Natural procreation would be impossible if the female body did not produce the hormone progesterone. An increase or decrease in its level significantly affects a woman’s health, her ability to bear and give birth to a child. What kind of hormone is this, what are its functions in the body and why progesterone levels change throughout life, we will find out further.
What is progesterone and its functions
Progesterone is a steroid sex hormone produced by the corpus luteum of the ovaries, the adrenal cortex and the placenta (during pregnancy). He is responsible for successful conception, childbearing and breastfeeding. Progesterone is also an agonist of some receptors and stimulates liver enzymes.
And yet the main role of the hormone is to maintain pregnancy. Thanks to it, processes occur in the endometrium of the uterus that prepare it for possible conception, and subsequently prepare the woman’s body for childbirth and breastfeeding (if pregnancy occurs).
The “pregnancy hormone” (as progesterone is often called) performs the following functions related to fetal development:
- changes the state of the uterine mucosa to successfully attach a fertilized egg to the overgrown endometrium;
- reduces the body’s immune response, which prevents it from “rejecting” the embryo (protects against miscarriage);
- reduces the contractility of the uterine muscles, which also allows you to maintain pregnancy;
- responsible for stretching the uterus in accordance with the size of the fetus;
- forms an additional fat layer on the woman’s abdomen, protecting the uterus and the child developing in it from mechanical influences;
- participates in preparing the pelvic bones of a woman in labor for childbirth;
- maintains a stable level of blood viscosity and blood sugar levels in the expectant mother;
- prepares the tissues and ducts of the mammary glands for lactation.
A drop in progesterone levels in a pregnant woman’s body leads to childbirth and becomes a signal to start breastfeeding.
The hormone is also responsible for the normal menstrual cycle (alternating ovulation and menstruation) and stops it for the period of gestation if the egg has been fertilized.
The biological role of progesterone in the body is not limited to reproductive functions. It is responsible for a number of several more important processes:
- for sexual attraction;
- for normal brain functioning (as a neurosteroid);
- for secreting skin secretions and maintaining youthful skin.
The maternal instinct is also formed under the influence of this particular hormone.
What affects progesterone levels
Progesterone levels are unstable at different periods of life. It depends on the woman’s age and the phase of the menstrual cycle. During pregnancy, hormone levels in the blood increase hundreds of times.
In the follicular phase of the monthly cycle (before ovulation), the hormone is produced only by the adrenal cortex - its level in the blood is minimal. But after ovulation, a corpus luteum forms in the ovary, which begins to produce progesterone - the level of the hormone increases sharply and remains so until the onset of menstruation. Its production depends on luteinizing hormone, which stimulates ovulation.
If pregnancy occurs, then the production of the hormone continues to increase and reaches a peak in the third trimester (from 17-18 weeks it is produced by the placenta).
The synthesis of progesterone is affected by the work of the female reproductive system, in particular the corpus luteum, a gland that reappears every menstrual cycle. Infections, stress, medication, and even strenuous physical activity can disrupt hormone production. But it often happens that its production can be disrupted for more serious reasons - disruptions in the functioning of the endocrine system.
The consequences of increased or insufficient progesterone synthesis are dangerous: menstrual irregularities, difficulties conceiving a child, and problems during pregnancy. Therefore, if you suspect a change in the concentration of the hormone in the body, it is necessary to take a blood test and identify the causes of pathologies.
What is the normal level of progesterone?
The hormone does not have a stable indicator, since its level depends on many factors. The so-called reference values (lower and upper limits) for each phase of the menstrual cycle are accepted, within which deviations in its concentration in the blood are considered normal.
For non-pregnant women, the following indicators are considered normal:
- 0.3 – 0.22 nmol/l – in the first (follicular) phase of the cycle (1-14 days of the cycle);
- 0.5 – 9.5 nmol/l – during the period of ovulation (14-16 days);
- 7 – 56.6 nmol/l – in the luteal phase (16-30 days of the cycle).
During menopause, the hormone content in the blood of women is at the level of 0.64 nmol/l.
It happens that the test result for progesterone is given in other units of measurement (in ng/ml). To convert units of measurement you need to use the formulas:
- ng/ml ∙ 3.18 = progesterone level nmol/l;
- nmol/l ∙ 0.314 = ng/ml.
It should be taken into account that laboratories use different sets of reagents for blood tests and different methods for determining progesterone levels. Therefore, hormone concentrations in the same woman on the same day of the cycle may vary in different laboratories. Comparisons of test results should always be based on data from the same laboratory.
Progesterone during pregnancy. Hormone norm by week
For pregnant women, other reference values have been determined. Progesterone concentration varies depending on the period:
- 1 – 13 weeks (I trimester) – 9-468 nmol/l;
- 14 – 26 weeks (II trimester) – 71.5-303 nmol/l;
- 27 – 40 weeks (III trimester) – 88.7-771.5 nmol/l.
If the test results differ greatly from those given, do not immediately sound the alarm. It is possible that other methods and reagents are used in this medical institution, so the values do not fall within the established range.
You need to be guided by the standards of the laboratory in which the analysis was taken (as a rule, each institution has its own). The individual characteristics of the woman are also taken into account, as well as the medications that are used expectant mother at the time of the analysis.
Causes of increased progesterone. How to downgrade
If a blood test for progesterone levels shows an increased value, there may be several reasons for this. If a non-pregnant woman does not take medications that affect the concentration of the hormone, this most often occurs due to endocrine disorders or gynecological diseases:
- congenital dysfunction of the adrenal cortex (adrenogenital syndrome);
- tumors or hyperplasia of the adrenal glands;
- ovarian neoplasms (cysts, cystomas);
- choriocarcenomas (uterine cancer);
- hyperprolactinemia (dysfunctional milk secretion and cessation of menstruation).
It happens that the level of the hormone increases with renal failure, uterine bleeding or cirrhosis of the liver.
The level of progesterone during pregnancy increases with:
- hydatidiform mole (a pathology associated with the defective function of egg fertilization and characterized by the growth of chorionic villi in the form of bubbles);
- delayed maturation of the placenta;
- fetoplacental insufficiency (a complex of morphofunctional disorders of the fetus and placenta);
- multiple pregnancy.
Requires a comprehensive examination to identify the causes. After diagnosis, the doctor will prescribe the necessary treatment tactics to normalize the hormone level. Along with medications (Clomiphene, Mifepreston, Tamoxifen), it is recommended to change lifestyle (give up bad habits, establish a work and rest schedule) and pay attention to nutrition (reduce the proportion of protein foods and give up foods high in saturated fat).
You can also use folk recipes to reduce hormone levels and use the following infusions:
- red rowan (1 tablespoon of dry berries, pour a glass of boiling water and consume 1/3 glass three times a day);
- Borovaya uterus (1 tbsp. crushed stems per 1 tbsp. water), drink half a glass in the morning and evening;
- red brush and cloves (for 1.2 liters of boiling water, take 6 tsp of carnation flowers and 1 tablespoon of red brush, bring to a boil, let cool and take 1/3 cup 3 times a day before meals).
Using Recipes traditional medicine with increased progesterone, it is possible only after consulting a specialist.
Causes of low progesterone. How to level up
A decrease in progesterone concentration in non-pregnant women is observed with the following pathologies:
- dysfunction of the adrenal cortex;
- dysfunction of the corpus luteum (insufficiency of the second (luteal) phase);
- chronic inflammatory diseases of the genital organs;
- taking medications that lower the level of the hormone in the blood;
- gynecological diseases (fibroids, endometriosis);
- strict diets and poor unbalanced nutrition.
