All Tests
Hormone Test

FSH and LH Blood Tests

FSH (follicle-stimulating hormone) and LH (luteinising hormone) are pituitary hormones that control reproduction. Together they are the key tests for assessing fertility, menopause, PCOS and pituitary disorders.1

Written by Suman Konda, Clinical Pharmacist · Based on peer-reviewed sources · Editorial policy · Not medical advice

Last reviewed and updated: · How we check our content

Quick answer

FSH and LH are pituitary hormones controlling reproduction. On day 2-3 of the cycle, FSH of 3-10 and LH of 2-15 mIU/mL is typical; FSH above 10 suggests declining ovarian reserve and above 25 suggests menopause. An LH:FSH ratio above 2:1 hints at PCOS. In men, FSH of 1.5-12.4 and LH of 1.7-8.6 is normal; high values indicate testicular failure.

What are FSH and LH?

Advertisement

FSH (follicle-stimulating hormone) and LH (luteinising hormone) are gonadotropins produced by the pituitary gland. In women, FSH stimulates ovarian follicle development and oestrogen production; LH triggers ovulation. In men, FSH stimulates sperm production (spermatogenesis) in the testes; LH stimulates testosterone production from Leydig cells. These hormones are part of the hypothalamic-pituitary-gonadal (HPG) axis and are used to evaluate fertility, menopause and pituitary problems.

FSH and LH normal ranges

GroupFSH (mIU/mL)LH (mIU/mL)
Women: follicular phase (day 2-3)3 – 102 – 15
Women: LH surge (ovulation)Up to 40+Up to 100+ (surge)
Women: luteal phase1 – 91 – 13
Post-menopausal women> 25 (typically 25-135)> 14
Adult men1.5 – 12.41.7 – 8.6
Key points
  • FSH and LH are pituitary hormones controlling reproduction: FSH grows ovarian follicles and drives sperm production; LH triggers ovulation and testosterone production.
  • A high day 2-3 FSH in women (above 10 mIU/mL) means the ovaries are responding poorly; above 25 suggests premature ovarian insufficiency or menopause.
  • An LH to FSH ratio above 2:1 or 3:1 on day 2-3 is a classic PCOS pattern; an isolated mid-cycle LH surge is normal ovulation.
  • Low FSH and LH together mean the brain's signal is insufficient (hypogonadotrophic hypogonadism): pituitary tumours, excessive exercise, eating disorders, high prolactin or anabolic steroid use.
  • In men, high FSH and LH indicate testicular failure; low LH means less testosterone is being made (secondary hypogonadism).
  • The tests are read as a pattern with oestrogen or testosterone, not as single numbers.

What does HIGH FSH mean in women?

High FSH in women: reduced ovarian reserve

A high FSH on day 2-3 of the menstrual cycle (the basal FSH) is the most important marker of ovarian reserve (the pool of eggs remaining). High FSH means the pituitary is working harder to stimulate the ovaries, which are responding less. FSH above 10 mIU/mL is considered elevated; above 25 indicates premature ovarian insufficiency (POI) or natural menopause. High FSH combined with high LH and low oestrogen in a young woman indicates premature ovarian failure. In menopause, both FSH and LH are persistently elevated.

What does HIGH LH in women mean?

High LH in women: PCOS or LH surge

An elevated LH to FSH ratio greater than 2:1 or 3:1, especially on day 2-3 of the cycle, is a classic pattern of polycystic ovary syndrome (PCOS). It reflects increased pituitary stimulation from insulin resistance and elevated androgens. Isolated high LH at mid-cycle (around day 14) is the normal ovulation surge and is the basis of LH ovulation predictor kits.

What do LOW FSH and LH mean?

Low FSH and LH: hypothalamic or pituitary failure

Low levels in both men and women indicate the signal from the brain is insufficient: called secondary or hypogonadotrophic hypogonadism. Causes: pituitary tumour (prolactinoma, other adenoma), excessive exercise or eating disorders (hypothalamic amenorrhoea), high prolactin, anabolic steroid use (suppresses natural production), and significant stress or illness. In men, low LH means less testosterone is being made (secondary hypogonadism).

What do HIGH FSH and LH mean in men?

High FSH and LH in men: primary testicular failure

High gonadotropins in men mean the pituitary is trying to stimulate the testes, but the testes are not responding (primary hypogonadism). Causes: Klinefelter syndrome (XXY), bilateral undescended testes, chemotherapy or radiation damage, mumps orchitis, testicular torsion injury.

