People can also measure their LH levels at home using a home ovulation test. This is a urine test that involves adding a few drops of urine to a test strip. Follow the instructions on the package. In this condition, the ovaries stop working properly before the female reaches the age of LH test results help a doctor determine whether a male or female has problems with their reproductive system.
Doctors also use LH tests to diagnose pituitary gland problems and the early or late onset of puberty. Females can take LH urine tests at home to work out when they are ovulating, which can help them conceive.
A person is most fertile around ovulation. Malnutrition occurs when the body does not get the nutrients it needs. Causes include limited food supply and some mental and physical health…. Infertility or a couple being unable to conceive a child can cause significant stress and unhappiness. There are numerous reasons for both male and…. Estradiol is a form of the hormone estrogen, which plays a role in many aspects of growth and development.
Doctors can measure estradiol levels with a…. What to know about luteinizing hormone tests. Medically reviewed by Debra Sullivan, Ph. What is it? What is an LH test? Share on Pinterest An LH test involves taking a blood sample.
What is an LH test used for? Share on Pinterest Low testosterone can cause reduced beard growth. Normal LH ranges and what they mean. Risks of the LH test. Share on Pinterest People afraid of needles should speak to their doctor before having a blood sample taken.
The kit is designed to detect the rise in LH that happens just before ovulation. This test may help you figure out when you will be ovulating and have the best chances of getting pregnant. But you should not use this test to prevent pregnancy.
It is not reliable for that purpose. The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health. What is a luteinizing hormone LH levels test? In women, LH helps control the menstrual cycle. It also triggers the release of an egg from the ovary. This is known as ovulation.
LH levels quickly rise just before ovulation. In men, LH causes the testicles to make testosterone , which is important for producing sperm.
Normally, LH levels in men do not change very much. In children, LH levels are usually low in early childhood, and begin to rise a couple of years before the start of puberty. In girls, LH helps signal the ovaries to make estrogen.
In boys, it helps signal the testes to make testosterone. Other names: lutropin, interstitial cell stimulating hormone. What is it used for? In women, these tests are most often used to: Help find the cause of infertility Find out when ovulation occurs, this is the time when you are most likely to get pregnant.
Find the reason for irregular or stopped menstrual periods. Confirm the start of menopause, or perimenopause. Menopause is the time in a woman's life when her menstrual periods have stopped and she can't become pregnant anymore. It usually starts when a woman is around 50 years old.
Perimenopause is the transition period before menopause. It can last for several years. LH testing may be done towards the end of this transition. In men, these tests are most often used to: Help find the cause of infertility Find the reason for a low sperm count Find the reason for low sex drive In children, these tests are most often used to help diagnose early or delayed puberty.
Puberty is considered early if it starts before age 9 in girls and before age 10 in boys. Puberty is considered delayed if hasn't started by age 13 in girls and by age 14 in boys. Why do I need an LH test? If you are a woman, you may need this test if: You've been unable to get pregnant after 12 months of trying.
Your menstrual cycle is irregular. New-onset asthma and systemic lupus erythematosus have been reported to occur twice as often in ERT users as in nonusers. Contraindications to Hormone Replacement Therapy.
Contraindications to HRT include uncontrolled hypertension, unexplained vaginal bleeding, impaired liver function, active thromboembolic disease, porphyria, and breast cancer Table 9. Although the data with regard to estrogens and breast cancer have led many clinicians to refuse to prescribe estrogens for women with a history of breast cancer, there are some clinical observations suggesting estrogens may not accelerate breast cancer.
First, there is no difference in survival when pregnant women with breast cancer are matched to nonpregnant women by age and stage of disease; moreover, termination of pregnancy is not associated with improved survival. Not all reports are in agreement on these issues. For example, a report from M. Anderson Cancer Center concludes that a concurrent or recent pregnancy adversely affects survival rates in women with breast cancer.
Taken together, these data suggest there may be times when it is acceptable to give exogenous estrogens to women with a history of breast cancer who want very much to take estrogen. There seems to be little point in withholding estrogen from women with widely disseminated breast cancer who desire estrogen because their quality of life is miserable with menopausal symptoms.
