What this test measures
Luteinising Hormone (LH) is a gonadotropin secreted by the anterior pituitary in pulses under hypothalamic GnRH control. In women, LH triggers ovulation around mid-cycle and supports the corpus luteum afterwards. In men, LH stimulates Leydig cells to produce testosterone.
LH and FSH are co-secreted and almost always interpreted together. In women they are most informative on cycle day 2 or 3 (early follicular phase) for fertility evaluation, or mid-cycle for ovulation timing. In men a single morning sample is sufficient.
Why it matters
LH is part of every reproductive workup — fertility, amenorrhoea, irregular periods, suspected PCOS, suspected pituitary disease, male hypogonadism, and puberty (early or delayed). An LH:FSH ratio above 2 in a woman with oligomenorrhoea supports PCOS — one of the most common conditions seen in Indian women of reproductive age (estimated at 1 in 5).
In men, LH plus total testosterone separate primary from secondary hypogonadism: low testosterone with high LH = primary testicular failure; low testosterone with low or inappropriately normal LH = secondary (pituitary or hypothalamic) hypogonadism. The distinction completely changes management.
How to prepare
No fasting required. Morning sample preferred. In cycling women in fertility workup, draw on cycle day 2 or 3 (early follicular). For mid-cycle ovulation testing, draw on suspected pre-ovulatory days based on cycle length. Stop biotin for 48–72 hours. Tell the lab if you are on hormonal contraception, HRT or fertility medications.
Markers & reference ranges
Reference ranges below are typical adult values. Your lab's reported range may differ slightly based on the assay platform and patient demographics — always read your report against the range printed on it.
| Marker | Normal range | If low | If high |
|---|---|---|---|
| Luteinising Hormone (mIU/mL)[1][2] | Female follicular: 2.4 – 12.6 · Mid-cycle peak: 14 – 95 · Luteal: 1.0 – 11.4 · Postmenopausal: 7.7 – 58.5 · Adult male: 1.7 – 8.6 | Low LH with low FSH and low sex steroids = hypogonadotropic hypogonadism — stress, low BMI, anorexia, pituitary tumour, Kallmann syndrome. Combined oral contraceptives suppress LH and FSH. | Raised LH (with raised FSH) in a woman with absent periods = primary ovarian failure. LH:FSH > 2 with oligomenorrhoea supports PCOS. In a man with low testosterone, raised LH indicates primary testicular failure (Klinefelter, post-chemo, orchitis, varicocele damage). |
LH + FSH — paired interpretation
| Scenario | LH | FSH | Likely picture |
|---|---|---|---|
| Cycling woman, normal | Normal | Normal | Normal axis |
| PCOS | Raised | Normal/low | LH:FSH > 2; oligomenorrhoea |
| Premature ovarian insufficiency | High | Very high | Ovarian failure |
| Hypothalamic amenorrhoea | Low | Low | Stress, low BMI |
| Mid-cycle peak | Very high (surge) | Mild rise | Pre-ovulatory |
| Primary male hypogonadism | High | High | Testicular failure |
| Secondary male hypogonadism | Low | Low | Pituitary / hypothalamic problem |
Frequently asked questions
When in my cycle should I get LH tested?
For fertility workup, cycle day 2 or 3 (with FSH and oestradiol). For ovulation timing, around mid-cycle when the LH surge is expected — most home ovulation kits work on this principle.
My LH is much higher than my FSH — does that mean PCOS?
An LH:FSH ratio above 2 with irregular periods and clinical features (hirsutism, acne, hair loss) supports PCOS. It is one of several criteria; ultrasound and clinical picture matter too. Many women with PCOS actually have a normal LH:FSH ratio.
Will birth control pills affect LH?
Yes — combined oral contraceptive pills suppress LH and FSH. For a true baseline, test 3 months after stopping.
My partner has low testosterone and a low LH — what does that mean?
Low testosterone with a low or non-raised LH indicates the problem is at the pituitary or hypothalamus — secondary hypogonadism. Workup includes prolactin, ferritin, full pituitary panel and often an MRI.
Is LH useful in puberty workup?
Yes. In suspected precocious puberty, a basal or GnRH-stimulated LH > 5 mIU/mL is a strong indicator of central (true) precocious puberty. In delayed puberty, low LH with low sex steroids prompts a hypogonadotropic workup.
Does menopause raise LH?
Yes — both LH and FSH rise substantially after menopause as ovarian feedback disappears. The classical pattern is FSH > 30, LH > 30, with very low oestradiol.
Can stress lower LH?
Yes — severe physical or psychological stress, very low BMI, intense exercise (in athletes), or eating disorders can suppress hypothalamic GnRH and lower both LH and FSH (functional hypothalamic amenorrhoea).
Related Hormones / Endocrine tests
Tests commonly ordered alongside LUTEINISING HORMONE (LH), or that help interpret an unexpected result.
Sources & references
- Endocrine Society — Female Infertility · accessed 2026-05-30T00:00:00.000Z
- NIH MedlinePlus — LH Test · accessed 2026-05-30T00:00:00.000Z
- NCBI StatPearls — Luteinising Hormone · accessed 2026-05-30T00:00:00.000Z
- ASRM — Diagnostic Evaluation of the Infertile Female · accessed 2026-05-30T00:00:00.000Z
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