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Increased Levels of FSH-Values: Problems and Conditions

In one of the previous articles we talked about conditions with decreased FSH levels and its consequences. This time we are giving a look to the opposite condition with increased levels of FSH-values and its consequences. As previously said, Follicle Stimulating Hormone (FSH) plays an important role in the reproductive system. One of its main task is to allow the growth of ovarian follicles. Follicles that then produce oestrogen and progesterone in the ovaries and help maintain regular menstrual cycles in women. In men instead, FSH is a part of the development of the gonads as well as contributing to sperm production. To know whether your FSH blood levels are normal, you should get an FSH test. This test measures the level of FSH hormone found in your blood. Your doctor will order an FSH test to find the underlying cause of some unusual symptoms you have been experiencing and that are affecting the reproductive system. Men and women can be tested, as well as children.

FSH Test for Women

In women, the most common reasons for an FSH test include the following:

  • assessing infertility problems
  • assessing irregular menstrual cycles
  • diagnosing disorders related to the pituitary gland or other diseases directly involving the ovaries

FSH Test for Men

In men, usually an FSH test may be done to:

  • evaluate the reason behind a low sperm count
  • assess hypothetical hypogonadism or gonadal failure
  • assess testicular dysfunction

FSH Test for Children

An FSH test might be used to determine if a child is experiencing premature puberty, which is basically early puberty. An FSH test may also be used to determine if a child is experiencing the opposite, delayed puberty. This occurs especially when secondary sexual features or organs don’t  develop in the time frsme in which they should.

Sometimes, elevated follicle-stimulating hormone (FSH) levels are measured to confirm menopause. However, high FSH level by themselves are not a diagnosis of menopause. When a woman’s FSH blood level is consistently higher than 30 mIU/mL, and she has not had a menstrual period for a period of a year, it is generally accepted that she has reached menopause. However, it is always a good idea to test also for the other hormone levels.

Elevated FSH tends basically to indicate that a woman’s ovarian reserve is becoming depleted and no it will no longer produce eggs at all, or it will produce very few, and also lower-quality eggs. Symptoms of high FSH in females often mimic those of menopause, that’s why it is also difficult to assess if it’s the menopause itself or some kind of hormonal unbalance. With menopause, other symptoms may occur, including irregular periods, hot flashes, and headaches.

It is important to know that FSH levels can vary based on gender and age. They also vary depending on where a woman is in her monthly cycle. Moreover, it is difficult also to have a standard since each lab has a slightly different reference range, which can change greatly the results. You should take the time to discuss your results with your doctor.

Conditions Caused By High FSH Levels

High FSH Levels in Women

  • a loss of ovarian function, or ovarian failure
  • menopause (this the most common cause)
  • polycystic ovarian syndrome, which is a condition where a woman’s hormones are out of balance, causing ovarian cysts and therefore problems with menstrual cycles
  • Genetic diseases, for example chromosomal abnormality, Gonadal dysgenesia at 45X0, known as Turner’s syndrome that occurs when one part or all of one of a woman’s X chromosomes is deleted/missing
  • condition after therapy with cystostatics (which is inhibition of cell growth and multiplication. It also refers to a cellular component or medicine that inhibits cell growth) or radiation

Moreover, an increase in FSH may also indicate a reduction in the production of good quality eggs and embryos for fertilization (not necessarily a reduction in eggs production). A common reason for this is simply related to your age. As you age, your fertility progressively starts to decline and as a consequence fewer eggs are able to mature successfully in your ovaries. On top of that, the quality of the remaining eggs released by the ovaries is lower than that of earlier years.

The FSH test may be used together with other tests that look at the levels of all the other hormones involved in women cycles and fertility such as luteinizing hormone, estradiol, and progesterone to determine the levels of a woman’s ovarian reserve. The term “ovarian reserve” refers to a woman’s age-related fertility potential. A high FSH level means your chances of becoming pregnant may be lower than what is expected for your age. Having low levels of FSH doesn’t mean you have no chance of conceiving, but you may have more difficulty and you might need infertility treatment.

High FSH Levels in Men

  • Klinefelter’s syndrome, which is a very rare condition in men which is caused by an extra X chromosome that can affect male sexual development
  • testicles that are absent or not functioning properly
  • testicles that have been damaged by a disease
  • testicles that have been damaged by some specific treatments for example as X-rays or chemotherapy

High FSH Levels in Children

High FSH levels in children may mean that puberty is about to start or it has been delayed for some reason.

To conclude, FSH is a good indicator to assess your hormone balance or unbalance. It is a great help in finding out if you are approaching menopause (although it is not necessary, but if it is performed its always recommended to test additional hormones) and also to uncover many pathologies related to the reproductive system.

REFERENCES

Clin Endocrinol (Oxf). 2019 Apr;90(4):579-585. doi: 10.1111/cen.13934. Epub 2019

Feb 10.

Exploration of the role of anti-Mullerian hormone and LH/FSH ratio in diagnosis of polycystic ovary syndrome.

Le MT, Le VNS, Le DD, Nguyen VQH, Chen C, Cao NT.

Gynecol Endocrinol. 2014 Jun;30(6):451-5. doi: 10.3109/09513590.2014.893572. Epub 2014 May 7.Age-specific reference values for serum FSH and estradiol levels throughout the reproductive period.Grisendi V, Spada E, Argento C, Plebani M, Milani S, Seracchioli R, Volpe A, La Marca  Horm Res. 2002;57 Suppl 2:2-14. The neuroendocrinology of human puberty revisited. Grumbach MM.