North American Registry of Midwives (NARM) Practice Exam 2026 – The All-in-One Resource to Master Your Midwifery Certification!

During peri-menopause, the levels of follicle-stimulating hormone (FSH) are known to increase. This change is a significant aspect of the hormonal fluctuations women experience as they approach menopause. FSH is produced by the pituitary gland and is responsible for stimulating the growth and maturation of ovarian follicles.

As women age, the responsiveness of the ovaries to FSH decreases, leading to a reduction in estrogen production and altering the normal feedback loop. In response to the declining estrogen levels, the pituitary gland increases the production of FSH in an attempt to stimulate the ovaries. This results in higher levels of FSH being present in the bloodstream during the peri-menopausal phase.

Monitoring FSH levels can be an important indicator of a woman's transition into menopause, as elevated levels often suggest that the ovaries are producing less estrogen and that the woman is moving further along in the menopausal transition. Understanding this hormonal shift is crucial for midwifery practice, as it helps in the management of symptoms associated with peri-menopause and provides insights into a woman's reproductive health.