If you are a woman then you may be familiar with this and you may have had your FSH tested. 

When we talk about the menstrual cycle or menopause, then the focus seems to always be on oestrogen and progesterone but actually FSH is a really important female hormone (although men make it too). 

It stands for ‘follicle stimulating hormone’ and it does exactly what it says on the bottle – it stimulates the follicles in the ovary to develop. (1)

FSH and our Cycle

Follicles are small sacs found in the ovaries that contain our eggs. At the start of our cycle, FSH is released from a gland in the brain called the pituitary gland, to tell the ovaries to start developing a few follicles at a time with the plan that the eggs inside will mature. It’s an egg race – most of the follicles do not reach maturity but disappear instead. The winning follicle (once it has matured and grown to the perfect size) will release the egg through its wall. This is ovulation.  As the follicles develop they produce oestrogen.

When the follicle ruptures the crater left (called the corpus luteum) then produces progesterone.   So FSH is involved in the production of both ostrogen and progesterone. 

FSH and Menopause

When we go through the transition into menopause – at first we may produce lots of follicles and sometimes we may not, sometimes we may ovulate and sometimes we may not – hence the imbalance in hormone production.  Both oestrogen and progesterone talk to the pituitary gland to control the amount of FSH produced. When there are low levels of oestrogen and progesterone (as happens at the end of your cycle), the pituitary gland starts making FSH.  When we hit menopause because there are low levels of oestrogen and no progesterone (due to not ovulating) – the pituitary gland pumps out LOTS of FSH. 

Testing

In NZ, the normal level of FSH for a woman of reproductive age is around 4-25 IU/L mid-cycle (the best time to test is half way through your cycle just before ovulation). If you haven’t had a period for 12 months and are considered post-menopausal then your levels will be anywhere above 19 IU/L. (2) 

FSH is tested when it is suspected that there may be fertility problems with both men (as it is involved in sperm production) and women, pituitary disorders and also irregular periods or to confirm menopause (although again FSH can fluctuate like oestrogen so is not always useful to test). 

Sometimes high amounts of FSH can indicate problems with the function of your ovaries and also PCOS. Low FSH can indicate problems with the pituitary gland. Both of these results need further assessment.  Stress (there’s a surprise) and malnutrition will also affect FSH results and ultimately reproduction function and hormonal symptoms.  

What is interesting is the link between dropping oestrogen and Alzheimers and now possibly high levels of FSH and Alzheimers – this is an area that is seeing an increase in research that I find fascinating (3) although it is still early days. There have also been studies suggesting that high FSH may be associated with a lowered risk of diabetes.  As you can see there is a lot we don’t know about the effects of this particular hormone especially in regards to post-menopausal women but more research is being done. (4) 

Top Tips

1. Manage your stress levels – rest when you can, learn to say no and protect your boundaries, find ways to have some fun!

2. Eat mainly wholefoods when you can – veggies, fruit, nuts and seeds, legumes, fish, free range chicken, eggs and fermented dairy (if you can tolerate it) and lots of olive oil. 

References

1. https://www.ncbi.nlm.nih.gov/books/NBK535442/
2. https://www.labtests.co.nz/for-referrers/tests/reference-ranges/
3. https://www.nature.com/articles/s41586-022-04463-0  
4. https://womensmidlifehealthjournal.biomedcentral.com/articles/10.1186/s40695-022-00079-6

 

Email me at admin@sarah-brenchley.com or book a free discovery call to discuss how I can help you. I offer a 1:1 sessions and various programmes on gut health, empowered eating (non-diet approach to food and weight) and menopause. Go to https://sarah-brenchley.com/links for information and free resources and join the best Facebook Group ever  – Women’s WellBeing Circle. 

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