September 20, 2014

How do I lower my FSH level?

Your site is fantastic. I have searched many infertility sites and there is nothing else like it. I have a question that I would respect your opinion on, please.
Recently, i found out that my FSH is high (20.4). My fertility doctor says that this is the reason for my infertility and it means my eggs are getting bad.  I also went to see a Chinese medicine specialist. She says I need to get a full evaluation and then she can come up with a formula of herbs that will definitely lower my FSH. I don’t really trust her. She’s not even Asian! What can I do to lower my FSH? Is there no hope for me?

Angel
Larkspur CA

Dear Angel,
I’m sorry to hear about the bad news that your doctor gave you. Since I don’t even know some very basic and crucial pieces of information, such as your age, I don’t have enough clues to directly comment about your specific situation. However, you do bring up a very popular topic, namely that of FSH values, so I will be glad to tell a little story about the significance of FSH.

FSH is the abbreviation for FOLLICLE-STIMULATING HORMONE. It is a substance created from part of the brain called the pituitary gland. In a young, healthy woman, a small wave of FSH released at the beginning of the cycle will get her follicles to start developing for that month. Why only a small amount? Because a young fertile woman’s ovaries are very sensitive. They don’t need much to get them going. After getting just a tiny whiff of FSH, they will start to do their thing. As the follicles do their thing, they start to grow bigger AND they will produce another hormone called estradiol. The news that estradiol is rising goes back up to the pituitary and tells it the good news that "OK, things are moving along just fine. You can ease up on the FSH production. Thank you very much. Talk to you later." The FSH factory supervisor gets this message and tells the production crew to slow down, get some rest and wait until next cycle. In physiological terms, this is known as NEGATIVE FEEDBACK, which is not a bad thing here, unlike the way it is when you’re talking about your EBay rating.

In a woman who is 45, the follicles are few in number and poor in quality, so a different scene plays out. The story begins the same way. At the beginning of the cycle, the pituitary faithfully sends out pulses of FSH and waits for a negative feedback estradiol signal from the follicles that will tell the pituitary to rest again. However, because the follicles are bad, they won’t develop as vigorously, if they even develop at all. So while the follicles struggle to grow and develop in a healthy manner, they will not send out a strong estradiol signal. Meanwhile, the pituitary starts to get a little nervous. "Hmm, it’s been several days and we still haven’t heard back from the follicles. Maybe they need a little more juice." The pituitary then makes the decision to crank up the FSH production and the FSH level goes up a bit. If the follicles eventually respond to this new increase of FSH, then the estradiol signal will arrive and the pituitary crew will breathe a sigh of relief. However, in a worst case scenario (for example if the woman is completely menopausal or if her ovaries have both been surgically removed), then the pituitary is in for a big surprise. The estradiol signal will never come. So what happens is the pituitary will frantically shift into panic mode, going full power and pouring out tons of FSH. The FSH levels will skyrocket!

This second scenario doesn’t just happen in 45 year-olds. It can also happen in some younger women whose ovaries for some reason or other are behaving much older than they really are. This is a condition, known as diminished ovarian reserve or in an extreme situation where the follicles have completely shut down, it is known as PREMATURE OVARIAN FAILURE.

So when your RE checks your FSH level, he is screening to see if your pituitary is overworking itself. If the FSH level is high, it typically means that the follicles are fewer in number and/or lower in quality. The elevated FSH is the INDICATOR of the bad news. It is NOT THE CAUSE of the bad news.

So the concept of trying to lower your FSH, as that herbalist suggests, is downright silly. It won’t solve your problem. It’s actually easy to lower you FSH. Can you guess how? That’s right. If you just give someone a high dose of estrogen through pills, injections or a patch, that will give the pituitary the signal it has been waiting, albeit a fake signal. The pituitary will then ease up on the FSH production. But you haven’t achieved anything helpful. The follicles are still as poor as they always were.

Think of it like this. You are happily driving your car when all of a sudden, a bright red warning light starts flashing telling you that the engine is overheating. Trying to lower the FSH would be like taking a wire cutter and cutting the wire that powers the warning light. The light will go off and you will longer see the bad news. However, that doesn’t change the fact that something is very wrong with the engine.

In general, FSH levels over 10 IU/L are a little bit concerning. If they are over 12 IU/L, it’s definitely a predictor of poor follicle function. And if it’s over 20, it’s almost for sure that something is seriously wrong with the follicles. I will share that I’ve had patients with FSH levels over 20 who eventually got pregnant with their own eggs, but those cases are so rare that they are distinctly memorable. But it’s not entirely without hope.

