Primary Gonadal Failure

• In Women: High FSH levels are common in menopause or premature ovarian failure (such as seen in autoimmune oophoritis), as the ovaries no longer respond effectively to the hormone’s stimulation.
• In Men: Elevated FSH may indicate primary testicular failure or damage.

Feedback Deregulation

• When the gonads (ovaries or testes) do not produce sufficient sex hormones, the loss of negative feedback results in increased secretion of FSH by the pituitary.

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Hypogonadotropic Hypogonadism

• Pituitary/Hypothalamic Dysfunction:
  Low FSH can be attributed to dysfunction in the pituitary or hypothalamus.
• Compromised Central Pathways:
  Conditions such as tumors, inflammatory processes, or even certain severe infections affecting the brain can disrupt the central regulatory pathways, leading to decreased FSH levels.

Delayed or Abnormal Puberty

• Impact on Development:
  In children and adolescents, inappropriately low FSH levels may contribute to a delayed onset of puberty, potentially affecting normal developmental milestones.

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Childhood & Puberty

• FSH levels are very low during childhood.
• They increase during puberty as the reproductive axis matures.

Reproductive Years & Menopause

• In Adult Women: FSH fluctuates with the menstrual cycle but becomes markedly elevated after menopause.
• In Men: FSH levels remain relatively stable; however, they may rise with age if testicular function declines.

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Reproductive (Hypothalamic–Pituitary–Gonadal) Axis 

• Follicle-Stimulating Hormone (FSH): Regulates gonadal function and gamete production.
• Luteinizing Hormone (LH): Stimulates gonadal hormone production, including triggering testosterone synthesis.
• Prolactin: Primarily known for its role in lactation, it also modulates reproductive function.
• Testosterone: The primary androgen produced in response to pituitary signals, essential for sexual development and reproductive function.
• Somatotropic Hormone (Growth Hormone, GH):
  Although primarily responsible for growth and metabolism, it indirectly enhances reproductive health by optimizing overall tissue function

These hormones provide a comprehensive insight into the endocrine mechanisms governing reproduction. FSH and LH regulate gonadal function and testosterone production, Prolactin modulates various reproductive processes, and GH indirectly supports reproductive health by influencing overall tissue function.

Prostate

• Acid Phosphatase:
  Historically used as a marker for prostate pathology before more sensitive tests were available.
  
  
• Prostate Specific Antigen (PSA):
  Currently the primary tool for screening and monitoring prostate cancer due to its high sensitivity.
  
  

Both markers are integral in evaluating prostate tissue, with acid phosphatase playing a historical role and PSA serving as the cornerstone of modern prostate cancer detection and management.

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