Rationale: Hormone levels such as gonadotropins (FSH and LH), estradiol, and progesterone vary significantly throughout the menstrual cycle. A random blood sample provides limited information without knowing the cycle day at the time of sampling and the overall cycle length. Sporadic anovulatory cycles in regularly menstruating women occur in 5.5–12.8% of cases. In premenopausal women, hormone levels can fluctuate considerably over short periods, and clinical presentation is a more important basis for decision-making than hormone levels.
Hormone testing in women using oral contraceptives should be avoided.
Androgen testing is unnecessary in the absence of signs of virilization or suspicion of PCOS.
Progesterone measurement confirms that ovulation has occurred within the previous 14 days, which is unlikely in cases of prolonged amenorrhea.
References:
- Malcolm CE, Cumming DC. Does anovulation exist in eumenorrheic women? Obstet Gynecol. 2003 Aug; 102(2):317-8.
- Lynch KE, Mumford SL, Schliep KC, Whitcomb BW, Zarek SM, Pollack AZ, Bertone-Johnson ER, Danaher M, Wactawski-Wende J, Gaskins AJ, Schisterman EF. Assessment of anovulation in eumenorrheic women: comparison of ovulation detection algorithms Fertil Steril. 2014 Aug;102(2):511-518.e2. doi: 10.1016/j.fertnstert.2014.04.035. Epub 2014 May 27.