At a Glance

Why Get Tested?

To evaluate fertility issues, the health of your reproductive organs (ovaries or testicles), or pituitary function

In children, to evaluate early or delayed puberty

When To Get Tested?

For women, when you are having difficulty getting pregnant or are having irregular or no menstrual periods

For men, when your partner cannot get pregnant, or you have a low sperm count, low muscle mass or decreased sex drive

When your health care practitioner thinks that you have symptoms of a pituitary disorder or hypothalamic disorder

When a health care practitioner suspects that a child has delayed or earlier than expected puberty

Sample Required?

A blood sample is drawn by needle from a vein.

Test Preparation Needed?

No test preparation is needed, but a woman’s sample should be collected at specific times during her menstrual cycle.

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What is being tested?

Follicle-stimulating hormone (FSH) is a hormone associated with reproduction and the development of eggs in women and sperm in men. This test measures FSH in the blood.

FSH is made by the pituitary gland, a small organ located in the center of the head behind the sinus cavity at the base of the brain. Control of FSH production is a complex system involving the hypothalamus in the brain, the pituitary gland, and the hormones produced by the ovaries or testicles. The hypothalamus releases gonadotropin-releasing hormone (GnRH), which stimulates the pituitary to release FSH and luteinizing hormone (LH), a closely related hormone also involved in reproduction.

In women of childbearing age, FSH stimulates the growth and maturation of eggs (follicles) in the ovaries during the follicular phase of the menstrual cycle. The menstrual cycle is divided into the follicular and the luteal phases, with each phase lasting about 14 days. During this follicular phase, FSH initiates the production of estradiol by the follicle, and the two hormones work together in the further development of the egg follicle. Near the end of the follicular phase, there is a surge of FSH and luteinizing hormone. Release of the egg from the ovary (ovulation) occurs shortly after this surge of hormones. The hormone inhibin as well as estradiol and progesterone help control the amount of FSH released by the pituitary gland. FSH also facilitates the ability of the ovary to respond to LH.As a woman ages and menopause approaches, ovarian function wanes and eventually ceases. As this occurs, FSH and LH levels rise.
In men, FSH stimulates the testicles to produce mature sperm and also promotes the production of androgen binding proteins. FSH levels are relatively constant in men after puberty. Less is known about FSH levels in aging men.
In infants and children, FSH levels rise shortly after birth and then fall to very low levels by 6 months in boys and 1-2 years in girls. Concentrations begin to rise again before the beginning of puberty and the development of secondary sexual characteristics.

Disorders affecting the hypothalamus, pituitary, and/or the ovaries or testicles can cause the production of too much or too little FSH, resulting in a variety of conditions such as infertility, abnormal menstrual cycles, or early (precocious) or delayed puberty.

Common Questions

How is the test used?

The test for follicle-stimulating hormone (FSH) may be used with other hormone tests such as luteinizing hormone (LH), testosterone, estradiol, and/or progesterone to help:

Determine the cause of infertility
Diagnose conditions associated with dysfunction of the ovaries or testicles
Aid in the diagnosis of pituitary or hypothalamus disorders, which can affect FSH production

In women, FSH levels are also useful in:

The investigation of menstrual irregularities
Predicting when or if a woman is entering menopause

In men, FSH levels are used to help determine the reason for a low sperm count.

In children, FSH and LH are used to help diagnose delayed or precocious (early) puberty. Irregular timing of puberty may be an indication of a more serious problem involving the hypothalamus, the pituitary gland, the ovaries or testicles, or other systems. The measurement of LH and FSH may differentiate between normal patterns of development and true disease. Once it is established that symptoms are a result of true disease, further testing can be done to identify the underlying cause.

When is it ordered?

For a woman, an FSH test may be ordered when she is having difficulty getting pregnant, has irregular or an absence of menstrual periods, or sometimes when it is suspected that she has entered menopause.

For a man, the test may be ordered when his partner cannot get pregnant, when he has a low sperm count, or when he has low muscle mass or decreased sex drive, for example.

In both women and men, testing may be ordered when a healthcare practitioner suspects that a pituitary disorder is present. A pituitary disorder can affect the production of several different hormones, so there may be signs and symptoms in addition to some of those listed above. They can include fatigue, weakness, unexplained weight loss, and decreased appetite to name a few.

In children, FSH and LH may be ordered when a boy or girl does not appear to be entering puberty at an appropriate age (either too late or too soon). Signs of puberty may include:

Breast enlargement in girls
Growth of pubic hair
Growth of the testicles and penis in boys
Beginning of menstruation in girls

What does the test result mean?

Results of an FSH test are typically considered with results of other hormone tests, such as LH , estrogens, and/or testosterone.

