Hormonal analysis in women: what are the normal levels?

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The hormonal examination is done to study the level of female hormones responsible for regulating the ovarian cycle and thus determine its influence on fertility. The main hormones that are analyzed are: progesterone, FSH, LH, estradiol, antimulleriana, prolactin and TSH.

Together with the transvaginal ultrasound, the hormonal analysis allows to define the state of the ovarian reserve of the woman. This is very helpful in determining your fertility potential, since it refers to the total number of oocytes a woman has.

Below you have an index with all the points that we will discuss in this article.

Index

Hormonal analysis in women: what are the normal levels?

Analysis of female hormones

The menstrual cycle is regulated by the hypothalamic-pituitary-ovary axis.

Any anomaly or irregularity that affects the release of hormones from this axis can lead to alterations in the menstrual cycle that in turn cause fertility problems. Therefore, hormonal analysis is key in the study of female fertility.

There are two clearly differentiated parts in this regulation: hypothalamic-pituitary control and ovarian control. As we can see in the image, the pituitary hormones (FSH and LH) activate the release of the ovarian hormones (estradiol and progesterone) that exert their action on the uterus and also on the pituitary gland. Thus, pituitary hormones are activated or blocked again, closing the cycle. This is what is known as feed-back regulation or feedback.

Hormonal control of the menstrual cycle

Pituitary hormones

Follicle stimulating hormone (FSH) and luteinizing hormone (LH) are the main sex hormones of women secreted by the pituitary gland. TSH and prolactin are also hormones released by the pituitary or pituitary gland with influence on the ovarian cycle. We detail below the function of each of them:

  • Follicle stimulating hormone (FSH): is a gonadotropin that acts on the ovary, favoring the development and maturation of the ovarian follicles (small sacks where the ovules grow and mature).
  • Luteinizing hormone (LH): this is a pituitary gonadotropin responsible for follicular maturation, ovulation (exit of the ovule), the onset of the corpus luteum (empty follicle after ovulation) and the secretion of progesterone by the latter.
  • Thyroid stimulating hormone (TSH): is a hormone released by the pituitary gland that exerts its action on the thyroid gland, regulating its activity.
  • Prolactin: This hormone is especially important during pregnancy. It stimulates the production of milk in the mammary glands and the synthesis of progesterone in the corpus luteum.

Ovarian hormones

The ovary, promoted by the pituitary hormones, initiates the release of hormones such as the following, which are also essential to complete the ovarian cycle.

  • Estradiol (E2): is a estrogen hormone that, among other functions related to sexual development, activates the release of LH, thus inducing ovulation. In addition, together with progesterone, it intervenes in the preparation of the endometrium for embryo implantation. During the menstrual cycle it is released by the growing follicle.
  • Progesterone (P4): is a steroid hormone, released mainly by the corpus luteum and the placenta (in case of pregnancy) acts during the second phase of the menstrual cycle preparing the endometrium for embryo implantation. It is also responsible for maintaining the emdometrium during pregnancy. If this does not occur, its level drops and causes the expulsion of the endometrium in what we know as menstruation.
  • Antimülleriana hormone (AMH): they secrete the cells of the granula in the ovary during the reproductive life of the woman. It has a fundamental role in the formation and development of follicles. It is used as an indication of the ovarian reserve.

If you want more information about sex hormones you can consult this article: male and female sex hormones.

Normal hormonal values

For the ovarian cycle of women to allow ovulation and thus fertilization and pregnancy, it is essential that the female hormonal system is well regulated. The way to control that the regulation is correct is by measuring the level of sex hormones in blood and comparing them with normal or reference values.

Normal values ??of female hormones

The study of reproductive hormones should be performed on day 2 or 3 of the cycle, except for progesterone that should be studied on day 21.

