FSH & LH Levels Explained: Am I in Menopause?

Condition 13 October, 2026

What is menopause vs perimenopause?

Menopause occurs when your menstrual cycle stops because your ovaries have stopped making 2 hormones called oestrogen and progesterone.

You are menopausal when you have not had a period for 12 consecutive months. Although this usually happens around age 45–55, it can happen earlier. If it happens before age 40, it’s called early menopause and, in some cases, may be due to primary ovarian insufficiency.

After menopause, you’re postmenopausal, but menopause symptoms can last for many years as your body adjusts to the change in hormones.

The Menopause Transition

Perimenopause is a menopause transition. It refers to the time before menopause when your progesterone and oestrogen levels are dropping, and you have irregular periods rather than no periods.

Menstrual cycle changes due to peri menopause last 4 years on average. You may go through months with no periods and then have an unusually heavy and/or long period. Perimenopause can also cause symptoms that are very similar to menopause symptoms.

Perimenopause and menopause symptoms

Symptoms of perimenopause and menopause are very similar. They include:

Disturbed sleep and night sweats
Hot flashes
Low mood, mood swings, anxiety and depression
Poor memory and brain fog
Vaginal dryness and low libido
Weight gain

Although these are common symptoms, the experience of menopause is unique to each woman. The severity of symptoms also varies. On average, menopause symptoms last 7–9 years; however, they can last longer.

Understanding FSH and LH in the menstrual cycle

Follicle stimulating hormone (FSH) and luteinising hormone (LH) are both made by the pituitary gland – a pea-sized tissue that sits at the base of the brain. FSH and LH levels naturally fluctuate during the menstrual cycle.

During the first few days of the menstrual cycle, FSH levels in the blood rise and affect the ovaries. FSH causes the ovaries to make oestrogen. There are 3 different types of oestrogen, and FSH causes the ovaries to make the most powerful type called oestradiol.

FSH also causes small sacs in the ovaries called ovarian follicles to mature. Follicles contain immature eggs. As the follicles mature, the eggs mature too. When a follicle reaches maturity, it releases an egg in a process called ovulation.

During a menstrual cycle, a group of follicles mature. In most cases, only one follicle of this group fully matures and releases an egg during ovulation.

Some women naturally have more than one follicle fully mature during a menstrual cycle. This is called hyperovulation and causes more than one egg to be released. If these eggs are fertilised, it can result in a twin or multiple pregnancy.

Ovulation is triggered in the middle of the menstrual cycle by a sudden rise in FSH and LH. LH causes the ovaries to make oestrogen and progesterone. Progesterone levels, which are low before ovulation, increase after ovulation. Progesterone helps thicken and prepare the lining of the womb for a potential pregnancy.

FSH and LH changes during perimenopause and menopause

During perimenopause and menopause, the ovaries gradually lose their ability to make oestrogen and progesterone, which are needed for ovulation and fertility.

As a result, the pituitary gland tries harder to make the ovaries produce oestrogen and progesterone. It does this by making more FSH and LH.

During perimenopause, the rise in FSH and LH levels can be erratic. This means that depending on when you have the blood test, it may not show high FSH levels. Normal FSH and/or LH levels, therefore, do not rule out perimenopause.

In contrast, in menopause, high levels of FSH and LH are more consistent.

Hormonal contraception and FSH and LH testing

If you’re taking any hormonal contraception (eg progestogen contraception pills, injections or implants), your LH test and FSH test may not be accurate. This is because the tests will not be able to measure your natural FSH and LH levels.

The artificial hormones in hormonal contraception cause the pituitary gland to make less FSH and LH. LH and FSH levels, therefore, drop due to the contraceptive and don’t reflect your natural hormone levels.

If you’re taking hormonal contraception and want to check your natural LH and FSH levels, you should stop taking hormonal contraception for around 6 weeks before your blood test.

Understanding LH and FSH results

For girls after puberty and women during their reproductive years, the normal FSH level ranges from around 4-22.5 IU (international unit) per litre, while the normal LH level ranges from around 1-9. The exact measurement will depend on the various stages of the menstrual cycle.

In menopause, a high FSH level is any result that is above 25 IU per litre, while a high LH level is anything above 19 IU per litre.

Other causes of abnormal FSH and LH levels

Although menopause causes high FSH and LH levels, there are other conditions that cause changes in LH and FSH levels.

PMOS (PCOS)

High LH levels and normal or low FSH levels, resulting in an abnormal LH-to-FSH ratio, can be a sign of polyendocrine metabolic ovarian syndrome (PMOS). This condition was formerly called PCOS, polycystic ovary syndrome or polycystic ovarian syndrome because some women with the condition develop cysts on their ovaries.

In 2026, the move was made to rename polycystic ovary syndrome (PCOS) to polyendocrine metabolic ovarian syndrome (PMOS),. as the condition causes a wide range of symptoms that affect more than fertility. This includes changes to metabolism that increase the risk of diabetes, fatigue, excessive weight gain and hair growth.

DOR

High FSH and LH levels can also be caused by a diminished ovarian reserve (DOR). This refers to ovaries that have a lower quality and/or a lower number of eggs than expected for the person’s age.

Although a diminished ovarian reserve is most commonly due to ageing, it can also be caused by autoimmune conditions, genetic disorders, chemotherapy and surgery on the ovaries.

Getting a diagnosis

Diagnosing whether your symptoms are due to menopause, perimenopause, PMOS or a diminished ovarian reserve needs more than a blood test for FSH and LH.

Your doctor will consider your medical and menstrual history, and may recommend that you have other blood tests and/or imaging tests (eg an ultrasound scan).

After a diagnosis of menopause

If your blood tests, symptoms, age, menstrual history and medical history suggest that you’re going through menopause, your doctor may recommend treatment to help relieve some of your symptoms.

Treatment after diagnosis may be targeted to relieve specific symptoms and/or to adjust your hormone levels.

The main form of hormone treatment for menopause is HRT or hormone replacement therapy, which usually provides oestrogen and progesterone. This is called combined HRT.

If you’ve had a hysterectomy and are diagnosed with menopause, you may receive hormonal therapy that only provides oestrogen.

There’s no set time limit for how long you can take HRT. However, as with any medication, there are risks. These risks need to be balanced against the benefits. As menopause symptoms decrease over time, you may not need to take HRT after several years, or you may switch to a lower dose.

Other treatments for menopause include:

Cognitive behavioural therapy and antidepressants for low mood, anxiety and depression
Testosterone gels or creams for low libido
Vaginal oestrogen (as a gel, cream, pessary, tablet or ring) for vaginal dryness

Your doctor can also advise you on lifestyle changes to help you cope with your symptoms. This may include keeping to a healthy bedtime routine, following a balanced diet and taking part in regular exercise, particularly weight-bearing exercises.

Check your hormone levels today

If you have irregular periods, fertility problems or potential menopause symptoms, Vista Health can help investigate the cause with our easy-to-use at home tests. All blood tests are analysed in a modern laboratory for reliable, accurate results.

With our at-home Women’s Hormone Health blood test, you can check the status of your FSH, LH and other hormones. Together with expert advice from our experienced doctors, you can get greater insights into your hormone health.