So now that you understand this, I hope that you don’t let anyone mislead you. As for your Chinese medicine provider not being Asian, you shouldn’t let that alone prejudice you against her. I once took martial arts from a non-Asian master and he’s definitely someone not to mess with.

  • travel

    Forgot to add, Dr. said he didn’t think it was entering menopause, ovaries were normal size, internal organs looked normal etc., he didn’t seem too concerned, said he’d check with the lab, but was pretty lackadaisical about it. Good Lord.

  • saima

    hi my name is saima..m30 yrs old..maried for 7 yrs…my blood test shows my fsh is 70…n doctor says i cant conceive….plz hlp me is dere ne way i can reduce my fsh

  • vanessa

    Hi, I am 30 years old, and I had a FSH of 70, my doctor has prescribed estrodol and provera. Is there any way to go round those meds and still get pregnant ?

  • Vicki

    I had a total thyroid removal July 22 2011. In July i did IUI. My Fsh was 9.75 and my estradial was 35…Im 46. Aug 5th got a period. Then no period for Sept. Just got labs back. My Fsh is 32…What the heck happened? Can this be reversed? I was not even premenapsal before surgery….Thank you for your help….Im crushed! Why did my surgery throw me into menapause???

  • Amal

    Hi, I am 38 years, my FSH is 39 mUI; LH is 18.38 mUI, TSH is 2.47 yUI and prolactine is 22.38ng/ml. these were at 3 days of the cycle. I would like to know if possible to lower FSH and have baby and this not now since i am not married yet.
    Thanks

  • Roli

    I am 39yrs . my LH is 31, FSH is 45, Prolactin, 13 and progesterone is 3. At time I don’t see my period for 2 months or for a month. Does it mine I cannot be pregnant. What can I do

  • Revathy

    Hello, I am 28 and my FSH level is 25.7 on Day 3, Estradiol 32.1, Lh 8.46, AMH 0.41, Inhibin B 78.5.
    Will i be able to conceive ?

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  • Marline

    i am 40 and m having a problem in FSH….did not get my periods. last was on Oct. 24…..my doc said to take a blood test on the second day of period and than she will tell me if i can get pregnant or not if my FSH is high..is there any way i can get pregnant??? pls help

  • IVF-MD

    How high is the FSH?

  • sujju

    hi iam 27 years old.my fsh is 9.67.dr says iam not able to natural pregnency.so better to go ivf.if possible to reduce fsh level.

  • Val

    I’m only 22 ,and I recently found out that my FSH level is high (13 IU/L) .. didn’t know how bad is that till i read this article ! I actually saw my doctor 2 days ago , but i felt that he didn’t really want to scare me or what ever, he explained to me that it COULD be bad , but he didn’t confirm anything to me , he just asked me to wait for 5 months and then i’ll do the test again to measure my FSH levels.
    why 5 months?! I wanna know now ! am I infertile?
    :( thanks any way doctor for this great article , it really made things clear to me!

    as for the lady who was asking …..I really hope that one day u’ll find a solution to ur problem ! :)

  • Val

    Oh,and I don’t know if this information is useful , but sometimes i miss my periods ! …this doesn’t happen regularly… I think i missed 2-3 periods last year (not in a row).

  • Armin

    Hello, I am 44 and had conceived earlier at the age of 29 and 32, naturally. My younger son died recently and I am trying for a baby again. My FSH during day 3 of the period was 14. Does the FSH level increase post the period. What are my chances of conceiving again? Thanks

  • Chris

    Hi, I need clarification on this FSH..My wife who is now 41 has recently been diagnosed by her doctor with being  perimenopausal after experiencing hot flushes, mood swings and missing her periods for the last 2-3 month. As a husband its very distressing to see your love one so upset confused and now depressed knowing chances of having a child is slim.
    As I sit here I have scanned her blood results to find the following which I seek clarification please: FSH level is: 84U/L, LH level is: 47 U/L, Oestradiol level is:130 pmol/L and finally her Progesterone level is: 1 nmol/L.
    In English terms reading all the facts presented in all the articles I have read I understand including yours, high level of  FSH over 20 IU/L pretty well much mean there are slim chances of her falling pregnant…Is that correct?
    Secondly, her levels as I have indicated above, do these in your professional opinion seem to be that of perimenopause.
    Lastly, is there anything odd about or unusal you can see with these levels.
    Can I get some clarification please…anything would help greatly. Thanks

  • Manuedith

    My wife is fsh 26 and the doctor had recomended in vitro, i think food and exercise is good to low de fsh level. It helps you, please help me to know about what food is good and how offen you exercise, thank a lot. How are you today?

