Patient's question:
Hello doctor, I heard from a friend that if you want to get pregnant, you need to have a gynecological endocrine examination in the hospital in advance. Now that you are preparing to get pregnant, you want to go to the hospital for a check-up, but you don't know how to have a gynecological endocrine examination, nor do you know what items to check, and you don't know which department to go to in the hospital. I hope the doctor can answer this. Thank you.Doctor's answer:
Hello, the third day of the menstrual period is the most accurate. Hormone six and their normal values: (Follicle-stimulating hormone (FSH); Prolactin (PRL); Luteinizing hormone (LH); Estradiol (E2); Progesterone (P); Testosterone (T)) 1) Follicle-stimulating hormone (FSH): It is a glycoprotein hormone secreted by basophilic cells in the anterior lobe of the pituitary gland. Its main function is to promote the development and maturation of ovarian follicles. The concentration of blood FSH is 1.5～10mIU/ml in the pre-ovulatory phase, 8～20mIU/ml during ovulation, and 2～10mIU/ml in the post-ovulatory phase. Generally, 5～40mIU/ml is considered the normal range. Low FSH values are seen during estrogen-progesterone therapy, Sheehan's syndrome, etc. High FSH values are seen in premature ovarian failure, ovarian hypo responsiveness syndrome, primary amenorrhea, etc. If FSH is higher than 40mIU/ml, it is ineffective against ovulation-inducing drugs such as clomiphene. 2) Luteinizing hormone (LH): It is also a glycoprotein hormone secreted by basophilic cells in the anterior lobe of the pituitary gland. Its main function is to promote ovulation. In conjunction with FSH, it forms the corpus luteum and secretes progesterone. The concentration of blood LH is 2～15mIU/ml in the pre-ovulatory phase, 30～100mIU/ml during ovulation, and 4～10mIU/ml in the post-ovulatory phase. The normal range during the non-ovulatory phase is generally 5～25mIU/ml. Values below 5mIU/ml suggest insufficient gonadotropin function, seen in Sheehan's syndrome. If high FSH is combined with high LH, ovarian failure is highly certain, and no further tests are necessary. An LH/FSH ratio of ≥3 is one of the diagnostic criteria for polycystic ovary syndrome. 3) Prolactin (PRL): It is secreted by lactotrophs, one of the acidophilic cells in the anterior lobe of the pituitary gland, and is a pure protein hormone. Its main function is to promote the proliferation of breast tissue, milk production, and lactation. In non-lactating women, the normal blood PRL level is 0.08～0.92mol/L. Values above 1.0mol/L indicate hyperprolactinemia. Excessive prolactin can inhibit the secretion of FSH and LH, suppress ovarian function, and inhibit ovulation. 4) Estradiol (E2): It is secreted by ovarian follicles and its main function is to promote the transformation of the endometrium into the proliferative phase and to promote the development of female secondary sexual characteristics. The concentration of blood E2 is 48～521 picomoles per liter in the pre-ovulatory phase, 70～1835 picomoles per liter during ovulation, and 272～793 picomoles per liter in the post-ovulatory phase. Low values are seen in ovarian dysfunction, premature ovarian failure, and Sheehan's syndrome. 5) Progesterone (P): It is secreted by the corpus luteum of the ovary and its main function is to promote the transformation of the endometrium from the proliferative phase to the secretory phase. The concentration of blood P is 0～4.8mol/L before ovulation and 7.6～97.6mol/L in the post-ovulatory phase. Low blood P levels in the post-ovulatory phase are seen in luteal phase deficiency and ovulatory dysfunctional uterine bleeding. 6) Testosterone (T): In women, 50% of testosterone is converted from peripheral androstenedione, about 25% is secreted by the adrenal cortex, and only 25% comes from the ovaries. Its main function is to promote the development of the clitoris, labia, and mons pubis. It has an antagonistic effect on estrogen and has a certain impact on overall metabolism. The normal blood T level in women is 0.7～3.1mol/L. High blood T levels, known as hyperandrogenemia, can cause infertility. Blood T levels are also elevated in polycystic ovary syndrome. Other hormones may be measured if necessary based on clinical manifestations. Hope this helps.