As part of an infertility workup, a high or low FSH is not diagnostic but provides a piece of information on what may be the cause. For example, a hormone imbalance may affect a woman’s menstrual cycle and/or ovulation. A health care practitioner will consider all the information from the workup to establish a diagnosis.

In Women

FSH and LH levels can help to differentiate between a condition affecting the ovaries themselves (primary) and dysfunction of the ovaries due to disorders of either the pituitary or the hypothalamus (secondary).

High levels of FSH and LH are consistent with conditions affecting the ovaries themselves. Some examples include:

Developmental defects:

Failure to develop ovaries (ovarian agenesis)
Chromosome disorder, such as Turner syndrome
Defect in the steroid production by the ovaries, such as 17 alpha hydroxylase deficiency

Damage to the ovaries due to:

Radiation exposure
Chemotherapy
Autoimmune disease

Underlying conditions that affect ovary function, such as:

Polycystic ovary syndrome (PCOS)
Adrenal disease
Thyroid disease
Ovarian tumor

When a woman enters menopause and her ovaries stop working, FSH levels will rise.

Low levels of FSH and LH are consistent with a pituitary disorder or problem with the hypothalamus.

Low FSH serum levels have been associated with increased risk of ovarian cancer.

In Men

High FSH levels are due to conditions affecting the testicles themselves. Some examples include:

Viral infection (mumps)
Trauma, injury
Radiation exposure
Chemotherapy
Autoimmune disease
Germ cell tumor
Failure to develop normal gonads (gonadal agenesis)
Chromosome disorder, such as Klinefelter syndrome

Low levels are consistent with pituitary or hypothalamic disorders.

In Children

Higher levels of FSH and LH than expected for age plus the development of secondary sexual characteristics at an unusually young age are an indication of early puberty. This is much more common in girls than in boys. This premature development is usually due to a problem with the central nervous system and can have a few different underlying causes. Examples include:

Central nervous system tumor
Brain injury, trauma
Inflammation within the central nervous system (e.g. meningitis, encephalitis)

Normal prepubescent levels of LH and FSH in children exhibiting some signs of puberty may indicate a condition called “peripheral precocious puberty.” The signs and symptoms are brought on by elevated levels of the hormones estrogen or testosterone. This may be caused by:

Tumors that produce and release hormones
Adrenal gland tumors
Ovarian tumors or cysts
Testicular tumors

Normal FSH and LH levels with a few signs of puberty (e.g., development of pubic hair and acne) may signal a previous environmental exposure to agents, such as testosterone cream or gel, or may be a normal variation of puberty.

In delayed puberty, LH and FSH levels can be normal or below what is expected for a youth within this age range. Examples of some causes of delayed puberty include:

Dysfunction of the ovaries or testicles
Hormone deficiency
Turner syndrome
Klinefelter syndrome
Chronic infections
Cancer
Eating disorder (anorexia nervosa)

I’m having a hard time getting pregnant. What tests do I need?

Basic tests for infertility often include measuring FSH and luteinizing hormone (LH) levels. Your health care provider may also ask you to keep track of your body temperature, which rises slightly during ovulation. Other hormonal tests as well as a postcoital (after intercourse) examination may be done. A hysterosalpingogram (image of fallopian tubes) may be ordered to see whether your fallopian tubes are blocked. Your partner may be asked to give a specimen of semen for analysis.

Why would a man need a test for FSH and LH? I thought these were female hormones.

Men also produce FSH and LH. These hormone levels are important for male reproduction too. In men, FSH stimulates the testicles to produce sperm just as in women FSH stimulates the ovaries to produce eggs. In men, LH can be measured if testosterone levels are low.

Is there a home test for FSH?

Yes. There is an FDA-approved self-test that measures the level of FSH in a urine sample. It is used as an indicator of menopause and perimenopause, which are associated with a rise in FSH levels. For more information, see this FDA website.

Is there anything else I should know?

FSH results can be increased with use of certain drugs, including cimetidine, clomiphene, digitalis, and levodopa. FSH results can be falsely elevated in people who are taking large doses of biotin as this can interfere with immunoassays. FSH results can be decreased with oral contraceptives, phenothiazines, and hormone treatments. FSH will also be low when women are pregnant.

Related Images

The female reproductive system, including the ovaries. Image credit: Don Bliss, NCI
A side view of the male reproductive system, including a testicle. Image credit: National Cancer Institute

Looking For Test Results?

Looking For Reference Ranges?

You may be able to find your test results on your laboratory’s website or patient portal. However, you are currently at Testing.com. You may have been directed here by your lab’s website in order to provide you with background information about the test(s) you had performed. You will need to return to your lab’s website or portal, or contact your healthcare practitioner in order to obtain your test results.