A woman's decreased levels of the hormone may indicate the onset of menopause.
During pregnancy, the level of progesterone decreases when:
- too rapid resorption of the corpus luteum (normally it should dissolve only by 16-17 weeks);
- placental insufficiency;
- severe stress affecting the functioning of the reproductive system;
- post-term (more than 41 weeks).
Prescribing medications (Utrozhestan, Inzhesta, Crinon gel, Duphaston) helps normalize the production of progesterone. It is also recommended to increase the proportion of foods containing proteins and cholesterol in the diet. They do not contain the hormone, but help stimulate its production in the body. Of no small importance is the normalization of the psycho-emotional state of pregnant women, increasing the number of hours of sleep and rest.
From folk remedies Infusions of plants help well:
- Pour 1 liter of boiling water over plantain seeds (1 tbsp) and mantle grass (2 tbsp), leave for 1 hour and take half a glass 3 times a day;
- wild yam and raspberry leaves (1 tablespoon of each plant in 0.5 liters of water, boil and drink instead of tea).
Independent use of medications or folk remedies to increase progesterone synthesis without consulting a doctor is unacceptable.
Consequences of abnormal progesterone levels
An increase or decrease in the concentration of progesterone in the blood in both pregnant and non-pregnant women can have serious consequences.
During pregnancy, a reduced level of the hormone often leads to miscarriage - spontaneous abortion or miscarriage. It can also threaten intrauterine growth retardation and premature birth.
An increased level of the hormone is dangerous due to delayed maturation of the placenta and disruption of the functioning of the fetoplacental complex, which affects the physical and mental health of the unborn child.
In non-pregnant women, abnormal progesterone levels affect the regularity and length of the menstrual cycle.
An increase in hormone concentration threatens the following conditions:
- secondary amenorrhea (lack of menstruation);
- dysfunctional uterine bleeding with an extended second phase of the cycle:
- (increased body hair);
- the appearance of pimples and acne that are difficult to treat;
- swelling.
Often, a violation of progesterone production is associated with abnormal synthesis of other sex hormones, so the signs and consequences of this can be varied, and other symptoms are added.
A decrease in hormone levels leads to:
- to the absence of ovulation and acyclic uterine bleeding;
- to primary or secondary amenorrhea;
- to prolonged painful menstruation (sometimes with a rise in temperature);
- to severe premenstrual syndrome;
- to difficulties with conception (due to insufficiency of the luteal phase and underdevelopment of the corpus luteum);
- infertility.
If you suspect a violation of the production of progesterone in the body, you must take an analysis of its level (necessarily over time) and, in case of abnormal results, undergo the treatment prescribed by your doctor.
Tests for progesterone levels and indications for them
Currently, to diagnose endocrine pathologies, laboratories conduct tests on the level of free progesterone and the level of the hormone 17OH progesterone in the blood. These are two different hormones (despite the similar name) and they are produced by different glands:
- the hormone 17OH progesterone is synthesized by the adrenal cortex;
- free progesterone - by the corpus luteum of the ovary or placenta (in pregnant women).
Both hormones affect the normal functioning of the female reproductive system, therefore, to fully diagnose the body in case of problems with conception or menstrual irregularities, you need to take a test for both hormones. To assess the progress of pregnancy and to diagnose its pathologies, women are usually prescribed a blood test only for the level of free progesterone.
Indications for prescribing a progesterone test are:
- menstrual irregularities;
- suspected ectopic pregnancy;
- risk of miscarriage;
- determination of ovulation when planning pregnancy;
- diagnosis of infertility;
- absence of menstruation in non-pregnant women of childbearing age;
- disruption of the activity of the corpus luteum;
- control over the condition of the placenta during pregnancy;
- ovarian cyst or tumor detected on ultrasound;
- adrenal tumors;
- assessment of the effectiveness of treatment with progesterone drugs;
- with congenital pathologies of the adrenal glands.
A progesterone test is not mandatory and is not usually performed as part of routine testing for pregnant women unless the pregnancy is progressing normally or the woman has not had more than two previous miscarriages or missed pregnancies.
At 40-42 weeks, doctors can prescribe a woman a progesterone test in order to differentiate between post-term and prolonged pregnancy.
If the level of progesterone in the blood is below the norm for the third trimester, this will indicate postmaturity and the need for urgent labor induction or cesarean section to minimize negative consequences for the health of the fetus.
If the level of progesterone in the blood at 41-42 weeks is within the normal range for the third trimester, then there is a prolonged pregnancy. In this case, you can calmly wait for the natural onset of labor.
How to take a progesterone test correctly (preparation, what day of the cycle to take)
Diagnosis of diseases will be correct if the progesterone test is performed correctly. To ensure this, several rules must be taken into account and followed.
- Blood testing for progesterone levels should only be done on an empty stomach. A 14-hour fast is recommended before taking the test. IN as a last resort, the period without water can be 8 hours. During this period, you can only drink water. Juices, tea and other drinks are excluded.
- The best time to take the test is in the morning (from 8.00 to 10.00). At this time, the concentration of the hormone in the blood is at its maximum level. At other times, there may be a slight deviation of the analysis parameters from the norm. If the test is taken several times, it must be taken at the same time.
- 2-3 days before the test, try not to take any medications (except for vital ones). You must inform the laboratory assistant and doctor about taking any medications.
- The day before blood sampling, you should avoid heavy physical activity, do not be nervous and do not drink alcohol, strong coffee or tea.
- 12 hours (or at least 2-3 hours before the test) stop smoking.
- Immediately before donating blood, it is advisable to rest and relax for half an hour in the premises of a medical institution (clinic, laboratory).
Women should donate blood for progesterone on certain days of the menstrual cycle:
Analysis of hormone levels should always be carried out over time. This is the only way to accurately diagnose a particular disease or pathology during pregnancy.
Blood tests for progesterone levels can be taken in private laboratories on a commercial basis or in public health institutions that have laboratories that perform such testing. In government institutions, a hormone test can be taken with a doctor’s referral free of charge on a first-come, first-served basis.
The average period of 28 days is considered the norm for the entire cycle. Depending on the characteristics of the body, its duration can vary from 21-35 days. On these days, the reproductive system of the fair sex works, which affects the well-being, behavior, and mood of the lady.
Cyclic processes include two main phases:
- Follicular. Accompanied by intensive growth of follicles, the maturation of the egg occurs, the ovaries intensively produce estrogen, which stimulates the renewal of the endometrial lining in the uterine cavity. The duration of the phase is two weeks.
- Luteal. Characterized by the cessation of follicular growth, the egg leaves the follicle. Its duration is no more than 16 days.
The next state is called ovulation, lasts about 24-48 hours - the egg enters the fallopian (uterine) tube, moving towards the uterus, awaiting fertilization.
A temporary gland appears in the ovary - the corpus luteum. The function of the corpus luteum, if pregnancy has not formed, is aimed at increasing the production of biologically active substances, starting from the 15-17th to the 28th day of the cycle. The walls of the uterus are being prepared, they become loose, the amount of 
colorings for successful attachment of the fertilized egg. Progesterone is the hormone responsible for the initial stage of pregnancy. Its level in the 1st phase of the menstrual cycle is 0.4-0.8 ng/ml. In the second phase, it increases sharply, reaching from three to thirty ng/ml.
In the absence of a fertilized egg, the corpus luteum begins to gradually decrease, and the process of rejection of the epithelial layer occurs - the stage of menstruation.
If conception has occurred, then the corpus luteum performs the necessary functions until the 12th week of pregnancy, exactly until the placenta itself begins to produce a sufficient amount of biologically active substance.
