Progestogen challenge test
The progestogen challenge test, or progesterone withdrawal test, is a test used in the field of obstetrics and gynecology to evaluate a patient who is experiencing amenorrhea. Due to readily available assays to measure serum estradiol levels, this test is now rarely used.
The test is performed by administering a progestogen, such as progesterone either as an intramuscular injection or oral medroxyprogesterone acetate. If the patient has sufficient serum estradiol low serum estradiol hypothalamic-pituitary axis dysfunction a nonreactive endometrium, or d) a problem with the uterine outflow tract, such as cervical stenosis or uterine synechiae. In order to distinguish between hypoestrogenism or a uterine outflow tract problem/nonreactive endometrium, estrogen may be administered followed by a course of progestin in order to induce withdrawal bleeding. If the patient experiences withdrawal bleeding with the combined estrogen/progestin therapy, then the amenorrhea is likely due to low estrogen.
