Perimenopausal women undergo many hormonal fluctuations as they near menopause. These changes in hormones cause some unpleasant perimenopause symptoms, including hot flashes, irritability, brain fog, and digestive problems. Estrogen and progesterone are the main hormones that cause symptoms in perimenopausal women. However, they are not the only players that hold a stake in your journey to menopause. FSH, or follicle-stimulating hormone, plays a crucial role in the reproductive health of both men and women. Let’s take a look at how this hormone changes throughout your menopausal years.
What is FSH hormone?
Follicle-stimulating hormone is released by the pituitary gland in your brain. The pituitary gland is signaled to release FSH by your hypothalamus with gonadotrophin-releasing hormone (GnRH). The FSH hormone function is to control the growth of ovarian follicles. When hormone levels are low during your menstrual period, it signals your pituitary gland to release more FSH to prepare a new follicle for fertilization.
An egg requires a follicle for maturation. Follicles also produce estrogen until the egg is released. Then, the follicle becomes a corpus luteum and releases progesterone, which plays an essential role in the menstrual cycle and pregnancy.
As you can see, FSH plays a critical role in your ability to get pregnant. But what happens when your FSH levels are too high or too low?
What Do High FSH Levels Mean?
Some health conditions can arise at birth if FSH levels are too high in a fetus. For example, Klinefelter’s syndrome and Turner syndrome. However, these syndromes are genetic conditions that are not the result of changing FSH levels in adulthood. Similarly, there are some conditions of the pituitary gland that lead to high levels of FSH.
FSH levels increase in women as they reach menopause. This is because the pituitary gland is reaching feedback that ovarian function is declining as estrogen production is lowering. When estrogen levels are low, the pituitary gland releases more FSH to try to get the ovaries to release a follicle to increase estrogen levels. Of course, when women are nearing menopause, their ovarian function naturally declines, which means that FSH levels will remain high once menopause is reached.
On the contrary, low FSH levels can cause genetic syndromes or may result in delayed puberty and infertility.
FSH levels perimenopause test
Follicle-stimulating hormone testing can help confirm if a woman is in menopause. Usually, the test is performed when a woman is close to or has likely reached menopause. An FSH level of 30 mIU/ml or more, coupled with the absence of periods for at least 12 months, indicates that a woman has reached menopause. Doing only a single FSH level can be misleading in perimenopause, as both estrogen and FSH vary greatly during perimenopause. Women who are on hormonal medications such as birth control pills or hormone-replacement therapy will not benefit from FSH testing, as the results will be invalid.
There are over-the-counter FSH urine tests that are marketed to women in perimenopause and menopause. While these products may be appealing because they may save you a doctor’s visit, these perimenopause tests are usually costly, not valid, and provide misleading information.
While there is no perfect test that states whether you are in perimenopause or not, an FSH test can help you and your doctor determine if your symptoms are related to menopause or another health condition. If you are experiencing perimenopause symptoms such as irregular periods, hot flashes, headaches, fatigue, irritability, and the rest of the 34 symptoms of perimenopause, it is a perfect time to meet with your doctor to have a complete medical exam.
If you found this article helpful, pass it along to your fellow peri gal pals!
Disclaimer: This is not medical advice, does not take the place of medical advice from your physician, and is not intended to treat or cure any disease. Patients should see a qualified medical provider for assessment and treatment.
Meet the Author
Perry Babe Julia ( RN, BSN, BA) is a registered nurse based in Colorado. Julia's nursing background in women’s health has ranged from neonatal and postpartum care to labor and delivery, to outpatient gynecological medicine for both adolescent and adult populations.
Much of her education and clinical experience are related to educating women on women’s health topics ranging from lifestyle improvements, disease management, and general health education.
Find Julia's Perry community profile right here.