From the Research
During menopause, FSH levels should be above 30 mIU/mL, often reaching 40-250 mIU/mL, as indicated by the most recent and highest quality studies 1. This significant elevation occurs as the ovaries stop responding to FSH stimulation due to the depletion of ovarian follicles. The body attempts to compensate by producing more FSH in a futile effort to stimulate follicle development. Some key points to consider when evaluating FSH levels in menopause include:
- FSH levels should be measured along with estradiol levels for proper interpretation, ideally with blood samples taken in the early follicular phase (days 2-5) of the menstrual cycle if periods are still occurring.
- A single elevated FSH reading isn't definitive for diagnosing menopause; confirmation typically requires persistent elevation over multiple tests, along with characteristic symptoms like hot flashes, vaginal dryness, and absence of menstruation for 12 consecutive months.
- FSH testing helps distinguish menopause from other conditions that may cause similar symptoms, as discussed in recent reviews of menopausal hormone therapy 2, 1. It's essential to consider the clinical context and individual patient characteristics when interpreting FSH levels and making decisions about menopausal hormone therapy, as highlighted in studies on the safety and efficacy of different hormone therapies 3, 4.