Follicle Stimulating Hormone (FSH)
FSH is a pituitary hormone that stimulates egg development in women and sperm production in men. Abnormal levels help diagnose fertility issues, menopause, and pituitary disorders.
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What the Follicle Stimulating Hormone (FSH) test tells you
Follicle-stimulating hormone, almost always shortened to FSH, is made by the front part of the pituitary gland, a small structure at the base of the brain that takes its own instructions from the hypothalamus above it. FSH travels in the bloodstream to the ovaries or the testes and tells them to get on with their work. In women it recruits a group of follicles at the start of each cycle and drives one of them to maturity. In men it acts on the supporting cells inside the testes that sustain sperm production, so it is a measure of the machinery of fertility rather than of male hormone levels.
The test is useful because of the feedback loop it sits inside. As the ovaries or testes respond, they release oestradiol or testosterone along with a protein called inhibin, and these travel back to the pituitary and quieten FSH production. When the gonads stop answering (after menopause, after ovarian insufficiency, or when the testes have been damaged), that quietening signal disappears and FSH climbs. When the pituitary or hypothalamus is itself the problem, FSH stays low even though the sex hormones are low too. That single piece of logic is why FSH is nearly always ordered together with LH and a sex hormone, and why the pattern between them matters more than any one of them.
In practice FSH is requested when periods are irregular or have stopped, when conception is proving difficult, when menopause seems to be arriving earlier than expected, when a semen analysis shows few or no sperm, when a child's puberty is delayed or unusually early, and in the follow-up of known pituitary disease. In women who are still cycling the level changes across the month, so the sample is conventionally taken in the first few days of the cycle, where readings can be compared meaningfully from one month to another. Where cycles are absent or irregular that convention does not apply, and the doctor will advise when to attend.
Key test for evaluating infertility, irregular periods, suspected menopause, delayed or precocious puberty, and pituitary disorders.
- Assessing ovarian reserve
An early-cycle FSH gives an indication of how hard the pituitary is having to work to recruit a follicle, which reflects how the ovaries are responding.
- Locating where the problem sits
A high FSH points to the ovary or testis itself, while a low FSH alongside low sex hormones points upstream to the pituitary or hypothalamus.
- Investigating male fertility
When a semen analysis shows few or no sperm, FSH helps distinguish a testis that is not producing sperm from a blockage in the path the sperm take.
- Puberty and pituitary follow-up
FSH helps explain puberty that is delayed or unusually early, and is monitored after pituitary surgery, radiotherapy or a diagnosed pituitary tumour.
Reasons your doctor may request the Follicle Stimulating Hormone (FSH) test
Your doctor may order this test for any of the reasons below. Some are routine checks, others follow specific symptoms or an earlier result.
Periods & early menopause
- Periods that are irregular, infrequent, or have stopped.
- Menopausal symptoms appearing earlier than would be expected for your age.
Fertility assessment
- Difficulty conceiving, as part of a baseline hormone assessment early in the cycle.
- A semen analysis showing a low sperm count or no sperm at all.
Puberty & pituitary disease
- Puberty that is delayed, or signs of puberty appearing unusually early in a child.
- Known or suspected pituitary disease, including follow-up after surgery or radiotherapy.
FSH is the pituitary's instruction to the ovaries or testes, so the reading only makes sense with your sex and, in menstruating women, the cycle day recorded. A result in the "Low" mIU/mL band, with low sex hormones alongside, points upstream to the pituitary or hypothalamus: a tumour, surgery or radiotherapy in that area, very low body weight or intensive training, raised prolactin, or sex hormones taken from outside the body. A "Normal" mIU/mL result is cycle-dependent. A "High" mIU/mL reading usually means the gonad is not responding, most commonly through the natural ageing of the ovaries and menopause, and less often primary ovarian insufficiency or testicular failure. Levels swing from month to month, and high-dose biotin can distort the assay, so a single value rarely settles anything. Your doctor reads it with LH, estradiol or testosterone, your symptoms and your history.
Medically reviewed by Dr Nirupama Sabhapathy
Ranges are a guide: your physician interprets your result alongside your symptoms and history.
What a higher result can point to
- Menopause and the natural ageing of the ovaries, the commonest reason by far for a raised FSH in women.
- Primary ovarian insufficiency, whether autoimmune, genetic, or following chemotherapy or radiotherapy.
- Primary testicular failure in men, including Klinefelter syndrome, undescended testes, mumps affecting the testes, or damage from cancer treatment.
- Surgical removal of the ovaries or testes, which removes the feedback that normally holds FSH down.
- A rare pituitary tumour that secretes gonadotrophins directly.
What a lower result can point to
- Damage to the pituitary gland from a tumour, surgery, radiotherapy, head injury or infiltrative disease.
- Suppression of the hypothalamus by very low body weight, disordered eating, intensive training, severe stress or serious illness.
- Raised prolactin, which switches off the pulses that drive FSH release.
- Sex hormones taken from outside the body, including testosterone therapy, anabolic steroids and combined hormonal contraception.
- A congenital deficiency of the hypothalamic signal, as in Kallmann syndrome, usually presenting as puberty that never starts.
