Follicle-Stimulating Hormone (FSH): Uses, Dosing & Side Effects

Summary of Key Points

Follicle-stimulating hormone (FSH) is a medication used to treat various reproductive health conditions, including infertility, ovarian dysfunction, and male hypogonadism. It works by stimulating egg growth in women and sperm production in men. FSH is commonly prescribed for fertility treatments. Always consult your healthcare provider before starting or adjusting your FSH dose. Our telemedicine providers are available to assist with any questions or concerns you may have.

Names of Medication

US Brand Names: Gonal-F, Follistim AQ

The generic name refers to the active ingredient in the medication, which in this case is follicle-stimulating hormone (FSH).

Pharmacologic Category

Gonadotropins

Hormones

FSH Dosing Guidelines

Follicle-stimulating hormone (FSH) is used to treat several reproductive health conditions. Dosing varies depending on the condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. You can also schedule a telemedicine appointment with one of our providers for personalized guidance.

Hypogonadism (Male)

Initial dose: 150 international units (IU) injected subcutaneously or intramuscularly three times per week.

Duration: Treatment may last several months, depending on the patient’s response.

Ovarian Dysfunction

Initial dose: 75-150 IU injected subcutaneously daily.

Duration: Treatment typically continues until adequate follicular development is achieved, usually around 10-14 days.

Infertility (Female)

Initial dose: 75-150 IU injected subcutaneously daily.

Duration: Treatment usually continues until the follicles are mature, which may take 7-14 days.

Polycystic Ovary Syndrome (PCOS)

Initial dose: 75 IU injected subcutaneously daily.

Duration: Treatment may last 7-14 days, depending on the patient’s response.

Testicular Failure

Initial dose: 150 IU injected subcutaneously three times per week.

Duration: Treatment may continue for several months.

Turner Syndrome

Initial dose: 75 IU injected subcutaneously daily.

Duration: Treatment duration varies based on individual response.

Kallmann Syndrome

Initial dose: 150 IU injected subcutaneously three times per week.

Duration: Treatment may last several months.

Anovulation

Initial dose: 75-150 IU injected subcutaneously daily.

Duration: Treatment usually continues until ovulation occurs, typically within 10-14 days.

Male Hypogonadism

Initial dose: 150 IU injected subcutaneously three times per week.

Duration: Treatment may last several months, depending on the patient’s response.

Premature Ovarian Insufficiency

Initial dose: 75-150 IU injected subcutaneously daily.

Duration: Treatment typically continues until adequate follicular development is achieved, usually around 10-14 days.

Dosage Forms and Strengths

Subcutaneous Injection: 75 IU, 150 IU, 300 IU, 450 IU, 900 IU

Administration Instructions for FSH Hormone

Follicle-stimulating hormone is administered via injection under the skin (subcutaneous) or into the muscle (intramuscular). Your healthcare provider will show you how to properly administer the injection. It’s important to rotate the injection site to avoid irritation. Follow the dosing schedule exactly as prescribed. If you miss a dose, contact your healthcare provider for instructions.

Adverse Reactions and Side Effects of FSH

Like all medications, follicle-stimulating hormone can cause side effects. While not everyone will experience them, it’s important to be aware of potential reactions. If you experience severe side effects, contact your healthcare provider immediately or schedule a telemedicine appointment with one of our providers.

Common Side Effects (affecting more than 1 in 10 people):

1. Injection site reactions: Redness, swelling, or pain at the injection site.
2. Headache: Mild to moderate headaches may occur.
3. Abdominal discomfort: Some patients may experience bloating or mild stomach pain.

Less Common Side Effects (affecting 1 in 100 to 1 in 1,000 people):

1. Ovarian hyperstimulation syndrome (OHSS): A rare but serious condition where the ovaries become swollen and painful.
2. Allergic reactions: Rash, itching, or swelling, especially of the face, tongue, or throat.

Rare Side Effects (affecting fewer than 1 in 1,000 people):

1. Blood clots: Increased risk of blood clots in veins or arteries.
2. Severe abdominal pain: This could be a sign of a more serious condition and should be evaluated immediately.

Contraindications for FSH Treatment

A contraindication is a specific condition where a medication should not be used because it may cause harm. If you have any of the conditions listed below, inform your healthcare provider before starting follicle-stimulating hormone (FSH) treatment. These conditions may increase the risk of side effects or reduce the effectiveness of the medication.

Pregnancy: FSH is contraindicated during pregnancy as it can interfere with the hormonal balance needed to support a healthy pregnancy. If you suspect you are pregnant, stop taking FSH and contact your healthcare provider immediately.

Uncontrolled thyroid or adrenal dysfunction: Hormonal imbalances in the thyroid or adrenal glands can affect how FSH works, potentially leading to ineffective treatment or worsening of your condition.

Primary ovarian failure: If your ovaries are no longer functioning (primary ovarian failure), FSH treatment may not be effective. Discuss alternative treatments with your healthcare provider.

Uncontrolled pituitary tumor: FSH is regulated by the pituitary gland. If you have an untreated pituitary tumor, taking FSH could worsen your condition or lead to complications.

Hypersensitivity to FSH or its components: If you are allergic to FSH or any ingredients in the medication, avoid taking it. Allergic reactions can range from mild to severe, including symptoms like rash, swelling, or difficulty breathing.

