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estrogen/progestin cycle test

Indications: - used in conjunction with the progesterone challenge test for the evaluation of amenorrhea Procedure: 1) 2.5 mg of conjugated estrogen QD for 21 days 2) add medroxyprogesterone acetate (Provera) 10 mg QD for the last 5 days Interpretation: 1) if there is no withdrawal bleeding, an end-organ problem is confirmed 2) if withdrawal bleeding occurs a) an elevated serum FSH confirms menopause b) a low serum FSH 1] should prompt an evaluation for pituitary tumor 2] no pituitary tumor suggests hypothalamic amenorrhea

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progesterone challenge test

References

  1. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 389
  2. Medical Knowledge Self Assessment Program (MKSAP) 16, American College of Physicians, Philadelphia 2012