Post Menopausal Tests - Technical Bulletin
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Technical Bulletin #5 Hormone Challenge

(A) Long Post Menopause Panel (PHP-2)xxxx(B) DHEA Challenge Test (DCT)

Clinical Objective
To customize an optimal hormone therapy in (A) post menopausal women using the Long Post Menopause Panel as a tool and (B) customize DHEA therapy in women with Estrogen associated pathologies and men with prostate problems, using the DCT.

(A) Long Post Menopause Panel (PHP-2)
First sample is a baseline hormone determination of Estradiol, Estriol, Progesterone, DHEA and Testosterone.

A hormone challenge, or trial, is then performed for 5-7 days. The following hormones are the pre-determined doses given individually or in combinations reflective of the projected therapeutic dose.

Examples
The 2nd sample (post challenge) is collected while taking the hormones as usual except for Sublingual* preparations. The 2nd sample should be collected about the same time of day as the 1st sample.

* When using Sublingual preparations, a double dose is taken in the evening.16 to 20 hours later saliva is collected for the post challenge determination.

Oral Other
Pregnenolone 50 mg bid
Micronized Progesterone 50 mg bid Suppository 25 mg bid, Dermal Gel 100mg/day
Micronized DHEA 15-25 mg bid Sublingual* 10-15 mg/day, Dermal Gel 25 mg/day
Estradiol: 0.6 -1.25 / day Dermal Gel 3 mg/day
TriEstrogen: 2.00-4.00 mg/day Suglingual* 2.0-3.0 mg/day
Testosterone: 10-25 mg/day Dermal Gel 3-5 mg/day


(B) The DHEA Challenge Test (DCT)
Clinical Application
First sample is a baseline hormone determination of Estradiol, Estriol, Progesterone, DHEA and Testosterone.
Then an oral DHEA hormone challenge of 15 mg bid in women and 25 mg bid in men is performed for 5 - 7 days.
The second sample (post challenge) saliva collection is performed while still using the hormone
to determine:
1.The conversion efficiency of DHEA to testosterone & Estradiol.
2.The appropriate range of the augmentation dose, i.e. scaling up or down on the amount of xtDHEA to be given on a therapeutic basis.
Women  Men
Breast Cancer Gynecomastia
Uterine Cancer Prostate Problems
Uterine Polyp & Fibroids Testicular Atrophy
Cervical dysplasia Low sperm count
Endometriosis
Cystic breast disease xx
Hirsutism
Masculinization
The same DHEA challenge can be performed using 5 - 7 mg bid of the sublingual
preparation for 7 days. On day 8, no sublingual DHEA is taken and a saliva sample is collected.
Please note: Sublingual refers to a true translingual preparation. Not all sublingual forms are efficiently translingually absorbed.

Timing of Test
Cycling Women: The most reliable results are obtained when test and challenge are performed within days 3 to 9 of patient cycle, considering first day of flow as day one.
Post Menopausal Women and Men: The test and challenge can be performed at any time.
The 2nd sample must be collected about the same time of day as
the 1st sample in all groups. 		Company Navigation
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6620 South 192nd Place, Building J
Kent, Washington 98032
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