After ovulation, the production of active biological substances increases, this is necessary for the following important points, to:
- prevent the onset of menstruation;
- stimulate the mammary glands of the expectant mother;
- change the emotional state of the mother in relation to the unborn child.
Cyclic phases are characterized by the following indicators:
- 1st week – accompanied by low levels of progesterone and estrogen;
- 2nd week – predominance of high estrogen, but low (progesterone);
- 3-4 weeks – both hormones have a high concentration.
Standard indicators of sex hormone and their deviation
Low levels of progesterone in the blood can indicate infertility and cause miscarriage. Patients with low levels of progesterone in the blood are prescribed drugs of natural origin or based on a synthetic analogue. The drug Utrozhestan in capsules has excellent reviews. Excellent natural composition, used orally, intravaginally.
A high progesterone level may indicate pregnancy or pathological abnormalities, such as:
- malignant neoplasms of the genital organs;
- uterine bleeding;
- dysfunction of the kidneys and adrenal glands;
- deviations in the development of the placenta in pregnant women.
It is imperative to monitor the biologically active substance in women carrying a child. An indicator of the hormone norm in pregnant women is considered to be:
- 1-13 weeks of pregnancy – 15-107.9;
- 14-27 weeks – 61.7-159;
- 28-41 weeks – 17.3-509 (nmol/l).
Before childbirth, the rate decreases greatly.
A common occurrence in the second trimester of pregnancy is elevated sugar, when the ALT norm is exceeded, this may indicate pathology.
Monitoring should be done using a biochemical blood test, which is done in the morning on an empty stomach. The ALT norm for the weaker sex is considered to be 31 U/L (international units per liter), for the male sex – 45 U/L.
On the 22nd day of the cycle, a biochemical blood test is prescribed to determine the level of progesterone in women, and to monitor the level over time, tests are taken several times.
The standard progesterone level in women depends on the day (nmol/l):
- 1-15 – norm 0.97-4.8;
- 16-22 – norm 2.4-9.55;
- 23-28 – norm 16.2-86.
Thus, the norm of progesterone in women on the 22nd day of the cycle is 9.55 nmol/l. During the postmenopausal period, the indicator will be 0.3-2.5 nmol/l.
The stronger sex also produces progesterone, the normal level is 0.35-0.63 nmol/l.
Hormonal changes are stressful for the body, so timely checks, blood tests, and consultation with a doctor will help balance the abnormalities and maintain health.
Progesterone is considered a female sex hormone that regulates menstrual cycles and supports pregnancy. Produced by the adrenal gland and corpus luteum.
The hormone is involved in the most important processes of the female body. The main functions are: preparing the uterus for future pregnancy, preventing rejection of the fertilized egg, developing the mammary gland for lactation, preparing nervous system for childbirth, normalization of blood pressure, control of blood sugar.
The role of the hormone for pregnant women
Progesterone is intensively produced immediately after ovulation before fertilization and continues to be produced by the corpus luteum until the 16th week of pregnancy. If pregnancy does not occur, the corpus luteum dies, hormone production stops, and then menstruation begins. For fertilization, progesterone levels in women must be met.
The importance of this hormone for procreation cannot be underestimated, since it greatly affects the female body, supporting reproduction. It is progesterone that allows the fertilized egg to attach to the wall of the uterus and reduce uterine contractility. Without the help of the hormone, the fertilized egg will be rejected, and if pregnancy occurs, there is a risk of miscarriage. He is also responsible for lactation after childbirth.
Estradiol is also important. The level of estradiol in the blood is affected by the phase of the menstrual cycle, just as the level of progesterone has different indicators depending on the phase of the cycle.
The 1st phase is characterized by an increase in the level of estradiol and progesterone, where the maximum value is reached at the time of ovulation. At the beginning of the 1st trimester, the level of progesterone and estradiol in the blood increases, forming favorable conditions for embryo growth and prevents the threat of miscarriage. If there is no fertilization, then the level of estradiol and progesterone decreases to a concentration in the 1st phase of the cycle, then menstruation begins.
The second phase lasts at least 10 days. In the second phase, progesterone is produced. With a short second phase, the endometrium does not have enough time to prepare to accept the fertilized egg, and conception does not occur.
We can come to the conclusion that for a pregnant woman, the hormone is the main component in all trimesters. It also creates an environment in the uterus suitable for pregnancy, promotes the attachment of the fertilized egg, increases the likelihood of embryo survival, and preserves the endometrium, which supports the continuation of pregnancy.
Effect on the body
It also performs several other functions that are not related to pregnancy: it prevents the formation of fibrous cysts in glandular tissue, promotes the conversion of adipose tissue into energy, and restores blood clotting and sugar levels.
Repeated scientific studies have proven the existence of a relationship between premenstrual and menopausal syndromes.
For this reason, progesterone levels in women are always important for the proper functioning of the body, and not just for periods of bearing a child. Progesterone levels in women also vary during periods of hormonal changes.
Long periods of pregnancy, menopause, and the use of contraceptives affect the concentration of the hormone. Norms for women (not pregnant) and women who do not use contraceptives should have certain indicators depending on the phase of the cycle.
Hormone norm
The following levels of progesterone are normal during pregnancy:
- in the follicular progesterone norm is 0.32 – 2.25 nmol/l;
- in ovulatory – 0.49 – 9.41;
- in the luteal phase - 6.95 - 56.53 nmol/l;
- in postmenopause - no more than 0.64;
- 1st trimester of pregnancy: 8.9 – 468.5 nmol/l;
- 2nd trimester: normal values are 71.5 – 303.2;
- 3rd trimester: 88.7 – 771.5 nmol/l.
Normal hormone levels in those taking hormonal medications:
- In the follicular phase: up to 3.6 nmol/l;
- in the ovulatory phase: 1.52 – 5.45;
- in the luteal phase: 3.01 – 66.8 nmol/l;
- postmenopause: no more than 3.19 nmol/l.
Progesterone for IVF
During IVF, this hormone is of great importance for conception, because IVF requires a lot of hormonal help. Before IVF, progesterone is prescribed to stimulate the ovaries. The effectiveness of the hormone during IVF depends on the method of its entry into the body, divided into vaginal and intravaginal, as well as on its properties.
After IVF, natural progesterone is prescribed in micronized form; it is almost identical to natural progesterone in its characteristics and does not entail side effects, does not affect metabolic processes, blood pressure, etc.
Progesterone administered vaginally increases its bioavailability. It affects only the uterus and endometrium and increases the level of the hormone in the blood after a few hours.
When to get tested?
In the absence of special medical recommendations, the test is taken on the twenty-second or twenty-third day of menstruation, always on an empty stomach. The study is carried out before lunch; at least eight hours must pass after the last meal.
When researching, it is very important to take into account the duration of the cycle (number of days). For example, if the cycle consists of 32 days, then by making calculations, you can determine that ovulation will occur on the 18th day of menstruation. Considering that the analysis will be scheduled on day 21 of the cycle, by this time only 3 days will have passed after ovulation.
If the test is carried out on a pregnant woman, it contains information about the week of pregnancy, the day of menstruation, and the use of birth control pills.
A high level may indicate the presence of amenorrhea, pregnancy, the formation of a corpus luteum cyst, deviation in the development of the placenta, kidney disease and adrenal glands. A low level of the hormone in the blood indicates a cycle disorder, improper functioning of the corpus luteum, the presence of chronic inflammation of the ovaries, and lack of ovulation.
During pregnancy in any trimester, a lack of the hormone indicates a delay in the development of the fetus, indicates the presence of a threat of miscarriage or post-term pregnancy. Women need to monitor the levels of progesterone and estradiol - the most important hormones for a woman’s body.
