estrogen/progestin cycle test

Indications

• used in conjunction with the progesterone challenge test for the evaluation of amenorrhea

Procedure

• 2.5 mg of conjugated estrogen QD for 21 days
• add medroxyprogesterone acetate (Provera) 10 mg QD for the last 5 days

Interpretation

• if there is no withdrawal bleeding, an end-organ problem is confirmed
• if withdrawal bleeding occurs
  • an elevated serum FSH confirms menopause
  • a low serum FSH
    • should prompt an evaluation for pituitary tumor
    • no pituitary tumor suggests hypothalamic amenorrhea

Additional terms

• progesterone challenge test