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Treat the Cause of High FSH– Not Just the Symptom

FSH levels are a symptom of a larger problem: ovarian insufficiency. Don’t delay fertility treatment when you have high FSH levels.

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Hello, I want today to discuss with you a question which we hear all the time from our patients and that is, “Doctor, how can I reduce my high FSH levels?” My answer usually is, “Why do you want to reduce your high FSH levels? And the reason why this is usually my answer is because you need to recognize that FSH is not the disease. FSH is just a symptom.

In other words, I can reduce even the menopausal FSH level literally within a few days into normal levels by giving the patient some estrogen. Giving estrogen– increasing the estrogen level– will automatically plunge FSH levels into normal territory. Yet, nothing changes because the high FSH is just a symptom of ovarian insufficiency. The disease is ovarian insufficiency.

The problem is ovarian, therefore the treatment has to be ovarian. It is kind of like when you have the flu– treating the fever. Okay, it may make you feel better, but it is not treating the virus. Same thing here.

One more point in that regard. There are colleagues who believe that how high the FSH level is at any given point will affect an IVF cycle. And these colleagues, therefore, tell patients with high FSH very frequently, “Okay, let’s wait until you have a month when your FSH is low.” Once again, in our opinion, really not a good idea because if your FSH is already elevated, time is usually of essence. And waiting does not help because time is not on our side in women who already have high FSH.

In other words, my advice is don’t bother lowering your FSH and certainly don’t bother waiting for your FSH to drop. FSH goes up with time. Therefore, it simply doesn’t make any sense. Thank you for listening.