Expected Laboratory Values for a 48-Year-Old Female
For a 48-year-old female, expected laboratory values include an Anti-Müllerian Hormone (AMH) level of approximately 0.5-1.0 ng/ml, Follicle-Stimulating Hormone (FSH) levels that may range from normal to elevated (7-30 IU/L), and estradiol levels typically between 30-400 pg/ml, depending on menstrual cycle phase and proximity to menopause. 1
Ovarian Reserve Markers
Anti-Müllerian Hormone (AMH)
- AMH serves as a biomarker of ovarian reserve, reflecting the quantity of remaining primordial follicles 1
- For women approaching perimenopause (age 45-50):
Follicle-Stimulating Hormone (FSH)
- FSH levels in a 48-year-old woman typically range from:
- Follicular phase: 7-30 IU/L (may be elevated compared to younger women)
- Mid-cycle: 8-30 IU/L
- Luteal phase: 2-10 IU/L
- FSH is inversely correlated with AMH 4
- Rising FSH is one of the earliest hormonal signs of approaching menopause 5
- FSH levels >10 IU/L in the early follicular phase may indicate diminished ovarian reserve
Estradiol
- Typical ranges for a 48-year-old woman:
- Follicular phase: 30-100 pg/ml
- Mid-cycle peak: 100-400 pg/ml
- Luteal phase: 50-200 pg/ml
- Levels become more erratic during perimenopause
- May be lower overall compared to younger women
Clinical Significance
Reproductive Potential
- Low AMH indicates limited remaining reproductive potential 1
- Women with low AMH (<0.7 ng/ml) have significantly higher miscarriage risk (OR 2.11; 95% CI, 1.53-2.92) 1
- At age 48, many women are in perimenopause with declining fertility
Proximity to Menopause
- AMH is inversely correlated with increasing age in women ≥25 years 1
- The rate of AMH decline accelerates after age 40 2
- By age 48, approximately 16-20% of women have AMH levels in the menopausal range 3
Antral Follicle Count (AFC)
- AFC correlates strongly with AMH levels 4
- Expected range for a 48-year-old woman: 2-8 follicles
- AFC decreases with age and is a visual confirmation of declining ovarian reserve
Important Considerations
- Laboratory values should be interpreted in the context of menstrual cycle regularity
- Wide individual variation exists in the timing of perimenopause transition
- AMH assays may vary between laboratories, affecting reference ranges
- A single measurement may not fully represent a woman's reproductive status
- FSH should be measured during the early follicular phase (days 2-4) for most accurate assessment
Common Pitfalls in Interpretation
- Isolated hormone measurements may be misleading; trends over time are more informative
- Oral contraceptive use can mask perimenopausal hormone changes
- Obesity can affect hormone measurements, particularly estradiol
- Some medical conditions (PCOS, endometriosis) may alter expected hormone patterns 6
- AMH levels below 8 pmol/L (1.1 ng/ml) should not automatically be interpreted as approaching menopause in all women 7