Lh Levels Throughout Your Menstrual Cycle
Luteinizing hormone is one of the many reproductive hormones that keep our bodies functioning properly. OBGYN Dr. Gleaton is here to explain what LH is, what LH levels should be expected, and how tracking LH can help you get pregnant.
By OBGYN and fertility expert Dr. Kenosha Gleaton
LH is a key hormone for both male and female reproductive systems- lets talk about why tracking LH is beneficial to getting pregnant.
Hormones : Luteinizing Hormone Function
Get ready to learn the role luteinizing hormone plays in our reproductive health. Join us on a journey of all things ovulatory as we answer the question what is luteinizing hormone? Well reveal how measuring luteinizing hormone can help you both plan and prevent pregnancy, as well as the best time to measure LH.
Role Of Lh In Fertility Treatment
LH plays a vital role in fertility treatment, and its manipulation can be highly beneficial. Women who suffer from irregular menstrual cycles and fail to get pregnant because of it can find a solution to their problem through LH injections or pills that stimulate the body into releasing LH in the same pattern every month. This is very useful for women who dont produce enough progesterone, and due to this failure, they dont release eggs during their monthly cycles. This treatment can be used to overcome other problems caused by the lack of luteinizing hormone, such as infertility, amenorrhea or irregular menstruation.
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When To Measure Lh
Ovulation happens at the end of the follicular phase in the menstrual cycle, but unless you know your predicted fertile window, it can be hard to know when to measure for the presence of luteinizing hormone. If you take an ovulation test, LH levels can usually be detected between 24-48 hours before ovulation.
Historically, the medical stance on ovulation was that it occurs around day 14 in the cycle. However, this calculation is based on the myth of the 28-day cycle, we now know that cycle lengths vary, so detecting ovulation will be easier if you understand the changes and length of your own menstrual cycle.
What Is A Luteinizing Hormone Levels Test
This test measures the level of luteinizing hormone in your blood. LH is made by your pituitary gland, a small gland located underneath the brain. LH plays an important role in sexual development and functioning.
- In women, LH helps control the menstrual cycle. It also triggers the release of an egg from the ovary. This is known as ovulation. LH levels quickly rise just before ovulation.
- In men, LH causes the testicles to make testosterone, which is important for producing sperm. Normally, LH levels in men do not change very much.
- In children, LH levels are usually low in early childhood, and begin to rise a couple of years before the start of puberty. In girls, LH helps signal the ovaries to make estrogen. In boys, it helps signal the testes to make testosterone.
Too much or too little LH can cause a variety of problems, including infertility , menstrual difficulties in women, low sex drive in men, and early or delayed puberty in children.
Other names: lutropin, interstitial cell stimulating hormone
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Luteinizing Hormone And Pregnancy
For those planning a pregnancy, its useful to understand the hormones at play and how they will change during gestation. Since luteinizing hormone is a hormone that works to regulate the phases of the menstrual cycle, there is no surge of LH during pregnancy. However, the sex hormones progesterone and estrogen play a key role in fetal development and getting the body ready for giving birth.
When To Take An Lh Blood Test
LH blood tests are often used to diagnose infertility in people of any sex in the following ways:
- If you have been unsuccessfully trying to get pregnant, or your menstrual cycle is irregular, a blood workup that includes LH will be helpful. Your results can help identify hormonal conditions such as PCOS or perimenopause .
- An LH blood test can help uncover genetic conditions that affect fertility in people with testes, such as Klinefelter’s syndrome. It can also uncover the underlying cause of a low sex drive.
If youre concerned that your child is entering puberty too early or too late, talk to their pediatrician. An LH blood test can help you get a diagnosis and figure out the next steps.
LH blood tests are also beneficial for uncovering problems in the central nervous system or a pituitary disorder. If you have unexplained symptoms such as fatigue, muscle weakness, weight loss, and a decreased appetite, your healthcare provider may order this test as part of a workup, although it is not enough to diagnose any disease.
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Why Is The Lh Surge Important
Your LH surge is important because it initiates the beginning of ovulation and your fertile period. If youre trying to get pregnant, this is the best time for you to begin having sex without a condom.
Once the egg is released, its only viable for about 24 hours. After that, your fertile window is over. This makes it very important to be able to identify this best time to conceive.
Variability In What Lh Surges Look Like Around Ovulation
Because the general narrative says the menstrual cycle is characterized by one quick LH surge before ovulation, you might be surprised to learn that according to some studies, less than half of women have LH patterns that look like that .
Of studies that have characterized what patterns of LH might look like for different people, there are three recent ones 00160-4/fulltext” rel=”nofollow”> here, here, and here) that stand out as being particularly strong, and all three have converged on around the same estimates for what percent of women display which patterns:
- Between 42% and 48% of cycles follow the short surge pattern. This is the one were most familiar with, because this is the pattern talked about in medical textbooks and in most descriptions of the menstrual cycle.