Testing.com is an award-winning patient education website offering information on laboratory tests. The content on the site, which has been reviewed by laboratory scientists and other medical professionals, provides general explanations of what results might mean for each test listed on the site, such as what a high or low value might suggest to your healthcare practitioner about your health or medical condition.

The reference ranges for your tests can be found on your laboratory report. They are typically found to the right of your results.

If you do not have your lab report, consult your healthcare provider or the laboratory that performed the test(s) to obtain the reference range.

Laboratory test results are not meaningful by themselves. Their meaning comes from comparison to reference ranges. Reference ranges are the values expected for a healthy person. They are sometimes called “normal” values. By comparing your test results with reference values, you and your healthcare provider can see if any of your test results fall outside the range of expected values. Values that are outside expected ranges can provide clues to help identify possible conditions or diseases.

While accuracy of laboratory testing has significantly evolved over the past few decades, some lab-to-lab variability can occur due to differences in testing equipment, chemical reagents, and techniques. This is a reason why so few reference ranges are provided on this site. It is important to know that you must use the range supplied by the laboratory that performed your test to evaluate whether your results are “within normal limits.”

For more information, please read the article Reference Ranges and What They Mean.

View Sources

Sources Used in Current Review

Jabbour, S. (2018 March 12, Updated). Follicle-Stimulating Hormone Abnormalities. Medscape Endocrinology. Available online at https://emedicine.medscape.com/article/118810-overview#showall. Accessed on 5/05/19.

Sofronescu, A. and Wheeler, T. (2015 July 16, Updated). Follicle-Stimulating Hormone (FSH). Medscape Laboratory Medicine. Available online at https://emedicine.medscape.com/article/2089048-overview#showall. Accessed on 5/05/19.

(© 1995–2019). Follicle-Stimulating Hormone, Serum. Mayo Clinic Mayo Medical Laboratories. Available online at https://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/602753. Accessed on 5/05/19.

Bayrak-Toydemir, P. et. al. (July 2017, Updated). Infertility. ARUP Consult. Available online at https://arupconsult.com/content/infertility. Accessed on 5/05/19.

Corenblum, B. and Mulinda, J. (2018 June 19, Updated). Hypopituitarism (Panhypopituitarism). Medscape Endocrinology. Available online at https://emedicine.medscape.com/article/122287-overview. Accessed on 5/05/19.

Genzen, J. et. al. (2018 March, Updated). Amenorrhea. ARUP Consult. Available online at https://arupconsult.com/content/amenorrhea?_ga=2.71540243.1479446145.1525530915-171446445.1522145782. Accessed on 5/05/19.

Sources Used in Previous Reviews

Corbett, JV. Laboratory Tests & Diagnostic Procedures with Nursing Diagnoses, 4th ed. Stamford, Conn.: Appleton & Lang, 1996. Pp 429-431, 726.

Clinical Guide to Laboratory Tests. 3rd ed. Tietz N, ed. Philadelphia: W.B. Saunders & Co; 1995: 248-249, 210-211.

The InterNational Council on Infertility Information Dissemination, PCOS in Pediatrics: When and How Does it Start? Originally written and presented by Silva Arslanian, MD, Children’s Hospital of Pittsburgh, Pittsburgh, PA; summarized in online version by Christine M. Schroeder, PhD. Available online at http://www.inciid.org/pcos/PCOS-pediatrics.html.

Gonadotropins: Luteinizing and Follicle Stimulating Hormones. Available online at http://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/hypopit/lhfsh.html.

Blondell RD, Foster MB, Kamlesh CD. Disorders of Puberty. American Family Physician, July 1999 (online publication). Available online at http://www.aafp.org/afp/990700ap/209.html.

Hormone Society. Fact Sheet on Female Infertility. Available online at http://www.endo-society.org/pubrelations/patientInfo/infertility.htm.

The Hormone Foundation. Fact sheet on Polycystic Ovary Syndrome (PCOS). Available online at http://www.hormone.org/pcos_factsheet.html.

Laurence M. Demers, PhD. Distinguished Professor of Pathology and Medicine, The Pennsylvania State University College of Medicine, The M. S. Hershey Medical Center, Hershey, PA.

A Manual of Laboratory & Diagnostic Tests. 6th ed. Fischbach F, ed. Philadelphia: Lippincott Williams & Wilkins; 2000.

Pagana K, Pagana T. Mosby’s Manual of Diagnostic and Laboratory Tests. St. Louis: Mosby; 1998.

Davis B, Mass D, Bishop M. Principles of lCinical Laboratory Utilization and Consultation. Saunders; 1999.

