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Monitoring of menstrual cycles, ovulation, and adrenal suppression by saliva sampling in female patients with 21-hydroxylase deficiency Nike M.M.L Stikkelbroeck, M.D., C.G.J.(Fred) Sweep, Ph.D., Didi D.M Braat, M.D., Ph.D., Ad R.M.M Hermus, M.D., Ph.D., Barto J Otten, M.D., Ph.D. Fertility and Sterility Volume 80, Issue 4, Pages (October 2003) DOI: /S (03)
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FIGURE 1 Salivary levels of progesterone (P) in a 15.5-year-old female patient with classic salt-wasting 21-hydroxylase deficiency and amenorrhea at the start of the sampling (patient A). Menstrual bleeding is indicated as black bars. At T = 0, the hydrocortisone dose was 10 mg/m2. Each increment (+2 mg/m2) is shown by open triangles. At T = 83 days, a dose of 18 mg/m2 was obtained. At T = 102 days, the night dose of hydrocortisone was replaced by dexamethasone, resulting in a regimen of 6 mg of hydrocortisone b.i.d. and mg of dexamethasone in the evening (total 12 mg/m2 hydrocortisone equivalents). This regimen was maintained for the rest of the sampling period. Stikkelbroeck. Menstrual cycles in 21-hydroxylase deficiency.Fertil Steril 2003. Fertility and Sterility , DOI: ( /S (03) )
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FIGURE 2 Salivary levels of progesterone (P) in a 17.3-year-old female patient with classic salt-wasting 21-hydroxylase deficiency and irregular menstrual bleeding (patient B). Menstrual bleeding is indicated as black bars. Daily medication was hydrocortisone 10-5 mg (morning-afternoon) and dexamethasone mg (evening) during the whole sampling period. Stikkelbroeck. Menstrual cycles in 21-hydroxylase deficiency. Fertil Steril 2003. Fertility and Sterility , DOI: ( /S (03) )
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FIGURE 3 Salivary levels of progesterone (P) in a 16.3-year-old female patient with classic salt-wasting 21-hydroxylase deficiency and regular menstrual bleeding (patient C). Menstrual bleeding is indicated as black bars. At the start of the sampling, the patient used hydrocortisone mg; it was changed to mg on day 22 (indicated by open triangle). Stikkelbroeck. Menstrual cycles in 21-hydroxylase deficiency.Fertil Steril 2003. Fertility and Sterility , DOI: ( /S (03) )
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