Questions to ask your doctor

  • Should I test on day 2 or day 3 of my cycle?
  • Do I need an AMH (anti-Mullerian hormone) test to check my egg reserve?
  • What is my FSH:LH ratio?
  • Does this result mean I am in menopause?
  • Should I see a fertility specialist or endocrinologist?

FSH & LH myths vs facts

Reproductive hormones are among the most over-interpreted numbers in medicine. Here is what the evidence actually says:

MYTH One FSH value can diagnose menopause or PCOS.

Fact: Hormones fluctuate — FSH varies across the cycle and with stress and illness. Menopause and PCOS are clinical diagnoses supported by patterns across tests and symptoms, never by a single hormone value.

MYTH A high FSH always means menopause.

Fact: High FSH with low oestrogen suggests ovarian decline, but the same pattern appears in premature ovarian insufficiency in younger women — a different condition needing different care. Age and the full picture decide.

MYTH You must stop birth control pills before testing.

Fact: Hormonal contraception does suppress FSH and LH, so doctors usually want a washout period — but how long depends on the method. Don't stop contraception without a plan; ask your doctor for the specific timing.

MYTH High LH with normal FSH always means PCOS.

Fact: It is a suggestive pattern, but PCOS diagnosis needs two of three: irregular ovulation, clinical or biochemical androgen excess, and polycystic ovaries on scan. LH alone doesn't make the diagnosis.

MYTH Stress can't change these hormones.

Fact: It can. Significant stress, illness, rapid weight loss and intense exercise all suppress the reproductive hormone axis — which is why doctors ask about recent life upheavals before interpreting a surprising result.

Your FSH/LH result: what to do next

Got your report and wondering what the numbers mean for you? Find the branch that matches your situation — every path ends with your doctor, because these hormones are never interpreted alone:

If your result is…Sensible next stepTalk to your doctor when…
High FSH, cycle day 2–3Interpreted with oestradiol and age; recheck if drawn on the wrong day or during illness.you're under 40 — premature ovarian insufficiency needs specialist care.
High LH, normal FSHA PCOS-suggestive pattern; diagnosis needs the full criteria — symptoms, androgens, scan.periods are irregular or androgen symptoms (acne, excess hair) are present.
Both lowPoints toward the pituitary/hypothalamus — stress, weight loss, exercise and medicines are reviewed.periods have stopped and the cause is unclear.
Tested on contraceptionResults are suppressed and hard to interpret; ask about washout timing for your method.before stopping contraception — get the plan first.

FSH & LH test price in India

In India, FSH and LH are reported in mIU/mL (equivalent to IU/L), and each test typically costs &rupee;700–1,400, varying by city and lab. Fertility panels bundling them with AMH, prolactin and TSH are widely offered and often better value than ordering separately. Day 2–3 testing is standard practice at most diagnostic labs. Where possible, choose a NABL-accredited lab, and remember the range printed on your own report is the one that counts.

Frequently Asked Questions

What day of my cycle should FSH and LH be tested?
Day 2 or 3 of the menstrual cycle (counting the first day of full flow as day 1) is the standard for assessing ovarian reserve, because baseline hormone levels are most informative then. Testing at other times — especially mid-cycle — gives values that cannot be compared with day 2–3 reference ranges. Confirm the timing with your doctor before booking.
My LH is high but FSH is normal. Is that PCOS?
Not on that alone. A raised LH-to-FSH ratio on day 2–3 is a classic PCOS pattern, but the same high LH at mid-cycle is simply the normal ovulation surge. PCOS is diagnosed on clinical criteria (irregular ovulation, androgen excess, polycystic ovaries on ultrasound), not on one hormone value — discuss the full picture with your doctor.
Can stress or illness change my FSH and LH results?
Yes. Significant stress, acute illness, very low body weight, excessive exercise and high prolactin can all suppress FSH and LH, and testing during such periods can mislead. For the most reliable result, test when you are well and your routine is normal, and tell your doctor about any major stressors.
Do I need to stop birth control pills before testing?
Usually yes, because hormonal contraception suppresses FSH and LH and the results will not reflect your natural cycle. How long to stop — and whether to use backup contraception meanwhile — is a decision to make with your doctor, not on your own.
How much does the FSH/LH test cost in India?
There is no single fixed price — it varies by city, lab, and whether the test is ordered alone or as part of a panel. NABL-accredited labs usually publish their rates online, so it is worth comparing a couple near you. Whatever you pay, the reference range printed on your own report is what counts — discuss the result with your doctor.
What is the full form of FSH and LH?
FSH stands for follicle-stimulating hormone and LH stands for luteinizing hormone.

