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Estrogen, Progesterone, LH, FSH & Getting Pregnant 

Estrogen, Progesterone, LH, FSH & Getting Pregnant

Getting pregnant is more complicated than you might think. The chance of getting pregnant in each cycle is around 25% even if there are no fertility problems whatsoever. Getting pregnant involves an intricate balance of your fertility hormones.

What is ovulation

The right kind of hormones must wax and wane at just the right time. If you don’t pay close attention to your menstrual cycle and monitoring your ovulation, you might lose your fertility window and it might take months and even years to get pregnant.

Hormones are the chemical messengers of our body that control every aspect, big and small, from fertility to appetite. Changes in hormone levels can have a devastating effect on the normal functioning of the body. Fluctuations of hormones that control appetite or mood are quite easy to spot. However, if there is an imbalance in the fertility hormones such as Luteinizing Hormone (LH), it can be difficult to trace, especially if you don’t know what to look for.

Your menstrual cycle and hence your fertility is controlled by four major hormones-Oestrogen, luteinizing hormone (LH), Progesterone, and Follicle Stimulating Hormone (FSH). A normal menstrual cycle involves a phasic rise and fall in levels of these four hormones. If there is an imbalance of even a single hormone, the whole menstrual cycle can be thrown off its course. An erratic, irregular menstrual cycle can pose the biggest hurdle in your getting pregnant.

Getting the levels of these hormones checked every day is not a feasible alternative, to say the least. That said, you can track some physical symptoms that can give you some valuable insights into your periods and fertility window.

Ovulating Regularly With PCOS
Image courtesy of The Bright Girl Guide by Demi Spaccavento.

Important fertility hormones Estrogen, Progesterone, LH, and FSH

What is estrogen & what does estrogen do?

Oestrogen is a steroidal fertility hormone that is synthesized in the ovaries by ovarian follicles. Proper estrogen levels are essential for the menstrual cycle to be fertile. Apart from its role in the menstrual cycle, estrogen also plays a vital role in bone formation, the development of secondary sexual characteristics, and even cholesterol levels.

What is an ideal estrogen level?

The amount of estrogen secreted in your body changes with your age. The two most common forms of estrogen are estrone and estradiol. Both these forms are responsible for fertility. The levels of these hormones vary in women depending on their age group.

    • Prepubescent girls have almost undetectable levels of both hormones in their blood. The levels hovering between 20 pg/ml to 29 pg/ml of estradiol and estrange respectively.
    • Pubescent girls also have a trace amount of these hormones. The level of estradiol and estrange can range between 10-200 pg/ml.
    • Adult, menstruating women can have about 17-200 pg/ml estrone and 15-350 pg/ml of estradiol.
    • Postmenopausal women have a very little amount of both these forms of estrogen. The level of estrone is between 7-40 pg/ml, while the level of estradiol is less than 10 pg/ml. An abrupt and abnormal change in the estrogen level can affect your menstrual cycle adversely including fertility and ovulation. Low levels of estrogen during and after menopause are responsible for menopause-related symptoms such as hot flashes and night sweats.

What does low estrogen mean and how to detect it?

A decline in estrogen levels can seriously hamper your chances of getting pregnant. If your body produces an inadequate amount of estrogen, it can cause anovulatory cycles where there is irregular or lack of ovulation. Low estrogen is also a sign of some eating disorders as well.

Excessive exertion in the form of heavy physical exercise and being underweight can also be one of the reasons for a low estrogen level. Women suffering from low estrogen levels often have irregular periods that can make it very difficult for them to get pregnant. Here are some symptoms of low estrogen levels:

    • Low estrogen means a lack of vaginal lubrication. This can lead to painful sex
    • An increase in Urinary Tract Infections can also be correlated to a lower level of estrogen
    • Frequent mood swings
    • Erratic or absence of periods
    • hot flashes and depression
    • frequent and unexplained headaches

High estrogen levels and what are its symptoms?

What causes high estrogen levels? An unusually high level of estrogen is also not a good thing. There is often an underlying medical cause for such high levels. Health conditions such as endometriosis and PCOS can cause an elevation of estrogen in the body. PCOS causes irregular periods while endometriosis can cause a build-up of scar tissue in the uterus. Both conditions can make your body a hostile environment for the fetus.

Another reason for an elevated level of estrogen is obesity and high body fat content. As estrogen is a fatty hormone, the more fat you have more estrogen your body will produce. It is also observed that obese and overweight women stand at a higher risk of developing PCOS. Medications such as oral contraceptive pills and some antibiotics may also be responsible for elevated estrogen levels. If you are or were on oral contraceptives, their effects on the body can last long after you have stopped using them. Some symptoms of higher levels of estrogen include:

    • Significant weight gain in the thigh and hip area
    • Heavy or light periods than usual
    • Fibroid development in uterus and breast
    • A loss of sex drive, the feeling of tiredness, and mood swings

What is progesterone?

