Sex hormone (chemical essence is lipid) is a steroid hormone synthesized from the gonads of animals, placenta, adrenocortical reticularis and other tissues, which has the functions of promoting sexual maturation, the development of secondary sexual characteristics and maintenance of sexual function. The ovaries of female animals mainly secrete two kinds of sex hormones - estrogen and progesterone, while the testes of male animals mainly secrete androgen dominated by testosterone.
Sex hormone levels are measured to understand the endocrine function of women and diagnose diseases associated with endocrine disorders. The examination usually includes six items, namely: follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), estradiol (E2), progesterone (P), and testosterone (T).
Clinical significance:
I、 Testosterone
Normal value: testo result 43.37ng/dl
Adult male:175-781
Female: follicular stage:10-75
1.Increased testosterone concentration: common in testicular benign stromal tumors, congenital adrenal hyperplasia, true precocious puberty, male pseudohermaphroditism, female virilizing tumors, polycystic ovary syndrome, hypercortisolism, and applied gonadotropin Hormones, obesity and late-stage pregnant women, the blood testosterone concentration can all increase.
2.Decreased testosterone concentration: male hyposexual function, naive primary testicular hypoplasia, hyperprolactinemia, hypopituitarism, systemic lupus erythematosus, hypothyroidism, osteoporosis, cryptorchiditis, gynecomastia, etc. The testosterone level can be seen to decrease.
II、 Estradiol
Norma valuel: estradiol (estrdl) results 35.00pg/ml
Adult male:20-75
Sex hormone six female: follicular stage:24-114
Luteal stage:80-273
Menopause:20-88
1.Estradiol in normal pregnancy is slightly elevated, and it drops sharply after the placenta is delivered.
2.Estradiol is mostly elevated in pregnant women with twin or multiple pregnancy with abnormal pregnancy and diabetes; severe patients with pregnancy-induced hypertension have lower estradiol. If estradiol is particularly low, it may indicate the possibility of fetal death in utero. It should be determined in combination with other examinations for timely treatment; anencephaly infants have lower estradiol; during hydatidiform moles, estradiol is low, and the estradiol content in urine is only 1-12% of normal pregnancy.
3.Pathological causes of increased estradiol value 1) Ovarian disorders: granulosa cell tumor of the ovary, ovarian embryo tumor, ovarian lipoid cell tumor, sex hormone generating tumor, etc., all show hyperfunction of the ovary and increased secretion of estradiol. 2) Heart disease: myocardial infarction, angina pectoris, coronary artery stenosis. 3) Others: systemic lupus erythematosus, liver cirrhosis, male obesity.
4.Pathological causes of decreased estradiol 1) Ovarian diseases: Absence or underdevelopment of ovaries, primary ovarian failure, ovarian cysts. 2) Pituitary amenorrhea or infertility. 3) Others: hypothyroidism or hyperthyroidism, Cushing’s syndrome, Addison’s disease, malignant tumors, large-scale infections, renal insufficiency, focal lesions of the brain and pituitary gland, etc., can cause plasma estrogen Alcohol decreases.
III、 Prolactin (PRL)
Normal value: Prolactin (PRL) result 14.61ng/ml
Adult male: 2.64-13.13
Female: <50 years old 3.34-26.72; ≧50 years old 2.74-19.64
1.Prolactin is a polypeptide hormone, also called prolactin (PRL), which is one of the hormones secreted by the pituitary gland. In the late pregnancy and lactation period, prolactin is secreted vigorously in women to promote breast development and lactation. The highest level of prolactin in the serum of non-pregnant women generally does not exceed 20 ng/ml.
2.Prolactin is secreted by specialized cells concentrated on both sides of the back of the pituitary, and it originates from the same cell as growth hormone. Elevated prolactin, medically called hyperprolactinemia, is a hypothalamic-pituitary-gonad axis dysfunction disease. Its main symptoms are significantly reduced menstrual flow, oligomenorrhea and even amenorrhea, infertility, galactorrhea, Menopausal symptoms, etc. Excessive prolactin will also cause the ovaries to lose their due ability to respond to gonadotropins, and the synthesis of estrogen and progesterone will be significantly reduced, making estrogen, which plays an important role in the process of conception, low levels, directly affecting the gestation function. When the amount of sex hormones is reduced to a certain level, the patient will have many symptoms that are exactly like female menopause.
