FSH and LH Levels

Women's health
1

Hello again!  I posted last week about my all-night hot flushes.  Well, I went to my endocrinologist on Monday for a usual check up of my thryoid and told him that I feared my thyroid meds were too much because of the sudden hot flashes but, it's hard to know anymore because of my age and perimenopause.

He decided to run my FSH and LH levels and here are the results:

FSH = 79.1

LH = 54.3

Now these levels aren't flagged as low, high, or normal because there are various ranges they can normally be at depending where you are in your cycle.  Now, I have been getting my period irregularly, but still getting it (last time was early June).  It's been on a every 2 month track for a bit.  

Haven't heard yet from my doctor (I got these off my lab's website).  Just wondering what you think of these levels.

Thanks,

Christine

2

Christine,

  I do realize that every lab has their own system and you didn't mention what unit of measurement these numbers represented.  However, both of those values seem very high for most lab results.   A normally cycling woman's FSH is usually well below 20, anything that gets up to the 50s usually indicates menopause.  

The fact that your cycles are so irregular would indicate you are in the middle of the change. However, your thyroid issue could certainly be making a huge difference with your cycles.   

Please let us know what your endocrinologist has to say about these levels.

It would be interesting to hear his/her take on these levels.   

3

Thanks, I have already put the call in to him so I should hear something today.  

Here are the ranges:

LH = 54.3

Range:  Follicular Phase 2.4 - 12. 6      miU/ml

              Ovulation Phase  14.0 - 95.6

               Luteal  Phase   1.0 - 11.4

              Post Menopausal - 7.7 - 58.5

FSH = 79.1

 

Range  Follicuar Phase - 3.5 - 12.5

            Ovulation Phase - 4.7 - 21.5

             Luteal Phase - 1.7 - 7.7

             Post Meno  -  25.8 - 134.8

So, since I don't know where I am in my cycle, it's hard to say.

4

Hi Christine after having my levels done I was of the understanding that the levels indicate the quality of egg production. I'm just under 10 which stlli counts as could get pregnant but I'm in perimenopause. 11-13 means egg reserves are low and above 13 means it's unlikely the eggs would be good enough quality to get pregnant. I'd be interested to hear other comments too.

5

Is that for LH or does that observation go for both measurements?

 

6

My doctor gave me a list of results and my FSH result was just listed like this:

FSH 9.6

So not really sure....

7

Christine,

 When you look at the FSH and the values from this lab, it certainly indicates that you are experiencing menopausal symptoms.  Your FSH wouldn't be this high if things were running normally.  Your brain is pushing off high levels of FSH as it screams for more estrogen.  

Tracky had some good points about what FSH levels can mean for egg production.  

As far as the LH, notice that the only time in the cycle that the LH is high is in the ovualtion phase.  This is your brain encouraging the follicule to rupture and produce progesterone.  When your body responds, then the level of LH goes back down for the final two weeks of the cycle.  

But in menopause the LH level will remain high, as your body is trying to encourage progesterone production.  

Not that I am a doctor, but your levels and irregular cycles, certainly indicate that you are in the transition.  You can still have some irregular periods, and therefore not be considered menopausal, as menopause is an after the fact diagnosis. (One full year without periods.)  

Just keep in mind tha while the sex steriods are a minor hormone system, they do effect every hormone in the body.  

8

Well, it sure sounding like I am in the final stages of perimenopause and I can't necessarily blame my thyroid medication anymore!  Of course, I really had no doubt as my periods have been irregular for about 2.5 years now and I'm 51 and HOT ALL NIGHT.

9

No, I wouldn't blame the thyroid.  This is a totally different issue.

And you're at just the right "standard" age for menopause.  

The next question becomes if you would consider any replacement therapy to help deal with the uncomfortable night sweats.  

While i thought I got through menopause with just a blink of the eye, I was totally wrong.  I didn't have night sweats or hot flashes, except in my 40s, but my problems were chronic constant pain and vaginal dryness and atrophy.  Just keep in mind that hot flashes and night sweats are just the tip of the iceberg when it comes to menopause.  

No here I am at age 58 and trying to restore some estrogen to my body.  I really don't think it's a good thing to never have confortable and enjoyable sex, or to live with constant chronic pain. 

10

Well, that is what my endo is probably going to discuss with me when he calls me back.  He brought it up at the appointment:  using low dose estrogen or low dose Zoloft.  To be honest, I'm not sure.

I am one of those "sensitive" people.  I get a side effect from anything.  I could never take oral contraceptives because they all made me horribly nauseous and I could never over come that (my poor daughter has the same issue).  The SSRIs also gave me awful side effects when taking them many years ago to combat some anxiety.  

So, I am a bit worried about what they might do to me.  I know my coworker tried the estrogen for sleep issues, which it helped, but then she said she was crying over everything.  

I guess I'll just have to give it a try.  I have no history of any of the cancers associated with taking HRT.

