Follicle-Stimulating Hormone (FSH) is a gonadotropin, a glycoprotein polypeptide hormone synthesized and extracted by the gonadotropin cells of the Anterior Pituitary Gland (APG), which regulates the development, growth, pubertal maturation, and reproductive processes consisting of two polypeptide units. The alpha subunits of the glycoprotein’s of FSH consist of 96ᾳ and has a beta subunit of 111 amino acids (FSH β), which confers its specific biological action, and is answerable for interaction with the FSH receptor [3]. In females, FSH initiates follicular growth, specifically affecting granulosa cells, but with the concomitant rise in inhibin B, FSH levels reduce in the late follicular phase. It induces the growth and recruitment of immature ovarian follicles in ovaries. In addition, it is also shown that gonadotropin surge-attenuating factor produced by small follicles in the first half of the follicular phase also apply negative feedback on pulsatile LH secretion amplitude, thus allowing a more favourable environment for follicular growth and preventing premature luteinisation, [4]. When a woman draws closer to pre menopause, the quantity of small antral follicles recruited in a cycle diminishes and consequently insufficient Inhibin B is produced to fully lower FSH and the serum level of follicle stimulating hormone begins to rise, at last the FSH level becomes so high that down regulation of FSH receptors occurs and by post menopause any remaining small secondary follicles has no FSH nor LH receptors [5].The increase in serum estradiol cause a decrease in FSH production by restraining GnRh production in the hypothalamus [6]. FSH regulates the development, growth, pubertal maturation and reproductive process in the body, [7]. In both genders, FSH stimulates the differentiation of primordial germ cells. In males, FSH induces Sertoli cells to secrete androgen-binding proteins (ABPs) regulated by inhibin's negative feedback mechanism on the anterior pituitary gland. Specifically, activation of Sertoli cells by FSH sustains spermatogenesis and stimulates inhibin B secretion. FSH helps control the menstrual cycle and eggs growth. FSH reached its highest levels just before an egg is released by the ovary (Medline plus, 2020).FSH is synthesized by gonadotropin cells for development and pubertal maturation processes.

Progesterone is among steroid hormones called progestogens [8]. Progesterone form corpus luteum, a temporary endocrine gland that is produced after ovulation. Progesterone prepares endometrial linings during pregnancy after ovulation. It triggers the lining to accept a fertilized egg. It also prohibits the uterus muscular contraction which will reject an egg. This change sparks menstruation and if the body does conceive, progesterone will continue to increase for vasculatures that will feed the growing foetus. Once the placenta develops, progesterone continues to increase throughout the pregnancy so that the body does not produce more eggs. It prepares the breasts for milk production. (The Hormone Health Network, 2021). Decreased progesterone result in irregular periods, difficulty conceiving, pregnancy complications while estrogen helps develop and maintain the sex organs. It helps to stimulate the eggs follicular growth, maintains the thickness trusted and promotes lubrication.

Luteinizing hormone is a heterodimeric glycoprotein produced by gonadotropic cells in the APG and is regulated by GnRh from the hypothalamus [9]. Each monomeric unit is a glycoprotein molecule consisting of one alpha and one beta subunit making it the full functional protein. An acute rise of LH triggers ovulation and growth of the corpus luteum [10]. The protein dimer contains 2 glycopeptides subunits labelled alpha- and beta- subunits that are non-covalently associated [3]. LH has a beta subunit of 120 amino acids (LHB) that confers its specific biologic action and is answerable for the occurrence with the LH receptor. It supports theca cells in the ovaries that provide androgens and hormonal precursors for estradiol production. In females LH surge triggers ovulation, which initiate the turning of the residual follicle into a corpus luteum that in turn produces progesterone to prepare the endometrium for a possible implantation. LH is necessary to maintain luteal function for the second two weeks of the female periodic cycle. LH levels are normally low during childhood but increases in women after menopause. During the reproductive years, typical levels are between 1–20 IU/L.

According to Rehman (2018) [11], ovarian cycle consists of alternating follicular and luteal phases. Menstrual phase is by interaction of luteinizing hormone and follicle-stimulating hormone [1]. FSH and LH raised levels is of ovarian malfunction [12]. FSH feedback mechanism will be lost and LH rise-Turners syndrome in women. Around day 14, LH levels rise causes ovarian follicle to rupture and release a mature oocyte (egg) from ovary, a process called ovulation [13]. Estrogen level is high at this phase while the Progesterone and estrogen cause uterus linings to thicken more, for possible fertilization and if the egg is not fertilized there will be corpus luteum degeneration with no progesterone production while the estrogen level decreases, the top layers break down and menstrual bleeding occurs- called hypergonadotrophic- hypogonadism, due to ovarian failure.