How to maintain the norm?
During pregnancy, the doctor observing the pregnant woman, together with the endocrinologist, decides on restoring normal progesterone levels.
Pregnant women and women with abnormal levels of the hormone can do the following to restore its concentration naturally: purchase food products that are not in plastic or polyethylene packaging; use glassware in microwave oven; use purified water for cooking and drinking; Use hair dye with caution.
It is worth reviewing your daily routine, night rest should last at least 8 hours, you need to do breathing exercises in the fresh air on a daily basis. Use vegetables and fruits enriched with vitamin C and E in your diet.
It is very important to be active and healthy image life, eat environmentally friendly and healthy food. Take care of your health, and in case of minor manifestations of malfunctions in the reproductive system, immediately contact a specialist.
Pregnant women need to remember that they are responsible not only for their health, but also for the health of their unborn child, so it is very important to follow the advice of a specialist.
The main hormone of the female reproductive system, which performs a number of necessary functions for implantation and gestation. Its indicators vary depending on many factors, but in any case, progesterone levels must correspond to the laboratory norm, the phase of the menstrual cycle and the age of the patient.
Obstetricians and gynecologists call progesterone “the main hormone of pregnancy,” but it is naive to assume that its functions are limited to this.
It is secreted by the adrenal glands, ovaries and the corpus luteum, which is formed immediately after the rupture of the follicle.
Normal concentration is necessary to stimulate and activate certain biological processes:
- Rupture of the “Graafian vesicle” (follicle) and.
- Formation and subsequent change in the size of the corpus luteum.
- Strengthening the endometrium, which is necessary for.
- Protects the cervix by secreting viscous mucus in the cervical canal.
- Enlargement of the uterus by inhibiting its contractile function.
- Suppression of menstruation/lactation during pregnancy.
- Transformation of the mammary gland, alveoli for the subsequent period of lactation, as evidenced by a sharp decrease in progesterone after childbirth.
- Inhibition of maternal immune reactions in order to implant the fetus without rejection.
- Nutrition of the embryo up to the 2nd trimester of pregnancy (placenta formation).
- Stabilization of the nervous system during pregnancy.
It turns out that without normal concentration, neither fertilization nor further development of the embryo is possible. Its role in the body is invaluable and has not yet been fully studied, as scientists are putting forward more and more new hypotheses regarding its effect on the body and even everyday behavior.
Important! In addition to reproductive function, progesterone stimulates sexual development, activates the growth of mammary glands, maintains healthy skin, increases blood pressure, and regulates the emotional sphere.
Cycle dependency
The concentration is never stable or the same. The numbers depend on many factors:
- day of the menstrual cycle;
- age;
- pregnancy;
- taking hormonal contraceptives.
In addition to the above mentioned nuances, there are others that indirectly affect the fact of an increase/decrease in the hormone. This is stress, an exhausting diet, gynecological diseases, intense physical activity, and taking medications. Firstly, it depends on the phase and day of the menstrual period.
First phase (follicular)
It is characterized by the active development of follicles, among which a dominant one containing a mature egg should be formed. The duration ranges from 11 to 17 days, depending on the total duration of the menstrual cycle.
Progesterone in phase 1 is fixed in the range from 0.92 to 4.7 nmol/l. Please note that these are only average values, as each laboratory has its own reference standards.
The hormone during this period should not increase or fluctuate greatly, because its biological time is ovulation and some period after it. At the same time, it is incorrect to assume that progesterone in phase 1 of the cycle is in a state of complete rest.
During active folliculogenesis, it gradually prepares the endometrium for implantation of the fertilized egg and indirectly contributes to the process of maturation of the “Graafian vesicle”.
Second phase (luteal)
The second phase of the cycle occurs after the rupture of the “Graafian vesicle” and is called the luteal phase. The day before ovulation, a woman experiences a sharp rise in progesterone, which is a normal condition because the dominant follicle should burst and form the corpus luteum.
Without a sufficient amount of the hormone, this process occurs with pathologies or is completely absent. The concentration before ovulation ranges from 0.5 to 4.8 nmol/l, and after its onset the hormone rapidly increases and reaches its peak on days 5-7 after rupture.
The phase makes itself felt immediately after ovulation is completed. This is the time when progesterone is especially active, since the corpus luteum has formed, producing the hormone. Its numbers can increase tenfold.
If we consider laboratory standards as a sample, then the concentration of the hormone in the luteal phase ranges from 7 to 57 nmol/l, but reference values allow values up to 86 nmol/l if it is the 18-22nd day of the cycle.
After ovulation
After the dominant follicle ruptures, the mature egg is released and sent into the fallopian tubes. The corpus luteum is formed from a clot of cells, which intensively produces progesterone.
The post-ovulatory phase is characterized by its highest levels. Some laboratories consider slightly higher readings as normal because the final numbers are directly dependent on the size of the corpus luteum and overall hormonal status.
It is worth remembering that 6 days before endometrial rejection, progesterone decreases sharply and reaches its minimum before menstruation.
Interesting! If a woman takes hormonal contraceptives, then progesterone values both after ovulation and in the luteal phase will be half the average values (from 2 to 30 nmol/l).
Decoding norm
The norm is not a fixed value, it depends on the phase, emotional state, the presence of stress and diets. And so we have prepared for you the main indicators at various points in life.
For 21 days
It marks itself at its maximum peak, as the yellow body reaches impressive sizes in diameter (18-24 mm). It is logical to assume that the formed clot begins to produce even more, but then as it decreases, the concentration decreases.
At the same time, the numbers directly depend on the total duration of the menstrual cycle. If it is more than 30 days, then on day 21 of the cycle progesterone will only increase. The opposite situation is observed when the total cycle period is less than 28 days.
The indicators will be slightly below average, but these nuances are not so significant. In any case, the data should fit into the range from 7 to 86 nmol/L.
Peculiarity! The total duration of the menstrual period for each woman is purely individual, but its average duration is 28 days. The norm is taken to be from 21 to 35 days, but small differences are acceptable depending on physiological factors.
Before, on the day and after embryo transfer
The term "embryo transfer" is inextricably linked with (in vitro fertilization). Its essence is quite simple: an embryo that was fertilized 48-120 hours ago is inserted into the woman’s uterine cavity using a catheter.
In order for fetal implantation to occur, it is necessary to stabilize the hormonal status, and especially progesterone. A woman's body must be ready for pregnancy.
Before the transfer, doctors carry out hormone therapy to adjust the level to the desired norm.
The procedure is carried out on the day prescribed by the reproductologist. Until this point, the doctor identifies successful factors for the operation (thickness of the endometrium, level of progesterone, estradiol). Before replanting, the numbers must correspond to the norm of the follicular phase of the cycle (from 0.6 to 2.3 nmol/l).
During the test it should not exceed 3.4 nmol/l. With high progesterone levels, the chances of getting pregnant are significantly reduced, as evidenced by the results of many studies.
After embryo transfer (5-6 days), progesterone gradually increases and should be at least 9 nmol/l. If a sharp decrease is recorded, then it is advisable to begin hormonal stimulation, since there is a risk of embryo rejection.
With successful fetal implantation, progesterone rises rapidly. In a pregnant woman, the hormone is first recorded in the range from 15 to 108 nmol/l.
In the first weeks of gestation, its levels are 18 nmol/l. A decrease indicates a high risk of miscarriage, so the expectant mother is stimulated throughout the first trimester of gestation.
