DUTCH Cycle Mapping with Sex Hormone Metabolism maps the progesterone and estrogen pattern throughout the menstrual cycle. It also includes a comprehensive assessment of the sex hormone metabolism to provide the full picture of a woman’s cycle. This test provides the answer to important questions for patients with month-specific symptoms, infertility and hormone imbalances. The cortisol and cortisone metabolites, free cortisol and cortisone daily patterns and organic acids are not included in this panel.
Nine targeted estrogen and progesterone measurements are taken throughout the cycle to characterise the follicular, ovulatory and luteal phases. The sample with the highest progesterone levels are used for both the progesterone and estrogen metabolite assessment. An additional 4 urine samples are taken at the start of the next cycle for the assessment of androgen metabolites: testosterone, DHT, DHEA-S and more.
For some women, testing reproductive hormones (progesterone, estrogen, etc.) on a single day is sufficient. In other scenarios, the clinical picture cannot be properly captured without “mapping” out the hormonal pattern throughout their menstrual cycle. The expected pattern of hormones shows relatively low estrogen levels early in the cycle, a surge around ovulation and modest levels in the latter third of the cycle (the luteal phase). Progesterone levels, on the other hand, stay relatively low until after ovulation. After ovulation, levels ideally increase (>10-fold) and then drop back down at the end of the cycle. A disruption in this cycle can lead to infertility or hormonal imbalance.
Estrogen and progesterone metabolites (?-pregnanediol and ?-pregnanediol) and androgens for this profile are all tested (9x) by GC-MS/MS.
When should I use
DUTCH Cycle Mapping with Sex Hormone Metabolites can help identify the root causes of sex hormone imbalances in women and is recommended when a closer assessment of the clinical picture is required. However, this panel does not include the adrenal assessment or organic acids.
Maybe useful for:
• Women struggling with infertility
• Women with cycling hormones and no menses
• Partial hysterectomy (ovaries intact but no uterus)
• Women with irregular cycles
• If the luteal phase shifts from month-to-month
• Not sure when to test due to long or short cycles
• Women whose hormonal symptoms tend to fluctuate throughout the cycle
• PMS, mid-cycle spotting, migraines, etc.
This test is not suitable for:
• Postmenopausal women
• Women on birth control
For postmenopausal women, women with cycles that follow the expected pattern or without cycle specific symptoms DUTCH Sex Hormone Metabolism, Adrenal, Complete or Plus maybe considered.
Please note, DUTCH Cycle Mapping (code HOR33) is available as a standalone test or can be combined with DUTCH Complete (code HOR34) if the hormone metabolism, adrenal assessment, and OATs are also needed.
DUTCH Cycle Mapping+ Plus is also available (code HOR46) as the most comprehensive DUTCH panel, this includes the sex hormone metabolism, adrenal assessment with the cortisol awakening response (CAR) and OATs.