  • FSH: help determine the ovarian reserve. A level of between 3 to 9 mUI / ml is indicative of good ovarian reserve. FSH values ??below 6 indicate an excellent ovarian reserve, from 6 to 9 good, between 9 and 10 moderate and from 10 to 13 is indicative of a decreased ovarian reserve. Values ??above 13 mIU / ml. they show a very low ovarian reserve.
  • LH: its values ??should be between 2 and 10 mIU / ml. The increase in LH above 20 mIU / ml shows that ovulation is about to occur. Together with progesterone it helps to determine if ovulation occurs normally.
  • TSH: must present values ??between 0.2 and 4.7 mUI / ml on day 3 of the cycle. Values ??above and below indicate hyper and hypothyroidism respectively. Both alterations can negatively influence ovulation and therefore affect fertility.
  • Estradiol (E2): its values ??at the beginning of the cycle range from 27 pg / ml to approximately 161 pg / ml. Values ??below 50 pg / ml are ideal in a fertile woman. Abnormally elevated levels may indicate presence of cyst or low ovarian reserve.
  • Progesterone (P4): the normal values ??of progesterone on day 21 of the cycle should be between 5 and 20 ng / ml to affirm that ovulation has occurred. Ideally, they should exceed 10 ng / ml. On day 3, progesterone should be less than 1.5 ng / ml.
  • Prolactin: in non-pregnant women the values ??range between 0 and 20 ng / ml and in pregnant women from 10 to 300 ng / ml. Out-of-pregnancy values ??above 80 ng / ml suggest a malfunction of the pituitary gland that may be caused by a tumor or by PCOS (polycystic ovarian syndrome).

    It is important to note that when especially high levels of prolactin (hyperprolactinemia) appear, hormonal regulation may be altered and therefore also ovulation.

  • AMH: values ??between 0.7-1 and 3.5 ng / ml are normal and below 0.7-1 ng / ml indicate low ovarian reserve. Values ??above 3.5 ng / ml may indicate excessive ovarian development and therefore special care should be taken with stimulation in assisted reproduction treatments.

Other hormones

Although these hormones are less commonly tested, in some situations they can be helpful in diagnosing the fertility problem.

  • Free Triodothyronine (T3): helps evaluate thyroid function. Your values ??on day 3 should be between 1.4 and 4.4 pg / ml approximately.
  • Free Thyroxine (T4): should be between 0.8 and 2 ng / dl. Low values ??may indicate poor thyroid gland insufficiency or poor functioning of the pituitary gland.
  • Total Testosterone (T): the normal values ??in women are between 24 and 47 ng / dl. Very high values ??may indicate polycystic ovary syndrome (PCOS).
  • Inhibin B: values ??below 45 pg / ml show changes in the ovarian reserve or poor response to stimulation

Questions from users

Is it serious to have the hormone progesterone below the reference value on day 21?

A low progesterone hormone value on day 21 of the cycle may be indicative that ovulation (ovum ovum output) has not occurred and therefore pregnancy will not be possible.

Does low antimullerian hormone indicate a low ovarian reserve?

Yes, although it will be necessary to corroborate it with other tests to determine the ovarian reserve, such as the FSH analysis or the antral follicle count by transvaginal ultrasound.

Can the level of female hormones be affected by anxiety?

Yes, stress and anxiety can influence the hormonal system and therefore affect the functioning of the menstrual cycle.

When should hormonal analysis be done to study fertility?

The ideal is to do the FSH, LH and estradiol test on day 3 of the menstrual cycle, that is, on the third day after the rule falls. Progesterone must be analyzed on day 21 of the cycle. The antimullerian hormone test can be done on any day of the cycle, because its value does not depend on the moment of the cycle.

What are the female injectable hormones for?

The injections of female hormones are used in assisted reproduction to externally control the reproductive cycle and thus be able to optimize the ovarian stimulation process applied in fertility treatments to achieve better results.

If you want more information about it, you can consult this article: stimulation of the ovary.


sexual health advice in Madrid(Spain)

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