The dosage of progesterone is selected individually and includes the following drugs:
- hormonal therapy (Duphaston tablets, injections);
- vaginal suppositories;
- vaginal tablets (“Lutein”);
- progesterone creams, ointments (Crinon).
Table by day for non-pregnant women
Indicators constantly change depending on the day of the cycle, age, pregnancy, use of contraceptives, etc.
The table shows the norms for non-pregnant women. It should be remembered that each laboratory has its own diagnostic standards and conversion standards, so the range of reference values varies somewhat.
Interesting! Hormonal contraceptives have a huge impact on progesterone, so in the follicular phase its norms will not exceed 3.6 nmol/l, and in the luteal phase - 30 mmol/l.
By week for pregnant women
In case of pregnancy, progesterone gradually increases, starting from gestation. Sometimes pregnancy itself is recognized by its increased indicators. High numbers are recorded at the end of the 1st trimester, as well as in the last weeks of gestation.
Before childbirth, the hormone begins to sharply decrease to stimulate uterine contractions.
The table shows the norm of progesterone according to weeks of pregnancy:
Possible deviations
A significant increase/decrease means a serious disorder and pathology, but first you need to understand the causes of this condition.
Small changes of a few points may be ignored by the doctor, but significant deviations should not be ignored.
An increase is possible in the presence of the following pathologies:
- dysfunctional uterine bleeding;
- renal failure;
- adrenal tumor;
- functional cyst;
- ovarian neoplasms;
- long absence of menstruation (amenorrhea);
- ovarian dysfunction;
- liver diseases;
- severe stress;
- diet;
- smoking, alcohol abuse;
- taking analogues of progesterone, the hormone ACTH.
In the case of pregnancy, an increase may indicate a pathology in the development of the placenta, including a slowdown in its growth and maturation abnormalities. However, most often the reason for high numbers is the growth of a corpus luteum cyst.
Reduction is no less dangerous and has its own reasons:
- ovarian dysfunction;
- tumor of the pituitary gland, hypothalamus;
- pelvic inflammatory diseases (chronic form);
- absence of menstruation;
- uterine bleeding;
- infertility;
- taking certain antibiotics, hormonal contraceptives, epostan, estradiol, etc.
On early stages causes miscarriage, therefore this condition is very dangerous and requires immediate medical attention.
Important! Progesterone deficiency in any trimester of pregnancy is a high risk of miscarriage.
On what day should I take the test?
To check the level, a woman takes a venous blood test. According to general standards, the collection of biomaterial occurs on days 21-23 of the menstrual cycle, that is, during the period when the concentration of the hormone is highest.
At the same time, the doctor can set other dates for laboratory testing if the clinical picture is not clear.
In the case of hormonal pathologies or irregular cycles, the patient is tested several times or on certain days prescribed by the doctor.
How it's done?
The level of the hormone can be recorded only by examining venous blood, which is performed using the solid-phase chemiluminescent immunoassay method.
Before collecting the biomaterial, the patient should not eat for 8-14 hours and do strenuous activities. physical activity, drink alcohol and smoke an hour before the test.
Important! Progesterone and 17-OH progesterone (17-OP) are 2 different hormones and studies that should not be confused when taking the test. 17-OP is the end result of cortisol and progesterone is a steroid hormone. Their indicators are calculated for various diagnostic purposes.
For the sake of reliability of the results, you should temporarily stop taking certain medications. Similar laboratory test can be taken at any public clinic or private medical organization.
Blood test for progesterone - indications, preparation, standards and interpretation. What affects the level of progesterone in the blood?
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Progesterone test is a laboratory test performed to determine the concentration of a sex hormone progesterone in blood. The analysis is used to diagnose and identify the causes of sexual and menstrual dysfunction in women, that is, mainly for menstrual irregularities, uterine bleeding, infertility, functional ovarian cysts and to assess the functioning of the corpus luteum.Progesterone analysis - what is it (what does it show)?
To understand what a progesterone test is, you need to know General characteristics and the functions of progesterone itself performed by it in the human body.So, progesterone itself is a female sex hormone that is involved in the normal course of the menstrual cycle and pregnancy. That is, this hormone is needed for normal regular monthly cycles and to ensure the progress of pregnancy, so that there are no spontaneous miscarriages or missed abortions.
Progesterone is normally produced in the female body in unequal amounts at different phases of the menstrual cycle and by different organs. So, in the first phase of the menstrual cycle, which is called follicular and lasts from the first day of menstruation until ovulation, the level of progesterone in a woman’s blood is low, since during this period it is produced only in the adrenal glands in very limited quantities. And in the follicular phase, progesterone is not needed, since during this period it is necessary to stimulate the growth and maturation of the egg in the ovarian follicle, and not to prepare the organs for a possible pregnancy.
During the follicular phase, the follicle (“vesicle”), which contains the future egg, grows and matures in the ovaries. After the follicle grows and the egg in it matures, this “bubble” ruptures, that is, ovulation occurs. As a result of ovulation, the egg is released into the abdominal cavity, from where it enters the fallopian tube and moves along it to the uterus. And in place of the burst follicle, a corpus luteum is formed, which begins to actively produce progesterone throughout the second half of the menstrual cycle (luteal phase), preparing the entire woman’s body for a possible pregnancy.
Thus, it turns out that in the first, follicular phase of the menstrual cycle, the level of progesterone in the blood is low, since it is produced only by the adrenal glands. Further, approximately 10 hours before ovulation (the moment the egg is released from the ruptured follicle), the level of progesterone in the blood increases sharply and remains so throughout the entire ovulation period, which lasts approximately 12 - 36 hours. After the release of the egg from the follicle and the formation of the corpus luteum in its place, the level of progesterone in the blood increases even more and remains so throughout the entire second phase of the menstrual cycle (luteal), that is, until the onset of menstruation. If pregnancy occurs during the cycle, then menstruation does not occur, and the level of progesterone continues to increase little by little, since this hormone is necessary for the preservation and normal development of the fetus. During pregnancy, the level of progesterone increases until the 37-38th week, and until the 16th - 17th weeks it is produced by the corpus luteum of the ovary, formed at the site of the burst follicle, and from the 17th-18th week the hormone is synthesized by the placenta.
Summarizing the above, it is obvious that the level of progesterone in the blood of a non-pregnant woman is low in the first half of the menstrual cycle, rises sharply from the moment of ovulation, increases in the second half of the cycle and reaches maximum values approximately 6–8 days after ovulation, after which it decreases slightly, but remains high until the last day before the next period. In the body of a pregnant woman, by approximately 7–8 weeks, the level of progesterone doubles compared to the values of the second half of the menstrual cycle and then constantly and gradually increases until the 37–38th week, that is, until the prenatal period.
Thus, it is obvious that the biological effect of progesterone is to provide conditions for the onset of pregnancy and its further maintenance.
Indeed, in the second half of the menstrual cycle (luteal phase), which lasts from ovulation to the next menstruation, under the influence of progesterone, the endometrium (mucous lining) of the uterus is prepared for the introduction of the fertilized egg into it in the event of pregnancy. Thus, under the influence of progesterone, the blood vessels of the endometrium become convoluted, blood flow to the uterus increases, and nutrients accumulate in the cells of the mucous membrane. Such changes are necessary for the subsequent attachment and development of the fertilized egg. If pregnancy occurs, then it is progesterone that “preserves” it, as it reduces the contractile activity of the uterus and prevents it from “rejecting” the fertilized egg.
In addition, progesterone stimulates the production of a special secretion by the mucous membrane fallopian tubes, which provides nutrition for the egg moving towards the uterus.
