What is the interpretation of the DUTCH (Dried Urine Test for Comprehensive Hormones) test results showing Estradiol (E2) levels, Estrone (E1) levels, alpha-Pregnanediol levels, beta-Pregnanediol levels, beta-Pregnanediol to Estradiol ratio, and Creatinine levels?

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Last updated: May 13, 2025View editorial policy

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From the Research

Ovulation appears to have occurred around day 15-16, with a clear estrogen peak followed by a progesterone rise in the luteal phase, indicating a healthy, ovulatory menstrual cycle with appropriate hormonal shifts at each phase. The estradiol levels show a classic pattern, rising from follicular phase levels (1.31-2.37 ng/mg) to peak at ovulation (6.23 ng/mg on day 16), then gradually declining through the luteal phase, as supported by the study 1 which found that serum estradiol and progesterone levels were better biomarkers for signaling the start of the 6-day fertile window and the ovulation/luteal transition interval.

Hormone Patterns

  • Estradiol levels are within the expected ranges for each phase of the menstrual cycle, with a peak at ovulation, as seen in the reference ranges provided.
  • Progesterone metabolites (a-Pregnanediol and b-Pregnanediol) appropriately surge after ovulation, peaking around day 26, confirming a functional corpus luteum, which is consistent with the findings of the study 2 that urinary profiles of pregnanediol-3-glucuronide lagged behind serum progesterone by one to two days.
  • The b-Pregnanediol/E2 ratio follows the expected pattern, remaining lower during ovulation (<100) and increasing during the luteal phase (188-383), as supported by the study 1 which found that the Area Under the Curve (AUC) algorithm with (E2, P) levels signaled the Day -1 to Day 0 ovulation/luteal transition interval in all cycles.

Sample Collection and Hormone Metabolism

  • Creatinine levels remain within normal range throughout the cycle, indicating reliable sample collection, which is important for accurate measurement of hormone metabolites, as noted in the study 2 that creatinine indexing was beneficial when urinary profiles in individual cycles were compared with changes of serum E2.
  • The study 2 also found that enzyme immunoassay (EIA) was a simple, flexible, and economical method for measuring urinary steroid metabolites, which could be useful for future studies on hormone metabolism and menstrual cycle regulation.

Menstrual Cycle Regulation

  • The hormonal shifts observed in this cycle are consistent with a healthy, ovulatory menstrual cycle, with estrogen dominance in the follicular phase, an estrogen surge triggering ovulation, and progesterone dominance in the luteal phase, as supported by the study 1 which found that serum E2 and (E2, P) were better biomarkers for signaling the start of the 6-day fertile window and the ovulation/luteal transition interval.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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