What does progesterone do? Progesterone is one of the most important fertility hormones. It is produced in small quantities by the adrenal glands and an insignificant amount by the remaining part of the ovarian follicles after ovulation. The structure that is formed in the ovaries, the remnant of the follicles is called the corpus luteum. Progesterone is the hormone that is going to prepare your body to harbour the fertilized egg. It is also responsible for the proper functioning of the Fallopian tubes. Progesterone is not only responsible for the implantation of the embryo it is crucial for carrying the fetus to term as well.

What is a healthy level of progesterone?

The levels of the fertility hormone progesterone keep changing throughout the menstrual cycle and throughout the pregnancy once you conceive. Depending on the phase of the menstrual cycle you are in, the progesterone levels can vary from zero to 214 ng/ml. Here are the typical progesterone levels during the various phases of your cycle:

    • Prior to ovulation: < 0.89 ng/ml
    • During ovulation: up to 12 ng/ml
    • After ovulation: 1.8 – 24 ng/ml
    • During the first trimester of pregnancy ( first 3 months): 11-44 ng/ml
    • During the second trimester of pregnancy ( second 3 months): 25-83 ng/ml
    • During the third trimester of pregnancy (final 3 months): 58-214 ng/ml As of now, there is no do-it-yourself method to detect the level of Progesterone. The only way to determine the levels of progesterone is to get it tested in a lab. If you suspect that you have an abnormally high level of progesterone, make an appointment with your physician as soon as you can for thorough testing.


What causes low progesterone?

Lower than normal levels of progesterone can be detrimental to your reproductive health. If your progesterone levels are too low but you have high levels of estrogen, the condition is called estrogen dominance.

This condition makes it all the more difficult to get pregnant. Low progesterone can occur due to many underlying medical conditions including PCOS. Some of the symptoms of low progesterone include the following:

    • Your LH levels can get messed up (more on that a bit later in the article)
    • You keep getting a negative ovulation test
    • Irregular menstrual cycles are heavier than usual bleeding
    • A diminished sex drive
    • Hot flashes
    • You can even experience anxiety or depression
    • low progesterone levels can also cause a pregnant woman to miscarry

What does high progesterone mean?

In many cases, a high level of this fertility hormone results from a congenital defect called adrenal hyperplasia. In this medical condition, children produce higher than usual amounts of male sex hormones and a very low amount of another hormone called cortisol.

Higher than usual levels of progesterone are also found in women taking oral birth control pills. Medical conditions such as endometriosis can also cause an elevation of progesterone levels in the body.

One of the most concerning effects of a sustained higher amount of progesterone in your body is an increased chance of developing breast cancer. That said, an increased level of progesterone has also been associated with a reduced risk of developing ovarian cancer.

A higher progesterone level can also cause a decrease in fertility by causing a low estrogen level. This creates an imbalance between hormones and can hamper your chances to conceive. Some of the symptoms of high progesterone levels include the following:

    • Feeling bloated
    • Feeling sluggish and sleepy
    • Dizziness
    • Increased incidences of yeast infections


What is Luteinizing hormone (LH)?

Luteinizing hormone is an important fertility hormone controlling your menstrual cycle. It is responsible for the release of a matured egg from the follicles in the ovary. LH is an excellent biomarker for the determination of the precise time of ovulation. It is one of the most important hormones to keep a track of if you are trying to conceive. The levels of LH surge during the menstrual cycle which sends out a signal to the ovaries that it is the time to release the egg. Ovulation strip tests and ovulation predictor kits (OPK) from Fertility2Family can help you track this surge in LH and predict when in your cycle you will ovulate.

What is a healthy level of Luteinizing hormone?

The levels of LH are constantly fluctuating during your menstrual cycle. The level of premenopausal women who are menstruating should be between 5-25 IU/L. This level can significantly spike at the time of ovulation. In postmenopausal women, the level of LH is higher than in premenopausal women. The levels can reach as high as 14.2-52.3 IU/L.

What is a low Luteinizing hormone and what are its symptoms?

The low levels of this fertility hormone are a result of something wrong with the pituitary gland and the hypothalamus. A medical condition where the pituitary gland produces too little of one or more hormones is called hypopituitarism.

If the hormone affected in such a case is the LH, it might result in a condition called secondary ovarian failure, which may result in infertility. Another probable cause of low LH is malnutrition resulting from eating disorders. Some of the symptoms of a low LH include:

    • Absence of menstrual period (Amnorrhoes)
    • Extreme tiredness
    • Weight loss that is sudden and unexplained
    • Decrease in appetite
    • Not getting a positive ovulation test


What happens when Luteinizing hormone levels are high?