Considering the above, it is quite obvious that the level of progesterone, determined in the second half of the menstrual cycle, shows how well the corpus luteum of the ovary works and whether there is a theoretical threat to the termination of a possible pregnancy. In the second half of pregnancy (from the 17-18th week), the level of progesterone in a woman’s blood shows how well the placenta is functioning and whether there is a threat of premature birth or fetal death.
When taking a test for progesterone in the first half of the menstrual cycle, the doctor will be able to determine the presence and identify the hormonal activity of a functional ovarian cyst (follicular or corpus luteum).
In addition, the level of progesterone in the blood of non-pregnant women, determined in the first and second phases of the cycle, makes it possible to identify the causes of uterine bleeding, infertility and menstrual irregularities.
Thus, the level of progesterone in a woman’s blood shows whether the menstrual cycles are proceeding correctly in her body and how successful a possible pregnancy may be.
Analysis for 17-OH progesterone
17-OH progesterone (17-alpha-hydroxyprogesterone) is a steroid hormone that is one of the intermediate products in the process of cortisol synthesis in the adrenal glands. Despite the similarity in name with progesterone, 17-OH progesterone has a different origin and function, and therefore tests for the content of these substances in the blood reflect disorders of the functioning of different organs.Thus, 17-OH progesterone is synthesized in the adrenal glands, and therefore the determination of its level reflects the pathology of this particular organ. The level of 17-OH progesterone is outside the normal range in people suffering from adrenal insufficiency, Addison's disease, thyroid diseases, etc. In addition, the production of an abnormal amount of 17-OH progesterone by the adrenal glands negatively affects the functioning of the ovaries, and therefore women with primary pathology of the adrenal glands experience an irregular menstrual cycle, lack of ovulation, infertility, and hirsutism (excessive hair growth in women).
That is why determination of the level of 17-OH progesterone is used in a comprehensive examination of women with infertility or menstrual dysfunction in order to determine the primary cause of such disorders.
What kind of progesterone tests are there and when to take them?
Currently, as part of the laboratory diagnosis of various endocrine disorders, the levels of progesterone and 17-OH progesterone in the blood are determined. Despite similar and even practically identical names, these are different hormones, produced by different organs that perform different functions, and therefore reflect the pathology of different endocrine organs. Thus, progesterone is produced mainly by the corpus luteum of the ovaries in non-pregnant women and the placenta in pregnant women, and therefore reflects the work of these organs. And 17-OH progesterone is produced by the adrenal glands and reflects their functioning.But since both progesterone and 17-OH progesterone affect the normal functioning of the genital organs (ovaries, uterus, etc.), a deficiency or excess of any of these hormones leads to disruption of menstrual, sexual and reproductive functions in women. Accordingly, it is justified to take an analysis for both of these hormones in case of menstrual irregularities, infertility, bleeding and difficulties during sexual intercourse. Despite the similar range of pathologies for which tests for progesterone and 17-OH progesterone are indicated, these hormones are still tested in different situations. Let's consider in what cases you need to take just progesterone, and when - 17-OH progesterone.
If a woman of normal normal build, who has undergone puberty at a normal time and has no signs of excess androgens (acne, excess hair growth, etc.), is concerned about uterine bleeding, amenorrhea (absence of menstruation), periodic disruptions of the menstrual cycle, chronic problems that cannot be treated inflammatory processes in the pelvic organs, as well as habitual miscarriages or missed pregnancies (2 or more), then she should be tested for progesterone, since sexual problems are most likely caused by a deficiency or excess of this hormone, that is, problems in the ovaries . With these signs, most likely, the woman has either ovarian cysts/cystomas or does not ovulate.
If a woman suffers from an irregular menstrual cycle, infertility, periodic bleeding, difficulties during sexual intercourse, and at the same time she has experienced early puberty, acne, excess hair growth, decreased libido, specific fat deposition in any part of the body and other signs of dysfunction adrenal glands, then she should take a blood test for 17-OH progesterone, since health problems are most likely caused initially by adrenal pathology. But since the adrenal glands influence the functioning of all organs and systems, including the ovaries, then with adrenal pathology, symptoms also appear in the genital organs. However, in such situations, the disorder of sexual, menstrual and reproductive functions is secondary; it is caused not by pathologies of the reproductive organs themselves (uterus, ovaries, fallopian tubes, etc.), but by a disease of the adrenal glands, which disrupts the normal functioning of the genital organs. Therefore, it is obvious that in case of disorders of sexual, menstrual and reproductive functions, which are combined with signs of adrenal gland dysfunction (excessive hair growth, low libido, acne, obesity with uneven fat deposition only in one or several areas of the body, vomiting, lethargy, low physical activity, etc.), you should be tested for the concentration of 17-OH progesterone in the blood in order to identify the nature and severity of the adrenal function disorder.
Women suffering from infertility need to take both tests - both progesterone and 17-OH progesterone - in order to identify which organs have dysfunction that can lead to the inability to conceive.
During pregnancy, women are advised to take a progesterone test if there is a suspicion of placental insufficiency, threat of miscarriage, intrauterine growth retardation, or post-term pregnancy. In other cases, when the pregnancy is proceeding normally, there have been no two or more missed pregnancies in the past, recurrent miscarriage, etc., there is no need to take a test for progesterone simply for control.
Test for progesterone during pregnancy
During pregnancy, a progesterone test is taken according to indications, and not as part of a routine routine examination provided for and approved by the protocols of the Russian Ministry of Health.Up to 16-17 weeks of pregnancy, inclusive, a progesterone test is taken to assess the functioning of the corpus luteum, which synthesizes the hormone during these periods and thereby ensures the normal development of pregnancy. If the corpus luteum synthesizes an insufficient amount of progesterone, then there is a high probability of pregnancy loss due to spontaneous miscarriage or fading (frozen pregnancy). Accordingly, in the early stages, up to the 16-17th week inclusive, a progesterone test is taken if there is a threat of miscarriage or if a woman has had several pregnancy losses in the past (miscarriage, miscarriage, recurrent miscarriage). In such cases, if progesterone deficiency is detected, the doctor prescribes medications containing this hormone (Duphaston, Utrozhestan) until the 16-17th week.
From the 17-18th weeks of pregnancy until birth, a progesterone test is most often prescribed in cases where there are suspicions of placental insufficiency, a threat of premature birth or intrauterine growth retardation based on other examinations. Indeed, from the 17-18th week, progesterone synthesis is carried out precisely by the placenta, and not by the corpus luteum of the ovaries, which by this time has already died and ceased its activity. This means that if from the 17-18th week until birth the placenta produces an insufficient amount of progesterone, then this indicates placental insufficiency and can lead to delayed fetal development and premature birth.
It must be remembered that when pregnant women are tested for progesterone for the reasons stated above, it is necessary to evaluate not only its level in accordance with the week of gestation, but also its increase over a certain period. This means that two different women's blood progesterone levels at the same stage of pregnancy can be quite different, but both will be fine. Such variations in hormone levels are due to the individual characteristics of the body. Therefore, experienced obstetricians-gynecologists recommend taking a progesterone test during pregnancy twice with an interval of 10 to 14 days. If, according to the results of two tests, an increase in progesterone levels along with the gestational age is clearly visible, then everything is in order (even if the hormone levels themselves are at the lower limit of normal or slightly below normal). But if the level of progesterone does not increase with the duration of pregnancy, or its concentration is significantly lower than normal, then this is an alarm, since such a situation reflects the threat of miscarriage, placental insufficiency or intrauterine growth retardation.
In addition, at the 40-42nd weeks of pregnancy, a progesterone test can be taken to determine whether the pregnancy is postterm or whether the woman simply has a slightly longer than average gestational age due to individual characteristics. Let's look at this aspect in more detail to avoid ambiguity and ambiguity.
