Gonadotropins (LH and FSH)

The control hormones LH and FSH, also known as gonadotropins, are secreted by the pituitary gland. These stimulate the ovaries and thus normally stimulate production of the female sex hormones.There is a so-called negative feedback between the gonadotropin FSH and the level of female sex hormones. This means that when the levels of estrogen and progesterone are high, the release of FSH from the pituitary gland is reduced, whereas when the levels of estrogen and progesterone in the blood are low, the release of FSH increases with the aim of raising the level of female sex hormones.

Since the release of LH and FSH is no longer slowed down by the actual sex hormones as usual during menopause, there is a significant increase in blood levels of LH and FSH. An FSH serum concentration of over 30 I. E.l, with a simultaneously low estradiol concentration (< 30 pg/ml or < 100 pmol/l) ensures the presence of postmenopause. After the menopause, the pituitary gland‘s control hormones also decrease again, but remain elevated compared to the time before the menopause.

The time after the last menstrual period is also called postmenopause. During this period, the production of male sex hormones (androgens) also decreases. This also causes a further drop in oestrogen levels, as androgens can normally be converted into oestrogens. If fewer androgens are available for conversion into oestrogens, this also affects the oestrogen level.

Hormone Studies

For the diagnosis of the climacteric syndrome, in most cases the medical history is sufficient. The anamnesis is therefore the most important diagnostic step. The clinical examination, including a microscopic examination of the inner lining of the vagina, the vaginal epithelium (so-called vaginal cytological examination) can verify the diagnosis.

Hormone tests are therefore usually not necessary, but in certain cases, especially if menopause occurs prematurely, they can simplify the diagnosis. Before the age of 50, two blood samples should be taken at an interval of three months in the absence of menstruation, as there are other reasons for the absence of menstruation at this age in addition to the menopause. The typical laboratory constellation during the menopause is a so-called hypergonadotropic hypogonadism, which merely means that the gonadotropin FSH is elevated, while the level of female sex hormones is low. After the age of 50, as already described, the diagnosis of postmenopause after the absence of menstruation for one year can only be made on the basis of the patient’s medical history and clinical examination.