Pharmacist's practical notes

Cycle day is the hidden variable: FSH and LH drawn on the wrong day answer a different question than the one asked. Day 2–3 is the standard for ovarian reserve assessment — a result drawn mid-cycle needs reinterpreting, not reacting to. Always check which day the blood was drawn before reading the numbers.

Hormonal contraception suppresses these hormones by design, which makes testing on the pill nearly uninterpretable — but stopping needs a plan, including backup contraception. Several other medicines also nudge the axis; bring the full list, and never stop a prescribed medicine over a lab number without medical advice.

In India

In India, FSH and LH are reported in mIU/mL (equivalent to IU/L), and each test typically costs &rupee;700–1,400, varying by city and lab; fertility panels bundling them with AMH, prolactin and TSH are widely offered.

Where possible, choose a NABL-accredited lab. Day 2–3 testing is standard practice at most diagnostic labs.

References

Sources cited on this page. PubMed links open the original abstract.

  1. Balen AH, Morley LC, Misso M, et al. The management of anovulatory infertility in women with polycystic ovary syndrome. Hum Reprod Update. 2016;22(6):687–708. PMID 27511809 · doi:10.1093/humupd/dmw025
  2. Yang J, Song W, Chen X. Hormonal changes in PCOS. J Endocrinol. 2024;261(1):e230342. PMID 38285626 · doi:10.1530/JOE-23-0342
  3. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 Consensus on Diagnostic Criteria and Long-Term Health Risks Related to Polycystic Ovary Syndrome. Fertil Steril. 2004;81(1):19–25. PMID 14711538 · doi:10.1016/j.fertnstert.2003.10.004

How the FSH/LH ratio helps diagnose the cause of infertility

Follicle-stimulating hormone (FSH) and luteinising hormone (LH) are glycoprotein hormones produced by the pituitary gland. They work in concert to regulate ovarian and testicular function, and interpreting them together, rather than in isolation, provides far more diagnostic power.

In women, a raised FSH with a raised LH in the context of absent periods typically indicates primary ovarian insufficiency (POI, previously called premature ovarian failure), the ovaries are not responding to pituitary signals. By contrast, a low FSH and low LH points to hypothalamic or pituitary dysfunction (secondary hypogonadism), which has a very different cause and treatment pathway. In polycystic ovary syndrome (PCOS), the LH:FSH ratio is classically greater than 2:1, though this criterion is no longer required for diagnosis under the Rotterdam criteria, which instead require any two of three features (irregular ovulation, clinical or biochemical androgen excess, and polycystic ovaries on ultrasound) and explicitly state that no single test, including an elevated LH, is sufficient on its own.23

The FSH surge and ovulation detection

In the normal menstrual cycle, FSH rises gradually in the early follicular phase to stimulate follicle development, then a sharp mid-cycle LH surge (and smaller FSH co-surge) triggers ovulation approximately 36 hours later. Home ovulation predictor kits measure this LH surge in urine. Timed blood tests to confirm ovulation typically measure a post-ovulatory progesterone level on day 21 of a 28-day cycle rather than LH or FSH, since the LH surge is very brief.

Male FSH and LH testing in azoospermia

In men presenting with azoospermia (no sperm in the ejaculate), FSH and LH are critical for distinguishing obstructive azoospermia from non-obstructive (testicular) azoospermia. Elevated FSH with elevated LH in an azoospermic man suggests testicular failure (Sertoli-cell only syndrome, maturation arrest), the testes are not producing sperm despite maximal pituitary stimulation. Normal FSH and LH with azoospermia suggests a mechanical obstruction (e.g., vasectomy, blocked vas deferens or epididymis) where sperm production is occurring but cannot exit, surgical reconstruction or sperm retrieval may be possible. LH levels also help assess testosterone production: low LH with low testosterone suggests a pituitary or hypothalamic cause rather than primary testicular failure.

Medical Disclaimer: This page is for general educational purposes only and does not constitute medical advice. Always consult a qualified doctor for diagnosis and treatment decisions.
Written and medically reviewed by Suman Konda, Clinical Pharmacist · Sources linked to PubMed · Not medical advice: see our disclaimer