Thus, a normal pregnancy in a woman can last 280–320 days. But for most women, pregnancy lasts 280 days, that is, exactly 40 weeks, and that is why doctors and scientists take 40 - 42 weeks as an average for a normal pregnancy. However, we should not forget about such a fact as a normal pregnancy, which lasts 320 days, that is, 45 - 46 weeks. Such a long pregnancy is called prolonged.
Considering the fact that a completely normal pregnancy can last 40–46 weeks, the question arises of how to distinguish after the 42nd week of gestation whether a post-term pregnancy or a normal prolonged pregnancy is occurring in a particular situation. In such cases, a blood test for progesterone comes to the rescue, which is done at 40 weeks or more in order to distinguish a prolonged pregnancy from a post-term pregnancy. If, at 41.5 or more weeks of pregnancy, the level of progesterone in the blood is below the norm for the third trimester, then this indicates postmaturity, and in this case, delivery must be carried out urgently in order to minimize the negative consequences of postmaturity for the fetus. If, at a pregnancy stage of 41.5 weeks or more, the level of progesterone in the blood is within the normal range for the third trimester, then this indicates a prolonged pregnancy, and not a post-term pregnancy, and in this case it is possible not to carry out an urgent artificial delivery (through labor induction or cesarean section ), and wait another 2 - 3 weeks for the natural onset of labor.
Normally, the concentration of progesterone in the blood of pregnant women is the following values, depending on the gestational age:
- First trimester of pregnancy (1 – 13 weeks inclusive) – 9 – 468 nmol/l;
- Second trimester of pregnancy (14 – 26 weeks inclusive) – 71.5 – 303 nmol/l;
- Third trimester of pregnancy (week 27 - before birth) - 88 - 772 nmol/l.
Indications for progesterone testing
A blood test to determine progesterone levels is indicated in the following cases:- Assessment of the functioning of the corpus luteum of the ovaries and detection of luteal phase deficiency (as part of a comprehensive examination of women suffering from infertility);
- Identification and confirmation of functional ovarian cysts (corpus luteum, follicular);
- Identification of the causes of menstrual irregularities (including amenorrhea - absence of menstruation);
- Identification of the causes of uterine bleeding during periods of ovulation;
- Assessment of the risk of termination of pregnancy for endocrine reasons (threat of miscarriage, fading, premature birth);
- Assessment of placental function during pregnancy (as part of an examination for the presence of placental insufficiency or fetal growth restriction);
- Diagnosis of post-term and prolonged pregnancy.
Preparing for a progesterone test
You need to take a progesterone test exclusively on an empty stomach after a period of fasting at night during sleep. This means that it is optimal for the fasting period to last 8–14 hours, during which you can only drink water. In the morning, on the day of the test, it is not permissible to drink juices, tea with sugar, compotes and other drinks containing fruit or sugar components. You are allowed to drink only regular water without gas.If it is impossible to take a progesterone test in the morning on an empty stomach after a period of overnight fasting, then this can be done in exceptional cases do it in the afternoon or evening. But in this case, it is necessary that at least 6 hours pass after the last meal, and you need to eat dietary products and dishes containing a small amount of fat.
However, it should be remembered that best time for donating blood for progesterone analysis, this is the period from 8-00 to 10-00 in the morning, since it is during these hours that the maximum concentration of this hormone during the day is determined. At other times, progesterone levels are lower than from 8-00 to 10-00 in the morning, although within normal limits. Therefore, theoretically, you can donate blood at any time, but in this case, the concentration of progesterone may be slightly lower than normal, although in reality it is at the lower limit of normal. And such a situation will lead to unjustified false research results.
Immediately before taking a progesterone test, it is advisable to rest in the clinic or laboratory for 15 to 30 minutes and during this time calm down and be in a good mood.
12–24 hours before taking blood for progesterone analysis, you should stop smoking, drinking alcohol, and avoid physical and psycho-emotional stress (including sports training). If a person cannot stop smoking for 12 - 24 hours, then he should stop smoking for at least 1 - 2 hours immediately before blood sampling.
2–3 days before taking blood for analysis, you should avoid taking any medications so that they do not affect the accuracy of determining progesterone concentration. However, if for some reason it is impossible to stop taking medications, then the laboratory and the attending physician should be informed about which drugs are being taken and in what dosages.
Preparation for taking a progesterone test in children over 5 years of age is the same as in adults, that is, described above. But for children under 5 years of age, preparation for taking the test is that they should not eat for half an hour before donating blood, but they should be given small portions of regular, clean, still water to drink. During this half hour, the child should drink 150 - 200 ml of water (glass).
What medications affect the level of progesterone in the blood?
Some medications can affect the concentration of progesterone in the blood, and therefore it is necessary to stop taking them several days before the test in order to get correct results. Let's consider which ones medicines can influence the level of this hormone in the blood.So, the following medications can increase the level of progesterone in the blood:
- Clomiphene (there is an increase in progesterone levels above normal in the second phase of the menstrual cycle);
- Corticotropin;
- Progesterone and its synthetic analogues (injections oil solution progesterone, Duphaston, Utrozhestan, etc.);
- Valproic acid.
A decrease in progesterone levels in the blood can be caused by taking the following medications:
- Goserelin;
- Danazol;
- Dinoprost;
- Carbamazepine;
- Leupromide;
- Tromethamine;
- Oral contraceptives;
- Pravastatin;
- Prostaglandin F2;
- Phenytoin;
- Cyproterone;
- Epostan;
- Estriol;
- Ethinyl estradiol.
How to take a progesterone test?
What time should I take the test?
Firstly, you need to know that to test for progesterone, blood is taken from a vein strictly on an empty stomach (at least after a 6-hour fast from food, but better than a 12-14-hour fast). Secondly, the best time to donate blood for analysis is the period from 8-00 to 10-00 in the morning, since it is during these hours that the maximum concentration of progesterone in the bloodstream during the day is determined. That is, at other times of the day the concentration of progesterone in the blood is lower than in the period from 8-00 to 10-00 in the morning, but still within normal limits. But the norms for the concentration of the hormone in the blood are determined specifically for the period maximum level hormone.
That is why, in order to know for sure whether the progesterone concentration is normal or not, it is better to donate blood from 8-00 to 10-00 in the morning. After all, if progesterone is at the lower limit of normal, then when donating blood at other times it may be lower than normal, and this will cause incorrect diagnosis and fruitless attempts at treatment.
On what day of the cycle should I take a progesterone test?
In addition to the time of donating blood for analysis, the second important factor, the observance of which is necessary to obtain a correct and accurate result, is the day of the menstrual cycle on which the concentration of progesterone should be determined. Regarding the day of the cycle on which the test should be taken, there can be two options - either it is 6 - 8 days after ovulation (approximately 19 - 23 days of the menstrual cycle), or it is 1 - 3 days of the cycle (during menstruation).So, if there is a suspicion of an ovarian neoplasm (cyst, tumor) or pathology of the adrenal glands, then a progesterone test should be taken on the 1st - 3rd day of the menstrual cycle, that is, on the 1st - 3rd day of the next menstruation. If during this period the level of progesterone is elevated, then this most often indicates a functional ovarian cyst (follicular or corpus luteum). Less commonly, a high level of progesterone in the blood in the first half of the cycle indicates a hormonally active ovarian tumor (cystoma). And even less often, high progesterone on days 1–3 of the cycle reflects dysfunction of the adrenal glands. But in this case, there is a deficiency or excess of other hormones, and signs of endocrine pathology (excessive hair growth, obesity, acne, etc.).
