At a Glance
Why Get Tested?
To evaluate your pituitary function, including fertility issues, gonadal failure, maturation concerns, or pituitary tumors
When to Get Tested?
When you are having difficulty getting pregnant or are having irregular or heavy menstrual periods; when your doctor thinks that you have symptoms of pituitary or hypothalamic disorders or symptoms of ovarian or testicular disease; or when a doctor suspects that a child has delayed or earlier than expected sexual maturation
Test Preparation Needed?
The Test Sample
What is being tested?
Luteinizing hormone (LH) is produced by the pituitary gland in the brain. Control of LH production is a complex system involving hormones produced by the gonads (ovaries or testes), the pituitary, and the hypothalamus.
Women's menstrual cycles are divided into the follicular and luteal phases, charaterized by a mid-cycle surge of follicle-stimulating hormone (FSH) and LH. The high level of LH (and FSH) at mid-cycle triggers ovulation. LH also stimulates the ovaries to produce steroids, primarily estradiol. Estradiol and other steroids help the pituitary to regulate the production of LH. At the time of menopause, the ovaries stop functioning and LH levels rise.
In men, LH stimulates a certain cell type (Leydig cells) in the testes to produce testosterone. LH (or sometimes referred to as Interstitial Cell Stimulating Hormone or ICSH in males) levels are relatively constant in men after puberty. An increasing testosterone level provides negative feedback to the pituitary gland and the hypothalamus, thus decreasing the amount of LH secreted.
In infants and children, LH levels rise shortly after birth and then fall to very low levels (by 6 months in boys and 1-2 years in girls). At about 6-8 years, levels again rise before the beginning of puberty and the development of secondary sexual characteristics.
How is the sample collected for testing?
A blood sample is taken by needle from a vein in the arm or a random urine sample is used. A 24-hour collection of urine may be requested if your doctor wants to measure LH levels produced over a 24-hour period. LH is released intermittently throughout the day; thus a random sample may not reflect a true reading. A 24-hour urine can eliminate this variation.
NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.
Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.
Is any test preparation needed to ensure the quality of the sample?
No test preparation is required, but a woman's sample should be collected at specific times during her menstrual cycle.
Ask a Laboratory Scientist
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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.
Sources Used in Current Review
Pagana, K. D. & Pagana, T. J. (© 2007). Mosby's Diagnostic and Laboratory Test Reference 8th Edition: Mosby, Inc., Saint Louis, MO. Pp 629-631.
Wu, A. (© 2006). Tietz Clinical Guide to Laboratory Tests, 4th Edition: Saunders Elsevier, St. Louis, MO. Pp 694-697.
Vorvick, L. (Updated 2009 July 29). LH. MedlinePlus Medical Encyclopedia [On-line information]. Available online at http://www.nlm.nih.gov/medlineplus/ency/article/003708.htm. Accessed February 2010.
Giannios, N. et. al. (Updated 2008 February 12). Luteinizing Hormone Deficiency. eMedicine [On-line information]. Available online at http://emedicine.medscape.com/article/255046-overview through http://emedicine.medscape.com. Accessed February 2010.
Meikle, A. W. et. al. (Updated 2009 November). Amenorrhea. ARUP Consult [On-line information]. Available online at http://www.arupconsult.com/Topics/Amenorrhea.html# through http://www.arupconsult.com. Accessed February 2010.
Brzyski, R. and Jensen, J. (Revised 2007 March) Female Reproductive Endocrinology, Introduction. Merck Manual for Healthcare Professionals [On-line information]. Available online at http://www.merck.com/mmpe/sec18/ch243/ch243a.html?qt=FSH&alt=sh through http://www.merck.com. Accessed February 2010.
Clarke, W. and Dufour, D. R., Editors (© 2006). Contemporary Practice in Clinical Chemistry: AACC Press, Washington, DC. Pp 360-361.
Sources Used in Previous Reviews
Corbett, JV. Laboratory Tests & Diagnostic Procedures with Nursing Diagnoses, 4th ed. Stamford, Conn.: Appleton & Lang, 1996. pp. 429-431, 726.
Clinical Guide to Laboratory Tests. 3rd ed. Tietz N, ed. Philadelphia: W.B. Saunders & Co; 1995: 248-249, 210-211.
The InterNational Council on Infertility Information Dissemination. PCOS in Pediatrics: When and How Does it Start? Originally written and presented by Silva Arslanian, MD, Children's Hospital of Pittsburgh, Pittsburgh, PA; summarized in online version by Christine M. Schroeder, PhD. Available online at http://www.inciid.org/pcos/PCOS-pediatrics.html through http://www.inciid.org.
Gonadotropins: Luteinizing and Follicle Stimulating Hormones. Available online at http://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/hypopit/lhfsh.html through http://arbl.cvmbs.colostate.edu.
Blondell RD, Foster MB, Kamlesh CD. Disorders of Puberty. American Family Physician, July 1999 (online publication). Available online at http://www.aafp.org/afp/990700ap/209.html through http://www.aafp.org.
Hormone Society. Fact Sheet on Female Infertility. Available online at http://www.endo-society.org/pubrelations/patientInfo/infertility.htm through http://www.endo-society.org.
The Hormone Foundation. Fact sheet on Polycystic Ovary Syndrome (PCOS). Available online at http://www.hormone.org/pcos_factsheet.html through http://www.hormone.org.
Laurence M. Demers, PhD. Distinguished Professor of Pathology and Medicine, The Pennsylvania State University College of Medicine, The M. S. Hershey Medical Center, Hershey, PA.
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Thompason, Sharon. LH response to GnRH. (Updated Aug 2005) MedlinePlus (online information). Available online at http://www.nlm.nih.gov/medlineplus/print/ency/article/003709.htm.
Neely EK, Wilson DM, Lee PA, Stene M, Hintz RL (July 1995). Spontaneous serum gonadotropin concentrations in the evaluation of precocious puberty. J Pediatric 127(1):47-52 from PubMed. Available online at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=7608810 through http://www.ncbi.nlm.nih.gov.
Nirupama Kakarla, M.D.; Karen D. Bradshaw, M.D. (Posted 03/05/2004.) Disorders of Pubertal Development: Precocious Puberty. From Seminars in Reproductive Medicine 21(4):339-351 from Medscape. Available online at http://www.medscape.com/viewarticle/468259 through http://www.medscape.com.
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Sheehan, M (Dec 2003). Polycystic Ovarian Syndrome: Diagnosis and Management. Clinical Medicine and Research, 2(1): 13-27. Available online at http://www.pubmedcentral.gov/articlerender.fcgi?artid+1069067 through http://www.pubmedcentral.gov.