DUTCH Cycle Mapping (CM) Plus

Overview:

WHY USE DUTCH CYCLE MAPPING™ PLUS?

The DUTCH Cycle Mapping™ PLUS not only maps estro­gen and progesterone through the monthly menstrual cycle but also adds the comprehensiveness of all the hormone metabolites along with the cortisol awakening response (CAR).

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.

Altered cortisol is seen in pain and migraines as well as psychiatric issues such as depression. In patients with migraines, altered cortisol may be of physiological origin and can contribute to pain and depression, especially when a high CAR is found. Estrogen fluctuations have also been linked to migraine frequency for some wom­en, combining the monthly measurement, hormone me­tabolites and the CAR is ideal for fully assessing hormon­al interactions with patients who have migraines.

In addition, women with PCOS often also have altered HPA axis function. As many providers know, PCOS is a syndrome but not all women have all the symptoms, so treatment should be guided by the unique set of circum­stances an individual woman faces. And although the syndrome is named after dysfunction in the ovaries, it is truly a syndrome involving the hypothalamic signaling, and some women experience adrenal-sourced androgen excess. Thoroughly assessing the HPA axis is essential for starting on the right path in treating PCOS.

WHEN IS CYCLE MAPPING™ PLUS RECOMMENDED?

• Women with cycling hormones and no menses
• Women struggling with infertility
• 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.

WHEN IS CYCLE MAPPING™ PLUS NOT NEEDED? (DUTCH COMPLETE™ IS SUFFICIENT)

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

EASY SAMPLE COLLECTIONS

DUTCH Cycle Mapping™ PLUS uses more sample collec­tions for mapping (first-morning urine collections) and performs testing on targeted samples based on the ac­tual length of the cycle. In addition, one full day of four (4) urine and five (5) or six (6) saliva samples are collect­ed, providing the comprehensive hormone metabolite and cortisol awakening response (CAR) results.

How to Collect Urine

1. Complete all information on each urine collection device. Fill in the day of cycle and date of collection with pen (not a gel pen).
2. Collect your samples with your first morning void/urination. Saturate the filter paper by urinating directly on it OR urinating into a clean cup and dip the filter paper for 5 seconds.
3. Leave each sample open to dry for at least 24 hours.
4. Once dry, close each collection device and conveniently store in the kit box until you are done collecting all samples.
5. Continue collecting according to your cycle schedule. Once ALL samples are completely dry, place them in the enclosed plastic bag and seal.

How to Collect Saliva

1. Begin collecting right when you wake up, before getting out of bed. Remove the blue cap and place the cotton swab from the collection device in mouth.
2. Leave in mouth until fully saturated but not longer than 5 minutes. Lightly chewing on the swab may help stimulate saliva flow.
3. Once done, place swab back in the same tube, just as you found it. Do not remove the inner tube. You do not need to spit into the tube. Touch the swab as little as possible with your hands. Label each device completely.
4. Please Freeze all saliva samples until they are ready to ship.

Important Note: For the waking sample, set the saliva collection device, the requisition form, and a pen next to your bed. It is helpful to have a timer nearby to set for 30 and 60 minutes after you have begun your first collection. After collecting the first sample, it is best for you to be in a well-lit place.

How to Return

Upon Completion

After drying the urine collection devices for 24 hours, be sure to check that each sample is clearly labeled and dry. Place them in the resealable plastic bag and back in the test kit box, along with the frozen saliva tubes. Include the completed requisition form.

Shipping Information

Place the entire test kit box inside the return envelope. Affix the prepaid label or postage if applicable. Return using the appropriate carrier. International patients: please check with your practitioner on where to return the kit if there is not a return envelope/label included (avoid leaving out in warm weather).

*Not available in NY, NJ , and RI*