Common knowledge and significance of female sex hormone measurement

The content of sex hormones varies at different stages of individual growth, but can be in dynamic balance according to the body's needs. If this balance is disturbed, or the sex organs' hormone secretion function is abnormal, it will cause a series of tissue and organ dysfunctions or pathological changes in the body. Therefore, measuring sex hormones can help us understand whether the body is in a state of balance. Today, let’s learn about the common sense and significance of female sex hormone measurement with the editor.

1. Common knowledge about sex hormone testing

1. Sex hormone drugs (including progesterone and estrogen) should not be used at least one month before checking basic sex hormones, otherwise the results will be unreliable (except when sex hormones need to be rechecked after treatment).

2. You can check sex hormones at any time during your menstrual period, as the normal values ​​are different for each period. However, when diagnosing and treating infertility, it is necessary to understand the basic hormone level. First of all, the test should be done on the 2nd to 5th day of menstruation, which is called the basic hormone level. It is best to measure it on the 3rd day. To confirm that it is the third day of menstruation, it is sufficient to check 5 sex hormones. Progesterone can be omitted, as it should be checked during the luteal phase (21 days after menstruation or 7 days after ovulation). However, it is not certain whether vaginal bleeding is menstruation. 6 items should be checked to prevent misdiagnosis (the menstrual cycle period can be roughly determined based on the P data).

3. For patients with infrequent menstruation or amenorrhea, if the urine pregnancy test is negative, vaginal B-ultrasound examination shows no follicles ≥10mm in both ovaries, and EM thickness ﹤5mm, it can also be used as the basic status.

4. The six sex hormones are: follicle-stimulating hormone (FSH), luteinizing hormone (LH), progesterone (P), estradiol (E2), prolactin (PRL), and testosterone (T).

2. Clinical significance of sex hormone testing

(1) FSH and LH: basic value is 5～10IU/L

In a normal menstrual cycle, blood FSH and LH are maintained at low levels in the early follicular phase (2-3 days after menstruation), and rise rapidly before ovulation. LH is as high as 3-8 times the basal value, reaching 160 IU/L or even higher, while FSH is only about 2 times the basal value, rarely >30 IU/L. After ovulation, FSH and LH quickly return to follicular phase levels. Monitoring the FSH and LH levels in the early follicular phase can provide a preliminary estimate of the function of the gonad axis. FSH is more valuable than LH in judging ovarian potential.

(ii) P: Basic value is generally <1ng/ml

Under normal circumstances, blood P remains at a low level during the follicular phase, averaging 0.6~1.9nmol/L, generally <10nmol/L (3.15ng/ml); when the LH peak appears before ovulation, P secretion begins to increase, and after ovulation, the corpus luteum of the ovary produces a large amount of P, and the blood P concentration rises rapidly; when the corpus luteum matures (6~8 days after the LH peak), the blood P concentration reaches a peak, reaching 47.7~102.4nmol/L (15~32.2ng/ml) or higher, and then continues to decline, reaching the lowest level before the menstrual period. The P content in peripheral blood changes in a parabolic pattern throughout the corpus luteum.

(III) E2: Basic value is 25-45 pg/ml

In a normal menstrual cycle, E2 in the early follicular phase is about 183.5 pmol/L (50 pg/ml). It reaches the first peak before ovulation, which can reach 917.5-1835 pmol/L (250-500 pg). It drops rapidly after ovulation and forms the second peak in the luteal phase, about 458.8 pmol/L (124.80 pg). After a period of maintenance, it drops to the level of the early follicular phase when the corpus luteum atrophies, that is, it should be 91.75-183.5 pmol/ml (25-50 pg/ml) on the third day of menstruation.

(IV) PRL is synthesized and secreted by eosinophilic PRL cells in the pituitary. PRL secretion is unstable. Emotions, exercise, sexual intercourse, hunger and eating can all affect its secretion state. It also fluctuates slightly with the menstrual cycle and has a rhythmicity related to sleep. PRL secretion increases in the short term after falling asleep, and is higher in the afternoon than in the morning. Therefore, according to the characteristics of this rhythmic secretion, blood should be drawn on an empty stomach between 9 and 10 am. Those with significantly elevated PRL can be confirmed with one test; those with mildly elevated PRL should undergo a second test. Do not easily diagnose hyperprolactinemia (HPRL) and abuse bromocriptine for treatment.

(V) Testosterone COS patients have mild to moderate elevation of T; ovarian or adrenal glands secrete androgen

T is elevated in tumors and hirsutism.

Are you confused after reading the editor's introduction to the common sense and significance of female sex hormone testing? Watch it patiently several times, or watch it together with the examination report, and you will understand it more clearly. Paying more attention to information about sex hormones in daily life is very helpful for increasing your knowledge. It can also help you regulate your body and balance your hormones.