Definition

FSH (Follicle Stimulating Hormone) test is a procedure that measures the concentration of FSH in the bloodstream. This hormone is produced by the pituitary gland, a small organ located at the base of the brain, which is responsible for secreting various essential hormones in the body.

FSH plays a crucial role in the reproductive system. In women, it is responsible for the production of egg cells and regulating the menstrual cycle. In men, FSH helps control sperm production and the development of the genital organs.

In children, FSH levels are typically low before puberty. During puberty, FSH levels rise, signaling the ovaries in girls to produce estrogen and stimulating the testes in boys to produce testosterone.

FSH tests are often performed alongside other hormone tests, such as the Luteinizing Hormone (LH) test. LH also plays a significant role in regulating sexual function in both women and men. Additionally, the doctor may recommend simultaneous tests for estrogen and testosterone levels.  

Indications

In women, this test is conducted to:

• Identify the cause of infertility or sterility
• Diagnose issues related to the ovaries
• Determine the cause of irregular or absent menstrual cycles
• Confirm menopause

In men, this test is conducted to:

• Investigate the cause of infertility or sterility
• Identify the cause of low sperm count
• Diagnose issues related to the testicles

In children, FSH tests are performed to determine if puberty is occurring too early or too late. Puberty is considered early if it begins before age 9 in girls or age 10 in boys. Puberty is considered delayed if it does not begin by age 13 in girls or age 14 in boys.

Contraindications

There are no known contraindications or specific conditions that would prevent someone from undergoing this test.

Preparation Before the Test

No special preparation is required before performing the FSH test. It can be done without the need for fasting. However, it is advisable to consult a healthcare provider before undergoing the test, as certain medications and medical conditions can influence the results, potentially making them unrepresentative of your actual condition.

Test Procedure

The FSH test typically requires a blood serum sample of approximately 0.25 - 0.5 ml. This blood sample is collected from a vein into a special tube. Laboratory personnel will use gloves and personal protective equipment (PPE) when drawing the sample.

Before drawing blood, the technician will place an elastic band around the upper arm and clean the puncture site with antiseptic gauze. Blood is usually drawn from the crease of the elbow. Once the blood is collected in the tube, the elastic band is removed, and pressure is applied to the puncture site, which is then cleaned with antiseptic gauze.

This procedure typically takes only a few minutes. The collected blood sample will then be processed in a laboratory using specialized equipment. Test results are usually available within a few hours.

Normal and Abnormal Values

The normal range of FSH values varies by age and gender. Below is the normal range of FSH test results:

Male 

Female

As shown in the table, FSH levels in the blood have normal values that differ based on age and gender. FSH levels are considered abnormal if they fall outside the normal range indicated in the table.

However, it's important to note that each laboratory may have slightly different reference ranges due to variations in the equipment or methods used.

Results and Recommendations (Further Testing)

Low

If your FSH test results show low values, it is important to consult with a healthcare provider. Low FSH levels in women may indicate:

• The ovaries are not producing eggs
• A disorder affecting the pituitary gland
• A dysfunction of the hypothalamus, the part of the brain that regulates the pituitary gland and other key bodily functions
• Being underweight or experiencing significant weight loss

For men, low FSH levels suggest:

• The testicles are not producing sperm
• A disorder of the pituitary gland or hypothalamus

Normal 

If your FSH test results show normal values, it generally indicates that you are maintaining a healthy lifestyle, and there are no apparent issues with the ovaries or pituitary gland, assuming no specific symptoms or clinical signs are present.

It is advisable to continue with your healthy lifestyle to prevent conditions such as infertility or tumors, which may be associated with FSH levels that are too low or too high.

High

If your FSH test results show high values and you are a woman, the following conditions may be present:

• Primary ovarian insufficiency, where the ovaries cease functioning prematurely, typically before the age of 40
• Polycystic ovary syndrome (PCOS)
• Entering menopause or perimenopause
• Ovarian tumors
• Turner syndrome

For men, high FSH levels may indicate:

• A disorder affecting the testicles, such as damage from chemotherapy, radiation therapy, infection, or alcohol abuse
• Klinefelter syndrome

Consult the Right Doctor

FSH test results in adults can be discussed with a general practitioner for further evaluation or to initiate appropriate treatment. You may also consult an obstetrician or andrologist for more in-depth guidance regarding your FSH results. In pediatric cases, any abnormal results should be reviewed with a pediatrician.

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