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What is a Follicle-stimulating Hormone (FSH) test? 
FSH is a gonadotropin hormone secreted by a small gland (pituitary gland) situated in the brain. It plays an important role in role in sexual development during puberty, including the production of sperms in males and ovarian follicles in females. The levels of this hormone are low in children, and they rise at puberty (near the ages of 10-14 years). 

In men, FSH remains constant throughout life. However, in women, its levels vary from time to time, according to their menstrual cycle. As ovaries stop functioning at menopause, blood FSH levels rise steeply in perimenopausal women.

Thus, the levels of FSH in blood and urine can help determine if a woman is going through menopause or perimenopause.

  1. Why is an FSH test performed?
  2. How do you prepare for an FSH test?
  3. How is an FSH test performed?
  4. What do FSH test results indicate?

A doctor may recommend an FSH test to diagnose different underlying conditions:

FSH test can either be done on a blood sample or a urine sample. In either case, no special preparation is required.

Women should inform the doctor about the dates of their menstrual cycle since the doctor might want to conduct the test on specific days.

It is also important that you inform your doctor about any medicines or herbal supplements you might be using. Intake of any Illicit or over-the-counter drugs must also be notified to the healthcare provider.

A urine sample is usually taken for menopausal women. You may be required to give a small sample in a sterile container provided at the test centre. The doctor would inform you regarding the requirement of a specific urine sample of a particular time. Urine test kits are also available, which can be used by women at home.

For a blood sample, the technician will wrap a tourniquet around your arm to make the vein more prominent on the skin surface. Then, using a sterile needle, he/she will withdraw blood from the vein. At this point, some individuals feel slight discomfort due to needle prick, though it fades away soon. After the test, the blood sample is collected in a sterile container and sent for testing. To stop bleeding, the technician will press some cotton gauze at the puncture site and apply a bandage. There may be minor bruising in some people, which usually disappears in a few hours.

Normal results: Normal results for the FSH test in women are as follows:

  • Pre puberty: 0-4.0 international unit per litre (IU/L)
  • During puberty: 0.3-10.0 IU/L
  • During menstruation, the different phases having varying values: 4.5-21.5 IU/L
  • Postmenopause: 25.8-134.8 IU/L

Normal results for FSH test in men are as follows:

  • Pre puberty: 0-5.0 IU/L
  • Through puberty: 0.3-10.0 IU/L
  • Adult stage: 1.5-12.4 IU/L

Normal values for an FSH test can vary from one laboratory to another. Therefore, it is best to speak to the doctor about the outcome of the test.

Abnormal results: 

  • TSH values higher than normal in women could be due to Turner syndrome or tumour of the pituitary gland.
  • Lower values could be due to pregnancy, recent rapid weight loss, halt in the production of eggs or sometimes due to reduced functioning of the pituitary gland or parts of the brain
  • Higher values in men could be due to Klinefelter syndrome, tumours in the pituitary gland, advanced age or damage to the testicles due to various reasons, such as alcohol and radiation. 
  • Lower values in men could be due to reduced functioning of the pituitary gland or parts of the brain.
  • Higher values in children could be an indication of the start of puberty

The doctor may recommend more tests to confirm any of the above conditions and provide an accurate evaluation and understanding of the test results.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.  

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References

  1. Gerard J. Tortora, Bryan Derrickson. [Iink] 14th ed. U.S: Wiley Publication; 2014. Chapter 28, Page no.1042-1085.
  2. Connecticut Children’s Medical Center. [Internet] Connecticut, U.S Blood Test: Follicle Stimulating Hormone (FSH)
  3. U.S. Food and Drug Association. [Internet]. Menopause
  4. Rodger F. Yen and Jaffe's Reproductive Endocrinology: Physiology, Pathophysiology, and Clinical Management BMJ Sexual & Reproductive Health, 2005;31:192
  5. Pennstate Hershey. [Internet] Milton S Hershey Medical Center, U.S. Follicle-stimulating hormone (FSH) blood test
  6. Provan D. Oxford Handbook of Clinical and Laboratory Investigation 4th ed. United Kingdom: Oxford University Press; 2018. Chapter 2, Page no:129-179, ISBN-13: 9780199233717
  7. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; Follicle-Stimulating Hormone
  8. National Heart, Lung, and Blood Institute [Internet]: U.S. Department of Health and Human Services; Blood Tests