Thompason, Sharon. LH response to GnRH. (Updated Aug 2005) MedlinePlus (online information). Available at http://www.nlm.nih.gov/medlineplus/print/ency/article/003709.htm.

Neely EK, Wilson DM, Lee PA, Stene M, Hintz RL (July 1995). Spontaneous serum gonadotropin concentrations in the evaluation of precocious puberty. J Pediatric 127(1):47-52 from PubMed. Available online at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=7608810.

Nirupama Kakarla, M.D.; Karen D. Bradshaw, M.D. (Posted 03/05/2004.) Disorders of Pubertal Development: Precocious Puberty. From Seminars in Reproductive Medicine 21(4):339-351 from Medscape. Available online at http://www.medscape.com/viewarticle/468259.

Brito VN, Batista MC, Borges MF, Latronico AC, Kohek MB, Thirone AC, Jorge BH, Arnhold IJ, Mendonca BB. (1999 Oct) Diagnostic value of fluorometric assays in the evaluation of precocious puberty. J Clin Endocrinol Metab. 84(10):3539-44. Available online through http://www.ncbi.nlm.nih.gov.

Sheehan, M (Dec 2003). Polycystic Ovarian Syndrome: Diagnosis and Management. Clinical Medicine and Research, 2(1): 13-27. Available online at http://www.pubmedcentral.gov/articlerender.fcgi?artid+1069067.

Storck, S. (Updated 2009 September 2). FSH. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003710.htm. Accessed February 2010.

Jabbour, S. (Updated 2009 June 15). Follicle-Stimulating Hormone Abnormalities. eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/118810-overview. Accessed February 2010.

Meikle, A. W. et. al. (Updated 2009 November). Amenorrhea. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/Amenorrhea.html#. Accessed February 2010.

Brzyski, R. and Jensen, J. (Revised 2007 March) Female Reproductive Endocrinology, Introduction. Merck Manual for Healthcare Professionals [On-line information]. Available online at http://www.merck.com/mmpe/sec18/ch243/ch243a.html?qt=FSH&alt=sh. Accessed February 2010.

MayoClinic.com: Menopause. Available online at http://www.mayoclinic.com/health/menopause/DS00119. Accessed February 2010.

National Institute on Aging: Menopause. Available online at http://www.nia.nih.gov/HealthInformation/Publications/menopause.htm. Accessed February 2010.

MedlinePlus Health Topics: Female Reproductive System. Available online at http://www.nlm.nih.gov/medlineplus/femalereproductivesystem.html. Accessed February 2010.

Helzisouer KJ, Alberg AJ, Gordon GB, et al. Serum gonadotropins and steroid hormones and the development of ovarian cancer. JAMA 274(24):1926-1930, 1995.

Backer LC, Rubin CS, Kieszak SM, et al. Serum follicle stimulating hormone and national health and nutrition examination survey (NANES III, 1988-1994). Menopause 6(1):29-35, 1999.

Lin, J. (Updated 2012 February 16). Follicle-Stimulating Hormone (FSH). Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/2089048-overview. Accessed April 2014.

Jabbour, S. (Updated 2012 January 3). Follicle-Stimulating Hormone Abnormalities. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/118810-overview. Accessed April 2014.

Coney, P. (Updated 2014 April 7). Menopause. Medscape Reference [On-line information]. Available online at [On-line information]. Available online at http://emedicine.medscape.com/article/264088-overview. Accessed April 2014.

Meikle, A. and Straseski, J. (Updated 2013 November). Infertility. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/Infertility.html?client_ID=LTD#tabs=0. Accessed April 2014.

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(Updated September 9, 2013) National Institutes of Health Office of Rare Diseases Research. Klinefelter Syndrome. Available online at http://rarediseases.info.nih.gov/gard/8705/klinefelter-syndrome/resources/9. Accessed April 2014.

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Kaplowitz, P. (Updated 2013 February 11). Precocious Puberty. Medscape Reference [On-line information]. Available online at http://emedicine.medscape.com/article/924002-overview. Accessed April 2014.

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Follicle-stimulating Hormone (FSH)

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Trustworthy Medical Support

Health Records You Control

At a Glance

Why Get Tested?

When To Get Tested?

Sample Required?

Test Preparation Needed?

Order your at-home health test online

Order the right test for you.

Collect your sample

Discreet Packaging

Get 25% Off

Discreet Packaging

Trustworthy Medical Support

Health Records You Control

What is being tested?

Common Questions

How is the test used?

When is it ordered?

What does the test result mean?

I’m having a hard time getting pregnant. What tests do I need?

Why would a man need a test for FSH and LH? I thought these were female hormones.

Is there a home test for FSH?

Is there anything else I should know?

Related Images

Looking For Test Results?

Looking For Reference Ranges?

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