Estrogen provocation test

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.^[2][3][4] 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).^[2][3] Estrogens that have been used in the estrogen provocation test include estradiol benzoate, estradiol valerate, ethinylestradiol, and high-dose transdermal estradiol patches.^[2][3][4][5] The test involves sustained estrogenic exposure equivalent to estradiol levels of 200 to 300 pg/mL or more for at least 50 hours^[6] and results in a surge in gonadotropin levels about 32 to 72 hours following initiation of estrogenic exposure.^[7][5] Levels of LH and FSH increase during the gonadotropin surge by about 10-fold and 4-fold, respectively.^[5]

Estrogen provocation test
Synonyms	Estrogen stimulation test; Estrogen challenge test
Purpose	Evaluate hypothalamic–pituitary–gonadal function

An estrogen provocation test showing gonadotropin surge after a single intramuscular injection of estradiol benzoate early in the menstrual cycle in normal premenopausal women.^[1]

See also

• Progestogen challenge test
• Pharmacodynamics of estradiol § Progonadotropic effects