Why follicle-stimulating hormone may be elevated in women
The content of the article:
- Follicle-stimulating hormone properties
-
Symptoms of high FSH levels
- Pituitary gland pathology
- Ectopic secretion of gonadotropins
- Premature production of FSH
- Primary gonadal insufficiency
- Premature ovarian failure syndrome
- How to normalize blood FSH levels
- Video
Follicle-stimulating hormone (follitropin, FSH) is a representative of gonadotropic hormones produced by the anterior pituitary gland. In the female body, the area of application of FSH is the sex glands - the ovaries. Hypergonadotropic disorders, or conditions when follicle-stimulating hormone is elevated in women, can be caused by:
- primary insufficiency of the sex glands;
- diseases of the pituitary gland;
- ectopic (outside the pituitary gland) hormonal secretion;
- premature hormone production.
The causes and consequences of changes in the level of follitropin are easier to imagine, knowing its properties and the regulatory system.
FSH in women may increase due to pituitary or ovarian pathologies
Follicle-stimulating hormone properties
Follitropin is produced in both men and women. FSH receptors are located on the cell membranes of the gonads. In the female body, the hormone regulates the menstrual cycle, the phase of which determines its content in the blood plasma.
| Age, phase of the menstrual cycle | Reference interval, mIU / ml |
| Follicular phase | 3.5-12.5 |
| Ovulatory phase | 4.7-21.5 |
| Luteal phase | 1.7-7.7 |
| Postmenopause | 25.8-134.8 |
In the first half of the cycle, the concentration of follitropin gradually increases, stimulating the growth of the dominant follicle and the maturation of the egg in it, triggering the synthesis of estradiol. In the middle of the cycle, a peak increase in the level of the hormone occurs, which makes ovulation possible and creates optimal conditions for the corpus luteum to work in the luteal phase. After this, the content of follitropin decreases, but begins to grow before menstruation, if fertilization has not occurred, that is, the union of the sperm with the egg.
A clear cycle of processes is provided by several regulatory mechanisms. Responsible for the secretion of FSH are: the cerebral cortex, the hypothalamus, which synthesizes follitropin-releasing hormone, estradiol and progesterone according to the feedback principle, the hormones inhibin and activin, which are produced by the ovaries.
Symptoms of high FSH levels
When the FSH concentration goes beyond the upper limit of the norm, this means that the cellular structure of the organ that synthesizes the hormone is disturbed, or there are malfunctions in the system of regulation of the pituitary gland.
Pituitary gland pathology
The reason for the increase in FSH may be tumor processes in the pituitary gland, provoking excessive synthesis of follitropin. Most often it is an adenoma with hormonal activity - gonadotropinoma. The etiology of the neoplasm in many cases remains unknown. A certain value in the development of pathology is attached to:
- traumatic brain injury;
- infectious diseases of the central nervous system;
- intoxications;
- pathological course of pregnancy and childbirth;
- the use of oral contraceptive drugs.
Most often, tumors of the glandular tissue of the pituitary gland appear in adults. This leads to menstrual irregularities, infertility, miscarriage. In rare cases, the development of hormonally active adenomas occurs in children, this is fraught with premature sexual development - the appearance of symptoms of puberty in girls under the age of 8:
- the growth of the mammary glands;
- the appearance of pubic hair;
- enlargement of the uterus and appendages, corresponding to the puberty period;
- the occurrence of bloody vaginal discharge or even regular menstruation.
This process is accompanied by accelerated growth and differentiation of bone tissue, and, as a result, premature closure of growth zones. As a result of the latter, stunting develops.
Overproduction of FSH can be caused by hormone production outside the pituitary gland.
Ectopic secretion of gonadotropins
Pathological secretion of gonadotropins, which, in addition to FSH, include luteinizing hormone and chorionic gonadotropin, is possible in some malignant neoplasms. Such tumors affect the lungs, kidneys, pancreas, liver, stomach, intestines, mammary glands.
It should be noted that this type of secretion is more concerned with chorionic gonadotropin, since the production of follicle-stimulating hormone outside the anterior pituitary gland is extremely rare. Nevertheless, this factor should be included in the list of causes leading to a violation of the normal concentration of follitropin in the blood serum.
Premature production of FSH
Hypergonadotropic disorders due to premature secretion of follitropin can be caused by:
- constitutional premature puberty;
- tumor processes and damage to the central nervous system;
- chronic renal failure.
An early increase in the level of follicle-stimulating hormone during constitutional premature puberty is associated with the stimulation of a special center in the hypothalamus. Until now, the cellular changes leading to such disorders have not been finally clarified. The prematurely started work of the ovaries in this condition does not differ from the function of the gonads of healthy women. Such girls usually do not suffer from other diseases, and their development corresponds to normal puberty, only comes much earlier. Bone growth outpaces age, and tooth growth lags somewhat behind, as does mental development, which later reaches peer level.
Primary gonadal insufficiency
An excess of normal FSH values is noted with gonadal dysgenesis, surgical removal of the gonads. A defect in the development of the ovaries is associated with a violation of their embryonic formation. This can be the result of chromosomal abnormalities, gene mutations, or fetal toxicity. It proceeds in the form of Shereshevsky-Turner syndrome, the main manifestations of which are expressed in the underdevelopment of sexual characteristics, combined with the absence of menstruation.
In such patients, insufficient development of the genitals in typical cases is accompanied by short stature, a peculiar head position, the presence of pterygoid skin folds on the sides of the neck, and bone anomalies. In laboratory studies, in addition to high levels of gonadotropins, there is a sharp decrease in the concentration of female sex hormones - estrogens.
Premature ovarian failure syndrome
All of these conditions lead to an increase in FSH in the blood, but they are much less common than the syndrome of premature ovarian failure. It is characterized by the absence of menstrual bleeding and the presence of vegetative manifestations (hot flashes, sweating, etc.) in patients under 38 years of age with a normal cycle and a history of reproductive function. The reason for such changes may be:
- chromosomal abnormalities;
- ionizing radiation;
- toxic effects of chemicals;
- teratogenic drugs;
- viral infections;
- autoimmune diseases;
- smoking;
- strict low-calorie diets.
The impact of provoking factors can be isolated or combined.
How to normalize blood FSH levels
Various approaches are used to correct elevated levels of follicle-stimulating hormone. The choice of method depends on the reason for the growth of follitropin:
- Tumor processes can be eliminated by radiosurgery or by surgery.
- Dysgenesis of the gonads requires hormone replacement therapy, as does the ovarian failure syndrome.
- For the treatment of increased secretion of gonadotropins, both gonadotropin-releasing hormone agonists and inhibitors of gonadotropic receptors are used.
It is important to lower the FSH content to normal values, since its high level leads to dysfunctional uterine bleeding, miscarriage, infertility and, therefore, violates the woman's quality of life.
Video
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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