FSH, LH & Prolactin

The levels of FSH can get affected by conditions like uncontrolled thyroid disease, sex-dependent hormone tumors, ovarian cysts, and unusual vaginal bleeding. Moreover, medicines like birth control pills, cimetidine, clomiphene, digitalis, levodopa, phenothiazines as well as medicines used in hormone replacement therapies can also affect the levels. Similarly, medicines used in hormone replacement therapies can also alter the FSH levels. Multivitamins containing biotin or vitamin B7 may also affect the accuracy of the FSH test. It is generally advised that a woman should avoid taking these supplements for at least 12 hours before a test.

High levels of FSH can indicate loss of ovarian function or ovarian failure, menopause, polycystic ovarian syndrome, chromosomal abnormalities (e.g., Turner’s syndrome), and reduction in the production of good quality eggs and embryos for fertilization.

High levels of FSH in men may indicate Klinefelter’s syndrome, absence of testicles or impaired functioning of testicles, damage to testicles by a disease such as alcohol dependence, and testicular damage by treatments such as X-rays or chemotherapy.

The start of puberty might be the cause for high levels of FSH in children.

Low levels of FSH may indicate decreased ovulation in women, reduced sperm count in men, problems at the level of the hypothalamus or pituitary gland, which are the hormone control centers in the brain, and stress.

There are certain medicines that can affect the levels of FSH. In order to prevent false readings, it is important for the individual to inform the doctor about all the medicines they are taking as they can alter the functioning of hormones. Medicines that could increase FSH levels include cimetidine, clomiphene, digitalis, and levodopa. Whereas, medicines that decrease FSH levels include hormone replacement therapies, oral contraceptives, and phenothiazines. Taking multivitamins that contain biotin or vitamin B7 may also affect the accuracy of the FSH test. Doctors usually recommend that a woman should not take these supplements for at least 12 hours before a test.

Yes, the FSH level can vary during the different phases of the menstrual cycle. Following are the normal range during different phases: Follicular phase: 3.1-7.9 mIU/ML Ovulation phase: 2.3-18.5 mIU/mL Luteal phase: 1.4-5.5 mIU/mL FSH levels can vary not only throughout the menstrual cycle but also from cycle to cycle. You can get a normal test value one month and an abnormal test value the next. Hence, to test basic fertility and to evaluate ovarian reserves, the FSH level is checked on day 3 of the menstrual cycle. The first day of the cycle is the day when the period begins. Reference range may vary from lab to lab* l range during different phases: Follicular phase: 3.1-7.9 mIU/ML Ovulation phase: 2.3-18.5 mIU/mL Luteal phase: 1.4-5.5 mIU/mL FSH levels can vary not only throughout the menstrual cycle but also from cycle to cycle. You can get a normal test value one month and an abnormal test value the next. Hence, to test basic fertility and to evaluate ovarian reserves, the FSH level is checked on day 3 of the menstrual cycle. The first day of the cycle is the day when the period begins. Reference range may vary from lab to lab*

In women, there are two types of ovarian failure, primary and secondary. This test helps to analyze LH and FSH levels which can in turn help to differentiate between the two types of ovarian failure. Primary ovarian failure is when the problem is within the ovaries or there is a lack of ovarian development. However, secondary ovarian failure occurs due to disorders of either the pituitary gland or the hypothalamus. Primary ovarian failure: In this, the levels of LH and FSH rise. The following can be some causes of primary ovarian failure: · Developmental defects: Failure to develop ovaries (ovarian agenesis) · Chromosomal abnormality: Turner syndrome · Defect in steroid production by the ovaries such as 17 alpha-hydroxylase deficiency · Premature ovarian failure due to exposure to radiation, chemotherapy, and autoimmune disease · Chronic failure to ovulate (anovulation) due to polycystic ovary syndrome (PCOS), adrenal disease, thyroid disease, and ovarian tumor · Menopause: In this, a woman's ovaries cease to function; thus, it results in increased levels of LH. Secondary ovarian failure: In this, low levels of LH and FSH are observed which indicates a problem with the pituitary gland or hypothalamus. Here, LH response to GnRH can help differentiate between secondary dysfunction and tertiary disorder (a problem involving the hypothalamus). Following baseline level of LH measurement, a dose of GnRH is given by injection. A subsequent increase in LH level shows that the pituitary gland responded to the GnRH and indicates a disorder involving the hypothalamus. However, a reduced level of LH shows that the pituitary gland did not respond to the GnRH and suggests a disease involving the pituitary gland.