Patients with a low risk of recurrence, including those more than 5 years from a diagnosis without evidence of disease, those with ductal carcinoma in situ , those without any positive axillary nodes, those with tumor size less than 1 cm, those who are estrogen receptor negative, and those with well-differentiated nuclear grade 1 tumors, would appear to be especially good candidates for consideration for estrogen.
However, women electing estrogen therapy must be aware of the potential risks; for most women, it is probably prudent to treat menopausal symptoms with agents other than estrogen until the risks are known. Relative contraindications include gallbladder disease, pancreatitis, leiomyomas, endometriosis, migraine headaches, seizures, hypertriglyceridemia, endometrial cancer, history of thromboembolic disease, and a strong family history of breast cancer. Consensus is developing that it is probably safe to prescribe HRT for a woman with an early-stage, low-grade endometrial cancer who has had a hysterectomy.
In most instances, the level of estrogen used in HRT is not sufficient to stimulate endometriosis and leiomyomas. The decision to give HRT to women who fall into any of these categories must be based on the severity of the symptoms and the circumstances.
The patient should be well informed of the potential adverse effects of the treatment and must clearly believe that the benefits to her are worth the risks. There is no contraindication to the use of HRT in women with a history of cervical or ovarian cancer. There are several classes of estrogens. Naturally occurring estrogens, including estradiol, estrone, and conjugated estrogens composed of many estrogens, including estrone sulfate, equilin, and equilenin , are the estrogens generally given for replacement therapy.
Synthetic estrogens, including ethinyl estradiol, mestranol, and quinestrol, and the nonsteroidal estrogens, including diethylstilbestrol and chlorotrianisene, typically are not used for ERT.
Estrogen can be administered through a variety of routes, including oral, intramuscular, topical, subcutaneous, nasal, and vaginal.
Not all forms are available in the United States. Nasal sprays allow direct rapid absorption. Intramuscular injection is convenient, requiring infrequent administration, but immediate reversal is impossible, and tolerance may develop. Moreover, very high circulating levels of estrogen may be achieved soon after administration. Subcutaneous pellets also give sustained release, but immediate reversal may not be possible because retrieval of the pellet is difficult.
Estrogen creams are used extensively in France but require a wide area of application. Transdermal patches allow direct absorption, but the effect is not sustained; therefore, the patch must be worn continually and reapplied at appropriate intervals. The most frequent complication of transdermal delivery is skin irritation.
Vaginal suppositories and creams permit direct absorption but are unacceptable to many women. A low-dose vaginal ring that delivers 7. The most commonly prescribed estrogen is oral conjugated equine estrogen. A daily dose of 0. Equivalent oral alternatives include piperazine estrone sulfate at a dose of 0.
Higher dosages may be necessary when first starting replacement therapy in women with severe symptoms. Moreover, the dosage of any estrogen preparation must be individualized. Administration Method. Estrogen administration is associated with a number of side effects that may affect compliance. Initially, most women experience some breast tenderness.
If breast discomfort persists, the dosage of estrogen should be reduced. Some women require much higher doses for alleviation of their symptoms; young, surgically oophorectomized women often need twice as much estrogen as those who underwent physiologic menopause. Other side effects include nausea, vomiting, weight gain up to 5 lb, fluid retention, and heartburn.
Fluid retention and weight gain often may be abolished by restricting salt intake. The most frequent complaint with hormonal replacement is uterine bleeding. The frequency of irregular bleeding is related to the estrogen dose, with 1.
Progestin is usually administered only orally. Common complaints include bloating, depression, premenstrual tension-like symptoms, acne, and breast tenderness.
Beginning with a dose of 5 mg and increasing the dose to 10 mg in those women without complaints reduces the number of women discontinuing therapy. It may even be necessary to decrease the dose to 2. These norsteroids lower the ratio of high-density to low-density lipoproteins more than MPA and therefore are not commonly used in the United States.
Other progestins may also be used. Micronized progesterone is well absorbed, has little or no effect on the lipid profile, , and has been approved for use in the United States.
Progesterone in vaginal gel form is also available. Other progestins, such as norgestimate, gestodene, and transdermal levonorgestrel and norethindrone acetate are being investigated. Many regimens are being used, none of which is physiologic.
