Description
DUTCH Cycle Mapping with Adrenal maps the progesterone and estrogen pattern throughout the menstrual cycle. It also includes a comprehensive assessment of the adrenal hormones including DHEA-S, cortisol and cortisone metabolites. This test also looks at the overall diurnal pattern of free cortisol and cortisone.
DUTCH Cycle Mapping with Adrenal provides the full picture of a woman’s cycle to answer important questions for patients with month-specific symptoms, infertility and hormone imbalances as well as assessing adrenal health. The sex hormone metabolites 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. An additional 4 urine samples are taken at the start of the next cycle for the assessment of DHEA-S, cortisol and cortisone metabolites along with free cortisol and cortisone daily patterns.
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.
Methodology
Estrogen and progesterone metabolites (?-pregnanediol and ?-pregnanediol) for this profile are all tested (9x) by GC-MS/MS. Cortisol, cortisone and metabolites related to cortisol are tested by LC-MS/MS.
When should I use
DUTCH Cycle Mapping with Adrenal can help identify the root causes of sex hormone and adrenal imbalances in women and is recommended when a closer assessment of the clinical picture is required of both the adrenal function AND sex hormones across the menstrual cycle. However, this panel does not include the sex hormone metabolites or organic acids.
Maybe useful for:
• Women struggling with infertility
• Women with cycling hormones and no menses
• Partial hysterectomy (ovaries intact but no uterus)
• Ablations
• Women with irregular cycles
• PCOS
• 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 Adrenal, Complete or Plus is sufficient.
Other Details
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 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.
