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[Shannonplussed]

Does FSH always decrease with HRT, and if so, by much? Does it go back down to the levels seen in reproductive years, or just down somewhat? If on HRT for many months and FSH is still high, is this ever a cause for concern or perhaps an indication of insufficient estrogen?

[Uptick]

Hi Shannonplussed, yes FSH levels decrease with HRT, some studies say to premenopausal levels, but it depends on the HRT dose. There are other issues that can cause persistent high levels of FSH, like PCOS or ovarian and pituitary tumour, but in menopausal women it usually means low oestrogen. In perimenopause FSH levels vary wildly and blood tests results won't be reliable as an indication of insufficient oestrogen.

[Hurdity]

shannonplussed - here is some basic information on hormonal control, oestrogen and FSH which might help. Yes oestrogen especially suppresses FSH so readings are not helpful once you start HRT. It is more important to go by how you feel or if you are taking a fairly lowish or medium dose of oestrogen and you want to achieve a minimum level for osteoporosis protection then several oestrogen measurements would give an indication of how much you are abosrbing. This is only useful if you are post-menopausal because if you are peri-menopausal and taking HRT you won't know if/when your own cycle is breaking through and perhaps adding to your own oestrogen levels? Doctors do not normally measure FSH I don't think, once a woman is taking HRT for menopausal symptoms as it is not useful - only really to diagnose peri-menopause in women who may experience premature or early menopause

https://www.menopausematters.co.uk/menopause.php
https://www.menopausematters.co.uk/article-perils-of-the-perimenopause.php

Hurdity x