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In women and men, LH (and FSH) tests are ordered as part of the workup of infertility, suspected pituitary problems, or gonadal disorders when a woman is having trouble getting pregnant or when pituitary, ovary, or gonadal disorders are suspected.
The test may be ordered along with an FSH test when a woman is having irregular menstrual periods, especially at the beginning of menopause.
LH and FSH may be ordered when a boy or girl does not appear to be entering puberty at an appropriate age (either too late or too soon). Signs of early (precocious) puberty may include:
- Breast enlargement in females
- Growth of pubic hair
- Genitalia growth in males
- Beginning of menstruation in females
Irregular timing of puberty may be an indication of a more serious problem involving the hypothalamus, the pituitary gland, the gonads (ovaries or testes), or other systems. The measurement of LH and FSH may differentiate between benign symptoms and true disease. Once it is established that symptoms are a result of true disease, further testing can be done to discern the underlying cause.
Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) are called gonadotropins because stimulate the gonads - in males, the testes, and in females, the ovaries. They are not necessary for life, but are essential for reproduction. These two hormones are secreted from cells in the anterior pituitary called gonadotrophs. Most gonadotrophs secrete only LH or FSH, but some appear to secrete both hormones.
As describef for thyroid-simulating hormone, LH and FSH are large glycoproteins composed of alpha and beta subunits. The alpha subunit is identical in all three of these anterior pituitary hormones, while the beta subunit is unique and endows each hormone with the ability to bind its own receptor.
All female infertility patients will undergo a complete hormone evaluation. Many different hormones must interact precisely to cause proper ovulation, implantation of an early pregnancy, and the maintenance of an ongoing pregnancy.
The pituitary gland is under hormonal control of the hypothalamus, an endocrine organ located at the base of the brain. The pituitary is responsible for the production of FSH, LH, and other important hormones. FSH stimulates the recruitment and development of eggs within the follicles located in the ovaries.
An estradiol test measures the amount of a hormone called estradiol in the blood. Estradiol is the most important form of estrogen found in the body. Most of it is made in and released from the ovaries, adrenal cortex, and the placenta, which forms during pregnancy to feed a developing baby.
Estradiol is responsible for the growth of the female uterus, Fallopian tubes, and vagina. It promotes breast development and the growth of the outer genitals. The hormone plays a role in the distribution of body fat in women and stops the process of growing taller.
17 OH Progestrone
This test is mainly used to check infants for congenital adrenal hyperplasia (CAH). It is often performed on infants who are born with outer genitals that do not have the typical appearance of a boy or a girl.
This test is also used to identify persons with nonclassical adrenal hyperplasia. This condition occurs when the body does not product enough of a substance that helps the adrenal gland make cortisol.
Your doctor may recommend this test if you are a woman who has excessive hair growth in places where adult men grow hair, or if you have other signs of virilization.
It may be measured when a woman presents with signs and symptoms such as amenorrhea, infertility, and/or those related to virilization. These changes vary in severity and may include:
- A deeper voice
- Male pattern baldness
- Enlargement of the Adam's apple
- Decreased breast size
It may also be ordered when a young girl shows signs of virilization, such as hirsutism, a deep voice, or when a female infant has ambiguous genitalia wherein the clitoris is overgrown but the internal female organs usually appear normal.
DHEAS may also be measured when young boys show signs of precocious puberty, the development of a deeper voice, pubic hair, muscularity, and an enlarged penis well before the age of normal puberty.
Growth hormone may be measured when adults or children are not growing normally, or when there is a history of a pituitary gland problem.
Growth hormone is released from the anterior pituitary gland. Too much growth hormone can cause abnormal growth patterns called acromegaly in adults and gigantism in children.
Too little growth hormone can cause short stature in children, and changes in muscle mass, cholesterol levels, and bone strength in adults.
This test is ordered when a patient has signs or symptoms associated with excess or deficient cortisol.
too much cortisol can cause symptoms that include:
- obesity, with majority of the weight on the trunk of the body and not the arms and legs
- rounded face
- fragile and thin skin
- purple lines on the abdomen
- muscle weakness
- increased body hair
these are often accompanied by findings such as high blood pressure, low potassium, high bicarbonate, high glucose levels, and sometimes diabetes.
people with insufficient cortisol production may exhibit symptoms such as:
- muscle weakness
- weight loss
- increased skin pigmentation, even in areas not exposed to the sun
- loss of appetite.
these are often accompanied by findings such as low blood pressure, low blood glucose, low sodium, high potassium, and high calcium.
symptoms suggestive of hypopituitarism include loss of appetite, fatigue, irregular menstrual cycle, hypogonadism, decreased sex drive, frequent nighttime urination, and weight loss. When the condition is due to a pituitary tumor (usually benign), the affected person may also have symptoms associated with the compression of nearby cells and nerves. The tumor can affect the nerves controlling vision, causing symptoms such as "tunnel vision" (inability to see things off to the side), loss of vision to some localized areas, and double vision, and can cause a change in a pattern of headaches.
Androgen tests are done to find out the level of different androgens in your blood. A testosterone test is most common. You may also have your dehydroepiandrosterone sulfate (DHEAS) level checked if you have symptoms that warrant it. Your fertility doctor will make this decision with you.
Almost all women who have elevated androgen levels have an underlying cause that can be identified. Approximately 80 to 90 percent of women with high androgen levels have PCOS. Congenital adrenal hyperplasia, Cushing syndrome, and tumors on the ovaries or adrenal glands are all rare but possible causes of increased androgen levels.
Angiotensin Converting Enzyme