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A follicle stimulating hormone is a hormone associated with reproductive functions such as the development of eggs in women and sperm in men. An FSH test is done for various problems, such as difficulty getting pregnant, menstrual irregularities, low sex drive, and early or delayed puberty.
Low levels of FSH might indicate decreased ovulation in women, reduced sperm count in men, or problems at the level of the hypothalamus or pituitary gland. Increased levels of FSH, on the other hand, can be indicative of loss of ovarian function and menopause. A FSH works closely with another hormone called luteinizing hormone(LH) to control sexual functions. Hence, the test is frequently recommended along with the LH test.
The other names are: follitropin test, FSH test.
There is only one parameter.
Follicle stimulating hormone(FSH) test measures hormones in the blood. FSH is produced in the pituitary gland, and its production is controlled by a feedback system involving the hypothalamus in the brain, the pituitary gland, and the hormones manufactured by the ovaries or testicles. Gonadotropin-releasing hormone from the hypothalamus stimulates the pituitary gland to release FSH and LH (luteinizing hormone is another closely related hormone also involved in reproduction). Follicle stimulation affects the growth and maturation of egg follicles in the ovaries during the follicular phase of the menstrual cycle. The menstrual cycle has been divided into follicular and luteal phases, each phase lasting for 14 days. It is during the follicular phase that FSH initiates the production of estradiol by the follicle, and the two hormones work together in the further development of the egg follicle. Near the end of the follicular phase, the production of FSH and luteinising hormone increases. It releases the egg from the ovary (ovulation) occurs shortly after this increased production of hormones. Hormones like inhibin as well as estradiol and progesterone help to control the amount of FSH released by the pituitary glands. Follicular stimulating hormone also facilitates the ability of the ovary to respond to LH. During menopause, ovarian function decreases and eventually ceases, which results in increased levels of follicle-stimulating hormone and LH.
In males, the role of FSH is to stimulate the testicles to produce mature sperm and also promote the production of androgen-binding proteins. Follicle stimulating hormone levels are relatively constant in men after puberty than in women.
In infants and children, FSH levels will increase shortly after birth and then fall to too low levels by 6 months in boys and 1-2 years in girls. Concentration begins to increase again before the beginning of puberty and the development of secondary sexual characteristics.
Disorders affecting the hypothalamus, pituitary, and ovaries or testicles can cause the production of high or low FSH, resulting in a variety of conditions such as infertility, missed menstrual cycles, or early (precocious) or delayed sexual maturation.
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For a woman, a follicle-stimulating hormone (FSH) test might be ordered when she is facing difficulty in getting pregnant, has irregular or an absence of menstrual periods, or sometimes when they have suspected that she has entered menopause.
For a man, the test might be ordered when his partner cannot get pregnant, when he has a low sperm count, or when he has muscle mass, decreased or low sex drive.
Testing can be ordered when a healthcare provider suspects that a pituitary disorder is present in both women and men. A pituitary disorder may affect the production of several different hormones, so there might be other signs and symptoms in addition to some of those listed above. They may include fatigue, weakness, unexplained weight loss, and decreased appetite, to name a few.
In children, FSH and LH can be ordered when a boy or girl does not appear to be entering puberty at an appropriate age (either too late or too soon). Signs of puberty might include:
Breast enlargement in girls
Growth of public hair
Growth of testicles and penis in boys
beginning of menstruation in girls.
No special preparation is required. Fasting is not required for this test.
This test requires a blood sample.
A healthcare provider, who is also called a phlebotomist, usually performs blood draws, including those for FSH tests, but any healthcare provider trained in drawing blood can perform this task. Samples are sent to a lab where a medical laboratory scientist prepares the samples and measures the tests on analysers or manually.
You can expect to experience the following during the blood test or a blood draw:
You sit comfortably on the chair, and a healthcare provider will check your arms for an easily accessible vein. It is an inner part of your arm on the other side of your elbow.
Once the phlebotomist has located a vein, they disinfect the area with an alcohol swab.
They will prick a needle into your vein to draw a blood sample. They may feel like a small pinch.
After the needle is inserted, the required amount of blood is drawn into a test tube.
When they draw enough blood for the test, they will remove the needle and hold a cotton ball or gauze on the pricked site to stop any bleeding.
They apply a band-aid over the pricked site, and the blood collection is finished.
This process takes less than five minutes.
Once the phlebotomist collects the blood sample, it will be sent to the laboratory for processing. When the reports are ready, your healthcare provider will share the results with you.
Blood tests are very common, and they don’t carry any significant risks. You may have a slight pain like an ant bite when the needle gets inserted, and a small bruise might develop there.
This report is available via email or WhatsApp within 6 hours after the collection of the blood sample.
