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progesterone challenge test
Indications: evaluation of amenorrhea
Procedure: testing:
1) 10 mg of medroxyprogesterone acetate (Provera) PO QD for 5 days
2) After stopping Provera, the patient will either bleed vaginally or not within 2-7 days
Interpretation:
1) bleeding confirms that there is adequate endogenous estrogen & that amenorrhea is caused by anovulation
2) if bleeding occurs & serum prolactin is normal & there is no galactorrhea, then no further evaluation is needed
3) if there is no withdrawal bleeding, an estrogen/progestin cycle test is indicated to evaluate end-organ function
- consider hypothalamic amenorrhea
- consider polycystic ovary syndrome
Related
estrogen/progestin cycle test
General
provocative clinical test
special chemistry test
References
- Saunders Manual of Medical Practice, Rakel (ed),
WB Saunders, Philadelphia, 1996, pg 389
- Medical Knowledge Self Assessment Program (MKSAP) 16, 17
American College of Physicians, Philadelphia 2012, 2015