11

Chris, 

I totally get being sensitive to medication.  This s something that I've had to work around also.  Most of my attempts with hormone therapy were a horrible failure.  Back when you and I were young, the birth control pills were very high dose.  I did them for 6 months when I was first married and wound up in an ER with severe abdonimal pain.  When I tried hormone replacement for perimenpausal symtoms in my forties, it was a complete mess.  I also was put on several  antidepressants.   Zoloft was the one what worked for awhile.   So in some ways, it's really a gamble that I am trying it all again.  But I personally believe, that it is better for our bodies to have these imortant substances.   I've seen what happened to my body over time, when I left well enough alone.  My chronic pain issue was horrible, and vaginal atrophy is definately NO FUN.  My cholesterol profile changed without any diet changes.  My sleep went to hell, my attitude and cheerful self went to the dump.   So if taking some estrogen and progesterone can help with all that, I say let's try.

What I can tell you, is that I am working with a specialized endocrinologist who truly believes that restoring our sex steriods helps all of our hormone systems.  

What I would tell you is to strart low and go very slow.  That's what I have been doing and it seems to work better.  My FSH started at 60, and with a very low dose of esradiol from a patch, it dropped to 54.1.  Then she slowly upped the estrgoen patch and again my body responded with an FSH drop down to 36.1.    When I talk about low dose, I mean it.  

She started me with 1/2 of the lowest dose patch of Vivellle 0.025mg.  

Believe it or not, I am now doing a 0.05mg patch every other day.  It has taken months, but my estradiol level is rising and my FSH is falling.  

I am sleeping better and people have mentioned that I am losing weight.  

I don't feel all back to normal, but realize that I am in the early stages of getting balanced.  

So again, I hear your concern about what it might do to you.  But you also have seen what meno does to woman.  We grow a huge fat pad on our bellies, often have difficulty with sex, suffer with night sweat and no sleep.  

The thing that I would suggest is to stay away from doctors who use a cookie cutter approach to hormones, but more importantly the hormone drugs, like Premarin or Prempro.  

Good luck, and I hope you do a bunch of research and find something that works for your body. 

12

Thank you.  That is very encouraging to hear. 

13

Well, my endocrinologist finally called back.  He said that my thyroid levels are a tad bit on the high side and that my LH and FSH indicate that I am perimenopausal.  He suspects a combination of the two as the "culprits" for the hot flashes.  Basically, since I am perimenopausal and cannot regulate temperature as well as I could in my youth, that the borderline hyperthyroidism is exacerbating it.

His recommendation is for me to cut back, very slightly, my thyroid meds to see if I can get *some* improvement.  If not, he would like me to work with my GYN to start some low-dose HRT (or the antidepressants, if i prefer that).  He also said, in the meantime, I might try consuming some soy products as that is reported to help some women.

So, not sure what I think but I guess I will start with lowering my thyroid meds a bit and see if there will be some relief.

14

So my thyroid result was 0.5 and I take 150mg a day a and I'm perimenopause. Are you over or underactive thyroid? I'm underactive Christine

15

Chris,

Well godd you got some kind of answer.  

Just a word of caution about the soy though.  Soy used to be touted as the answer to low estrogen, and yes it has some similar properties.  But I think the latest that I have read is suggesting that it will take up spots on your estrogen receptors and therefore will displace what estrogen your body does have.  Now the thinking is that soy might not be such a great thing.

Let's just face the fact that our bodies aren't screaming for soy, or acting strangely from a soy defiency.  While herbs and supplements might help calm some symptoms, it really isn't addressing the true nature of the problem.     

16

Ok can't find an edit button.  The first line was:

Well good, you got some kind of answer.

17

My thyroid was removed 20 years ago due to thyroid cancer.  I take suppressive doses of thyroid hormone to keep the cancer from recurring (that's protocol).  Because I am low risk and 20 years out, it is easier/safer for me to tweak the meds a bit.  But, based on my number, I am marginally hyperthyroid.

18

I didn't hold out much hope for working with soy.  I'm not overly a fan of it.  I do know that they suspect Asian women have less trouble with hot flashes due to the extra consumption of it, though.  But, yeah, it just covers the symptoms rather than corrects the problem, I guess.

19

Asians have different blood types to westerners, different enzymes (they can digest some things better than we can and vice versa), smaller bodies, and probably a whole lot of other reasons why soy works for them (or is it just a theory?).

gailannie and Tracky:  Glad to read an intelligent discussion of hrt use for a change.  Plus you are working around a thyroid issue.

 

20

FSH stands for follicule stimulating hormone.  It comes from our puitutary gland and is a regulating hormone that tells our ovaries to product an egg and therefore estradiol.  For a normal, healthy, young woman it usually doesn't have to go very high for those eggs to get the point!  This is why the FSH is usually <10.   As we age those older eggs (and there are less of them)  don't hear the message and this is why our FSH rises.  Your brain is trying to get a response from your ovaries and more etrogen.

This is a feed back mechanism, much like the TSH (thyroid stimulating hormone).  The TSH keeps our thyroid production in check as long as everything thing is healthy.  When your thyroid gland has a problem, TSH will rise.  

LH  is again another hormone from the brain, that tells the folliclule to rupture and produce progeserone.  Again, as we age and this hormone system act up, LH will rise.  

That's the short version, but just think of FSH and LH as regulating hormones.  They try their hardest to keep our estrogen and progesterone levels up and moving.  Unfortunately when we run out of good quality eggs in our ovaries, that simply can't happen.