Lab

Estrogen-Progesterone Challenge Test

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Estrogen-Progesterone Challenge Test

  • See Also
  1. Progesterone Challenge Test
  • Indications
  1. Secondary Amenorrhea evaluation
  2. No withdrawal bleeding with Progesterone Challenge Test
  • Procedure
  1. Administer Estrogen-Progesterone (options below)
    1. Premarin 1.25 mg orally daily for 21 days or
    2. Oral Contraceptive for 2 Cycles or
    3. Estradiol 2 mg orally daily for 21 days and
      1. Follow with 7-10 days of Progesterone
      2. See Progesterone Challenge Test for options
  2. Assess for Menstrual Bleeding after stopping medication
    1. Anticipate within 7 days of medication completion
  • Interpretation
  1. No withdrawal bleeding occurs
    1. Suggests uterine bleeding outflow obstruction
  2. Withdrawal bleeding (but not after Progesterone alone)
    1. Obtain Serum FSH and Serum LH
      1. FSH>20 and LH>40: Hypergonadotropic Hypogonadism
      2. FSH and LH<5: Hypogonadotropic Hypogonadism