Hormones

Day 3 Hormone Levels – Women

The female reproductive cycle is influenced by the relationships between several hormones especially FSH, LH, and estrogen (E2). The hypothalamus signals the pituitary to produce FSH which stimulates the recruitment and development of the ovarian follicles. As the follicles grow, they produce estrogen which signals the hypothalamus to regulate the pituitary’s production of FSH.

When viable follicles are not developing, estrogen levels are low and more FSH is produced leading to elevated Day 3 levels. A high FSH level on Day 3 is one indication of reduced ovarian function or impending menopause.

We check Day 3 levels, after the uterus has shed it’s endometrial lining.  This allows a consistent baseline for testing.

In general, diminished ovarian reserve is indicated by an FSH of >10, a high FSH/LH ratio (>2.5; even in the FSH level is normal), or a high E2 level (>80 pg/ml). An elevated estrogen level like this may also be caused by an ovarian cyst.

In polycystic ovarian disease (PCOS), the LH level is higher than FSH.
Normal ratio of LH:FSH should be about 1:1.  With PCOS, the ratio is often 2:1, or higher.

Elevated prolactin levels may indicate a benign pituitary tumor.  More often, elevated levels are a result of excess alcohol consumption, marijuana smoking (or other hallucinogens), painkiller/antidepressant/headache medicine use, or high protein consumption.  Artificial sweeteners can also raise prolactin levels.  When this happens, the luteal phase (after ovulation) shortens which inhibits ovulation, causing infertility.  Low thyroid levels and PCOS may also cause prolactin levels to rise.

Many other hormone levels are evaluated in the fertility workup.

Elevated levels of androgens (male hormones) can cause irregular ovulation and are seen in women with polycystic ovarian syndrome (PCOS). These women may also exhibit hirsutism (excessive hair) on the chin and lower abdomen.

Thyroid hormone levels also influence fertility. Hypothyroidism (low levels) can cause anovulation and early pregnancy loss. Hyperthyroidism (high levels) is associated with irregular ovulation, fetal abnormalities, and premature labor.

Acupuncture, herbal medicine, vitamin/mineral supplementation and dietary changes work well to balance these hormonal problems.

A comprehensive testing of bloodwork on Day 3 of your cycle is recommended every 3 months.

Please click here for information on Day 3 bloodwork levels.