2025 Hormone Series - Follicle Stimulating Hormone (FSH) Deep Dive!

FSH stands for follicle-stimulating hormone. It’s a gonadotropin, meaning it’s a hormone that helps regulate the reproductive system. It’s made and released by the pituitary gland, a small gland at the base of the brain.

What FSH Does

Its role differs slightly depending on sex :

female:

• Stimulates the growth of ovarian follicles (tiny sacs in the ovaries that contain eggs).

• Works with luteinizing hormone (LH) to trigger ovulation (release of an egg).

• Helps regulate the menstrual cycle.

male:

• Stimulates the Sertoli cells in the testes to support sperm production.

• Works together with testosterone to maintain fertility.

Why FSH Levels Matter in the Cycle

• High FSH early in the cycle can signal low ovarian reserve (fewer eggs left)—common in perimenopause or infertility.

• Low FSH can indicate a problem with the pituitary gland or hypothalamus, or conditions like hypothalamic amenorrhea (often stress, weight, or exercise-related).

• FSH is often checked on day 3 of the cycle in hormone blood tests.

Follicle-Stimulating Hormone (FSH) plays a central role in the female reproductive system, but it also influences a wide range of processes across the body. Here's a comprehensive breakdown of **all the major areas** FSH affects in a woman's body and health:

• Reproductive System: 

Ovaries follicle development: FSH stimulates the growth and maturation of ovarian follicles (egg-containing sacs).
Estrogen production: Growing follicles produce estrogen, especially estradiol, under FSH stimulation.

• Menstrual Cycle:

Regulation of cycle phases: FSH peaks in the early follicular phase, recruiting a follicle forward toward ovulation.
Ovulation (indirectly): While luteinizing hormone (LH) triggers ovulation, FSH helps prepare the follicle to be ovulated.

• Hormone Regulation

Estrogen balance: FSH increases estrogen levels, influencing secondary sex characteristics and uterine lining thickening.

Negative feedback loops: High estrogen inhibits FSH production to prevent overstimulation of the ovaries.

• Fertility and Conception

Egg quality and availability: FSH levels influence the number and health of available eggs.

Predictor of ovarian reserve: Higher-than-normal FSH can indicate diminished ovarian reserve, relevant for fertility assessments.

• Neuroendocrine Effects

Hypothalamic-pituitary-gonadal (HPG) axis: FSH is part of this hormone axis and interacts with the brain to regulate reproductive hormones.
Mood and cognition (indirectly): Estrogen affected by FSH plays a role in neurotransmitter function (serotonin, dopamine), influencing mood, sleep, and memory.

• Bone Health

Bone density maintenance: Estrogen produced under FSH influence helps preserve bone density.
Osteoporosis risk: Low estrogen (e.g., after menopause due to high FSH and low ovarian activity) leads to bone loss.

• Cardiovascular Health

Vascular protection: Estrogen has vasodilatory and cholesterol-regulating effects, which depend on FSH-induced production.
Postmenopausal risk: High FSH/low estrogen states are linked with increased cardiovascular disease risk in aging women.

• Menopause and Aging

FSH rises as ovaries decline: During perimenopause and menopause, FSH levels rise significantly due to decreased ovarian feedback.
Marker for menopause: A single elevated FSH level can indicate menopause in conjunction with symptoms (hot flashes, cycle length variances).

• Metabolism and Body Composition (Indirectly)

Weight and fat distribution: Estrogen influenced by FSH helps regulate fat deposition (e.g., hips/thighs).
Insulin sensitivity: Estrogen has a role in glucose metabolism, and its reduction (as FSH rises postmenopause) can contribute to insulin resistance and increased central fat.

• Clinical and Diagnostic Use

Fertility testing: FSH levels are measured to assess ovarian reserve and function.
Menopause diagnosis: High FSH levels help confirm menopause or premature ovarian insufficiency (POI).

⚠️ When things go wrong:

• Chronic stress can lead to overactivation of the HPA axis → high cortisol levels, which can cause issues like anxiety, depression, weight gain, immune suppression, and even memory problems.
• Dysregulation of CRH - high CRH levels due to chronic stress, trauma, etc. decrease FSH and this leads to ovulatory dysfunction. CRH has been implicated in psychiatric conditions, like PTSD, major depression, and anxiety disorders.

What Nutrients encourage FSH

Zinc helps increase levels of FSH, which helps increase progesterone and support a healthy ovulation, helps convert thyroid hormone. 

Additionally, Zinc enhances FSH activity by:

• Supporting GnRH and thus upstream FSH release

• Aiding in receptor function and hormone signaling

• Protecting reproductive cells involved in FSH action

How to navigate those nutrients - 

You can add Zinc to your daily nutrition with supplements or foods like:pumpkin seeds, legumes, seeds, eggs, nuts, oysters.

Managing Stress and Recovery Response 

When we manage our stress with things like daily prayer and meditation, deep breathing, meaningful movement and appropriate sleep, we can help the HPA axis in the brain and in turn help our bodies recover. When the ovulatory cycle improves you can KNOW your overall health is improving too! Women in peri/post menopause can also see changes in overall health with the adoption of consistent health practices paired with curated interventions of supplements and/or hormone replacement. 

Conclusions: 

When FSH is dysfunctional the ovulatory cycle is interrupted in women - ovulatory dysfunction is the root cause to MANY health issues for women. Women who have suffered with ovulatory dysfunction at some point in their life are at greater risk for heart disease, dementia, osteoporosis, Type 2 Diabetes, Insulin Resistance, Alzheimers, and a host of other metabolic and physiological issues. 

Learning how to chart your cycle (even in perimenopause) and learn your body's signs is the BEST way to become an advocate for your own health, regardless of where you are on the reproductive continuum. Learning more about HOW your body works is valuable. FEMM charting along with partnering with a FEMM medical practitioner can make a WORLD of difference in your Integrated Health journey! 

Book a 30 minute ovulatory health* session for just $35 today! 

*Betsy is a trained and certified FEMM educator & Women's Master Health Coach. She has coached over 450 women to improve their health and hormones through her 1:1 and small group coaching programs.