DUTCH Cycle Mapping with Complete maps the progesterone and estrogen pattern throughout the menstrual cycle. It also includes a comprehensive assessment of 35 different sex and adrenal hormones, including oestrogen, progesterone, testosterone, DHEA and cortisol along with their metabolites, and measures daily free cortisol and cortisone patterns, the oxidative stress marker 8-OHdG, melatonin and nine organic acids including markers for vitamin B12 (methylmalonate), vitamin B6 (kynurenate and xanthurenate), biotin (β-hydroxyisovalerate), glutathione (pyroglutamate), dopamine (homovanillate), norepinephrine/epinephrine (vanilmandelate), neuroinflammation (quinolinate) and tryptophan putrefaction (indican).
DUTCH Cycle Mapping with Complete provides the full picture of a woman’s cycle to answer important questions for patients with month-specific symptoms, infertility and hormone imbalances.
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 measurement will be used to assess the estrogen and progesterone metabolism. An additional 4 urine samples are taken at the start of the next cycle for the assessment of the androgens and metabolites, adrenal hormone metabolites, free cortisol and cortisone daily patterns and OATs.
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) for this profile are all tested (9x) by GC-MS/MS. Cortisol, cortisone, 8-OHdG, melatonin (6-OHMS), organic acid tests and metabolites related to cortisol are tested by LC-MS/MS.
When should I use
DUTCH Cycle Mapping with Complete is useful in many scenarios, including:
• 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
• When timing of testing is difficult 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 Complete or Plus is sufficient.
Please note, DUTCH Cycle Mapping (code HOR33) is available as a standalone test or can be combined with DUTCH Plus (code HOR46) if the hormone metabolism, OATS and cortisol awakening response are needed. DUTCH Cycle Mapping is also available with Adrenal (code HOR36).