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MENOPAUSE ‘ASK THE EXPERTS’ QUESTIONS & ANSWERS

Tuesday, November 2nd, 2021

The following ‘Ask the Experts’ questions were sent in to The Menopause Exchange by our members, the answers were provided by our ‘Ask the Experts’ panel and included in issue 87 (winter 2020/21) and issue 88 (spring 2021) of The Menopause Exchange newsletter.  If you would like to read the questions and answers in the latest issue of The Menopause Exchange newsletter sign up for FREE emailed newsletters.

What do follicle-stimulating hormone (FSH) levels indicate, and what are the normal levels for women in the perimenopause, at the menopause and after the menopause?

Mr Nick Panay, consultant gynaecologist, replies:

FSH is a hormone made by the anterior pituitary gland in your head. It triggers the release of oestrogen from an ovary. When oestrogen levels fall at the menopause, FSH levels start to rise by a mechanism called “negative feedback” to try to make more oestrogen. But, because the follicles that make oestrogen (and eggs) eventually run out, oestrogen levels remain low. FSH levels remain higher than normal for many years but eventually start to drop. FSH levels vary during your normal menstrual cycle so it’s important that the timing of your blood test is recorded according to the day of your cycle. FSH levels usually remain below 10 International units per litre (IU/L) except at ovulation when levels can increase to more than 20 IU/L. In the perimenopause, FSH can change in a more exaggerated way, although levels usually remain below 40 IU/L. At the menopause, FSH levels are typically more than 40 IU/L and can even be more than 100 IU/L. After the menopause, FSH can remain higher than normal for many years, although eventually levels fall to below 10 IU/L due to the loss of the negative feedback. In the past, FSH was measured to confirm the diagnosis of menopause, but the NICE Menopause: diagnosis and management guideline published in 2015 advised that an FSH test wasn’t required to confirm menopause in women aged 45 years or higher once their periods have stopped and they are experiencing typical hot flushes and sweats. (more…)

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