The progestogen test is done to check the levels of hormones produced by women when they do 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 carried out by administering progestins, 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 was bleeding or not and, thus, the gynecologist is able to assess the woman’s health.
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 physical exercise. . Learn more about secondary amenorrhea and its main causes.
When is indicated
The progestogen test is recommended by the gynecologist to evaluate the production of hormones by women, and is mainly requested 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 physical exercise.
Therefore, this test is indicated when the woman presents some of the following factors:
- Absence of menstruation;
- History of miscarriages;
- Signs of pregnancy;
- Fast weight loss;
- Use of contraceptives;
- Premature menopause.
The test is also indicated for women who have polycystic ovarian syndrome, in which several cysts appear inside the ovary that can interfere with the ovulation process, making pregnancy more difficult.
How is done
The test is performed by administering 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, preventing menstruation. Thus, at the end of using 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 must be carried out to check for other possible causes of secondary amenorrhea. This test is called the estrogen and progestogen test and is carried out by administering 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 does the result mean
The progestogen test is carried out under medical supervision and can have two results according to the characteristics that the woman may present after using medroxyprogesterone acetate.
1. Positive result
A positive test is one in which bleeding occurs after five to seven days of using medroxyprogesterone acetate. This bleeding indicates that the woman has a normal uterus and that her estrogen levels are also normal. This could mean that the woman spends 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 hormone prolactin, and the doctor should investigate.
2. Negative result
The test is considered negative when no bleeding occurs after five to seven days. The absence of bleeding may indicate that the woman has Asherman syndrome, in which there are several scars on the uterus, which cause there to be excess endometrial tissue. This excess allows adhesions to form inside the uterus, which prevents menstrual blood from being released, which can be painful for the woman.
After the negative result, the doctor may recommend the use of 1.25 mg of estrogen for 21 days with the addition of 10 mg of medroxyprogesterone acetate in the last 10 days. If there is bleeding after using the medication (positive test), it means that the woman has a normal endometrial cavity and that estrogen levels are low. Therefore, it is recommended to measure the hormones that stimulate the production of estrogen and progesterone, which are the luteinizing hormones, LH, and follicle stimulating hormones, FSH, to find out the real cause of the absence of menstruation and initiate appropriate treatment.
What is the difference with the progesterone test?
Unlike the progestogen test, the progesterone test is done to check the levels of progesterone circulating in the blood. The progesterone test is generally requested in cases of high-risk pregnancy, difficulty getting pregnant and irregular menstruation. Understand more about the progesterone test.
