why are fsh levels high in menopause?
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FSH causes ovarian follicles to enlarge and produce estrogen. Over time, fewer and fewer follicles remain to be stimulated and thus estrogen levels decline as a woman ages. This decline in estrogen leads to an increase in FSH as there is not enough estrogen being produced to "turn off" the brain's production of FSH.
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During perimenopause (the time period before menopause), there is a marked decrease in ovarian estrogen production. This is associated with an increase in heart rate (sinus tachycardia) and an increased frequency in palpitations and non-threatening arrhythmias, such as premature ventricular contractions or PVCs.
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The follicle-stimulating hormone (FSH) level should be checked to rule out primary ovarian failure. In patients with PCOS, FSH levels are within the reference range or low. Luteinizing hormone (LH) levels are elevated for Tanner stage, sex, and age. The LH-to-FSH ratio is usually greater than 3.
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Gonadotropin levels greater than 30 mIU/ml are typically diagnostic of menopause, with the ratio of FSH to luteinizing hormone (LH) being greater than 1. After oophorectomy in a woman of reproductive age, there is a variable rise in gonadotropins. It may take more than a month for final menopausal levels to be reached.
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Before menopause, most estrogens are produced in the ovaries. After menopause, the ovaries no longer produce much estrogen and estrogens mainly come from fat tissue. Higher amounts of estrogen in the blood are linked to an increased risk of breast cancer in women after menopause [19].
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It's possible the same thing happens with women when estrogen levels drop after menopause. Some evidence suggests that estrogen hormone therapy increases a woman's resting metabolic rate. This might help slow weight gain.
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According to a recent article in Psychology Today, “in perimenopause, levels of the hunger-stimulating hormone ghrelin increase, a reason why many women find themselves frequently hungry during this phase. Levels of the hormone leptin, which promotes a sense of fullness, reduce throughout peri- and postmenopause.”
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Hormone changes during menopause affect how your body responds to insulin. That makes it hard for your body to keep your blood sugar stable. Changes to blood sugar levels can make you dizzy.
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Symptoms of high FSH in females often mimic those of menopause, including irregular periods, hot flashes, and headaches. In couples actively trying to conceive, difficulty getting pregnant can also be a sign.
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The term “ovarian reserve” refers to a woman's age-related fertility potential. A high FSH level means your chances of becoming pregnant may be lower than expected for your age. This doesn't mean you have no chance of conceiving, but you may have more difficulty and need infertility treatment.
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Changes in hormones during menopause can lead to weight gain and make your blood pressure more sensitive to salt in your diet — which, in turn, can lead to higher blood pressure. Some types of hormone therapy (HT) for menopause also may lead to higher blood pressure.
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For most women, this occurs somewhere between the ages of 40 and 55, with an average age of 51. Once you've reached menopause, your LH and FSH levels remain high and your estrogen and progesterone levels remain low. You no longer ovulate and you cannot conceive a child.
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For women who are not ovulating regularly, the cause is usually that the ovary is not receiving the appropriately timed signals to mature and release an egg. The pituitary gland, at the base of the brain, produces the hormones that control the ovaries – FSH (follicle stimulating hormone) and LH (luteinizing hormone).
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As your ovaries age and release fewer hormones, FSH and LH can no longer perform their usual functions to regulate your estrogen, progesterone and testosterone. These inevitable changes in your hormones and natural decline of estrogen levels during menopause can significantly affect your health for years to come.
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FSH stimulates an immature follicle to grow. Once it is grown, it releases estradiol, which signals the release of GnRH and LH, prompting ovulation. Prior to ovulation, FSH levels will peak, signaling the ovary to release an egg.
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If no egg has been fertilized, estrogen and progesterone levels are low. As a result, the top layers of the endometrium are shed, and menstrual bleeding occurs. About this time, the pituitary gland slightly increases its production of follicle-stimulating hormone.
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Too much or too little FSH can cause a variety of problems, including infertility (the inability to get pregnant), menstrual difficulties in women, low sex drive in men, and early or delayed puberty in children.