Progestins are sex hormones that are produced in the ovaries in the corpus luteum (corpus luteum) and increase during the luteal phase (corpus luteum phase): the maximum serum level is reached on the fifth to eighth day after ovulation (ovulation).
High progestin serum levels are also present during pregnancy.Progestins, which include progesterone in particular, are responsible for nidation (implantation of the fertilized egg) and also serve to maintain pregnancy.
The procedure
The progestogen test is performed in cases of amenorrhea – absence of menstruation.A progestogen preparation (e.g., medroxyprogesterone acetate) is administered for ten consecutive days. A few days after discontinuation of the drug, there is a cessation bleeding (= endometrial reaction) in case of a positive failure.The positive failure of the progestogen test (cessation bleeding) requires that the endometrium (uterine lining) has been sufficiently stimulated beforehand, i.e. that the maturing follicle must have produced sufficient estrogens to build up the endometrium.
Indications
- Amenorrhea (absence of menstruation; to check ovarian estrogen production).
- Infertility diagnostics
Contraindications
- Liver dysfunction
- Severe hypertension (high blood pressure)
- Thromboembolism
Interpretation
Positive test (= progestin-positive amenorrhea).
- Abortion bleeding occurs a few days after cessation of progestogen use→ endometrium (endometrium) sufficiently built up by estrogens; anatomic disturbances are thus largely excluded
Negative test (= progestin-negative amenorrhea).
- No abrupt menstrual bleeding occurs after cessation of progestogen use→ estrogen deficiency likely → follow up with estrogen/testagen test if necessary.