Ovarian cysts or enlargement (unrelated to polycystic ovary syndrome): FSH can stimulate the ovaries, potentially worsening ovarian cysts or leading to complications.

Drug to Drug Interactions with Follicle-Stimulating Hormone (FSH)

Certain medications can interact with follicle-stimulating hormone (FSH), potentially reducing its effectiveness or increasing the risk of side effects. It is crucial to inform your healthcare provider about all medications you are taking, including over-the-counter drugs, supplements, and herbal remedies. Below are some medications that may interact with FSH:

1. Clomiphene (Clomid): Clomiphene is commonly used to stimulate ovulation. When combined with FSH, it may increase the risk of ovarian hyperstimulation syndrome (OHSS), a condition where the ovaries become swollen and painful.
2. Gonadotropin-releasing hormone (GnRH) agonists and antagonists: Medications like leuprolide (Lupron) and cetrorelix (Cetrotide), often used in fertility treatments, can alter the effects of FSH, requiring careful monitoring.
3. Human chorionic gonadotropin (hCG): hCG is sometimes used alongside FSH to trigger ovulation. However, improper use of these medications together can increase the risk of OHSS or multiple pregnancies.
4. Androgens (testosterone): In men, testosterone supplements taken during FSH therapy for male hypogonadism can disrupt the body’s natural hormone balance, reducing the effectiveness of FSH.

Follicle-Stimulating Hormone in Pregnancy

Taking follicle-stimulating hormone during pregnancy is not safe. FSH stimulates the ovaries to produce eggs, but once pregnancy occurs, this is no longer necessary. Continuing FSH during pregnancy could disrupt the hormonal balance needed to maintain a healthy pregnancy. If you become pregnant while taking FSH, stop the medication immediately and consult your healthcare provider.

Follicle-Stimulating Hormone While Breastfeeding

It is not recommended to take follicle-stimulating hormone while breastfeeding. Although there is limited data on whether FSH passes into breast milk, FSH affects hormone levels and could interfere with milk production or potentially impact the baby. If you are breastfeeding and considering FSH treatment, discuss the risks and benefits with your healthcare provider.

Estimated Cost of Follicle-Stimulating Hormone Medication

The cost of a 30-day supply of follicle-stimulating hormone can vary depending on the brand and dosage. Without insurance, the estimated cost using a GoodRX coupon ranges from $1,000 to $3,000 for a 30-day supply. Prices may differ based on the pharmacy and the specific formulation. Check with your pharmacy for the most accurate pricing.

Possible Alternatives to Follicle-Stimulating Hormone Treatment

Depending on your condition, alternative treatments or lifestyle changes may help manage symptoms or improve your chances of success. Always discuss these options with your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers for personalized advice.

1. Hypogonadism: Alternatives include testosterone replacement therapy for men or estrogen/progesterone therapy for women. Lifestyle changes, such as weight loss and regular exercise, may also improve symptoms.
2. Ovarian dysfunction: Hormone replacement therapy (HRT) or oral contraceptives may help regulate menstrual cycles. Lifestyle changes like stress management and a healthy diet can also be beneficial.
3. Infertility: Other fertility treatments, such as in vitro fertilization (IVF) or intrauterine insemination (IUI), may be considered. Acupuncture and stress-reduction techniques may also improve fertility outcomes.
4. Polycystic ovary syndrome (PCOS): Lifestyle changes, such as weight loss, a low-carbohydrate diet, and regular exercise, can help manage PCOS symptoms. Medications like metformin or oral contraceptives may also be used.
5. Testicular failure: Testosterone replacement therapy is often the primary treatment for testicular failure. Assisted reproductive technologies may be needed for fertility in some cases.
6. Turner syndrome: Hormone replacement therapy (HRT) is commonly used to manage Turner syndrome. Growth hormone therapy may also be recommended to promote growth in children with this condition.
7. Kallmann syndrome: Hormone replacement therapy, including testosterone or estrogen/progesterone, is often used to treat Kallmann syndrome. Fertility treatments like FSH and hCG may be required in some cases.
8. Anovulation: Clomiphene (Clomid) or letrozole (Femara) may be used to induce ovulation. Lifestyle changes, such as weight loss and stress management, can also help restore ovulation.
9. Male hypogonadism: Testosterone replacement therapy is the most common treatment. Lifestyle changes like weight loss, exercise, and reducing alcohol consumption can improve symptoms in some cases.
10. Premature ovarian insufficiency: Hormone replacement therapy (HRT) is often used to manage symptoms. Assisted reproductive technologies may be needed for fertility in some cases.

Recent Updates on Follicle-Stimulating Hormone Research

Recent research on follicle-stimulating hormone focuses on improving fertility treatments and reducing complications like ovarian hyperstimulation syndrome (OHSS). One promising area of study is the development of long-acting FSH formulations, which may reduce the number of injections needed during fertility treatments. Researchers are also exploring the use of FSH in combination with other medications to improve outcomes for conditions like polycystic ovary syndrome (PCOS) and male hypogonadism.

Ongoing studies are examining genetic factors that influence patient responses to FSH treatment. This research could lead to more personalized treatment plans, allowing healthcare providers to tailor FSH dosages based on a patient’s unique genetic makeup. If you’re interested in learning more about the latest research or participating in a clinical trial, speak with your healthcare provider or schedule a telemedicine appointment with one of our specialists.

James Kingsley

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