Can you please let me know what the standard is for FSH testing. I am 56 and am done with menopause; my sister is 48 and believes she's in perimenopause. She had 'the test' and was told she was at level 13. What does this mean?

Answer:

Basically FSH testing is conducted to check the levels of follicle-stimulating hormones (FSH) in the body. These hormones are related to menopause, and when the level of these hormones is high enough it typically signals that menopause is happening. FSH levels can be measured through a blood test by your doctor.

FSH are the hormones that regulate the menstrual cycle and egg production by the ovaries. In men, these hormones regulate the production of sperm. FSH levels are highest right before the ovaries release an egg. Usually FSH testing is done to determine the best time for achieving pregnancy. Couples who are having trouble becoming pregnant often have FSH testing done to diagnose any problems of the reproductive system.  

This test, however, has also been used to determine the beginning or end of menopause. The level of FSH is higher during menopause because as the function of the ovaries begins to decline; the amount of follicle stimulating hormones increase to try to get the process of ovulation working again.

It must be noted that FSH testing for menopause has a history of being very unreliable. This is because the test only measures the level of hormones in the body at the specific time the blood was taken. But hormone levels tend to raise and lower continuously, so for accurate results, you would need to take the test a number of times to ensure the accuracy of the results before jumping to any conclusions.

Age, sexual maturity, the stage of a woman’s menstrual cycle, and the use of oral contraceptives can also affect the results of the test. The levels of FSH naturally fluctuate during puberty, pregnancy, menstrual cycles, and menopause. During any other time, the FSH levels are usually too low to measure.

The results of the test are usually measured in U/L (units per liter) or mIU/mL (micro international units per milliliter). The test values for a woman who is perimenopausal fall in the range of 4-30 U/L or 5-20 mIU/mL. What this means is that the test is measuring the amount of units of follicle-stimulating hormone per liter of blood. When the units are high enough, it can mean that the woman is starting menopause. The test can also be used to detect when a woman is done menopause, because the amount of FSH is even higher. Normal values for postmenopausal women fall between 40-250 U/L and 50-100 mIU/mL.

 I am not doctor so I can not say for sure, but it looks as though your sister falls in the perimenopausal range. Ask your sister to go back and see her doctor again to get a full explanation of her test results.