If you need to evaluate the functioning of the corpus luteum, identify insufficiency of the luteal phase, reveal the causes of dysfunctional uterine bleeding or menstrual irregularities, then a progesterone test is taken 6–8 days after ovulation! It is very important to “catch” ovulation, notice this date and take a progesterone test on days 6–8. You can “catch” ovulation using different methods - by doing an ultrasound on the days when it should approximately occur, measuring the basal temperature in the rectum in the morning, or simply using an ovulation test (the principle of use is the same as a pregnancy test), sold in pharmacies .
! It is important to know that the standard indication that a progesterone test can be taken on days 19–23 of the cycle is correct only for a 28-day menstrual cycle. After all, for a 28-day cycle, the period 6–8 days after ovulation falls on days 19–23. And for menstrual cycles of other durations (25, 30, 35 days, etc.), the delivery period for days 19–23 is incorrect, since it does not fall on days 6–8 after ovulation. To obtain the correct result, the test should be taken 6–8 days after ovulation. That is why, in order to assess the level of progesterone at the right time and avoid incorrect diagnosis, you need to “catch” ovulation and get tested 6–8 days after its onset.
Pregnant women can take a progesterone test any day they need it.
Norms for progesterone analysis
Before giving specific figures for normal values of progesterone levels for men and women of different ages, let’s consider what is meant by normal and why they differ in different laboratories.So, the norm for a particular indicator (in this case, progesterone) is the limits of the values that it can take in a population of completely healthy people living in a particular area and belonging to the same racial type. Such limits of normal values for any laboratory indicator are determined by examining healthy volunteers. But these identified standards are valid only if subsequent analysis is carried out using exactly the same method and using a set of completely identical reagents. That is, it is obvious that for each set of different reagents and method for determining the same indicator it is necessary to identify standards.
And given the fact that each laboratory uses different sets of reagents and methods for determining progesterone concentration, it becomes obvious that they will have completely different standards, sometimes very different from each other. This does not mean that one laboratory’s standards are not correct, while another’s, on the contrary, are correct. This only means that laboratories use different sets of reagents and methods for determining progesterone in the blood. And therefore, if the analysis was carried out in a specific laboratory, then to decipher the results you need to take the standards of this particular institution, and those in force at the current moment in time. After all, in six months, the same laboratory may begin to use a different method or set of reagents to determine progesterone, and then its standards will change. Therefore, standards for assessing results must be taken every time an analysis is taken.
Below in the table we present two options for progesterone standards for the most common and frequently used determination methods and reagent kits. Moreover, we will write the first norms for one common set of reagents after a colon or dash, and the second norms for another frequently used determination method will be indicated next to the first ones in parentheses.
| Men | Women |
| Boys 1 – 10 years: | Girls 1 – 10 years old: Less than 1.1 nmol/l (or 0.2 – 1.7 nmol/l) |
| Boys 1 – 18 years old: I, II stages of puberty according to Tanner - less than 1.1 nmol/l (or 0.3 - 1.0 nmol/l) Stage III of puberty according to Tanner – less than 1.1 nmol/l (or 0.3 – 1.5 nmol/l) Stage IV of puberty according to Tanner – less than 3.5 nmol/l (or 0.56 – 7.8 nmol/l) Stage V of puberty according to Tanner – 0.7 – 2.6 nmol/l (or 0.7 – 2.6 nmol/l) | Girls 1 – 18 years old: Stage I of puberty according to Tanner – less than 1.1 nmol/l (or 0.3 – 1.0 nmol/l) Stage II of puberty according to Tanner – less than 1.8 nmol/l (0.3 – 1.7 nmol/l) Stage III of puberty according to Tanner – 0.3 – 14.4 nmol/l (or 0.3 – 14.3 nmol/l) IV stage of puberty according to Tanner – 0.3 – 41.6 nmol/l (or 0.5 – 15.0 nmol/l) Stage V of puberty according to Tanner – 0.3 – 30.4 nmol/l (or 0.3 – 30.2 nmol/l) |
| Adult men over 18 years of age: 0.3 – 2.2 nmol/l (or 0.4 – 3.1 nmol/l) | Adult non-pregnant women over 18 years of age and before menopause: Follicular (first) phase of the menstrual cycle – 0.3 – 2.2 nmol/l (or 0.5 – 2.2 nmol/l) Ovulation period (mid-cycle) – 0.5 – 9.4 nmol/l (or 3.7 – 7.1 nmol/l) Luteal (second) phase of the menstrual cycle – 7.0 – 56.6 nmol/l (or 6.4 – 79.5 nmol/l) |
| Adult women during menopause: Less than 0.6 nmol/l (or 0.06 – 1.3 nmol/l) |
|
| Pregnant women: First trimester (1 – 13 weeks) – 9 – 468 nmol/l (or 32.6 – 139.9 nmol/l) Second trimester (14 – 26 weeks) – 17.5 – 303.1 nmol/l (or 62.0 – 262.4 nmol/l) Third trimester (27 weeks - before birth) - 88.7 - 771.5 nmol/l (or 206.7 - 782.2 nmol/l) |
In some laboratories, the test result for progesterone is given not in nmol/l, but in ng/ml, that is, in other units of measurement. To convert units of measurement to each other, you need to use the following formulas:
- nmol/l*0.314 = ng/ml;
- ng/ml*3.18 = nmol/l
Explanation of progesterone analysis
Let's look at what an increase or decrease in progesterone levels in the blood may indicate.So, an increase in the concentration of progesterone in the blood in non-pregnant women and men is typical for the following conditions:
- Dysfunctional uterine bleeding with an extended second phase of the menstrual cycle;
- Secondary amenorrhea (absence of menstruation);
- Ovarian neoplasms (cysts, cystomas);
- Kidney failure (due to which progesterone is slowly eliminated from the body and accumulates in the blood);
- Tumor or hyperplasia of the adrenal glands;
- Testicular tumor in men;
- Taking medications that increase the level of the hormone in the blood.
- Hydatidiform drift;
- Delayed maturation of the placenta;
- Impaired functioning of the feto-placental complex.
A decrease in progesterone concentration in non-pregnant women is typical for the following conditions:
- Persistence of the follicle (hyperestrogenism - increased level of estrogen hormones);
- Lack of ovulation;
- Insufficiency of the luteal phase or low functional activity of the corpus luteum;
- Dysfunctional uterine bleeding due to lack of ovulation;
- Primary or secondary amenorrhea (absence of menstruation);
- Chronic inflammatory processes in the internal genital organs;
- Primary or secondary hypogonadism;
- Taking medications that reduce hormone levels in the blood.
A decrease in progesterone concentration in pregnant women is typical for the following conditions:
- Threat of miscarriage;
- Placental insufficiency;
- Intrauterine growth retardation;
- True post-term pregnancy (41.5 weeks or more).
Where can I get tested for progesterone?
Tests for progesterone can be done in private laboratories on a commercial basis. Such private laboratories are available in all major cities, and branches for blood collection are also available in small villages. Blood sampling for analysis in private laboratories is carried out at any time at the client’s request, but, of course, during business hours.In addition, a progesterone test can be taken at public medical institutions that have laboratories that perform such research. As a rule, these are laboratories of large research institutes (research institutes), regional or city hospitals, diagnostic clinics, etc. In government institutions, upon referral from a doctor, the test can be taken free of charge on a first-come, first-served basis. But if a woman wants to take tests without a queue or at her own request without a referral from a doctor, then this can also be done in a government institution only on a commercial basis (for a fee).
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