LH and FSH are hormones produced by the pituitary gland in the brain. These hormones are responsible for ensuring the normal function of the ovaries and the menstrual cycle.

Testosterone is the main male sex hormone, but levels are also important in women.

Free Androgen Index (FAI) is a marker of how much “active” testosterone is circulating in your body.

Hormones are found in saliva, urine, and blood. While all of these specimen samples can be used to test female hormone levels, blood testing is the most sensitive and accurate method.

It’s important to note that not all female hormone tests are treated equally. Some blood test panels are tailored specifically for fertility and evaluating the reproductive abilities of women, while others are focused on Menopause, puberty, and other specific conditions. The best way to test female hormones is a blood test that covers specific markers of interest, such as Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH), Oestradiol, Prolactin, Testosterone and Sex-hormone Binding Globulin (SHBG), which all play a role in a woman’s reproductive health.

When it comes to testing hormones in women, the timing of the test is very important. For females that are having periods, it’s generally best to test hormone levels on day 3 of their menstrual cycle, assuming a typical 28-day cycle. (Day one begins at the start of the menstrual period.)

For women who experience longer cycles (e.g. 40-day cycles), it’s also advised to conduct the test on day 3.This is because it’s generally recommended to assess certain health and hormonal markers during a woman’s early follicular phase, which is characterised by low progesterone and low levels of LH and FSH. This means that any tendency towards menopause or low ovarian reserve will be picked up.

In situations in which a woman is not menstruating, a female hormone blood test can be done at any time.

Although FSH levels will vary widely depending on a woman’s age, stage of life, and menstrual period, FSH levels typically need to be at an optimum level depending on the stage of the cycle for a woman to conceive. When FSH levels are either too low or too high, it can be much more difficult to get pregnant because FSH has such a profound effect on a woman’s menstrual cycle and whether or not she ovulates.

Perimenopause, or the transition period before menopause, can last for several years in some women. Generally, FSH levels are higher than normal but during this stage, FSH levels are also known to fluctuate. Because of this variation of FSH, testing for FSH alone can be misleading in determining perimenopause. Instead, a more comprehensive assessment of markers, including LH and oestrogen are needed for a menopause test.

It is possible to lower FSH levels with oestrogen medication and birth control pills. Lifestyle changes like reducing stress, losing weight, diet, exercise, herbal supplements, and acupuncture have also supposedly been reported to help lower FSH levels.It’s critical to note that reducing high FSH levels will not directly influence a woman’s ovarian reserve or her chances of getting pregnant. In other words, the primary issue is egg quality, and simply lowering FSH levels will not work in improving egg quality and fertility.

LH is an important chemical that effectively controls the menstrual cycle in women. It’s secreted from the pituitary gland into the bloodstream and signals to the sex organs to produce key hormones (progesterone or testosterone) which support reproductive health in both men and women. For females, LH levels rise dramatically just before ovulation to trigger the release of an egg from the ovary. This makes LH a key player in stimulating the female reproductive system and supporting a healthy pregnancy.

Low LH levels may indicate that your pituitary gland is not producing adequate hormones required to stimulate necessary changes to support reproductive health. This is a condition referred to as hypopituitarism. Other conditions that contribute to lower than normal LH levels are Kallmann syndrome (a rare condition) and Functional Hypothalamic Amenorrhea¹ (a condition in women characterised by irregular or missed periods due to excessive exercise).

Sex hormone-binding globulin (SHBG) is an essential protein that’s primarily synthesized in the liver but also produced in smaller quantities by the placenta, uterus, breast, ovaries, and brain. SHBG serves a vital role in binding to sex hormones (testosterone and oestradiol) and transporting these hormones around the body. Abnormal levels of SHBG are associated with a number of different diseases, with high levels being found in conditions like hyperthyroidism, hypogonadism, and androgen insensitivity.

In addition to fertility problems surrounding conception and menstrual cycles, the symptoms of high SHBG in women can also include:

Decreased sex drive

Vaginal dryness

 Memory loss

 Low mood and fatigue

 Reduced wellbeing

Having an SHBG blood test done, or a female hormone test that includes SHBG is critical when these symptoms start showing up.

In healthy women, the ovaries and adrenal glands produce about 40% to 50% of the body’s testosterone. Ovarian overproduction of androgens, thereby resulting in high FAI values, is a condition of the ovaries producing too much testosterone. Symptomatically, this can lead to the development of male characteristics in a female, including concerns surrounding reproductive health.

Polycystic ovary syndrome (PCOS) as well as tumors of the ovaries can result in overproduction of androgen. Additionally, Cushing’s Disease, a condition of the pituitary gland that involves excess production of corticosteroids, can also cause symptoms of masculine body changes in women. While rare, tumors in the adrenal glands can also lead to overproduction of androgens, elevated FAI values, and fertility issues in women.