Precision Analytical DUTCH Testing

Key Advantages

  • Maps Hormones Through a Full Menstrual Cycle
  • Provides a Comprehensive View of Key Hormone Fluctuations Throughout an Entire Cycle
  • More Accurate than Saliva for Progesterone and Especially for Estradiol


This test ‘maps’ out estrogen (E1, E2) and progesterone (a- and ß- metabolites) fluctuations throughout the menstrual cycle. The results come as visualised urinary measurements and a separate report offers “serum equivalent” numbers to make the test more intuitive to more classically trained providers.

Plus, you can also add our regular DUTCH hormone profiles along with Cycle Mapping from one convenient collection kit.

Why would I use this test?

This test is not for everyone. It is intended for any particularly challenging premenopausal patients.

It is most useful in cases of:

  • Infertility
  • Patients with functional ovaries, but who have had their uterus removed (no bleeding)
  • Patients with uterine ablations (cycling, but not bleeding)
  • Patients with highly irregular cycles (making it hard to test them well in one day)
  • Patients with intermittent symptoms that seems to ‘cycle’ with their hormones

This test is not Intended for:

  • Postmenopausal women
  • Women on birth control (suppresses ovulation and produces clinically irrelevant data on a cycle mapping test)

What are the key benefits of this test?

  • Provides a uniquely comprehensive view of key female hormone fluctuations/balance throughout an entire cycle
  • More accurate than saliva for progesterone and especially for estradiol
  • Easier and more extensive collections for improved characterisation of hormone peaks over time
  • The most accurate methods available are used for each test. These methods show increased accuracy over the standard immunoassays used in typical serum and saliva testing
  • All Precision Analytical testing methods go through a rigorous and ongoing validation process to verify accuracy, precision, recovery, linearity, etc. in the pursuit of the most accurate and precise techniques available for hormone testing

Collection Instructions

Cycle Mapping Collection DUTCH Instructions


Cycle Mapping Case Study


How are the Reference Ranges Calculated?

The reference ranges are calculated based on testing “healthy” folks. Estradiol, for example is based on over 1,000 measurements with patients pre-screened to be off of birth control and other hormones. Precision Analytical only use the data for estradiol if the progesterone is within the luteal range. The postmenopausal ranges are based on women’s samples that are >55 years old with progesterone levels that are NOT in the luteal range. Obviously these women are also pre-screened to make sure they are not on hormones. Precision Analytical also offer follicular and ovulatory ranges for some hormones. These are based on fewer measurements of cycling women.

For estradiol, Precision Analytical use a 20th-80th percentile range. For progesterone, they use a 20th-90th percentile range (since modestly elevated progesterone is not as likely to be associated with issues compared to estrogen). That type of approach is used and a case-by-case approach is used for each hormone. For example, our range for 4-OH-E1 begins with zero (range = 0-80th percentile), not an actual value. We don’t want to tell anyone they are deficient for a carcinogenic estrogen! Precision Analytical also have age-dependent ranges for DHEA and testosterone (men only for T). The ranges are based on extensive testing. Precision Analytical’s actual reports show a woman’s reproductive hormones relative to both pre and postmenopausal ranges, which can be very helpful if you’re using HRT. The results shown here, for example, are from a postmenopausal woman who is obese. Her progesterone is where it belongs, but her estrogens are way high (up and into the premenopausal range) because she is inflamed and obese.

precess dials

The DUTCH test performs at a high level (reproducible and accurate) but Precision Analytical are engaged in an endless pursuit of improved performance and some of these improvements require slight adjustments to reference ranges.

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