Follicle-Stimulating Hormone Abnormalities

Introduction:

Follicle-stimulating hormone is a vital hormone responsible for growth, development, and proper reproductive functioning in humans. The pituitary gland produces and secrets the hormone, and the hypothalamic-pituitary-gonadal axis regulates its production. Various underlying causes can make the level of the follicle-stimulating hormone abnormally increase or decrease in concentration. This phenomenon can lead to follicle-stimulating hormone abnormalities. These abnormalities include delayed or absent puberty, infertility in both men and women, menstrual problems, low sex drive, etc.

What Is the Pituitary Gland?

The pituitary gland is a small endocrine gland known as the master endocrine gland. Although the pituitary gland is the size of a pea, it controls the functioning of various other endocrine glands. The pituitary gland weighs approximately 0.5 grams in humans, about half-inch in diameter. The pituitary gland is divided into anterior and posterior pituitary lobes. The pituitary gland produces several hormones, including growth hormone, thyroid-stimulating hormone, follicle-stimulating hormone, adrenocorticotropic hormone, luteinizing hormone, prolactin, etc.

What Is the Follicle-Stimulating Hormone?

Follicle-stimulating hormone is one of the hormones produced by the pituitary gland. Follicle-stimulating hormone is necessary for pubertal development and the functioning of reproductive organs in both genders (women's ovaries and men's testicles). In women, follicle-stimulating hormone initiates ovarian follicle growth before the egg is released. In addition, the production of estradiol is also increased. Follicle-stimulating hormone stimulates sperm production in men by acting on the sertoli cells of the testes. The follicle-stimulating hormone also promotes the growth of the testicles. In addition, it increases the production of androgen-binding protein by the sertoli cells, which are crucial for the sustenance of maturing sperm cells.

How Is Follicle-Stimulating Hormone Regulated?

• The amounts of various circulating hormones released by the ovaries and testes control the synthesis and release of follicle-stimulating hormones. This mechanism of regulation of follicle-stimulating hormone is called the hypothalamic-pituitary-gonadal axis.

• The hypothalamus secretes the gonadotropin-releasing hormones, which bind to the receptors present in the anterior pituitary gland. This binding initiates the production and release of follicle-stimulating hormone and luteinizing hormone.

• Follicle-stimulating hormone is carried to the various receptors on the ovaries and testes through the blood after its release. Then the follicle-stimulating hormone binds to these receptors.

• Towards the end of a menstrual cycle, the hormone levels fall, stimulating the hypothalamus to produce more gonadotropin-releasing hormones. This, in turn, induces the pituitary gland to produce more follicle-stimulating and luteinizing hormones.

• In men, a steady production of the follicle-stimulating hormone is regulated with the help of a negative feedback mechanism. The levels of circulating testosterone regulate the production of follicle-stimulating hormones.

What Are the Follicle-Stimulating Hormone Abnormalities?

Follicle-stimulating hormone is a vital hormone crucial for carrying out various functions in the body. The primary functions are; proper pubertal growth and normal functioning of the gonads (ovaries and testes). An increase or decrease in the levels of the follicle-stimulating hormone can cause multiple health and reproductive conditions, which are called follicle-stimulating hormone abnormalities.

What Happens if There Is Excess of Follicle-Stimulating Hormone?

Elevated follicle-stimulating hormone levels are typically a symptom of ovarian or testicular dysfunction. If the proper feedback mechanism of follicle-stimulating hormone production from the pituitary gland is altered, the level of the follicle-stimulating hormone will rise. Elevated levels of the follicle-stimulating hormone will cause a condition known as hypogonadotropic-hypogonadism.

What Happens if There Is a Lack of Follicle-Stimulating Hormone?

In Women:

• Incomplete pubertal development.

• Ovarian failure.

• Infertility.

• Reduced sense of smell.

In Men:

• Improper sperm production.

• Lack of puberty or delayed puberty.

• Infertility.

What Are the Symptoms of Follicle-Stimulating Hormone Abnormalities?

The symptoms of follicle-stimulating hormone abnormalities depend upon the condition's underlying cause. Moreover, the symptoms also differ in men and women. The symptoms of follicle-stimulating hormone abnormalities in women with high or low levels of the hormone include:

• Ovarian failure.

• Irregular menstrual cycles (oligomenorrhea).

• Absence of menstrual cycles (amenorrhea).

• Hot flashes.

• Irregular sleep cycles.

• Mood swings.

• Depression.

• Galactorrhea (milk discharge unrelated to lactation).

• Vaginal dryness.

• Urinary tract infections.

• Urinary incontinence.

• Dyspareunia (recurrent genital pain).

• Hypopituitarism.

• Headaches.

• Visual defects.

• Ovarian cysts.

• Thick endometrial lining.

Symptoms of Follicle-Stimulating Hormones in Men Include:

• Testosterone deficiency.

• Infertility.

• If testosterone deficiency occurs before puberty, the small size of testicles, short phallus, high-pitched voice, decreed muscle mass, decreased body hair, etc.

• If testosterone deficiency occurs after puberty, soft testes, decreased muscle mass, decreased strength, reduced facial and pubic hair, abnormal growth of breasts (gynecomastia), etc.

How Are Follicle-Stimulating Hormone Abnormalities Diagnosed?

Various blood examinations make the diagnosis of follicle-stimulating hormone. These blood examinations include evaluating the levels of the following:

• Luteinizing hormone.

• Testosterone levels.

• In men with low follicle-stimulating hormone levels, feminizing characteristics, such as gynecomastia, serum estradiol levels are measured to rule out an estrogen-secreting tumor.

• Semen analysis to evaluate fertility.

• Other pituitary hormone levels must be measured in patients with gonadotroph adenomas to screen for hypopituitarism. The other pituitary hormones include growth hormone, adrenocorticotrophic hormone, cortisol (morning sample), thyroid-stimulating hormone, free thyroxine, etc.

• Prolactin levels must be checked in women, along with the levels of luteinizing hormones and estrogen levels.

• Imaging tests may be done to locate and assess ovarian masses.

How Are Follicle-Stimulating Hormone Abnormalities Managed?

• Depending on the underlying cause, medical treatment is given to patients with abnormal FSH levels. For example, hormone replacement therapy may be used in women with primary (ovarian) or secondary (pituitary) hypogonadism (estrogen and progesterone). However, research by the Women's Health Initiative revealed that taking estrogen and progesterone has potential health risks.

• Testosterone replacement therapy is given to men with primary (testes) or secondary (pituitary) hypogonadism, either intramuscularly or using patches or gel. Unless prohibited for other medical reasons, surgery is the preferred course of treatment for patients with gonadotroph adenomas, adrenal tumors, or gonadal tumors.

Conclusion:

Follicle-stimulating hormone abnormalities can cause multiple health problems especially related to puberty and reproductive functioning. The most problematic consequence of these abnormalities is infertility in both men and women. However, if diagnosed early and managed with proper treatment modalities, the levels of the follicle-stimulating hormone can be restored, and related fertility problems can be cured.