Positive Progestin Challenge

• signifies chronic anovulation
• estrogen is present
• Is patient hirsute?
• If not, dx is "chronic anovulation"
• if Yes,
  • serum Testosterone, DHEAS, 17-OHP
  • if T>= 200 mg/dL, w/u for ovarian tumor (CT or US)
  • if DHEAS >= 700 mg/dL, w/u for adrenal tumor (CT)
  • if 17-OHP >300, w/u for late onset CAH, consyntropin test
  • if all are nl or only mildly elevated, then hirsutism with mild elevation of T, DHEAS is c/w diagnosis of chronic anovulation

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