How to read a hormone blood test result

[Periperinotchicken]

So I know that NICE guidelines for over 45s are based on symptoms rather than blood test results. My GP is happy to prescribe HRT if I decide but I asked for hormones to be included as I was having a blood test anyway.

Can anyone help me decipher it? Just the hormones, the thyroid one has been explained to me.

The receptionist indicated it was within the normal range but it would be good to know what it all means. I know they fluctuate all the time so it was only a snapshot of a moment.

en.wikipedia.org/wiki/Reference_ranges_for_blood_tests#Sex_hormones

Not a doctor, but to me the Estradiol and FSH levels suggest you're menopausal.

It doesnt help that the columns are out of wack with the results, but your FSH is too high to be considered fertile range. The higher the FSH, the harder the ovaries are trying to ovulate. Beyound that I'm not sure. Ie the ovaries are diminished in egg reserves

Thank you both for coming back so quickly so what does the 2.4 - 12.6 mean and is that my results or the range. Even with the link @TalbotAMan sent me, I can’t make head nor tail of it, I better add brain fog to my symptom list 😂

The figures there show the ranges. eg 2.4- 12.6

I'm confused as what appear to be your results have the words NO Action beside them..

This is FSH range

What level of FSH indicates menopause?
Sometimes, elevated follicle-stimulating hormone (FSH) levels are measured to confirm menopause. When a woman's FSH blood level is consistently elevated to 30 mIU/mL or higher, and she has not had a menstrual period for a year, it is generally accepted that she has reached menopause.

How old are you and are you still having periods?

Also, you will get a more accurate result if done on days 2-5 of your cycle, if you still have periods.

Move the column with LH, FSH and oestradiol along to the right so that they are in line with the numbers below. This then becomes a readable table that you can compare your results to. Your FSH is suggesting that you are menopausal. The comment of "normal range" by the doctor suggests that they are happy with this result and that your clinical picture is that of menopause.

Thank you @JinglingHellsBells, yes I don’t understand the results either especially when it says no action which lead me to believe that my symptoms weren’t hormone related.

I’m 48 and on a period now but it was really late and the one before that was really early - prior to that they were regular 27 days apart.

If @TalbotAMan and @WhiteJellycat reading of it is accurate, I might be having an anovulatory cycle. Which strengthens going down the HRT route.

@TheVeryHungryTortoise thank you for trying to help me, is my FSH result 54.4, if so is that way off the scale?

Is there anything else significant on there?

@JinglingHellsBells - they didn’t give me an option of when to have it.

The "no action" is just an administrative note that the doctor writes after reviewing the results. Don't worry about that part, it is purely telling the admin team that they don't urgently need to call you- without knowing you and your medical history I would expect your reviewing doctor was happy with these results based on your clinical picture.

Your FSH is not "wildly" high, but is at a level which could indicate menopause, however a diagnosis such as menopause is usually decided without hormone tests. To simplify why you have a higher FSH I'll quickly explain the axis. FSH is produced by a gland in your brain, it tells your ovaries to produce oestrogen. If your ovaries then produce enough oestrogen the gland stops sending the FSH signals and FSH decreases. When you start to enter menopause, your ovaries don't produce enough oestrogen and the gland in your brain tries to rectify this by sending out extra FSH to stimulate oestrogen production. So you continue to get this increasing level of FSH during that time.

Hormone blood tests are not considered necessary by NICE in most patients to diagnose menopause or perimenopause. Usually the GP would diagnose based on your presenting symptoms and the changes in your period.

I would recommend trying to discuss with your GP. NICE has a section for information for patients which may be useful for you, you can Google "NICE menopause information for public" and find it there. Hope this helps a little.

I'd also add @Periperinotchicken that a single blood test is often inaccurate. I had a blood test around 50, when I saw my gynae (not for menopause at the time) and my FSH was around the high 50s and in theory indicated post menopause. I was still having regular periods and went on having them for almost another 3 years. My consultant said it proved that tests can be very inaccurate (which he knew already ) but the tests were not to diagnose meno, just one of a whole range of tests done at the time.

So, you could have the same test next week and it could be very different.

That's the beauty of peri! Hormones can change by the day which is why NICE says don't do them for women over 45. If it looks and sounds like menopause, it usually is and treatment is offered on that basis.

@TheVeryHungryTortoise you are so kind, thank you so much. So this could probably explain my weight loss, anxiety, low mood and insomnia. I thought it might be a mental health condition but this suggests it’s hormonal and HRT might help. I’m very grateful.

NICE has a section for information for patients which may be useful for you, you can Google "NICE menopause information for public" and find it there. Hope this helps a little.

@Periperinotchicken The NICE guidance is pinned at the top of this page. (I asked for it to be :) )

You can read it there.

@TheVeryHungryTortoise @JinglingHellsBells
Ladies, thanks so much for your really insightful comments.
I'm currently stuck between my consultant Gynae and my GP, who seem to have very differing opinions on BC risk! The mixed messages are very unsettling; the GP put the fear of God into me ref the Consultant prescribing oral oestrogen.....
I've tonight sat and digested the NICE document and I'm going to decide what MY risk profile is, factoring in my quality of life.
@Periperinotchicken - good luck on your HRT journey. Although I've had this recent hiccough with the GP's concerns, I can honestly say that the drugs have made me feel like a new woman (after 5 odd years of increasing physical symptoms and anxiety/anger/low mood).

@JinglingHellsBells so helpful to hear your experience and thank you for the link to the guidance. You are so well informed about all of this and always happy to help others.

@Falifornia thank you for the encouragement and I’m delighted to hear HRT worked for you and good luck in weighting up all the factors.

Thank you again to everyone that read my results and told me that overall it indicates high FSH. Even if the results might be different the following hour/day, psychologically it’s helped me to know that at that moment my hormones indicated something and that I’m not going mad.

If there is anyone that can talk me through each line and explain the numbers, I’d be grateful. I have no idea what

2.4 - 12.6
14 - 95.6
3.5 - 12.5
45 - 854
etc etc means.

Is my results those in bold (76, 20.2, 54.4) and which range should I compare them with? I feel really stupid and just want to educate myself. I could ask the Gp but you only get a few minutes with them and I’d rather use the time to discuss the HRT options.

The only important reading is the FSH- follicle stimulating hormone. This is how hard your ovaries have to work to push out an egg (putting it very simply). If it's over 30, then it can often mean you are in menopause (no eggs left.)

I think that on your results, the numbers and columns are not aligned properly.

I THINK that the sub-heading GONADTROPHIN LEVELS should be moved to the left, so that the numbers 20.2 and 54.4 are under the FSH heading.

They show an LH reading of 20.2 (and the range for normal/ fertility is
between 1.00 and 11.4) and the normal FSH levels are between 2.00 and 12.6.

Your LH is 20.2 and your FSH is 54.4

Both are above the range for normal fertility.

These
2.4 - 12.6
14 - 95.6
3.5 - 12.5
45 - 854

are ranges that can be considered normal and will depend on when the test is done in women having a cycle.

I honestly wouldn't get hung up on it all as peri and post menopause now is diagnosed on symptoms alone in women aged 45 (and sometimes of course a year younger- not an exact science.)

Thank you @JinglingHellsBells, yes I’m probably a bit hung up on it but until I came on here yesterday, I was under the impression that mine was in the normal range. It was an eye opener and a reminder to be more proactive.

Thanks again for the explanation.