- Between 33% and 44% of cycles follow the two surges pattern, which yup, you guessed it is characterized by an initial big rise, a small drop, and then a second rise in LH.
- Between 11% and 15% of cycles are characterized by the plateau pattern, which is when LH levels remain high after an initial surge .
There are other patterns as well, including multiple surges , though they are less frequent.
While some studies suggest that the pattern of LH around ovulation should look the same within an individual from cycle to cycle, others report the opposite . Our take? If you have a short surge one cycle and a plateau next, it isnt something to lose sleep over.
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What Is A Normal Luteinizing Hormone Level
When you get your test results, remember that whats considered normal depends on various factors, including your age, gender and medical history. For DFAB people, the timing of your menstrual cycle or whether youve gone through menopause will affect your LH levels.
The numbers below provide a general snapshot of normal LH levels for cisgender men and women. Ask your healthcare provider what your test results mean for you.
- Women, weeks one and two of the menstrual cycle: 1.37 to 9 IU/L .
- Women, week two, before ovulation: 6.17 to 17.2 IU/L.
- Women, weeks three and four of the menstrual cycle: 1.09 to 9.2 IU/L.
- Women, postmenopausal: 19.3 to 100.6IU/L.
- Men: 1.42 to 15.4 IU/L.
How Is The Test Administered
To administer an LH blood test, a health professional will draw a small amount of blood from you, most likely from your arm. The short procedure will be done in your doctors office or at a lab. The sample will then be analyzed for LH levels.
To draw blood, a health professional will wrap your upper arm with an elastic band to make your veins easier to see. Theyll disinfect the skin and insert a needle into a vein on the inside of your arm. A tube attached to the needle will collect a small sample of your blood. The process is short and mostly painless.
Your doctor may request that you have samples of blood drawn each day for several days. Because the amount of LH in the blood varies with your menstrual cycle, a few samples may be necessary to get an accurate measurement of your LH levels.
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Role Of Luteinizing Hormone In Ovulation
Ovulation is an essential step in the development of a womans monthly cycles. This happens when an egg bursts out of its follicle located in the ovarian wall and starts traveling into the fallopian tube, where it may either be fertilized or expelled with menstrual blood during the next cycle, which also sheds a womans uterine lining and forms it anew. This is what occurs when LH levels are high in a womans body every month, initiating the follicle to rupture and release another egg for potential fertilization.
Luteinizing Hormone Test Results
Your doctor will probably have the results in a few days.
Normal LH numbers depend on a few things, like your sex and age. For women, normal results are:
- 5-25 international units per liter before menopause
- 14.2-52.3 IU/Ll after menopause
The level peaks higher during the middle of your cycle.
For men, the normal levels are around 1.8-8.6 IU/L.
For children, LH levels are generally low.
Keep in mind that the ânormalâ value ranges can differ depending on the lab, so you should always talk to your doctor about what your result means for you.
High levels of LH in a womanâs blood can be a sign of whatâs called âprimary ovarian failure,â which means that the problem is with the ovaries themselves.
Doctors often canât pinpoint why primary ovarian failure happens. But it can happen if:
- You have a metabolic disorder, a genetic disorder, like Turner syndrome, or an autoimmune disorder, like Addison disease
- You have a low number of follicles, the tiny sacs in your ovaries
- Youâve gone through chemotherapy or radiation therapy
- You were exposed to toxins like chemicals, pesticides, or smoke from cigarettes in the past
Low levels of LH may be a sign of âsecondary ovarian failure,â which means the problem starts with the pituitary gland or hypothalamus .
In men, high levels of LH in the blood are a sign of a problem with the testicles and can be a sign of primary testicular failure.
Primary testicular failure isnât common, but it can happen if you:
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Lh Urine Vs Blood Serum Test
LH can be tested by blood serum or with at-home ovulation tests. An LH surge appears in the urine within 12 hours after it appears in the blood. One study found that blood serum and urinary tests show excellent agreement and can be used interchangeably.
Keep in mind that with blood tests, each lab has a different range for what’s normal. You should get a lab report showing the range that your lab uses for each test, and if your results fall into low, normal, or high. Talk to your doctor if you have any questions about your lab results.
What Happens If I Have Too Much Luteinising Hormone
Too much luteinising hormone can be an indication of infertility. Since the secretion of luteinising hormone is tightly controlled by the hypothalamic-pituitary-gonadal axis, high levels of luteinising hormone in the bloodstream can indicate decreased sex steroid production from the testes or ovaries .
Polycystic ovary syndrome is a common condition in women associated with high levels of luteinising hormone and reduced fertility. In this condition, an imbalance between luteinising hormone and follicle stimulating hormone can stimulate inappropriate production of testosterone.
