What are the test results of the six sex hormones? This article gives the "arrangement" clearly!

*For medical professionals only

One item for you to "break open and crush" to see! Sex hormone six items are the routine examination of the reproductive endocrine system, and when women have menstrual cycle disorders, amenorrhea, infertility, abnormal bleeding of the genital tract, gynecological-related tumors, etc.

• Basal E2> 45-80 pg/ml (165.
  
  ● Progesterone (P)
  
  
  
  

• Low progesterone: progesterone levels in the luteal phase are lower than physiological values, suggesting luteal insufficiency and ovulatory uterine dysfunctional bleeding

  
  
  
  

• Progesterone levels 5-9 days before menstruation > 5.

  
  
  
  

• The 4-5 days of menstruation is still higher than the physiological level, indicating incomplete luteal atrophy

  
  
  
  

• Differentiating ectopic pregnancy: the P level of ectopic pregnancy is low, and most patients have a P< 15 ng/ml (47.

  
  
  
  

• Assisted diagnosis of threatened miscarriage: low progesterone levels and high risk of early miscarriage within 12 weeks' gestation
  .
  
  In threatened miscarriage, a downward trend in progesterone values is likely to be miscarriage
  .
  

• Observation of placental function: when placental function is reduced during pregnancy, the level of progesterone in the blood decreases
  .
  
  A single serum progesterone level of P≤5 ng/ml (15.
  6 nmol/L) suggests stillbirth
  .
  

Fig.
1 Female menstrual cycle and curves of changes in various
hormones ● Before testosterone (T)
menopause, ovarian androgens are the main source of serum testosterone, and the postmenopausal adrenal cortex is the main site
of androgen production.

More than 99% of testosterone binds to sex hormone-binding globulins (SHBG) in the blood circulation and is inactive
.

Only 1% of free testosterone is biologically active
.

In metabolic disorders of insulin resistance, SHBG levels decrease, free testosterone rises, and in cases where total testosterone is not elevated, manifestations of
hyperandrogenemia occur.

• Testosterone is at a high reference value, and in addition to pcOS considerations, urine 17-keto and 17α-hydroxyprogesterone need to be checked, if both are high values, it is a patient
  with congenital adrenal hyperplasia.
  
• Testosterone is slightly higher than the high reference value, and in addition to PCOS and congenital adrenal hyperplasia, the possibility
  of ovarian tumors should be considered.
  
• Testosterone alone is high, 2-2.
  5 times higher than the upper limit of normal reference values, and androgens of male pseudophroditic malformations are considered
  
• Polycystic ovary syndrome: testosterone levels usually do not exceed 2 times the
  upper limit of the normal range.
  
  In patients with POLYOS, blood testosterone values are mildly to moderately elevated
  .
  
• Abnormally elevated serum testosterone considers adrenal cortex tumors, and if the testosterone level is more than 2 times the upper limit of normal, the
  tumor with androgen secretion in the ovaries or adrenal glands should be excluded first.
  
  

● Prolactin (PRL)
non-lactation, normal value of PRL female: 5.
18-26.
53 ng/ml
.

PRL levels fluctuate less with the menstrual cycle, but have a rhythm associated with sleep, secretion increases in the short term of falling asleep, decreases after waking, rises in the afternoon compared with the morning, rises after meals than before meals, and 9-10 a.
m.
is the low point
of its secretion.

Its secretion is affected by a variety of factors, such as fullness, hunger, cold, sexual intercourse, mood swings, breast stimulation, etc.
can lead to elevated
PRL.

A high test value is not enough to diagnose hyperprolactinemia, and the diagnosis can be made by repeating the test 1-2 times after excluding the above influencing factors
, and two consecutive times higher than the normal range.

• PRL≥ 25 ng/ml or higher than laboratory-set normal, is a high prolactin blood sign, subject to exclusion of pregnancy, medications, and hypothyroidism
  .
  
  

• PRL> 50 ng/ml, about 20% have pituitary prolactinomas; PRL> 100 ng/ml, about 50% have prolactinomas, pituitary CT or magnetic resonance examination can be done;

• Elevated PRL levels are both physiological and pathological, which can be seen in pregnancy, lactation, neuropsychiatric stimulation, drug factors (such as mecyanopyridine, reserpine, antipsychotic drugs), precocious puberty, primary hypothyroidism, premature ovarian failure, poor luteal function, polycystic ovary syndrome, etc.
  , of course, the most common cause of significant elevation of PRL is pituitary prolactinoma;

• Decreased PRL: hypopituitarism, Sihan syndrome, simple prolactin secretion deficiency, use of antipramines such as bromocriptine, levodopa, VitB6, etc
  .
  
  

Note: Too high prolactin can inhibit the secretion of FSH and LH, indirectly inhibit ovarian function, and affect ovulation
.

Therefore, hyperprolactinemia requires treatment
in the presence of amenorrhea, menstrual irregularities, and infertility.

Resources:

Hu Jianhua, HUJian-hua.
The application value of six index determination of female sex hormones in the auxiliary diagnosis of infertility[J].
Journal of Practical Medicine in China, 2013, 40(14):90-92.
Wang Zhou, Sa Yinglong, Ye Xuxiao, et al.
Clinical diagnosis and treatment analysis of androgen insensitivity syndrome (with 6 case reports)[J].
Journal of Clinical Urology, 2013(4):287-291.
Shang Haijing,Wang Xiumei,Hao Qinfang,Liu Liping,Zhang Yuanyuan,Li Ligang.
Clinical significance of serum sex hormone changes in menstrual disorders[J].
Armed Police Medicine,2017,28(03):280-282.
Luo Youwen,Zhang Yicong.
Analysis of the diagnostic value of six sex hormone detections on children's precocious puberty[J].
Shenzhen Journal of Integrative Traditional Chinese and Western Medicine,2018,28(02):64-65[5]Li Zhen.
The application of six sex hormone tests in the diagnosis of female infertility[J].
Practical Gynecological Endocrine Electronic Journal,2019,6(30):100-101.
[6] Ayiguri Suleiman.
The value of six tests of sex hormones in the diagnosis of gynecological diseases[J].
Practical Gynecological Endocrine Electronic Journal,2019,6(19):55.
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Source of this article Medical community endocrinology channel Author Doctor Benevolence Renshu This article review Shandong Province Jinan Hospital Diabetes Diagnosis and Treatment Center Director Wang Jianhua Responsible Editor Cao Qian

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