Estrogen provocation test

{{Infobox diagnostic | name = Estrogen provocation test | image = | alt = | caption = | pronounce = | purpose = Evaluate hypothalamic–pituitary–gonadal function | test of = | based on = | synonyms = Estrogen stimulation test; Estrogen challenge test }}

[[File:Estrogen provocation test and gonadotropin surge with a single injection of estradiol benzoate in premenopausal women.png|thumb|right|350px|class=skin-invert-image|An estrogen provocation test showing gonadotropin surge after a single intramuscular injection of estradiol benzoate early in the menstrual cycle in normal premenopausal women.<ref name="Shaw1978">{{cite journal | last1 = Shaw | first1 = Robert W. | title = Neuroendocrinology of the menstrual cycle in humans | journal = Clinics in Endocrinology and Metabolism | date = November 1978 | volume = 7 | issue = 3 | pages = 531–559 | issn = 0300-595X | doi = 10.1016/S0300-595X(78)80008-5 | pmid = 365398| url = }}</ref>]]

The '''estrogen provocation test''', also known as the '''estrogen stimulation test''' or '''estrogen challenge test''', is a diagnostic procedure used to evaluate the function of the hypothalamic–pituitary–gonadal axis.<ref name="pmid1009729">{{cite journal | vauthors = Shaw RW | title = Tests of the hypothalamic-pituitary-ovarian axis | journal = Clinics in Obstetrics and Gynaecology | volume = 3 | issue = 3 | pages = 485–503 | date = December 1976 | pmid = 1009729 | doi = 10.1016/S0306-3356(21)00360-5| url = }}</ref><ref name="pmid3055821">{{cite journal | vauthors = Goh HH, Ratnam SS | title = The LH surge in humans: its mechanism and sex difference | journal = Gynecol Endocrinol | volume = 2 | issue = 2 | pages = 165–82 | date = June 1988 | pmid = 3055821 | doi = 10.3109/09513598809023624 | url = }}</ref><ref name="pmid1149302">{{cite journal | vauthors = Shaw RW, Butt WR, London DR, Marshall JC | title = The oestrogen provocation test: a method of assessing the hypothalamic-pituitary axis in patients with amenorrhoea | journal = Clinical Endocrinology | volume = 4 | issue = 3 | pages = 267–76 | date = May 1975 | pmid = 1149302 | doi = 10.1111/j.1365-2265.1975.tb01534.x | s2cid = 22809364 | url = }}</ref> It involves the administration of a large amount of estrogen, resulting in estrogenic exposure similar to or greater than normal preovulatory estradiol levels, in an attempt to induce a positive feedback surge in levels of the gonadotropins, luteinizing hormone (LH) and follicle-stimulating hormone (FSH).<ref name="pmid1009729" /><ref name="pmid3055821" /> Estrogens that have been used in the estrogen provocation test include estradiol benzoate, estradiol valerate, ethinylestradiol, and high-dose transdermal estradiol patches.<ref name="pmid1009729" /><ref name="pmid3055821" /><ref name="pmid1149302" /><ref name="McCartneyGilrain2021" /> The test involves sustained estrogenic exposure equivalent to estradiol levels of 200 to 300 pg/mL or more for at least 50 hours<ref name="pmid767352">{{cite journal | vauthors = Young JR, Jaffe RB | title = Strength-duration characteristics of estrogen effects on gonadotropin response to gonadotropin-releasing hormone in women. II. Effects of varying concentrations of estradiol | journal = J Clin Endocrinol Metab | volume = 42 | issue = 3 | pages = 432–42 | date = March 1976 | pmid = 767352 | doi = 10.1210/jcem-42-3-432 | url = }}</ref> and results in a surge in gonadotropin levels about 32 to 72 hours following initiation of estrogenic exposure.<ref name="pmid365398">{{cite journal | vauthors = Shaw RW | title = Neuroendocrinology of the menstrual cycle in humans | journal = Clin Endocrinol Metab | volume = 7 | issue = 3 | pages = 531–59 | date = November 1978 | pmid = 365398 | doi = 10.1016/s0300-595x(78)80008-5 | url = }}</ref><ref name="McCartneyGilrain2021">{{cite journal | last1=McCartney | first1=Christopher R | last2=Gilrain | first2=Melissa | last3=Lundgren | first3=Jessica A | last4=Kim | first4=Su Hee | last5=Solorzano | first5=Christine Michele Burt | title=Assessment of Estradiol-Induced Gonadotropin Surge Generation: Preliminary Results From a Protocol of Graded Transdermal Estradiol Dosing | journal=Journal of the Endocrine Society | publisher=The Endocrine Society | volume=5 | issue=Supplement_1 | date=2021-05-01 | issn=2472-1972 | doi=10.1210/jendso/bvab048.1484 | pages=A729–A730| pmc=8089709 | doi-access=free }}</ref> Levels of LH and FSH increase during the gonadotropin surge by about 10-fold and 4-fold, respectively.<ref name="McCartneyGilrain2021" />

==References== {{Reflist}}

Category:Estrogens Category:Female genital procedures