Primary Causes & Action Plans
FSH
Elevated if cycle is becoming anovulatory (skipped ovulation) FSH rises when ovulation is failing. Chronically elevated FSH indicates declining ovarian reserve or anovulation.
Target < 10 mIU/mL (normal cycle)
Suggested Action Plan
If FSH is elevated, investigate causes: thyroid dysfunction, stress, nutrient deficiency, metabolic dysfunction. Once root cause is corrected, FSH typically normalizes.
LH
LH surge is required for ovulation; absent surge indicates anovulation Normal cycles show clear LH surge mid-cycle. Absence of LH surge indicates anovulation (no progesterone production).
Target Surge: 17-77 mIU/mL
Suggested Action Plan
Use LH urine tests to confirm LH surge occurs monthly. If no surge, investigate causes and correct.
Progesterone
Low luteal progesterone shortens cycle and indicates inadequate corpus luteum function Progesterone should be >5-10 ng/mL in luteal phase. Low progesterone shortens luteal phase, producing frequent periods or breakthrough bleeding.
Target Luteal: 8-20+ ng/mL
Suggested Action Plan
Support progesterone production through stress management, sleep, magnesium supplementation. If very low despite ovulation, bioidentical progesterone supplementation may be needed.
Thyroid Panel (TSH, Free T4)
Thyroid dysfunction is a common cause of irregular cycles Hypothyroidism suppresses ovulation and shortens luteal phase. Hyperthyroidism can also disrupt cycles.
Target TSH: 1.0-2.5 mIU/L
Suggested Action Plan
If thyroid function is abnormal, thyroid replacement or antithyroid treatment restores cycle regularity quickly.
Prolactin
Elevated prolactin suppresses GnRH and ovulation High prolactin suppresses GnRH and LH, preventing ovulation. Causes include hypothyroidism, pituitary adenoma, medications.
Target < 25 ng/mL
Suggested Action Plan
If elevated, investigate causes (especially thyroid dysfunction, which is common). Treat underlying cause. If pituitary adenoma, cabergoline may be needed.