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Female Hormone Levels

  What are Hormones?

Hormones carry messages from glands to cells to maintain chemical levels in the bloodstream that achieve homeostasis. "Hormone" comes from a word that means, "to spur on." This reflects how the presence of hormones acts as a catalyst for other chemical changes at the cellular level necessary for growth, development, and energy.

As members of the endocrine system, glands manufacture hormones. Hormones circulate freely in the bloodstream, waiting to be recognized by a target cell, their intended destination. The target cell has a receptor that can only be activated by a specific type of hormone. Once activated, the cell knows to start a certain function within its walls. Genes might get activated, or energy production resumed. As special categories, autocrine hormones act on the cells of the secreting gland, while paracrine hormones act on nearby, but unrelated, cells.

There are two types of hormones known as steroids and peptides. In general, steroids are sex hormones related to sexual maturation and fertility. Steroids are made from cholesterol either by the placenta when we're in the womb, or by our adrenal gland or gonads (testes or ovaries) after birth. Cortisol, an example of a steroid hormone, breaks down damaged tissue so it can be replaced. Steroids determine physical development from puberty on to old age, as well as fertility cycles. If we are not synthesizing the correct steroidal hormones, we can sometimes supplement them pharmaceutically as with estrogen and progesterone.

Peptides regulate other functions such as sleep and sugar concentration. They are made from long strings of amino acids, so sometimes they are referred to as "protein" hormones. Growth hormone, for example, helps us burn fat and build up muscles. Another peptide hormone, insulin, starts the process to convert sugar into cellular energy.

Hormones so perfectly and efficiently manage homeostasis due to negative feedback cycles. Our goal is to keep the concentration of a certain chemical, such as testosterone, at a constant level for a certain period of time, the way that a thermostat works. Using negative feedback, a change in conditions causes a response that returns the conditions to their original state. When a room's temperature drops, the thermostat responds by turning the heat on. The room returns to the ideal temperature, and the heater turns off, keeping the conditions relatively constant.

Hormone to TestTime
to Test

Values What Value Means
Follicle Stimulating Hormone (FSH)Day 33-20 mIU/mlFSH is often used as a gauge of ovarian reserve. In general, under 6 is excellent, 6-9 is good, 9-10 fair, 10-13 diminished reserve, 13+ very hard to stimulate. In PCOS testing, the LH:FSH ratio may be used in the diagnosis. The ratio is usually close to 1:1, but if the LH is higher, it is one possible indication of PCOS.
Estradiol (E2) Day 3 25-75 pg/mlLevels on the lower end tend to be better for stimulating. Abnormally high levels on day 3 may indicate existence of a functional cyst or diminished ovarian reserve.
Estradiol (E2) Day 4-5 of meds 100+ pg/ml or 2x Day 3There are no charts showing E2 levels during stimulation since there is a wide variation depending on how many follicles are being produced and their size. Most doctors will consider any increase in E2 a positive sign, but others use a formula of either 100 pg/ml after 4 days of stims, or a doubling in E2 from the level taken on cycle day 3.
Estradiol (E2) Surge/hCG day 200 + pg/mlThe levels should be 200-600 per mature (18 mm) follicle. These levels are sometimes lower in overweight women.
Luteinizing Hormone (LH)  Day 3< 7 mIU/mlA normal LH level is similar to FSH. An LH that is higher than FSH is one indication of PCOS.
Luteinizing Hormone (LH) Surge Day > 20 mIU/mlThe LH surge leads to ovulation within 48 hours.
Prolactin  Day 3< 24 ng/mlIncreased prolactin levels can interfere with ovulation. They may also indicate further testing (MRI) should be done to check for a pituitary tumor. Some women with PCOS also have hyperprolactinemia.
Progesterone (P4) Day 3 < 1.5 ng/mlOften called the follicular phase level. An elevated level may indicate a lower pregnancy rate.
Progesterone (P4) 7 dpo > 15 ng/mlA progesterone test is done to confirm ovulation. When a follicle releases its egg, it becomes what is called a corpus luteum and produces progesterone. A level over 5 probably indicates some form of ovulation, but most doctors want to see a level over 10 on a natural cycle, and a level over 15 on a medicated cycle. There is no mid-luteal level that predicts pregnancy. Some say the test may be more accurate if done first thing in the morning after fasting.
Thyroid Stimulating Hormone (TSH) Day 3 .4-4 uIU/mlMid-range normal in most labs is about 1.7. A high level of TSH combined with a low or normal T4 level generally indicates hypothyroidism, which can have an effect on fertility.
Free Triiodothyronine (T3) Day 3  1.4-4.4 pg/mlSometimes the diseased thyroid gland will start producing very high levels of T3 but still produce normal levels of T4. Therefore measurement of both hormones provides an even more accurate evaluation of thyroid function.
Free Thyroxine (T4) Day 3 .8-2 ng/dlA low level may indicate a diseased thyroid gland or may indicate a non- functioning pituitary gland which is not stimulating the thyroid to produce T4. If the T4 is low and the TSH is normal, that is more likely to indicate a problem with the pituitary.
Total Testosterone Day 3 6-86 ng/dlTestosterone is secreted from the adrenal gland and the ovaries. Most would consider a level above 50 to be somewhat elevated.
Free Testosterone Day 3 .7-3.6 pg/ml---
Dehydroepiandrosterone Sulfate (DHEAS)  Day 335-430 ug/dlAn elevated DHEAS level may be improved through use of dexamethasone, prednisone, or insulin-sensiting medications.
Androstenedione  Day 3.7-3.1 ng/ml---
Sex Hormone Binding Globulin (SHBG) Day 3 18-114 nmol/lIncreased androgen production often leads to lower SHBG
17 Hydroxyprogesterone Day 3 20-100 ng/dlMid-cycle peak would be 100-250 ng/dl, luteal phase 100-500 ng/dl
Fasting Insulin 8-16 hours fasting < 30 mIU/mlThe normal range here doesn't give all the information. A fasting insulin of 10-13 generally indicates some insulin resistance, and levels above 13 indicate greater insulin resistance.

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