FSH Testing in Menopause: A Tool for Managing and Predicting Symptoms

What is FSH? What Does It Regulate?

Follicle Stimulating Hormone, or FSH, is a type of gonadotropin that’s an essential hormone for the reproductive system of both men and women. In men, the hormone is crucial for sperm production, and in women, it helps in the growth of eggs. The role of FSH in the female reproductive system includes stimulating the growth of ovarian follicles, which are sacs that contain developing eggs. The level of FSH in the body changes throughout the menstrual cycle, which eventually leads to the release of the egg during ovulation.

The purpose of FSH tests is mainly to assess fertility health in both men and women. FSH blood test results can help doctors diagnose several reproductive health problems in patients and understand any improper reproductive system function. In women, FSH tests are often prescribed to understand the onset of menopause by doctors. However, the results of an FSH blood test alone cannot determine the onset of menopause or help doctors manage menopausal symptoms.

Normal Results

The FSH levels can differ among patients based on their sex and age. Here is a detailed look into the normal level of FSH in men and women based on their age.

Male

●     Childhood (before puberty): 0 to 5.0 mIU/mL (0 to 5.0 IU/L)

●     During puberty: 0.3 to 10.0 mIU/mL (0.3 to 10.0 IU/L)

●     Adult: 1.5 to 12.4 mIU/mL (1.5 to 12.4 IU/L)

Female

●     Childhood (before puberty): 0 to 4.0 mIU/mL (0 to 4.0 IU/L)

●     During puberty: 0.3 to 10.0 mIU/mL (0.3 to 10.0 IU/L)

●     Menstruating women: 4.7 to 21.5 mIU/mL (4.5 to 21.5 IU/L)

●     After menopause: 25.8 to 134.8 mIU/mL (25.8 to 134.8 IU/L)

The FSH levels mentioned above may vary among different laboratories.

Predicting Menopause

Indicator of Ovarian Function: If the results of your FSH test are higher than normal, it could indicate a decline in the functioning of the patient’s ovaries. Even though this is an important indicator of menopause onset, one single test result cannot predict the onset or exact timing of menopause.

Combined Assessment: To offer a complete assessment of menopause onset, doctors often consider other symptoms like hot flashes and irregularity of menstrual cycle and test results like estradiol hormone levels. The symptomatic overview and other diagnostic test results play a crucial role in determining the onset of menopause.

Managing Menopausal Symptoms

Hormone Replacement Therapy (HRT): The results of an FSH test can help doctors determine whether your HRT treatment is working as expected or not. This is mainly because elevated FSH levels, even while ongoing HRT treatment, can indicate that there’s a need for adjustments to the hormone regimen.

Symptom Assessment: The clinical symptom assessment of menopause is not related to an FSH test. The results of an FSH blood test are not used to measure symptoms directly. The clinical symptoms are addressed separately based on the presented symptoms.

Individual Variability: The results of an FSH test also need to be considered with respect to the patient’s overall health and other symptoms. Generally, the symptoms of menopause are not similar among all women, and the individual differences must be accounted for during diagnosis to understand the onset of menopause accurately in patients.

Considerations

Clinical Evaluation: A thorough clinical evaluation performed by a medical professional is required to understand how to manage menopausal symptoms. The evaluation generally includes a review of medical history, symptoms, and hormonal assessments such as an FSH test.

Lifestyle Factors: Managing your diet, exercising regularly, and managing stress levels can help you live healthily even after menopause onset.

FSH testing is an important part of menopause onset determination performed by doctors. However, it cannot independently predict the onset of menopause. A proper clinical evaluation of symptoms, lifestyle habits, and overall health is required to offer effective management to patients undergoing a menopausal transition.

References

Garibaldi LR, Chemaitilly W. Disorders of pubertal development. In: Kliegman RM, St Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 578.

Jeelani R, Bluth MH. Reproductive function and pregnancy. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 26.

Lobo RA. Infertility: etiology, diagnostic evaluation, management, prognosis. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 40.