Estrogen is usually given with a progestin to women with a uterus to prevent endometrial hyperplasia. Estrogen is given alone to women without a uterus to avoid the deleterious effect of progestin on lipoproteins. One of the most widely prescribed regimens in the United States for women with a uterus is the use of an estrogen for the first 25 days each month with the addition of MPA 5 to 10 mg for days 13 to Women who are symptomatic during the drug-free days can be given estrogen continuously, with MPA administered for the first 13 days of each month.
In Europe, most women are given continuous estrogen therapy with 12 to 14 days of progestin. This regimen has gained popularity in the United States, because bleeding is no more frequent than with the intermittent cyclic regimens and because this regimen is easier for the patient to remember.
Women with fibrocystic condition of the breast may benefit from cyclic regimens with days off estrogen therapy. Continuous daily administration of a combination of an estrogen and a progestin has become more popular. Occasional reports of cancer of the uterus occurring with this regimen have appeared.
Quarterly use of progestin has also been reported. Although women preferred the quarterly progestin to monthly progestin, they did have longer, heavier menses, with almost twice the incidence of hyperplasia of the endometrium after 1 year 1. How long therapy of postmenopausal and oophorectomized women should continue is unknown. Relief of mild menopausal symptoms may be achieved by short-term therapy tapering to none.
Prophylaxis against cardiovascular disease in the setting of a strong family history of cardiovascular disease may result in indefinite use of HRT. The same is true for protection against osteoporosis. Before institution of HRT, a complete history and physical examination should be completed Table Pertinent tests include a stool guaiac, a Pap smear, baseline mammogram, a sequential multiple analyzer SMA assay, and fasting cholesterol, triglycerides, and glucose concentrations.
Liver function tests are required in women with a history of liver disease. Pretreatment endometrial biopsies are not necessary for all women. Biopsies should be performed in women with irregular bleeding and in those at increased risk for endometrial carcinoma. Women at increased risk include those with a positive family history for endometrial or breast carcinoma, obesity, alcoholism, hepatic disease, and a long history of amenorrhea or oligomenorrhea during their reproductive years.
Some recommend pretreatment biopsies in women who still withdraw to a short course of MPA, although the value of this has not been confirmed. TABLE History and physical examination Stool guaiac Pap smear Mammogram SMA Fasting cholesterol Triglycerides Glucose Liver function tests with past history of liver disease Endometrial biopsy in high-risk groups.
SMA, sequential multiple analyzer assay. After replacement therapy is initiated, patients should be evaluated in 4 to 6 weeks to adjust the dosage if necessary and to evaluate side effects or complications. If severe headaches, visual changes, chest pain, or symptoms of thrombophlebitis develop, estrogen should be discontinued immediately.
If hypertension develops with the onset of therapy and cannot be controlled, then therapy should be stopped. Blood pressure usually returns to normal in those women. It has been suggested that biopsies be performed in women receiving cyclic progestin only if bleeding occurs before day 11 of progestin therapy, but these data require substantiation.
A biopsy should be performed immediately in any woman who develops abnormal bleeding. Women on unopposed estrogen should have an annual endometrial biopsy even in the absence of any bleeding. Breast and pelvic examination, blood pressure monitoring, and a stool guaiac test should be repeated at least yearly. Periodic mammograms should also be performed, with the frequency dictated by age and the presence of risk factors. Pap smears should be obtained every 1 to 3 years, depending on history and risk factors.
Although the roles of exogenous estrogen and progesterone therapy in cardiovascular disease and breast cancer have not been clearly defined, the use of this hormonal combination has been found to be cost effective and also has been shown to increase life expectancy by 1 month relative to no treatment. Menopause is a normal and natural event in the female life span. The life expectancy of women already exceeds that of men, and many elderly women enjoy an excellent quality of life without HRT.
All women should be counseled regarding the healthy lifestyle that they themselves can adopt: low-fat, lowcholesterol diet; adequate calcium and vitamin D; exercise; and avoidance of smoking, excessive alcohol, and obesity. A decision to use or not to use HRT is not irrevocable; it can be changed as new information becomes available.
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