An essential part 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).
- 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 BKS (blood cell 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 (“hidden”) 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 | |
