From the Guidelines
To lower luteinizing hormone (LH) levels, the most effective approach is to use hormonal contraceptives, such as combined oral contraceptives, which provide negative feedback to the pituitary gland, suppressing LH release 1.
Approaches to Lower LH Levels
Several approaches can be effective in lowering LH levels, depending on the underlying cause. These include:
- Hormonal contraceptives like combined oral contraceptives (containing estrogen and progestin), typically taken daily for 21 days followed by a 7-day break
- GnRH agonists such as leuprolide (3.75 mg monthly injection) or GnRH antagonists like cetrorelix (0.25 mg daily injection during fertility treatments)
- For those with polycystic ovary syndrome (PCOS), metformin (starting at 500 mg daily, potentially increasing to 1500-2000 mg daily in divided doses) may help normalize hormone levels
- Lifestyle modifications including maintaining a healthy weight, regular exercise (30 minutes daily), stress reduction techniques, and adequate sleep (7-9 hours nightly) can naturally help regulate hormones
Mechanism of Action
These approaches work because LH is regulated through the hypothalamic-pituitary-gonadal axis, and interventions that affect this feedback system can modulate LH production 1. It's essential to consult with a healthcare provider before starting any treatment, as the appropriate approach depends on your specific situation and health goals.
Considerations for Women with Epilepsy
For women with epilepsy, it's also important to consider the potential effects of antiepileptic drugs on LH levels, as some drugs may decrease or increase biologically active serum sex hormone levels 1. Additionally, women with epilepsy may be at higher risk for reproductive dysfunction, including PCOS, hypothalamic amenorrhoea, and functional hyperprolactinaemia, which can all impact LH levels 1.
From the Research
Lowering Luteinizing Hormone (LH) Levels
To lower LH levels, several studies suggest the use of metformin, a medication commonly used to manage type 2 diabetes, in women with polycystic ovary syndrome (PCOS) [ 2, 3, 4, 5, 6 ].
- Metformin has been shown to improve insulin resistance, menstrual regularity, and androgen levels in women with PCOS [ 2, 3 ].
- It may also enhance fertility when combined with other treatments [ 2 ].
- In non-pregnant women, metformin can help reduce LH levels, particularly in those with obesity or insulin resistance [ 4 ].
- Metformin administration has been found to modulate and restore LH spontaneous episodic secretion and ovarian function in nonobese patients with PCOS [ 4 ].
- The medication has also been shown to decrease total testosterone levels and improve clinical symptoms of PCOS, including acne and hirsutism score [ 5 ].
- Additionally, metformin treatment has been found to enhance luteal progesterone concentration in PCOS women [ 6 ], which may be related to its effect on LH levels.
Mechanism of Action
The exact mechanism by which metformin lowers LH levels is not fully understood, but it is thought to be related to its ability to improve insulin sensitivity and reduce hyperinsulinemia [ 6 ].