Challenges in Skin Testing for Progestogen Hypersensitivity

Challenges in Skin Testing for Progestogen Hypersensitivity: Progestogen hypersensitivity (PH) is an increasingly recognized heterogenous clinical entity that presents as hypersensitivity symptoms associated with the progesterone surge during the luteal phase of the menstrual cycle or following exposure to exogenous progestins1. Diagnosis requires a careful clinical history and assessment to evaluate other potential triggers, and at minimum, compatible symptoms associated with exposure to endogenous or exogenous progestogens. Testing modalities used to support the diagnosis include progesterone skin testing, progesterone challenge, inhibition of ovulation with gonadotropin-releasing hormone (GnRH) agonists, response to progesterone desensitization, and several in vitro assays2,3.