High levels of LH are equally bad, if not worse. Higher than normal levels of LH indicate a condition called primary ovarian failure which can cause infertility. An elevation of levels of LH is often attributed to a problem with the ovaries rather than with the pituitary gland. Medical conditions such as PCOS can also be a reason for elevated LH levels. Another effect of an increased level of LH is an increase in the level of testosterone, which is generally secreted in very small amounts. Some genetic congenital diseases such as burners syndrome and Klinefelter’s syndrome can also cause the body to produce more than the required amount of LH. Having high levels of luteinizing hormone levels are often connected to polycystic ovary syndrome.

Some of the symptoms of an elevated level of LH include the following

    • Absence of ovulation (anovulation) or period (Amenorrhoea)
    • Early puberty in young girls
    • Early menopause in menstruating women
    • Infertility


What is Follicle-stimulating Hormone (FSH) & What Does Follicle-stimulating Hormone Do?

Follicle-stimulating hormone (FSH) is also a pituitary fertility hormone. It works in tandem with the LH to help the ovarian follicles to mature. An egg released from the matured follicles is only capable of fertilization. So, it is crucial for the follicles to mature properly before they release the egg. FSH also changes the composition of your cervical mucus. A change in the consistency of the cervical mucous is also an excellent way of predicting your fertile window. For most of the menstrual cycle, the cervical mucous is thin, creamy, and white. However, it becomes much thicker and almost transparent almost like an egg white, when you ovulate. The body does this to let the sperm survive and reach the egg during the fertile window.

What is a healthy FSH level?

The level of this fertility hormone fluctuates with your age. It is normal to have a negligible amount of FSH (0-4.0 mIU/ml). The level significantly increases during puberty, reaching between 0.3-10.0 mIU/ml. Menstruating women have a level of FSH between 4.7-21.5 mIU/ml depending on age and depending on the phase of the menstrual cycle. As with LH, the level of FSH increases after menopause and can reach levels of 25.8 to 134.8 mIU/mL.

What does low FSH mean and what are its’ symptoms?

A low FSH can be a roadblock to your pregnancy. Lesser FSH in the body means that there are fewer follicles that are maturing and developing in your ovaries. The reason for low FSH can be related to an issue with the pituitary or hypothalamus. Being extremely underweight can also have a negative impact on your FSH levels. Lack of proper nutrition due to some sort of an eating disorder can cause irregular periods-a condition called hypothalamic amenorrhea. Some other symptoms of a low FSH include the following:

    • Your cervical mucous does not change its consistency throughout the cycle
    • You might experience hot flashes
    • you might also experience sleep disturbances
    • there might be significant mood swings
    • Higher rate of urinary tract infections


What does a high level of FSH mean and what are the symptoms?

There can be multiple reasons for higher than usual FSH levels. One of the reasons can be a primary ovarian insufficiency-a condition in which the ovaries stop producing eggs before the age of 40.

Women with primary ovarian insufficiency (POI) might get their periods, but as the ovaries are not functioning their menstrual cycles are anovulatory. POI can be a significant cause of infertility. PCOS can be another cause of elevated levels of FSH. A genetic condition called Turner’s syndrome can also result in elevated levels of FSH. People suffering from turner’s syndrome have a genetic defect due to a missing or an incomplete X chromosome. That said, an increased level of FSH is common among women who are in post-menopause.

However, if you are younger than 40, a high FSH level might indicate that you are undergoing premature menopause. In some instances, a higher than usual amount of FSH in the body might be a sign of ovarian cancer. Ovarian cancer is one of the most common cancers in females. Some data suggests that as high as one in 78 women stand the chance of developing ovarian cancer in their lifetime. The chances of developing ovarian cancer increase if you have mutations called BRCA1 or BRCA2. That said, the mean age of women diagnosed with ovarian cancer is around 63 years.

If you are younger than this, it is unlikely to develop ovarian cancer. Ovarian cancer has a high mortality rate because it is often detected at a later stage. If you observe that you have a high FSH level, it is important to talk to your doctor as soon as possible to rule ovarian cancer. Some of the symptoms of high FSH include the following:

    • erratic and irregular periods
    • hot flashes and headaches
    • infertility
    • fewer follicles in ovaries

All four of these hormones are crucial for maintaining your reproductive health and fertility. It is important to check the levels of these hormones throughout your cycle to keep an eye on your fertility window.

It is a common practice for doctors to suggest their patients try getting pregnant naturally for at least a year (six months if you are over the age of 35), before they prescribe any diagnostic test. However, it is wise to track your hormones using various fertility tests and kits from Fertility2Family.

Keeping track can not only help you to conceive but also give you an insight into the proper functioning of your reproductive system. If you see any abnormal changes in your hormonal levels, you can report them to your doctor before it is too late.