Clarification Required: Question Does Not Match Evidence
The question appears to contain a typographical error or autocorrect issue. Based on the context provided, I believe you are asking about "prolactin versus progesterone labs" in evaluating motor symptoms in women, not "proline" (an amino acid).
However, neither prolactin nor progesterone laboratory testing plays a role in the diagnostic evaluation of motor symptoms in women based on current clinical guidelines.
Appropriate Laboratory Testing for Motor Symptoms in Women
For women presenting with motor delays or motor symptoms, the initial laboratory workup should be guided by muscle tone assessment and clinical findings, not by sex hormone levels.
High Muscle Tone (Upper Motor Neuron Signs)
- Brain MRI is the recommended initial test for women with motor symptoms and increased tone, as this suggests cerebral palsy or other upper motor neuron pathology 1
- Thyroid-stimulating hormone (TSH) should be measured, as acquired hypothyroidism and hyperthyroidism can present with motor delay 1
Low or Normal Muscle Tone (Lower Motor Neuron or Muscle Disease)
- Serum creatine kinase (CK) concentration is the essential initial laboratory test for motor symptoms with hypotonia or weakness 1
- CK is significantly elevated (usually >1000 U/L) in Duchenne muscular dystrophy and other muscular dystrophies 1, 2
- Normal CK essentially excludes muscular dystrophies and points toward congenital myopathies or neurogenic causes 2, 3
- TSH should also be measured in this population 1
Why Progesterone/Prolactin Are Not Indicated
The evidence provided focuses extensively on:
- Progesterone's role in breast cancer risk and hormone replacement therapy 4, 5
- Cardiac imaging in women with suspected ischemic heart disease 1
- Motor symptom evaluation in neurological disease 1, 6, 2, 3
None of these guidelines recommend sex hormone testing (progesterone or prolactin) for the evaluation of motor symptoms. The American Academy of Pediatrics guidelines on motor delays specifically recommend CK and TSH as the initial laboratory tests, with no mention of sex hormones 1.
Clinical Pitfall to Avoid
Do not order progesterone or prolactin levels when evaluating motor symptoms unless there are specific endocrine symptoms (amenorrhea, galactorrhea, infertility) that are separate from the motor presentation. The diagnostic algorithm for motor symptoms is based on muscle tone assessment, not hormonal status 1.