Menopause is defined as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity. It is usually diagnosed retrospectively after 12 months of amenorrhea in women over the age of 45 years. The perimenopausal transition typically begins 3-5 years before menopause. During this time, fluctuations and overall increases in follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels occur due to decreased inhibin B and estradiol production by the ovaries.
LH levels tend to be variably elevated during the menopausal transition. As a woman approaches menopause, ovulation becomes less frequent and regular due to the declining number of ovarian follicles. To compensate, the pituitary gland increases secretion of FSH and LH to try to stimulate follicle growth and ovulation. However, the ovaries become less responsive, leading to high but ineffective LH secretion.
After menopause occurs, estrogen levels decrease substantially due to the loss of ovarian estrogen production. This reduction in negative feedback leads to a further rise in FSH and LH levels.
In postmenopausal women, LH levels are typically elevated to about twice the upper limit of normal for reproductive age women. FSH levels also increase but to a lesser degree.
The increased LH pulse frequency and amplitude after menopause is believed to contribute to hot flashes and night sweats during this time. Genetic variations that augment LH secretion may worsen menopausal symptoms.
Key points:
- During perimenopause, LH levels fluctuate but tend to increase overall as ovulation becomes irregular.
- High but ineffective LH levels are characteristic of the menopausal transition as the ovaries fail to respond to stimulation.
- After menopause, LH and FSH levels increase substantially due to lack of follicular estrogen/inhibin feedback.
- Postmenopausal LH levels are typically elevated to about twice the upper limit of normal but FSH increases to a lesser degree.
- Elevated LH after menopause may exacerbate hot flashes and other menopausal symptoms.
If you are concerned about changes in your hormone levels during the menopausal transition, it is a good idea to have relevant blood tests performed. FSH, LH, and estradiol levels can provide information about ovarian function and menopausal status.
Hormone testing and treatment of menopausal symptoms may be effectively managed by providers with expertise in this area, like those at Hormone Harmony. Our outstanding physicians and nurse practitioners offer evidence-based hormone replacement therapies, including bioidentical hormones, to help women achieve hormone balance and alleviate uncomfortable symptoms associated with perimenopause and menopause. We also provide counseling on lifestyle strategies that can ease this transition. Contact us today to see how we can develop an individualized treatment plan to help you feel your best through midlife and beyond!
