How often should I get my FSH levels checked?

When you are trying to get pregnant actively, or experiencing something such as irregular periods, your doctor might advise you to test your FSH levels early on in your most fertile days. In fertility treatment planning, repeat testing may be recommended.

Is high FSH always a sign of infertility?

Not always. Although elevated FSH may indicate a lower ovarian reserve, numerous women with elevated levels conceive spontaneously or with intervention. Other hormones and egg quality should also be evaluated.

Understanding High and Low FSH Levels in Your Menstrual Cycle

Whether you are trying to conceive or just monitoring your menstrual health, you may have heard of FSH- Follicle-Stimulating hormone. However, the question is, what exactly does this hormone do, and why does its level matter?

What Is FSH and Why Is It Important?

FSH is an abbreviation of Follicle-Stimulating Hormone. It is synthesised in a tiny section of your brain known as the pituitary gland. What is its primary mission? To support your ovaries in creating mature eggs monthly. FSH tells your ovaries to make a couple of follicles (containing eggs) when your menstrual cycle starts. One of these large follicles will then ovulate, releasing an egg.

In other words, FSH assists with the management of your cycle and is a major contributor to your fertility.

What Does “Normal” FSH Look Like?

A blood test is used to measure FSH, typically on Day 2 or 3 of your cycle (1-2 days after your period begins). This is the point at which the baseline level provides the best assessment of your ovarian reserve, or the number and quality of eggs remaining.

Here's a general idea of FSH levels (in mIU/mL):

Standard: 4.7 to 10 (can vary slightly between labs)
Low FSH: Below 4.7
High FSH: Above 10 (especially if it’s over 20, it might be concerning)

Keep in mind that FSH levels naturally rise with age, especially after 35.

What Happens When FSH Is Too High?

When your FSH level is high, it indicates that the ovaries are not responding positively to the hormone. In case of improper reaction of the ovaries, your brain releases more FSH in an attempt to make them react.

This tends to take place when:

You have low ovarian reserve (fewer or poor-quality eggs).
You are approaching menopause.
You’ve had ovarian surgery or specific medical treatments.
There’s early ovarian failure or a genetic condition.

How High FSH Affects Your Cycle and Fertility?

When FSH is too high:

Your periods may become irregular or even stop.
Ovulation may not occur every cycle.
It might be harder to get pregnant naturally.
Fertility treatments may not work as effectively.

However, do not get frightened about the fact that you have a high FSH. It is only a part of the puzzle. Your doctor may also examine other hormones and conduct tests, such as AMH (Anti-Müllerian Hormone) and ultrasounds, to obtain a comprehensive picture of your fertility health.

What Happens When FSH Is Too Low?

Conversely, when your FSH is too low, it indicates a lack of sufficient levels of the hormone in your brain to develop eggs. This may occur as a result of:

Extreme stress.
Under-eating or being underweight
Excessive exercise
Certain pituitary disorders

How Low FSH Affects Your Cycle and Fertility?

Low FSH can lead to:

Missed periods or very light periods.
No ovulation (anovulatory cycles).
Hormonal imbalance with high levels of other hormones, like LH.
Difficulty in conceiving, especially if ovulation isn’t regular.

Low FSH is usually more manageable than high FSH. Once the cause is identified, such as a lifestyle or dietary issue, it can often be corrected with medical help and support.

Can You Lower or Improve FSH Levels?

Technically, one cannot compel their body to alter its FSH level due to age or genetics. However, there are things you can do to help balance your hormones overall:

Maintain a well-balanced, healthy diet that includes a variety of fats, proteins, and complex carbohydrates.
Reduce your intake of caffeine, alcohol, and refined foods.
Deal with stress by meditating, practising yoga, or engaging in gentle exercise.
Are you underweight or overtraining? Make an effort to add balance.
Certain physicians may recommend supplements such as CoQ10, DHEA, or specific vitamins, but only after consulting with a medical professional.

Can You Still Get Pregnant with High or Low FSH?

Yes, not all of them with high or low levels of FSH fail to conceive, but it may take them longer than usual, or they may need medical assistance. There are treatment options available, including:

Ovulation-inducing medications.
IVF or IUI treatments.
Donor eggs are used in some cases of high FSH and low ovarian reserve.
Lifestyle adjustments, especially in cases of low FSH, can be beneficial due to stress or poor nutrition.

Your FSH level is a measure of how your body communicates to you about the performance of your ovaries. Having a high FSH may indicate that your body is making every effort to trigger your ovaries, which is usually the case following a low number of eggs. One of the possible implications of FSH being low is that your brain is not prompted enough to trigger ovulation.

Being aware of your FSH can provide beneficial information, particularly when you are attempting to conceive or you experience abnormal periods. However, do not forget that this is only one of the many intricacies of your reproductive system. The best way to move forward is to talk to a doctor, understand your hormone picture, and explore the proper treatment or lifestyle approach.

FAQs on Understanding High vs Low FSH in Your Cycle

How often should I get my FSH levels checked?
When you are trying to get pregnant actively, or experiencing something such as irregular periods, your doctor might advise you to test your FSH levels early on in your most fertile days. In fertility treatment planning, repeat testing may be recommended.
Is high FSH always a sign of infertility?
Not always. Although elevated FSH may indicate a lower ovarian reserve, numerous women with elevated levels conceive spontaneously or with intervention. Other hormones and egg quality should also be evaluated.