FSH/LH levels

Ovarian failure is indicated by consistently raised FSH levels - over 30IU/l - together with raised LH and low serum oestradiol levels (1).

If a woman has symptoms typical of the menopause and has a slightly irregular menstrual cycle, then a raised FSH in the early follicular phase may indicate the perimenopause, and it is likely that the patient will become menopausal during the next five years.

NICE state (2):

• FSH test:
  • do not use a serum follicle-stimulating hormone (FSH) test to diagnose menopause in women using combined oestrogen and progestogen contraception or high-dose progestogen
    
    
  • consider using a FSH test to diagnose menopause only:
    • in women aged 40 to 45 years with menopausal symptoms, including a change in their menstrual cycle
      
      
    • in women aged under 40 years in whom menopause is suspected
      
      
      • diagnose premature ovarian insufficiency in women aged under 40 years based on:
        • menopausal symptoms, including no or infrequent periods (taking into account whether the woman has a uterus) and
        • elevated FSH levels on 2 blood samples taken 4-6 weeks apart

Reference:

• Update (1998), 56 (7), 646-8.
• NICE (November 2015). Menopause: diagnosis and management