Published 16 September 2024
- Written by Emma Matthews
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Key takeaways
This massively important hormone not only affects fertility and ovarian health in women, it even affects men. We know, crazy, right? And yet, despite that male connection, there’s surprisingly little information out there for anyone with fritzy FSH. Which, as it turns out, could be almost anyone. But it’s mostly women. Shocker.
FSH – A pain in the anterior pituitary
Let’s start with where and why FSH exists in the first place. That first part is pretty simple. FSH is produced and released into your bloodstream from your anterior pituitary gland. And although we said we were going deep into your brain, technically, it’s actually located underneath your amazing brain.
Regular Hormonas will definitely recognize this particular cranial resident, as will anyone with Graves or Hashimoto’s, as FSH isn’t the only hormone the pituitary gland is in charge of. As part of the endocrine system, the gland plays a huge part in the healthy function of your thyroid.
But in the case of FSH, the pituitary plays a crucial role in the development and smooth running of your reproductive system. The whole shebang. From start to finish.
How does the FSH hormone function?
All things being equal, you shouldn’t even notice FSH quietly doing its job until you reach puberty. From then on, as a biological woman, FSH will be part of your daily existence and will be for much of your life. Even as a biological man, the hormone works away, but generally in a much more stable fashion.
So, what exactly, is this hormone responsible for in both sexes? Essentially, it’s the bedrock of reproduction. For women, it’s in charge of the growth and maturation of ovaries and Fallopian tubes, as well as the production and release of eggs on a monthly basis.
FSH in men oversees the formation and proper working of the testes and the production of sperm and testosterone. Without it, low fertility is almost certain regardless of sex.
Post-puberty imbalance in FSH
Once your periods have begun, your FSH levels, in a similar way to estrogen, rise and fall according to where you are in your menstrual cycle. The hormone is responsible for getting eggs to the right place at the right time, should some sperm happen to come by, but even before that, it’s got a job to do.
The eggs sit inside the follicles in your ovaries, but can’t just plunge into the unknown. They first have to mature to the right level before being released into the uterus. So, long before we have any idea anything is happening, we’ve already grown and sent an egg that’s ready for fertilization.
PMS notwithstanding, natch, this all generally happens with little fanfare. The problems arise when FSH levels are too high, or have dropped or even disappeared. And that’s outside of any of your usual period-related changes. Complex, right?
Complexity of the hormone in puberty
Those complexities actually start before puberty. If FSH levels are too high, both biological girls and boys can experience early-onset puberty at around age nine. Conversely, a deficit of FSH in children can lead to delayed puberty. Both may point to the glandular, central nervous system, or brain issues.
Complexity of the hormone in adults
In adults, FSH imbalance can lead to infertility questions, regardless of sex, and can also be part of a larger pituitary issue.
Once you’re an adult, FSH imbalance can be caused by a number of things. Ovarian issues, PCOS, cancer, and Turner Syndrome can all have an adverse effect on your levels. But so, too, can menopause, the aforementioned pituitary and hypothalamus gland issues and, believe it or not, being what’s described as “very underweight”.
All of the above can have a direct effect on your fertility. And it doesn’t get more direct than not producing eggs.
What is a normal FSH level to get pregnant?
Here’s where it gets a little odd. Weirdly, shall we say, healthy FSH levels should be fairly low, even during that menstrual spike. It seems that it doesn’t take a huge amount of the stuff to persuade an egg to mature and start its journey.
FSH only really gets very high when your pituitary isn’t getting the egg-ready message. And that happens when there isn’t enough estrogen in your body to switch it off. As a result, you produce more and more FSH in an effort to force an egg to maturation.
Struggling with infertility
If you’re under 40 and have been trying to conceive with no success, there’s a chance that FSH is in the mix. And that goes whether you’re biologically female or male.
High FSH in males can point to wider sperm development issues, as well as the problems described above. In females, it might indicate ovarian or egg development changes. And this is probably why there’s so little literature about FSH before it was discovered as part of a wider reproductive issue.
Essentially, you don’t know it’s a problem until it’s a problem and you’re struggling with infertility. And that in and of itself is a massive problem.
Menopause Strikes Back
If you’re in or around your 40s, there’s a good chance your FSH is spiking right now. Because, oh yes, it’s back again, the menopause is one of the most common causes of high FSH.
And here’s why:
FSH levels are directly linked to the number of egg sacs you currently have. Each sac dies back after the release of an egg, and we’ve all got a finite number of sacs. As you get older, that number gets smaller, until, sadly, they’re all gone. And that, in essence, is the menopause.
FSH levels in menopause
As such, FSH levels are often taken as a good indicator that you’re in the menopausal transition. It’s a VIP at the hormonal extravaganza that is the end of your periods and a spike in levels can help with a diagnosis. We say can because, as with any and all things hormonal, it’ll be individual to you.
Some women experience huge rises in FSH levels, while others will see almost no change at all. Any diagnosis of menopause or otherwise should include a thorough discussion of all of your symptoms in conjunction with any test results.
Signs and symptoms of FSH imbalance
This brings us neatly to the signs that something might be awry with your FSH levels. You’re probably way ahead of us here, but any long-term changes to your period are good indicators that something isn’t right. These changes include:
- Absence of period
- Severity of period
- irregularity of periods
Likewise, if you’ve been trying to conceive for 12 months with no success, it’s possible there could be a low fertility issue somewhere.
Other signs and symptoms include:
- If you’re fatigued
- Have lost weight
- Experienced any of the symptoms associated with menopause
- Experienced any of the symptoms associated with thyroid conditions
You’re definitely ahead of us now. The good news is, there are tests that can help point you in the right direction.
If you recognize anything at all from what we’ve talked about, please see your healthcare professional. Don’t just put up with it. Don’t sit in silence. An FSH blood test is quick and easy, and can build up a great record of what’s going on with you. It can also help you plan starting a family, if conceiving is your goal, and give you some idea of where your hormones are at in all life stages.
FSH at home test
However, if you’re unable to get to one, or just can’t face that many trips to the doctor, help is at hand.
Home FSH test kits do exist, and while we always recommend getting professional advice, these too can be of some help.
Hormona is also working hard behind the scene to develop a home hormone test where one of the biomarkers checked is FSH. The beauty with Hormonas test is that we’re actually measuring and giving you your exact FSH level on that day, not just a positive or negative test result.
By testing quantitatively we can help you build a more complete picture of your overall hormone health. And to be honest gang, that’s something we could all do with.
They’re such an important part of our lives, our wellbeing, our ability to exist in good health, that everyone should be keeping a record of them. Medical profession take note: We’re going to be coming at you with A LOT of numbers. Stay Hormonal gang!
Disclaimer: This website does not provide medical advice
The information, including but not limited to, text, graphics, images and other material contained on this website are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.
Disclaimer: This website does not provide medical advice. The information, including but not limited to, text, graphics, images, and other material contained on this website is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new healthcare regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.
Written by
Emma Matthews
Reviewed by
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Dr Singh is the Medical Director of the Indiana Sleep Center. His research and clinical practice focuses on the myriad of sleep.