Primary testicular failure: High levels of LH may indicate primary testicular failure. The following can be the causes: · Developmental defects: Failure to develop gonads (gonadal agenesis) · Chromosomal abnormality such as Klinefelter syndrome · Testicular failure: Viral infection (mumps), Trauma, Exposure to radiation, Chemotherapy, and Autoimmune disease · Germ cell tumor · Testicular injury Secondary failure: Low levels of LH and FSH can be seen in case of secondary failure of the testicles. This may indicate a problem with the pituitary gland or hypothalamus.

In young children, high levels of LH and FSH with the development of secondary sexual characteristics at an unusually young age are an indication of precocious puberty. Usually, this premature development is due to impaired functioning of the central nervous system. It can also have a few different underlying causes such as: · Central nervous system tumor · Brain injury, trauma · Inflammation within the central nervous system (e.g., meningitis, encephalitis) · Brain surgery Normal prepubescent levels of LH and FSH in children showing some signs of pubertal changes may indicate a condition called "precocious pseudopuberty". The signs and symptoms are caused by elevated levels of the hormones estrogen or testosterone. This may be caused by: · Hormone-secreting tumors · Adrenal gland tumors · Ovarian tumors or cysts · Testicular tumors However, normal FSH and LH levels with a few signs of puberty can also indicate a benign form of precocious puberty, with no underlying or discernible cause, or may just be a normal variation of puberty. In delayed puberty, LH and FSH levels can be normal or below considerable range. The test for LH response to GnRH in addition to other tests may help to diagnose the reason for the delayed puberty. Some of the underlying causes of delayed puberty can include: · Failure of the ovaries or testicles · Hormone deficiency · Turner syndrome · Klinefelter syndrome · Chronic infections · Cancer · Eating disorder (anorexia nervosa)

The healthcare provider takes a blood sample from the arm. The site from where the blood is to be withdrawn is cleaned with a swab of rubbing alcohol. This is then followed by inserting a small needle which has a tube attached to it for collecting blood. Once the sufficient blood for analysis is withdrawn, the needle is removed. The site is then covered with a gauze pad.

As such there is no risk but in few cases, bruising, bleeding, and infection at the puncture site can be seen. In very few cases, there can be swelling of the vein after the blood is withdrawn.

No, prolactinoma is not a form of cancer. It is a benign tumor of the pituitary gland which means it is simply overgrowth of cells in the pituitary gland.

Yes, prolactin hormone is present in men. High levels of prolactin have been associated with low sex drive and decreased erectile function.

Yes, high levels of prolactin can cause erectile dysfunction, as the levels of testosterone start to decrease.

Certain drugs can cause a low level of Prolactin such as Dopamine (used in conditions like shock), Levodopa (used for Parkinson’s disease), or Ergot alkaloid derivatives (used for severe headaches). However, certain drugs can cause elevated levels of Prolactin such as CNS depressants, Estrogen, drugs used for the treatment of hypertension (e.g., Reserpine, Verapamil, Methyldopa), and drugs used for treating gastroesophageal reflux like cimetidine.

Prolactinomas are tumors which are usually benign (non-cancerous) of the pituitary gland in which there is production of high amounts of prolactin. These are more common in women as compared to men. Prolactinomas may cause menstrual irregularities, infertility, and bone loss in women. However, in men it can cause erectile dysfunction, gynecomastia (breast enlargement), decreased muscle mass, and bone loss. If the size of the tumor is quite large, it can cause pressure symptoms like headache and problems of the vision.