Research Blog
October 30, 2023
Optimal Takeaways
Luteinizing hormone (LH) is a pituitary hormone that stimulates the production of estrogens and androgens. A negative feedback system regulates LH's output, which increases as estrogens and androgens decrease with age. Elevated levels of LH in the postmenopausal period have been associated with cognitive deficits, loss of lean body mass, and lower bone mineral density. Low levels of postmenopausal LH have been associated with an increased risk of metabolic syndrome and its components.
Standard Range: 10.0-54.7 mIU/mL (Immunoassay)
Low postmenopausal LH may be associated with an increased risk of metabolic syndrome (Chen 2023).
High postmenopausal LH may be associated with cognitive deficits (Burnham 2015), lower lean body mass (Garcia-Martin 2013), decreased bone mineral density, and increased bone loss (Seifert-Klauss 2012).
Overview
Luteinizing hormone (LH) is produced in the anterior pituitary and is a factor in the hypothalamic-pituitary-gonadal axis. It stimulates the production of estrogens and androgens. LH increases with age in both men and women as negative feedback from estrogen and testosterone is reduced. Serum LH levels rise to an average of 30 mIU/mL in menopausal women and 10 mIU/mL in aging men, potentially having an increasingly adverse effect on cognition and the brain. Human and animal studies suggest elevated serum LH and its homologue, human chorionic gonadotropin (HCG), induce cognitive deficits and may be associated with an increased risk of Alzheimer’s. Alzheimer’s is characterized by progressive memory loss, impaired visual-spatial skills, impaired language, immobility, and malnutrition (Burnham 2015). Research suggests that reducing peripheral LH may reduce associated cognitive deficits, potentially by balancing brain levels of LH due to the inverse association between brain and blood levels of LH (Blair 2015).
Higher LH has been associated with lower lean body mass in menopause. A cross-sectional study of 91 postmenopausal women used bioelectrical impedance analysis and the appendicular skeletal muscle mass index to demonstrate a significant association between higher serum FSH and LH levels and lower lean body mass. Those with LH in the highest tertile of serum LH had the lowest lean body mass versus those in the lowest tertile, i.e., 40.9 ± 15.2 mIU/mL vs. 36.1 ± 12.3 respectively. Interestingly, estradiol levels were not correlated with lean body mass in the study, and testosterone levels were not evaluated (Garcia-Martin 2013). Decreased testosterone may also contribute to a decrease in lean body mass, including in the postmenopausal period (van Geel 2009).
Higher average LH levels during the menopausal transition and postmenopause were associated with accelerated bone loss in a prospective observational study, especially loss of trabecular bone, which responds to hormonal changes more quickly than cortical bone. Bone loss was most significant in the menopausal transition, during which participants had a mean LH level of 37.1 mIU/mL versus 7.7 in premenopause and 31.4 mIU/mL in the postmenopausal period. Researchers also note that significant risk factors for bone loss include a low BMI and a family history of osteoporosis (Seifert-Klauss 2012).
However, low postmenopausal LH may be associated with an increased risk of metabolic syndrome. A review of NHANES data for 3,831 women found that the risk of metabolic syndrome decreased by 18.5% with each 1 standard deviation increase in LH in those who were postmenopausal. Risk decreased by 22.6% for each 1 standard deviation increase in FSH. Median LH levels in those with metabolic syndrome were 8.60 mIU/mL versus 11.70 in those without metabolic syndrome. Metabolic syndrome was defined as having at least 3 of the following criteria: waist circumference 88 cm or greater, triglycerides 150 mg/dL (1.69 mmol/L) or higher, HDL-C below 50 mg/dL (1.29 mmol/L), systolic blood pressure 130 mm Hg or higher, or diastolic blood pressure 85 mm Hg or higher or taking hypertension medications, or fasting plasma glucose level 100 mg/dL or higher or taking diabetes medication (Chen 2023).
A randomized controlled 15-week trial of postmenopausal women suffering from vasomotor symptoms (VMS) found that increased activity and resistance training decreased VMS. The decrease in VMS correlated with reductions in serum LH, especially in pulsations of LH. However, researchers suggest the decrease in VMS may be associated with increased endogenous opioids versus a direct effect of decreased LH (Nilsson 2022).
Supplementation with ashwagandha herb was also found to significantly decrease menopausal symptoms, serum FSH, and serum LH and increase serum estradiol (Gopal 2021).
References
Blair, Jeffrey A et al. “Luteinizing hormone: Evidence for direct action in the CNS.” Hormones and behavior vol. 76 (2015): 57-62. doi:10.1016/j.yhbeh.2015.06.020
Burnham, Veronica L, and Janice E Thornton. “Luteinizing hormone as a key player in the cognitive decline of Alzheimer's disease.” Hormones and behavior vol. 76 (2015): 48-56. doi:10.1016/j.yhbeh.2015.05.010
Chen, Yongjie et al. “Associations of follicle-stimulating hormone and luteinizing hormone with metabolic syndrome during the menopausal transition from the National Health and Nutrition Examination Survey.” Frontiers in endocrinology vol. 14 1034934. 9 Feb. 2023, doi:10.3389/fendo.2023.1034934 This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).
García-Martín, Antonia et al. “Gonadotropins Are Related to Lean Mass in Healthy Postmenopausal Women.” Endocrine research vol. 38,3 (2013): 119-124. doi:10.3109/07435800.2012.733987
Gopal, Sriram et al. “Effect of an ashwagandha (Withania Somnifera) root extract on climacteric symptoms in women during perimenopause: A randomized, double-blind, placebo-controlled study.” The journal of obstetrics and gynaecology research vol. 47,12 (2021): 4414-4425. doi:10.1111/jog.15030
Seifert-Klauss, V et al. “Bone loss in premenopausal, perimenopausal and postmenopausal women: results of a prospective observational study over 9 years.” Climacteric : the journal of the International Menopause Society vol. 15,5 (2012): 433-40. doi:10.3109/13697137.2012.658110
van Geel, Tineke A C M et al. “Measures of bioavailable serum testosterone and estradiol and their relationships with muscle mass, muscle strength and bone mineral density in postmenopausal women: a cross-sectional study.” European journal of endocrinology vol. 160,4 (2009): 681-7. doi:10.1530/EJE-08-0702
