A minimal set of hormone investigations is likely to include FSH, LH, prolactin levels and thyroid function tests (Q6.8).Luteinising hormone (LH) levels rise just before ovulation (Q 2. 14;Figure 2. 3) and a high level with normal FSH should be assessed according to whether a spontaneous period occurs two weeks later (LH Surge Figure 2.3). Otherwise a high LH may suggest polycystic ovary syndrome (Q7.2). When both LH and FSH are elevated (hypergonadotrophic hypogonadism), the menopause should be suspected (1). Occasionally, in younger women with amenorrhoea and hypogonadotrophic hypogonadism (Low gonadotrophin levels resulting in reduced ovarian hormone output), pregnancy or resumption of periods can occur and the diagnosis is resistant ovary syndrome. In these circumstances it seems as if there were no eggs timed for release during the episode of amenorrhoea (Q 2.3).