3.The secretion of prolactin is pulsed and changes a lot in a day. The pulse amplitude of prolactin secretion increases rapidly within 1 hour of sleep, and then the secretion amount during sleep is maintained at a high level, and then begins to decrease after waking up. The secretion concentration of serum prolactin at 3 and 4 o'clock in the morning is twice that of noon.
Ⅳ、progesterone
Normal value: progesterone (Prog) result 0.55ng/ml
Adult male: 0.10-0.84
Female: Follicular stage: 0.31 1.52
luteal phase: 5.16-18.56
Menopause: 0.08-0.78
1.During the menstrual cycle of normal women, the blood progesterone content is highest in the luteal phase and lowest in the follicular phase. The use of dynamic detection can help determine the ovulation period, understand the function of the corpus luteum, and study the mechanism of action of various steroid contraceptives and anti-early pregnancy drugs.
2.From the 11th week of normal pregnancy, the blood progesterone content rises and reaches a peak at 35 weeks, reaching 80-320ug/L. In threatened abortion, progesterone is still high; if there is a downward trend, there is a possibility of abortion. In multiple pregnancies, progesterone increases.
3.The pathological increase of progesterone is seen in pregnant women with diabetes, hydatidiform mole, ovarian granulosa cell tumor, ovarian lipoid tumor, congenital adrenal hyperplasia, congenital 17a-hydroxylase deficiency, essential hypertension and other diseases.
4.Pathological reduction of progesterone is mainly seen in luteinizing disorders and dysfunction, polycystic ovary syndrome, anovulatory dysfunctional uterine bleeding, severe pregnancy-induced hypertension, pregnancy-induced placental dysfunction, fetal growth retardation and stillbirth.
Ⅴ、Follicle stimulating hormone (FSH) and luteinizing hormone (LH)
Normal value: Luteinizing hormone (hLH) result 3.17mIU/mL
Reference range: Adult male: 1.24-8.62
Female: Follicular stage: 2.12-10.89
Ovulation period: 19.8-103.3
luteal phase: 1.20-12.86
Menopause: 10.87-58.64
Follicle Stimulating Hormone (hFSH) result 7.65mIU/mL
Reference range: Adult male: 1.27-12.96
Six female sex hormones: follicular stage: 3.85-8.78
Ovulation period: 4.54-22.51
luteal phase: 1.79-5.12
Menopause: 16.74-113.5
1.Increased FSH and LH are common in primary gonadal diseases, such as premature ovarian failure, gonadal hypoplasia, primary amenorrhea, primary sexual dysfunction, dysplasia of seminiferous tubules, complete (true) precocious puberty.
2.Decreased FSH and LH are mainly seen in pituitary or hypothalamic amenorrhea, incomplete (false) precocious puberty.
3.In patients with pituitary FSH tumor or LH tumor and FSH/LH tumor, due to different types of adenomas, serum FSH and LH concentrations show different types of changes: FSH tumors are mainly manifested as increased FSH and LH can be normal; LH tumors, LH is obvious Increased, FSH decreased; FSH/LH tumor, FSH and LH increased.
4.Detection of FSH and LH concentrations in women with amenorrhea can effectively distinguish ovarian amenorrhea from pituitary or hypothalamic amenorrhea. It is generally believed that low LH (<51U/L= is a more reliable indicator of insufficient GTH secretion by the adenohypophysis, while high FSH (>40IU/L) is a more reliable indicator of ovarian failure. If it is high FSH with high LH, it can be reliably confirmed Ovarian failure. If serum FSH and LH are abnormally low or FSH is at the lower limit of normal, LH is abnormally low, and it can be diagnosed as pituitary or hypothalamic amenorrhea. Then use Luteinizing Hormone (LRH) for pituitary stimulation The test can further distinguish the pituitary and hypothalamic amenorrhea: the excitement test shows that LH and FSH are increased and the peak time is delayed, indicating that the pituitary reserve function is good, and should be considered as hypothalamic amenorrhea; such as weak response of LH and FSH, indicating pituitary reserve Low function, it should be considered as pituitary amenorrhea. In summary, multiple indicators can be combined to identify the lesions of amenorrhea.
