FSH and LH Tests: What These Fertility Hormones Reveal

What Are FSH and LH?

Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are made by the pituitary gland at the base of the brain. They act as messengers to the ovaries and testes, telling them to mature eggs or make sperm and to produce sex hormones such as estrogen and testosterone. In women, FSH stimulates the growth of ovarian follicles in the first half of the menstrual cycle, while a sharp mid-cycle surge of LH triggers ovulation. In men, FSH supports sperm production and LH stimulates testosterone release from the testes.

Because these hormones sit at the top of the reproductive chain, they are among the first tests ordered for infertility, irregular periods, suspected menopause, delayed puberty, or low testosterone symptoms. They are measured with a simple blood draw, and results are reported in milli-international units per milliliter (mIU/mL). This guide is educational information, not medical advice, and your own lab report reference range is the final word on your result.

When to Test FSH and LH

Timing matters more for these hormones than for most blood tests, because levels shift across the menstrual cycle. Common reasons and timing include:

• Fertility evaluation: FSH is usually drawn on cycle day 2, 3, or 4 to capture a baseline, often with estradiol
• Ovulation tracking: LH is checked around mid-cycle to detect the surge that precedes ovulation by about a day
• Irregular or absent periods: baseline FSH and LH help separate ovarian causes from pituitary signaling problems
• Suspected menopause or perimenopause: persistently high FSH supports the transition, alongside symptoms and age
• Male infertility or low testosterone symptoms: FSH and LH show whether the problem starts in the testes or in pituitary signaling
• Delayed or early puberty in adolescents: levels show whether puberty hormones have activated

For men and for postmenopausal women, timing is flexible because levels are relatively steady. For cycling women, note the cycle day on the lab requisition so results can be read correctly.

Typical Normal Ranges

Reference ranges vary by laboratory and assay, so always read your result against the range printed on your own report. Typical adult ranges used by many labs are:

A day-3 FSH above roughly 10 to 12 mIU/mL is often described as elevated and may suggest diminished ovarian reserve, though cutoffs differ between labs and a single value never tells the whole story. Anti-Mullerian hormone (AMH) and antral follicle count are commonly checked alongside for a fuller fertility picture.

What High or Low Results Mean

High FSH in a cycling woman, especially with low estradiol, often reflects diminished ovarian reserve or approaching menopause, because the pituitary releases more FSH when the ovaries respond less. In men, high FSH with low testosterone can point to testicular failure, since the pituitary compensates for low output. High LH at mid-cycle is normal and expected. A high baseline LH relative to FSH, sometimes a ratio above 2 to 1, is commonly seen with polycystic ovary syndrome, though it is not diagnostic on its own.

Low FSH and LH together can point to a pituitary or hypothalamic signaling problem, which may follow significant stress, very low body weight, intense overtraining, or certain medications including hormonal contraceptives and testosterone therapy. In men on testosterone therapy, suppressed LH and FSH with reduced sperm counts are expected effects. Because many factors shift these hormones, abnormal results are usually confirmed with repeat testing plus estradiol or testosterone before any conclusions are drawn.

How to Order an FSH and LH Test

You can order FSH and LH testing in two ways. Through a clinician, the tests are ordered during a fertility workup, a menopause evaluation, or a hormone panel, and results are reviewed in a follow-up visit. Through direct-access lab testing, you order online yourself: select FSH, LH, or a combined female hormone or fertility panel, pay at checkout, and visit a local collection site for the blood draw. No physician order or insurance is needed.

For the most useful result, schedule a baseline draw for cycle day 2 to 4 if you menstruate, and avoid biotin supplements for at least 24 to 72 hours before the draw if your lab advises it, since high-dose biotin can interfere with some hormone assays. Results are typically available in a secure online account within one to two business days. Share them with your clinician, especially if you are actively trying to conceive or considering fertility treatment.

How Much Does FSH and LH Testing Cost?

Direct-access pricing varies by panel and region. As a rough guide, a single FSH or LH test often costs between about $40 and $80, while a combined FSH plus LH draw commonly falls between about $70 and $130. Broader female hormone or fertility panels that add estradiol, progesterone, prolactin, or AMH typically range from about $150 to $350.

Clinician-ordered testing billed through insurance follows your plan deductible and copay instead, which can be higher or lower than direct pricing. When comparing options, check whether the quoted price includes the collection fee, how quickly results post, and whether repeat testing is discounted, since fertility workups often require more than one draw.