Genetic conditions, such as Klinefelters syndrome and Turner syndrome, can also result in high luteinising hormone levels. Klinefelters syndrome is a male-only disorder and results from carrying an extra X chromosome . As a result of this, the testes are small and do not secrete adequate levels of testosterone to support sperm production. Turner syndrome is a female-only disorder caused by a partial or full deletion of an X chromosome . In affected patients, ovarian function is impaired and therefore luteinising hormone production increases to try to stimulate ovarian function.
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When Should I Consult With A Doctor
You should speak with your doctor if you have been experiencing irregular cycles, and you have been:
*Struggling to conceive for more than a year or*Struggling to conceive for more than six months
However, dont be afraid to speak with your doctor sooner if your irregular cycles are also accompanied with abnormal pain, cramping, fever, or bleeding.
What Are The Common Conditions And Disorders Associated With Luteinizing Hormone
LH levels fluctuate, especially with your menstrual cycle. A high or low LH level isnt simply good or bad.
For instance, a surge in your LH can show that youre about to ovulate. Youre most likely to become pregnant at this time. This information that LH provides about your fertility is helpful if youre trying to have a baby.
LH levels in your body can signal problems, too. Knowing your LH level at a particular moment in time can help your provider learn:
- If you have a pituitary disorder.
- Whats causing fertility issues.
- Whats causing you to have irregular periods .
- How close you are to perimenopause or menopause .
- Whats causing you to have low testosterone levels .
LH levels tests can also help your provider diagnose early or delayed puberty in children.
What happens when luteinizing hormone levels are high?
High LH levels can signify that your sex organs arent producing enough steroid hormones needed for a reproductive process to take place. This is typical of when the ovaries and testes have exhausted their ability to produce estrogen and testosterone, from genetic, autoimmune, surgical, or physiologic causes.
Turner syndrome or Fragile X in DFAB people and Klinefelter syndrome in DMAB people are examples of genetic conditions associated with high LH levels.
Polycystic ovary syndrome is a condition that affects DFAB people that can cause mildly elevated LH levels. These are associated with irregular periods and infertility.
Low LH levels can be a sign of:
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What Are The Functions Of The Lh Hormone In The Reproductive Cycle
Luteinizing hormone is a type of gonadotropin that is synthesized in the pituitary gland of the brain in both males and females.
Together with follicle stimulating hormone , LH has the function of regulating the reproductive and endocrine system in both sexes once puberty is reached:
- In men
- stimulates the production of steroid hormones in the testicle, such as testosterone .
- In women
- stimulates the production of androgens in the ovaries, which are the precursors of estrogens . It is also the hormone responsible for triggering ovulation in the middle of the menstrual cycle.
In addition, LH is used in assisted reproduction treatments in combination with drugs that also contain FSH
Provided below is an index with the 7 points we are going to expand on in this article.
What Is A Normal Lh Level On Different Days Of The Cycle
The fact that many manufacturers of ovulation test kits use a single threshold for all uterus owners might lead you to think that there are thresholds that predict ovulation for everyone, and/or that there is a well-defined, narrow window of what normal LH looks like before ovulation and across different cycle days.
Just like there is a range of whats considered normal for the Modern Fertility Hormone Test , we can use data from a large enough pool of people to figure out what typical levels of urinary LH are across different days of the cycle:
- According to one of the largest studies that analyzed LH daily and used ultrasound to confirm the timing of ovulation, there is quite the range in what LH values we can expect across different cycle days, and this range is the largest 24 hours before ovulation.
- In the graphic below, we show median LH , and the distribution of reported LH values, minus the upper 10% and lower 10%. This is also called an 80% reference range all the values that constitute the middle 80% of the distribution of LH.
- While some studies or labs choose to report 80%, 90%, or 95% reference ranges, the study these data come from chose to use an 80% reference range.
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Measuring Fsh Levels For More Insights
Follicle-stimulating hormone works closely with LH and other hormones to regulate menstruation, and support sperm production.
FSH testing is often done alongside LH level testing. It helps provide information about ovarian function, the beginnings of menopause, and other fertility concerns.
In people with testes, FSH testing can help uncover issues with sperm count. In children, it can be used to diagnose issues with early or late puberty.
What Lh Can Tell You About Your Fertile Window
LH remains relatively low and stable during the first half of the menstrual cycle. However, 24-36 hours prior to the day of ovulation, LH levels spike dramatically. This sharp increase in LH is often referred to as the LH surge, and it is this increase in LH that triggers the body to ovulate.
Once ovulation is over, LH then falls back to its baseline level. The few days where LH levels are rising and elevated are considered the most fertile days of the fertile window, and it is the window of time during the menstrual cycle where the chances of conception are the highest.
Because LH is so closely linked with ovulation, it is common for women to measure their LH levels as ovulation approaches in order to predict when they are the most fertile. If they are trying to conceive, they can then use this information to plan sex with their partner at the most optimum time of their cycle.
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