An essential component of laboratory diagnostics is hormone diagnostics. This is necessary for a possibly necessary or sensible, individually-dosed hormone replacement therapy (HRT). The most important laboratory parameters for hormone status are listed below:
1st order laboratory parameters – obligatory laboratory tests.
- FSH (follicle-stimulating hormone) – used to diagnose peri- and postmenopause in women between the ages of 40 and 45 years with menopausal symptoms and in women younger than 40 years with evidence of premature ovarian failure (depletion of ovarian function with progressive follicular atresia (failure to lay down follicles)).
- LH (luteinizing hormone)
- 17-beta estradiol
Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification.
- Estrone
- TSH
- Prolactin
- Small blood count
- Inflammatory parameters – CRP (C-reactive protein) or ESR (erythrocyte sedimentation rate).
- Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment, if necessary urine culture (pathogen detection and resistogram, that is, testing suitable antibiotics for sensitivity / resistance).
- Fasting glucose (fasting blood glucose), if necessary oral glucose tolerance test (oGTT).
- Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT), alkaline phosphatase, bilirubin.
- Renal parameters – urea, creatinine, cystatin C or creatinine clearance, if necessary.
- Atherosclerosis parameters:
- Total cholesterol, LDL cholesterol, HDL cholesterol.
- Triglycerides
- Homocysteine
- Vitamins D3, B6, B12, folic acid, trace elements selenium and zinc.
- Test for occult (not visible) blood in the stool.
Menopause: time of the last menstrual period.
Postmenopause: onset 1 year after the last menstrual period.
Hormone constellation
- FSH significantly increased
- LH increased
- FSH/LH > 1
- 17-Beta estradiol decreased
The diagnosis of menopause is considered confirmed when:
- FSH serum concentration: > 30 I.U/l
- Serum 17-β-estradiol concentration < 30 pg/ml (< 100 pmol/l).
| Phase/Age | FSH – normal values | |
| Women, serum | Follicular phase | 2-10 IU/ml |
| Mid-cyclic phase (periovulatory). | 8-20 IU/ml | |
| Luteal phase | 2-8 IU/ml | |
| Menopause | 20-100 IU/ml | |
| Phase/Age | LH – normal values | |
| Women, serum | Follicular phase | 2-6 U/l |
| Ovulatory peak | 6-20 U/l | |
| Luteal phase | 3-8 U/ l | |
| Menopause | > 30 U/l | |
| Phase/Age | 17-Beta-estadiol – normal values | |
| Women, serum | Early follicular phase | 20-190 pg/ml |
| Preovulatory peak | 150-530 pg/ml | |
| Luteal phase | 55-210 pg/ml | |
| Postmenopausal | <30 pg/ml | |
