Follicle Stimulating Hormone (FSH) & Luteinising Hormone (LH)

  • FSH is known as a gonadotropic hormone. It stimulates the follicles in your ovaries to grow and prepare for ovulation. As the follicle in the ovary grows it releases the hormone oestrogen.

  • High oestrogen levels stimulate the release of LH from the pituitary. This is another gonadotropic hormone. LH brings about ovulation (release of an egg from the ovary).

  • After ovulation the follicle forms a corpus luteum which releases the hormone progesterone.

  • Progesterone inhibits (stops) the release of FSH from the pituitary. This usually occurs in a cycle – the menstrual cycle.

  • When your pituitary gland is damaged the feedback loop between hypothalamus, pituitary and ovaries can be partially or fully affected.

  • This is why your periods (menstruation) may not have returned (amenorrhoea) or be less frequent (oligomenorrhoea).

  • It can also cause secondary ovarian failure. This means your ovaries can still work, however your pituitary is not releasing the hormones needed to stimulate them to release an egg. This means if you would like to conceive, your ovaries can be stimulated to produce and release an egg with assisted conception.

    You can find support and understanding in our community. We will also be hearing from women in our blog and their story around fertility and early menopause.

Further reading at You & Your Hormones here.

Testing for FSH & LH deficiency

This involves a routine blood test to check the levels in your blood. Your hospital laboratory will have reference intervals for each part of the menstrual cycle.

Hormone replacement for FSH & LH deficiency

  • You will usually be given oestrogen and progesterone hormone replacement unless you are hoping to conceive.

  • Low levels of oestrogen can cause symptoms of menopause, such as hot flushes, night sweats, changes in mood, anxiety, insomnia, joint aches, brain fog, low bone density, low libido, vaginal dryness, and discomfort having sex.

  • Oestrogen replacement can be across the skin as a gel, in a patch or a tablet. If vaginal dryness or discomfort is a problem a small dose of oestrogen directly into the vagina can help.

  • Usually, women younger than the age of menopause will be given a progesterone replacement as well as oestrogen. This is to enable the womb lining to be shed in a withdrawal bleed (like a period). This is important for reducing the risk of uterine cancer.

  • This might be as a separate medication or combined with oestrogen.

  • Some women use a combination of patches, tablets and gels depending on their individual symptoms and recommendation of their doctor. This is usually referred to as “HRT” meaning Hormone Replacement Therapy.

  • Testosterone can fall at the same time as these other hormones and this can also affect well-being, libido and sexual function. Testosterone supplementation, usually via a gel across the skin, is easy and helps a lot of women feel better. Please see our section below for more information.


Testosterone

  • Testosterone is often thought to be purely a male hormone; however, it is also an important female hormone.

  • Testosterone is released from the ovaries (50%) and adrenal glands (50%) and naturally declines through life.

  • Testosterone plays an important role in libido and sexual arousal. It also maintains bone and muscle, metabolism, cognition, and mood.

Testosterone Deficiency

  • Having a deficiency in testosterone can lead to low libido, reduced sexual arousal, or reduced pleasure from sex. This can be difficult to deal with and affect relationships.

  • You may also experience reduced quality of life, tiredness, fatigue, reduced bone density and muscle mass.

Testing for testosterone deficiency

  • According to the British Menopause Society, it is difficult to accurately test for this. The gold standard test uses free testosterone assays, but these may not always be available. They suggest going on clinical response (your symptoms) to measure success of any replacement medication.

Hormone replacement for testosterone deficiency

  • This is usually in the form of low doses of testosterone gel applied to the skin.

Find out more in this factsheet from Women’s Health Concern here and from the British Menopause Society here.