Follicle-stimulating hormone: the norm in women and men
The content of the article:
- Normal FSH
- Functions of FSH in a woman's body
- FSH in men
- Rules for taking the analysis for FSH
Follicle-stimulating hormone (follitropin, FSH) is a gonadotropic hormone secreted by the cells of the anterior pituitary gland that is active against the gonads. Determination of the concentration of this hormone in the blood plays an important role in the diagnosis of gynecological, urological, andrological and endocrine pathologies. FSH analysis is a mandatory step in the diagnosis of infertility.
Normal FSH
The content of the hormone in the blood of men and women is different. In men, its concentration is 1.5–12.4 mIU / ml. In women, the rate of follicle-stimulating hormone depends on the day of the menstrual cycle.
Follicle-stimulating hormone in women regulates the menstrual cycle
In the proliferative phase, which lasts from the onset of menstrual bleeding to the moment of ovulation (from the 1st to the 13th day of the cycle), the FSH concentration is 3.5–12.5 mIU / ml. On the day of ovulation, its content increases and is 4.7–21.5 mIU / ml. During the luteal phase, which begins immediately after ovulation and lasts until the next menstrual bleeding, the FSH concentration decreases to 1.7-7.7 mIU / ml. In postmenopausal women, the hormone rate is 18–150 mIU / ml, and in girls before puberty - 0.12–0.17 mIU / ml.
Functions of FSH in a woman's body
In the female body, the secretion of follicle-stimulating hormone by the pituitary gland is controlled by ovarian hormones (progesterone, estradiol). Control is carried out by the type of feedback, i.e., with a decrease in the secretion of estradiol and progesterone, an increase in FSH secretion occurs and, accordingly, vice versa.
In the first phase of the menstrual cycle, follitropin stimulates the growth and development of the dominant follicle, the maturation of the egg in it. Together with luteinizing hormone, it promotes the conversion of testosterone into estradiol, and also activates the secretion of the latter by ovarian follicles.
In the ovulatory phase, the maximum release by the pituitary gland of luteinizing and follicle-stimulating hormones occurs, which contributes to the rupture of the dominant follicle and the release of the mature egg into the abdominal cavity, from where it then penetrates into the fallopian tubes. After that, the production of FSH by the pituitary gland decreases.
Normally, on any day of the cycle, the concentration of luteinizing hormone should be significantly higher than follicle-stimulating hormone.
If follicle-stimulating hormone is increased in women, this indicates insufficient secretion of sex hormones (estradiol and progesterone) by the ovaries.
After the onset of menopause, the ovary stops the secretion of sex hormones, which becomes the reason for the increased release of FSH by the pituitary gland.
Indications for conducting an analysis for the content of follitropin in women are the following diseases and pathological conditions:
- habitual miscarriage (spontaneous abortion two or more times);
- lack of ovulation;
- various violations of the menstrual cycle;
- infertility;
- dysfunctional uterine bleeding;
- polycystic ovary syndrome;
- decreased libido;
- endometriosis;
- ovarian hypofunction;
- chronic inflammatory diseases of the reproductive system.
FSH in men
FSH also has a significant impact on the development and functioning of the male reproductive system. It stimulates:
- development of the seminiferous tubules of the testicles, in which division and maturation of sperm take place;
- proliferation and functioning of Sertoli cells, providing growing sperm with nutrients;
- division and growth (to a small extent) of Leydig cells that synthesize testosterone.
A reduced concentration of follicle-stimulating hormone in the blood in men is observed under the following conditions:
- genetic diseases (cryptorchidism, Kalman syndrome, Reifenstein syndrome);
- decreased function of the pituitary gland or hypothalamus (pituitary dwarfism, hypothalamic-pituitary insufficiency, secondary hypogonadism);
- brain damage (inflammatory diseases, consequences of traumatic brain injury, cerebrovascular insufficiency, tumors);
- hormonally active tumors of the testicles and adrenal glands;
- severe course of diabetes mellitus;
- chronic diseases of the pancreas;
- obesity or prolonged fasting, leading to an excess or, conversely, a deficiency of leptin;
- malabsorption syndrome;
- chronic intoxication of the body, including salts of heavy metals, alcohol;
- exposure to ionizing radiation;
- long-term therapy with certain drugs (anticonvulsants, anabolics, corticosteroids);
- chronic stress;
- depressive conditions.
High FSH levels in men can be caused by:
- primary hypogonadism;
- Klinefelter's syndrome;
- Shereshevsky-Turner syndrome (false male hermaphroditism);
- chronic renal and hepatic failure;
- dysfunction of the prostate gland;
- chronic obstructive pulmonary disease;
- orchiepididymitis;
- varicocele;
- chemical, tumor or traumatic castration.
Determination of the level of follitropin in men is indicated for delayed or vice versa early sexual development, male infertility, and also in order to assess the effectiveness of the treatment.
Rules for taking the analysis for FSH
In women, FSH levels change with the day of the menstrual cycle. Usually, the analysis is performed on the 6-7th day of the cycle, less often on another day as directed by the patient's attending physician. Men can donate blood for follitropin any day.
If the results show a reduced level of FSH, the study must be repeated, since the release of the hormone by the pituitary gland is impulsive and it is impossible to give a correct assessment of hormonal regulation by a single analysis. A single study is considered sufficient for conditions associated with an increase in the concentration of the hormone.
Women usually take a follicle-stimulating hormone test on the sixth to seventh day of the cycle.
Patients receiving high doses of biotin (over 5 mg per day) should take the last dose of the drug no later than 8 hours before the study.
The following factors can influence the analysis results:
- taking shortly before the study of hormonal drugs, radioisotope drugs;
- hemolysis in a blood sample;
- the introduction of heterophilic (including monoclonal) antibodies;
- pregnancy;
- smoking and drinking alcohol before the study;
- conducting shortly before the test of magnetic resonance imaging;
- taking medications that increase the level of FSH (tamoxifen, pravastatin, phenytoin, nilutamide, naloxone, metformin, levodopa, leuprolide, ketoconazole, hydrocortisone, somatoliberin, gonadoliberin analogs, finasteride, erythropoietin, digital, cimetinifin, danenazolum);
- taking medications that lower the concentration of FSH in the blood (valproic acid, toremifene, stanazolol, prednisolone, pimozide, phenothiazides, oral contraceptives, octreotide, megestrol, medroxyprogesterone, goserilin, finasteril, diethylstilbazole drugs, corticosteroids, anti-vascular drugs)
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
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