  • Kelhow

    i was diagnosed with pof it started when i was 23 years old but it took the
    doctors 4 years to agree as i was to young. i was put on the list for ivf also
    my partner has a low sperm count my fsh 156. i was told to go on hrt by my ivf doctor as it
    would give me a regular cycle i tried loads of different ones i found prempak c
    to work for me those hot flushes kill me by now i was 29 been on hrt for 1 year. then one day i
    kept feeling tried-couldn’t eat certain food-felt sick surely i couldn’t be
    pregnant did a test got a positive went to see my doctor he told me i have got
    more chance of winning the lottery than having a baby.

    Well they don’t know everything as my son is now 4 years old i tried for 6
    years i defoe think the hrt helped me get pregnant. what they don’t realize is
    that i have won the lottery.

    i wish you all luck miracles can happen mine did..be positive

    also i had put loads of weight on 3 stone in 4 years, was eating junk food and drinking every weekend.

  • Bush

    Dr. Lee, your article is great, but it does not have a good conclusion!! what should a person do after the understanding?

  • Sid

    The best thing is wheatgrass worked for me and friends that had high fsh an couldn’t be stimulated by ivf then had natural healthy pregnancies

  • Nisha4s

     Hi,
     
    i am not quite sure if you will be able to help me as i have lost all hopes. im a 23 years  women and i have recently done a blood test after having number of weird symptoms such as hot flashes, no periods for three months, mood swings, head aches. I have recently done a blood test and my FSH has come to 1110.8 I have seen a specialist who has told me this is extremely high and that I will not be able to receive any IVF treatment. I am totally shattered I would like to know if there is you can suggest which may help me be able to conceive.
     

  • Kary

    I am 36 . I will be 37 in a couple of weeks. I had 2 kids before I was 21. I recently decided to potentially have another child by 38. This summer I began to miss my periods . I had attributed it to being on a diet, working out a lot & stress. I went to my doctor again because I have not gotten my period for 2 months . He ordered blood work & my results broke my heart. Lh 56.7 FSH 113.5 estradiol 21.86 but this is not day 3. In the last year and a half, I had taken the Plan B pill 5 times. The last time I took it was almost a month ago. Did the plan b impact these blood results? Do I not have a chance to get pregnant on my own with my own eggs? My mother also informed me she was premenopausal at 38. Thanks for the help.

  • Qudsia7

    where do u live..

  • Sam

    My gf is just 23 years old & she had absolutely norrmal[ periods till one day when the condom tore & she had to have an i-pill within an hour. its been 2 weeks since she has an i-pill & here bleeding was due on 24th of this month which started the same day,there was no delay but the bleeding was very very mild & she is suffering from constipation to an extend that she hasn’t pooped for past 4 days even after taking medicines for constipation.Today her FSH was 11.2 in the reports. Is that because of the i-pill only or is there some other major problem. She did pregnancy tests 3-4 times but it all showed negative. Please suggest me what to do?

  • paro

    dear nitin… I m of same age and same FSH leve… & i m unmarried……. if u’ll find any solution plz do let me know.

  • Guest

    Hello Doctor. Thank you for your article. Very informative!
    I’m 27 year old female. I’ve done my blood work recently and my FSH came as 24.1 and FSH and LH together in range 14.5, estradiol was 18.
    My doctor sent me for an ultrasound to check my ovaries’ size, which I’ll do next week… She did not sound hopeful when she was explaining everything to me… Actually to me she sounded hopeless :-(
    Then doctor said that my results came out like a woman who’s 45 would receive. With Menopause… Can you please advise if there is at least a small chance I may get pregnant one day? I read all the comments here and I’m so happy I did… Please provide your opinion.

  • Lily

    Hello Doctor. Thank you for your article. Very informative!
    I’m 27 year old female. I’ve done my blood work recently and my FSH came as 24.1 and FSH and LH together in range 14.5, estradiol was 18.
    My doctor sent me for an ultrasound to check my ovaries’ size, which I’ll do next week… She did not sound hopeful when she was explaining everything to me… Actually to me she sounded hopeless :-(
    Then doctor said that my results came out like a woman who’s 45 would receive. With Menopause… Can you please advise if there is at least a small chance I may get pregnant one day? I read all the comments here and I’m so happy I did… Please provide your opinion.