DUTCH Cycle Mapping™ PLUS

Hormonal balance is key. Fluctuating levels of estradiol and progesterone play a major role in a woman’s overall health. This panel is designed for cycling women who struggle with ongoing symptoms such as monthly migraines, fertility issues, or PCOS. The addition of the cortisol awakening response (CAR), a transient, immediate rise in cortisol upon awakening (distinct from the diurnal rhythm), provides a fuller assessment of hormone fluctuations, baseline stress response, and reflects a patient’s ability to cope with anticipated challenges. CAR also shows a patient’s perception of control around chronic stress, providing insight into HPA resiliency.

• Women struggling with infertility
• Women with cycling hormones and no menses
• Partial hysterectomy (ovaries intact but no uterus)
• Ablations
• Women with irregular cycles
• PCOS
• If the luteal phase shifts from month-to-month
• Not sure when to test due to long or short cycles
• Women whose hormonal symptoms tend to fluctuate throughout the cycle
• PMS, mid-cycle spotting, migraines, etc.

• Postmenopausal women
• Women on birth control
• Women with cycles that follow the expected pattern

Even though a patient may have “normal” free cortisol levels throughout the day, that does not always mean everything is functioning properly. The graph below shows two good examples. A blunted or exaggerated CAR can appear even when single samples return “normal” results. The HPA axis might not be appropriately responding when faced with a stressor, even when cortisol levels are fluctuating nicely throughout the day.