Progestogen test: how it is done and what the result means

The progestogen test is done to check the levels of hormones produced by women when she does not have normal menstrual periods and to assess the integrity of the uterus, as progestogen is a hormone that promotes changes in the endometrium and maintains pregnancy.

The progestogen test is done by administering progestogens, which are hormones that prevent the production of the sex hormones estrogen and progesterone, for seven days. After the administration period, it is checked whether there has been bleeding or not. If there is bleeding it means that the woman has a healthy uterus and normal estrogen levels. If there is no bleeding, another test should be performed to check for other causes of lack of ovulation, such as Asherman's Syndrome, in which the woman has adhesions in the uterus, which often prevents menstrual blood from being released.

This test is widely used in the investigation of secondary amenorrhea, which is a condition in which a woman stops menstruating for three cycles or six months, which may be due to pregnancy, menopause, use of contraceptives, physical or emotional stress and frequent strenuous exercise.. Learn more about secondary amenorrhea and its main causes.

When to do

The progestogen test is indicated when a woman has some of the following factors:

• Absence of menstruation; History of spontaneous abortions; Signs of pregnancy; Rapid weight loss; Use of contraceptives; Premature menopause.

The test is also indicated for women who have polycystic ovary syndrome, in which several cysts appear inside the ovary that can interfere with the ovulation process, which makes pregnancy more difficult. Understand more about this syndrome.

How is done

The test is performed with the administration of 10 mg of medroxyprogesterone acetate for seven days. This medication acts as a contraceptive, that is, it prevents the secretion of hormones responsible for ovulation and reduces the thickness of the endometrium, with no menstruation. Thus, at the end of the use of the medication, the egg can go to the uterus to be fertilized. If there is no fertilization, bleeding will occur, characterizing menstruation and the test is said to be positive.

If the result of this test is negative, that is, if there is no bleeding, another test should be performed in order to verify other possible causes of secondary amenorrhea. This test is called the estrogen and progestogen test and is done with the administration of 1.25 mg of estrogen for 21 days with the addition of 10 mg of medroxyprogesterone acetate in the last 10 days. After this period, it is checked whether or not there was bleeding.

What the result means

The progestogen test is done under medical guidance and can have two results according to the characteristics that the woman may have after using medroxyprogesterone acetate.

Positive test

The positive test is one in which, after five to seven days of using medroxyprogesterone acetate, bleeding occurs. This bleeding indicates that the woman has a normal uterus and that her estrogen levels are also normal. This may mean that the woman goes a long time without ovulating due to some other situation, such as polycystic ovary syndrome or hormonal changes involving the thyroid, the adrenal gland or the prolactin hormone, and the doctor should investigate.

Negative test

The test is considered negative when there is no bleeding after five to seven days. The absence of bleeding (negative test) may indicate that the woman has Asherman's syndrome, in which there are several scars in the uterus, which cause excess endometrial tissue. This excess allows adhesions to form inside the uterus, which prevents menstrual blood from being released, which can be painful for women. Asherman's syndrome is usually associated with abortion and infertility.

Thus, the doctor is asked to use 1.25 mg of estrogen for 21 days with the addition of 10 mg of medroxyprogesterone acetate in the last 10 days. If after using the drug there is bleeding (positive test), it means that the woman has a normal endometrial cavity and that estrogen levels are low. Thus, it is recommended to measure the hormones that stimulate the production of estrogen and progesterone, which are the luteinizing hormones, LH, and stimulating follicle, FSH, to find out the real cause of the absence of menstruation and to start the appropriate treatment. Learn more about female hormones.

What is the difference for the progesterone test?

Unlike the progestogen test, the progesterone test is done to check circulating blood levels of progesterone. It is usually requested in cases of high-risk pregnancies, difficulty in becoming pregnant and irregular menstruation. Understand more about the progesterone test.