Progesterone challenge test and Amenorrhea - dukeupt

[ArchivalUser]

Hey can someone explain the progesterone challenge test and Amenorrhea to me, i've always had a hard time understanding it

[ArchivalUser]

@Dukeupt

Progesterone challenge test is given as medroxyprogesterone acetate (oral or im) , it is used to check if the cause of secondary amenorrhea is due to 1) lack of estradiol, 2) obstruction of flow , 3)anovulation or 4)hypothalamus -pituitary axis dysfunction.

If the patient experience withdrawal bleeding 2 to 7 days after administering progesterone then the cause is due to anovulation ! ( patient has enough estradiol therefore problem is not during the proliferative phase of the menstrual cycle). High progesterone level will have an inhibitory effects on GnRH , LH/FSH therefore causing withdrawal bleeding!

If the patient does not experience withdrawal bleeding after progesterone challenge test then the cause can be either due to 1) lack of estradiol, 2)hypothalamic- pituitary dysfunction or 3) outflow obstruction!

good luck
hope it helps

[ArchivalUser]

But aren't the hypothalamic-pituitary dysfunction causes the same as causes of anovulation?

[ArchivalUser]

I meant that if withdrawal bleeding happens that consider to be anovulation secondary to PCO syndrome as a cause...sorry for typo

[ArchivalUser]

gotcha thanks a bunch

[ArchivalUser]

can you tell me when is it we done the progesterone challenge test?

If we do it during the Luteal Phase (which last for 14 days), there will be no withdrawal bleeding within 7 days after progesterone were given. So when exactly we administered the progesterone?