Results of a FSH test are typically considered with the results of other hormone tests, such as LH, estrogens, and testosterone.
As a part of infertility therapy, a high or low FSH is not diagnostic but provides information on what might be causing it. For example, a hormone imbalance can affect a woman’s menstrual cycle and ovulation. A health care provider will consider all the information from the workup to establish a diagnosis.
In Women
A FSH and luteinizing hormone (LH) levels might help to differentiate between conditions affecting the ovaries themselves (primary) and dysfunction of the ovaries due to disorders of either the pituitary or the hypothalamus.
High values of FSH and LH are consistent with conditions that are affecting the ovaries themselves. Some examples include:
Developmental defects:
Failure to develop ovaries (ovarian agenesis)
Chromosome disorders, such as Turner syndrome
A defect in steroid production by the ovaries, such as 17 alpha-hydroxylase deficiency
Damage to the ovaries due to:
Radiation exposure
Chemotherapy
Autoimmune disease
There are underlying conditions that affect ovary function, such as:
Polycystic ovary syndrome (PCOS)
Adrenal disease
Thyroid disease
Ovarian tumour
When a woman enters the menopause cycle and her ovaries stop working, FSH levels will rise. Low levels of FSH and LH are consistent with pituitary disorders or problems with the hypothalamus.
Low FSH serum values have been associated with an increased risk of ovarian cancer.
In Men
Increased FSH levels are due to conditions affecting the testicles themselves.
Some examples include:
Viral infection (Mumps)
Trauma, injury
Radiation exposure
Chemotherapy
Autoimmune disease
Germ cell tumours
Failure to develop normal gonads (gonadal agenesis)
Chromosome disorders, such as Klinefelter syndrome
Low values are consistent with pituitary or hypothalamic disorders.
Increased levels of FSH and LH than expected for age, plus the development of secondary sexual characteristics at an unusually young age, is an indication of an early stage of puberty. It's more common in girls than in boys. It is premature development is usually due to a problem with the central nervous system and can have a few different underlying causes. Examples include:
Central nervous system tumours
Brain injury, trauma
Inflammation within the central nervous system (e.g. meningitis, encephalitis)
Normal prepubescent levels of FSH and LH in children exhibiting some signs of puberty might indicate a condition called “peripheral precocious puberty.” Signs and symptoms are brought on by elevated levels of the hormone estrogen or testosterone. This might be caused by:
Tumours that produce and release hormones
Adrenal gland tumours
Ovarian tumours or cysts
Testicular tumours
Normal FSH and LH levels with a few signs of puberty (e.g., development of pubic hair and acne) can signal a previous environmental exposure to agents such as testosterone cream or gel or might be a normal variation of puberty.
In delayed puberty, FSH and LH levels may be normal or below what is expected for a youth within this age range. Examples of some causes of delayed in puberty include:
Dysfunction of the ovaries or testicles
Hormone deficiency
Turner syndrome
Klinefelter syndrome
Chronic infections
Cancer
Eating disorders (anorexia nervosa)
Normal ranges might vary slightly among different laboratories. Some of the labs use different measurements or may test different samples. Speak to the doctor about the meaning of your specific test results.
LH, Prolactin test
Frequently Asked Questions on FSH Test
Symptoms of low FSH deficiency in adult females at birth may include:
Your ovaries are not producing enough eggs.
Your pituitary glands are not working properly.
You have a problem with your hypothalamus, a part of the brain that controls your pituitary gland and other important body functions.
You are very underweight.
If you are a man, low FSH levels can mean you have a disorder of the pituitary gland or hypothalamus. Low FSH levels in children can be a sign of delayed puberty. Delayed puberty can be caused by such as
A disorder of the ovaries or testicles
Turner syndrome in girls
Klinefelter syndrome in boys
A hormone deficiency
An eating disorder
To balance your FSH values, eat foods like salmon, avocados, and nuts to increase the production of FSH with essential fatty acids. Additionally, maintain a healthy endocrine system by consuming lots of dark green vegetables like spinach, kale, and broccoli.
A high FSH value means that you have primary ovarian insufficiency, also known as premature ovarian failure. The primary ovarian insufficiency is the loss of ovarian function before the age of 40, and polycystic ovary syndrome (PCOS) is a common hormonal disorder affecting childbearing women.
Follicle-stimulating hormone (FSH) results are read as
1.98 to 11.6 mIU/mL - Normal Female follicular phase
5.14 to 23.4 mIU/mL - Normal female mid-cycle peak
1.38 to 9.58 mIU/mL - Normal female luteal phase
21.5 to 131 mIU/mL - Post-menopausal females
1.55–9.74 mIU/mL - Normal males
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