1. Cortisol: Test is performed to establish the diagnosis of adrenocortical insufficiency, Addison's disease, adrenocortical hypersecretion, Cushing's syndrome. Malfunction of the organs in the hypothalamic-pituitary-adrenal cortex axis will result in alteration of the cortisol levels.
2. DHEA-Sulfate: Test is performed to work up women with infertility, amenorrhea, or hirsutism to identify the source of excessive androgen; aid in the evaluation of androgen excess (hirsutism and/or virilization), including Stein-Leventhal syndrome and adrenocortical diseases, including congenital adrenal hyperplasia and adrenal tumor. DHEA-S is not increased with hypopituitarism. It is low in Addison disease.
3. Estradiol: An estradiol test is a simple blood test to measure the amount of estradiol in a person’s blood. Estradiol, also known as E2, is one of the four types of estrogen that the ovaries chiefly produce. The adrenal glands, placenta, testes, and some tissues also produce smaller amounts of this hormone.
4. Estrogens, Total: Evaluate for ovarian estrogen producing tumor in the premenarcheal and postmenopausal female; evaluate estrogen excess in males. Estrogen analysis may be helpful in establishing time of ovulation and optimal time for conception.
5. Testosterone, Free, Direct: Evaluate hirsutism and masculinization in women; evaluate testicular function in clinical states where the testosterone binding proteins may be altered (obesity, cirrhosis, thyroid disorders)
6. Testosterone, Serum: Testosterone testing is used to evaluate androgen excess or deficiency related to gonadal function, adrenal function, or tumor activity. Testosterone levels may be helpful in men for the diagnosis of hypogonadism, hypopituitarism, Klinefelter syndrome, and impotence (low values). Testosterone levels may be requested in women to investigate the cause of hirsutism, anovulation, amenorrhea, virilization, masculinizing tumors of the ovary, tumors of the adrenal cortices, and congenital adrenal hyperplasia (high values). Testosterone levels in children may be helpful to investigate issues related to puberty and development as well as the aforementioned.
7. Progesterone: Establish the presence of a functioning corpus luteum or luteal cell function; confirm basal body temperature measurements for the occurrence of ovulation; obtain an indication of the day of ovulation; evaluate the functional state of the corpus luteum in infertility patients; assess placental function during pregnancy; ovarian function test.
8. Prolactin: First test for work-up of galactorrhea (inappropriate lactation). Pituitary function test useful in the detection of prolactin-secreting pituitary tumors (microadenomas, macroadenomas) with or without galactorrhea, with or without structural evidence of sellar enlargement. An adult female premenopausal patient having amenorrhea and galactorrhea is highly suspect of pituitary prolactinoma and is a candidate for radiologic evaluation of the pituitary as well as serum prolactin levels. Elevated prolactin may be associated with corpus luteum insufficiency or anovulation. Sequelae of hyperprolactinemia include amenorrhea, anovulation, and decreased bone density.
9. FSH, Serum: Excessive FSH and LH are found in hypogonadism, anorchia, gonadal failure,1 complete testicular feminization syndrome, menopause, Klinefelter syndrome, alcoholism, and castration. FSH and LH are pituitary products, useful to distinguish primary gonadal failure from secondary (hypothalamic/pituitary) causes of gonadal failure, menstrual disturbances, and amenorrhea. Useful in defining menstrual cycle phases in infertility evaluation of women and testicular dysfunction in men. FSH is commonly used with LH, which also is a gonadotropin. Both are low in pituitary or hypothalamic failure. FSH and LH levels are high following menopause.
10. Luteinizing Hormone (LH), S: The primary clinical use of LH measurement is in evaluating the normalcy of hypothalamic-pituitary-gonadal axis. Measurement of serum gonadotropin levels will allow for distinguishing between primary gonadal failure and deficient gonadal stimulation. LH measurement may also be of clinical importance because growth hormone and LH are frequently the first hormones to be affected by pituitary disease. The serum analysis of LH has also been found to be very useful in the diagnosis and treatment of infertility in women.