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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

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Volume 30, Issue 10


A pilot study on the utility of reduced urine collection frequency protocols for the assessment of reproductive hormones in adolescent girls

Heather C.M. Allaway
  • Women’s Health and Exercise Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
  • Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Esther M. John
  • Cancer Prevention Institute of California, Freemont, CA, USA
  • Department of Health Research and Policy (Epidemiology), Stanford Cancer Institute, Stanford School of Medicine, Stanford, CA, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Theresa H. Keegan
  • Cancer Prevention Institute of California, Freemont, CA, USA
  • Department of Health Research and Policy (Epidemiology), Stanford Cancer Institute, Stanford School of Medicine, Stanford, CA, USA
  • Division of Hematology and Oncology, Comprehensive Cancer Center, University of California Davis, Sacramento, CA, USA
  • Other articles by this author:
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/ Mary Jane De Souza
  • Corresponding author
  • Women’s Health and Exercise Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2017-09-26 | DOI: https://doi.org/10.1515/jpem-2017-0050



The objectives of this study were to assess the feasibility of and compliance to collecting urine samples in pre- and postmenarcheal girls and to determine if a less than daily collection frequency was sufficient for assessing ovarian function.


Twenty-five postmenarcheal girls (11–17 years) collected samples using either a two or a three samples/week protocol during one menstrual cycle. Exposure and mean estrone-1-glucuronide (E1G) and pregnanediol glucuronide concentrations were calculated, and evidence of luteal activity (ELA) was evaluated. Sixteen premenarcheal girls (8–11 years) collected one sample/month for six consecutive months. Samples were analyzed for E1G concentration. Participant compliance was calculated using dates on the urine samples and paper calendars.


Participants collecting three samples/week were more compliant to the protocol than those collecting two samples/week (83.6%±2.6% vs. 66.8%±6.6%; p=0.034). There were no differences (p>0.10) regarding paper calendar return (81.8%±12.2% vs. 92.9%±7.1%), recording menses (55.6%±17.6% vs. 92.3%±7.7%) or sample collection (88.9%±11.1% vs. 84.6%±10.4%) between the two protocols. The average cycle length was 30.5±1.3 days and 32% of cycles had ELA. The premenarcheal girls were 100% compliant to the protocol. Only 68.8% of participants returned the paper calendar and 81.8% of those participants recorded sample collection. The average E1G concentration was 15.9±3.8 ng/mL.


Use of a less than daily collection frequency during one menstrual cycle in postmenarcheal, adolescent girls is feasible and provides informative data about ovarian function. Collection of one sample/month in premenarcheal girls is feasible and detects the expected low E1G concentrations. Alternate strategies to the use of a paper calendar should be considered.

Keywords: epidemiology; estrone-1-glucuronide; menarche; pregnanediol glucuronide; reproductive hormone analysis


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About the article

Corresponding author: Mary Jane De Souza, PhD, Women’s Health and Exercise Laboratory, Department of Kinesiology, The Pennsylvania State University, University Park, PA 16802, USA, Phone: 814-863-0045, Fax: 814-865-4602

Received: 2017-01-31

Accepted: 2017-08-12

Published Online: 2017-09-26

Published in Print: 2017-10-26

Author contributions: HCMA was responsible for analysis design, data analysis and interpretation, and manuscript writing. MJD and EMJ designed the studies and assisted in data interpretation. MJD supervised the design of the analyses and writing of the manuscript. THK and EMJ obtained study approvals, supervised data collection and analyses, and participated in manuscript revision. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: This work was supported by a 2013 Stanford Cancer Institute Developmental Cancer Research Award (to EMJ). The California site of the LEGACY Girls Study was funded by R01 CA138638 from the National Cancer Institute (to EMJ).

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 30, Issue 10, Pages 1083–1093, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2017-0050.

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