E NDOCRINOLOGY A SSESSMENTS Rhythm

sample type:

Rhythm is a comprehensive salivary assessment of oestradiol, and spanning a full cycle period. Imbalances revealed in this profile can help illuminate root causes of disorders such as premenstrual syndrome (PMS), infertility, and menstrual irregularities.

Balance is the key. Research has long shown that fluctuating levels of oestradiol, progesterone and testosterone play a major role in a woman’s overall health, effecting:

• • Appetite Level • Mood Swings • Sex Drive • Sleep Patterns

Chronic imbalances of these hormones are implicated in disorders such as:

• PMS • Breast • • Endometriosis • Infertility • Polycystic Ovary Disease • Amenorrhyea • Osteoporosis

Interpretation: Saliva testing provides a thorough analysis of oestradiol and progesterone over a full • Rhythm– oestradiol cycle. Testosterone is measured mid cycle and from the last day specimen. By utilising 12 progesterone saliva samples for analysis, the relationship and balance of these essential hormones are testosterone analysed more precisely through time. The levels of oestradiol and progesterone, as well as the ratio between the two, are clearly graphed for easy reference and patient • Rhythm Plus– education. oestradiol progesterone testosterone Unlike serum measurements that typically reflect both bound and unbound fractions of hormones, salivary samples represent only the free (unbound) bioavailable fraction of DHEA hormone. Factors that effect binding globulin such as obesity and thyroid function do not influence test results with false high or low test levels. • Specimen Requirement: • Rhythm– Indications: 12 (2ml) saliva samples collected Rhythm is indicated for both premenopausal and perimenopauseal women not over a full Cycle; currently supplementing with hormones. An analysis of oestrogen, progestesterone and • Rhythm Plus– 16 (2ml) saliva samples collected testosterone can reveal ovulatory function and trends in hormone production. over a full Cycle Imbalances such as unopposed oestrogen, high follicular progesterone, anovulation and defects are easily identified. This test is especially useful in treatment of • Before Taking this Test: patients with chronic gynaecologic disorders. - Inform practitioner about all medication, oral contraceptive, The comprehensive version of Rhythm ( Rhythm Plus ) includes a circadian analysis of and hormone supplement use - Avoid caffeine, alcohol, and cortisol, melatonin, and an assay of DHEA. (on day of test) - Do not eat, brush or floss teeth, use mouthwash, or chew gum (1 hour before) -Wash hands before collection - See instructions inside test kit for details

O NE -P AGE T EST D ESCRIPTION Accession No: Rhythm (Saliva)

Patient Details Ms Sample Report This Test reveals Parkgate House important 356 West Barnes Lane information New Malden Practitioner Details Surrey about: KT3 6NB Genova Diagnostics ( Europe ) • Bioavailable oestradiol, Parkgate House Client ID No: IWX500220 progesterone, and 356 West Barnes Lane testosterone, New Malden Accession No: Surrey Patients DOB: 02/03/1975 imbalances of which are linked to reproductive KT3 6NB Sample Date: disorders and menstrual Date Of Report: 01/04/2008 cycle irregularities, as well as osteoporosis, Female Hormone Panel cardiovascular disease, Progesterone Distribution and of the 3 5 8 11 12 14 16 18 20 23 216 3 Progesterone Oestradiol breast and 10 - 100 pg/ml 2 - 5 pg/ml endometrium • Hormone balance Sample 1 22.0 2.5 through the complete Sample 2 36.0 2.7 menstrual cycle with evaluation of twelve Sample 3 32.0 3.0 260 easily gathered saliva Sample 4 33.0 2.6 220 samples over a cycle. Sample 5 40.0 3.0 130 • Levels of cortisol, 110 75 65 DHEA, and melatonin 45 Phase 22 36 32 33 40 (in the Rhythm Plus) for Progesterone Oestradiol information relevant to 10 - 100 pg/ml 5 - 14 pg/ml 1234 516 78 9101 12 the interrelationship of these hormones with Sample 6 45.0 8.4 Oestradiol Distribution female hormones 3 5 8 11 12 14 16 18 20 23 216 3 Luteal Phase Progesterone Oestradiol 100- 400 pg/ml 4 - 7 pg/ml

Sample 7 75.0 5.0

Sample 8 130 4.2 8.4 Sample 9 260 4.3 5.0 4.2 4.3 4.2 Sample 10 220 4.2 4.0 2.5 2.7 3.0 2.6 3.0 2.6 Sample 11 110 4.0 Sample 12 65.0 2.6 1234 516 78 9101 12

Distribution Analysis & Testosterone

785 46.5 23.0 Luteal Progesterone Output Total Oestradiol Output Progesterone : Oestradiol 600 - 1300 pg/ml 30 - 55 pg/ml Ratio 10 - 40

Analyte Reference Range (pg/mL)

Testosterone (Female) 35.0 Testosterone 35.0 20 - 70

Reported By: NRA

For test kits, clinical support, or more information contact: Genova Diagnostics, Europe Parkgate House 356 West Barnes Lane New Malden Surrey KT3 6NB +44 (0)20 8336 7750 • Fax: +44 (0)20 8336 7751 More detailed publications with references are also available: www.GDXuk.net

© 2009 Genova Diagnostics, Europe e,td,rhythm,012609