These are possibilities, not diagnoses. A single value outside the reference range is interpreted alongside your symptoms, history and other tests: your doctor decides what it means for you.
What this test cannot tell you
- In women who still menstruate, FSH varies across the month, so a sample taken outside the early part of the cycle can be misleading; the cycle day must be recorded.
- Levels also fluctuate from one month to the next, so a single raised result does not by itself establish menopause or ovarian insufficiency.
- FSH gives an indirect impression of ovarian reserve; it does not count eggs or measure their quality.
- High-dose biotin supplements can interfere with the assay and distort the result.
Risks of the blood draw
- Mild bruising or brief soreness where the needle went in.
- Occasional lightheadedness, which settles after a few minutes of rest.
- Bleeding or infection at the site, which is rare with sterile single-use equipment.
- 1FSH is the pituitary's instruction to the ovaries or testes, not a hormone made by them.
- 2For ovarian reserve or absent and irregular periods, the sample is conventionally taken in the first few days of the cycle: timing changes the meaning of the result.
- 3If your cycles are absent, irregular or you are past menopause, that timing rule does not apply and your doctor will advise when to attend.
- 4A high FSH usually means the gonad is not responding; a low FSH with low sex hormones points to the pituitary or hypothalamus.
- 5It is interpreted alongside LH and estradiol or testosterone, and usually more than once.
Follicle Stimulating Hormone (FSH) is also part of these health checkups, which add a wider screen in the same appointment.
Follicle Stimulating Hormone (FSH) also comes in these focused packages, which pair it with the tests usually read alongside it.
- Hormones & FertilityLuteinizing Hormone (LH)
LH is a pituitary hormone that triggers ovulation in women and stimulates testosterone production in men. Abnormal levels help diagnose fertility…
60View - Hormones & FertilityEstradiol (E2)
Estradiol is the primary female sex hormone responsible for reproductive development and menstrual cycle regulation. Testing helps evaluate…
55View - Hormones & FertilityTestosterone, Total
Total testosterone measures all testosterone in your blood: free, albumin-bound, and SHBG-bound. It is the primary test for evaluating male…
65View - Hormones & FertilityProlactin
Prolactin is a pituitary hormone primarily known for stimulating breast milk production. Elevated levels in non-pregnant individuals can cause…
70View
Frequently Asked Questions
Everything you need to know about the Follicle Stimulating Hormone (FSH) test. Can't find what you're looking for?
Talk to our team→Our laboratory reports 1.5 to 12.4 mIU/mL as within a typical range, below 1.5 mIU/mL as low and 12.5 mIU/mL or more as high. In women who still have periods FSH changes across the cycle, so the result is only meaningful with your sex and the cycle day recorded, and it is read alongside LH and estradiol or testosterone.
It can support the picture but rarely settles it alone. A high FSH most commonly reflects the natural ageing of the ovaries and menopause, yet levels fluctuate from month to month during the transition, so a single raised result does not by itself establish menopause. Your doctor reads it with your periods, symptoms, age and estradiol, and may repeat it.
A low FSH with low sex hormones points upstream to the pituitary or hypothalamus rather than the ovaries or testes. Causes include very low body weight, disordered eating, intensive training, severe stress, raised prolactin, a pituitary tumour, surgery or radiotherapy, and hormones taken from outside the body such as testosterone, anabolic steroids or combined contraception.
If you still have periods and the test is for ovarian reserve, irregular cycles or fertility, your doctor will usually ask for a sample in the first few days of the cycle, counting from the first day of bleeding. If your periods have stopped, are unpredictable or you are past menopause, that rule does not apply and your doctor will tell you when to attend. Men can attend on any day.
FSH is the pituitary's signal to the ovaries, so it gives only an indirect impression of reserve and varies across the cycle and between months. AMH is made by the developing follicles themselves, so it reflects the remaining follicle pool more directly. Neither counts eggs or measures their quality, and doctors often use the two together with an ultrasound follicle count.
The ovaries normally send hormones back to the pituitary that tell it to ease off. When fewer follicles respond, that return signal weakens and the pituitary compensates by pushing harder, so FSH rises. The high level is the pituitary working harder, not the ovaries producing more.
Yes. Combined hormonal contraception deliberately suppresses the pituitary signal, so FSH will read low and cannot be used to judge ovarian reserve. Your doctor will usually want the test after a break from it, and will advise how long that break should be.
Yes, and this is common. FSH speaks only to the signal reaching the ovaries and their broad response. It says nothing about the fallopian tubes, the uterus, egg quality, or the male side, so a normal result narrows the question rather than closing it.
When sperm are few or absent, a raised FSH suggests the testes themselves are not producing sperm well, while a normal FSH with absent sperm points more towards a blockage in the tubes that carry them. The two situations are managed quite differently.
No, fasting is not required; timing in your cycle matters far more, and a morning appointment is preferred for consistency. Ask your doctor about pausing high-dose biotin supplements for a few days beforehand, since biotin can distort the result.
The FSH test is AED 40, including a physician-reviewed report, with results usually within 24 hours. Home collection anywhere in Dubai is free when your order reaches AED 300 or includes a package; below that, a AED 100 home collection fee applies (AED 50 for a lab walk-in).