, occurring in women under age 45, is shown in about 5 % of women.Women should be evaluated for menopause with the absence of menstrual periods for 12 consecutive months. And, if women start having irregular menstrual periods for a few years, they should see a doctor to look into possible causes. The symptoms of menopause include, hot flashes and night sweat and/or cold flashes, vaginal dryness, uterine urgency, difficulty sleeping, dry skin, racing heart, etc.Menopause is a natural stage in a woman’s life as a normal part of aging and means that a woman can no longer become pregnant. Naturally, the number of follicles in the ovaries decline, which secretes less estrogen that induces the brain signals to produce more FSH, thus stimulating the follicles. However, there are not enough follicles, so FSH levels in your bloodstream rise. The reduced estrogen from the fewer follicles leads the period to cease.Generally, FSH levels of >20 mIU/L may imply that a woman is approaching the menopausal transition. However, FSH levels by themselves are not conclusive. Specialists have to evaluate additional symptoms and menstrual regularity in order to conclude that someone is entering menopause.All of our content is reviewed and approved by our expert in-house staff, including our board certified physicians.