Which syndrome is indicated by a negative progesterone challenge test?

A negative progesterone challenge test suggests that there is insufficient estrogen in the endometrium to induce a withdrawal bleed. This test is commonly used to evaluate certain conditions related to menstrual abnormalities.

In the case of Asherman's syndrome, which involves intrauterine adhesions or scarring, the endometrium may be unable to respond adequately to hormonal stimulation. Asherman’s syndrome often leads to amenorrhea or oligomenorrhea due to the impaired endometrial lining, resulting in the absence of a menstrual bleed even in the presence of estrogen. Therefore, when progesterone is administered and no withdrawal bleed occurs, it indicates that the endometrial lining is not functioning normally, which is characteristic of Asherman’s syndrome.

In contrast, the other conditions listed typically do not yield a negative progesterone challenge test in the same way. For example, polycystic ovary syndrome (PCOS) often presents with an abnormal response to estrogen rather than a complete lack of estrogen effects, leading to different findings on testing. Cushing's syndrome and hyperprolactinemia may also impact menstrual cycles but do not primarily cause the endometrial atrophy seen in Asherman's syndrome, which is the reason for the negative progester