Elevated LH/FSH-ratio

A disproportionately increased serum luteinizing hormone concentration relative to follicle-stimulating hormone (follicular phase: 1:1, ovulatory peak; 3:1, luteal phase: 1:1, menopause: <1). Possible causes are polycystic ovary syndrome, diminished ovarian reserve, hyperandrogenism, insulin resistance, obesity, metabolic syndrome, hypothalamic-pituitary dysregulation, premature ovarian insufficiency, and lifestyle factors (chronic stress, extreme exercise, weight fluctuations).

A disproportionately increased serum luteinizing hormone (LH) concentration relative to follicle-stimulating hormone (FSH), resulting in an elevated LH:FSH ratio compared with the expected physiologic range, reflecting altered hypothalamic–pituitary–gonadal (HPG) axis regulation and abnormal gonadotropin secretion.

• Follicular phase: ~1:1

• Ovulatory peak: ~3:1

• Luteal phase: ~1:1

• Menopause: typically <1

Causes

• Ovarian and reproductive disorders

  • Polycystic ovary syndrome

  • Diminished ovarian reserve

  • Premature ovarian insufficiency

  • Hyperandrogenism

• Metabolic disorders

  • Insulin resistance

  • Obesity

  • Metabolic syndrome

• Hypothalamic–pituitary disorders

  • Hypothalamic–pituitary dysregulation

  • Altered gonadotropin-releasing hormone (GnRH) pulsatility

  • Pituitary disorders affecting LH/FSH secretion

• Lifestyle-related factors

  • Chronic stress

  • Extreme physical exercise

  • Significant weight loss or weight gain