DUTCH Test

Cycle Mapping

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.

Our Recommendations

When is Cycle Mapping Recommended?

  • Women struggling with infertility
  • Women with cycling hormones and no menses
    • Partial hysterectomy (ovaries intact but no uterus)
    • Ablations
    • Mirena IUD (no actual menstrual bleeding due to IUD but still has hormonal symptoms)
  • 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.
    • PMD, mid-cycle spotting, migraines, etc.

When is DUTCH Cycle Mapping Not Needed?

  • Postmenopausal women
  • Women on birth control
  • Women with cycles that follow the expected pattern

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More Information About DUTCH Cycle Mapping Testing

Easy Samples Make for Better Testing

Salivary mapping of hormones limits the number of collections, which may result in missing progesterone and especially estrogen peaks if not timed correctly. For women with irregular cycles, this is particularly problematic. DUTCH Cycle MappingTM uses more sample collections (convenient, first morning urine collections) and performs testing on targeted samples based on the actual length of the cycle. This allows for better characterisation of both the ovulatory and luteal peaks.

Better Testing Can Make for Better Treatment

Treating women appropriately and effectively with irregular cycles, fertility problems, or who have had an ablation can be challenging to practitioners because it is difficult to fully ascertain what their hormones are doing and when. By using the DUTCH Cycle MappingTM test, a complete picture of the patient’s cycle in graph format will allow for a more accurate and comprehensive treatment program specific to the patient’s situation. The clinician can understand if and when a patient is ovulating. They can also determine why their patients are having mid-cycle spotting or hormonal migraines. This will help them get a clear understanding of how their patient’s ovaries are functioning or look further into fertility issues. These answers will help with the clinician’s goal of individualized medicine.

Methods Used for Testing

Estrogen and progesterone metabolites for this profile are all tested (9x) by GC-MS/MS. This is the most accurate method for testing urinary reproductive hormones and their metabolites. Other options include immunoassays, LC-MS/MS or GC-MS/MS.

Hormone patterns throughout the menstrual cycle parallel simultaneously collected serum samples very well. When compared to salivary measurements, DUTCH measurements showed improved correlation to serum for both progesterone and especially for estradiol.

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