Progesterone

About Progesterone Hormone:

Progesterone is a hormone produced in the ovaries and the adrenal cortex during the menstrual cycle, and during pregnancy, it is produced in the placenta. In the second stage of the menstrual cycle, it helps increase the thickness of the uterine lining (endometrium). In the case of a successful pregnancy, the future embryo implants here. In this case, progesterone continues to be actively produced in the ovaries, contributing to the maintenance and progression of pregnancy. Later on, the placenta takes over all tasks related to progesterone production. If pregnancy does not occur, hormone levels decrease, endometrial cells are shed, and menstruation begins.

In men, progesterone is produced in smaller quantities than in women. The ovaries and adrenal cortex participate in its synthesis. The hormone partially regulates the process of sperm maturation and serves as a precursor to testosterone and cortisol hormones.

Synonyms:
Progesterone, gestagen, pregnancy hormone, corpus luteum hormone. P4, pregn-4-ene-3,20-dione, gestagen, histagen, pregnancy hormone, progestin.

Uses of the Test:

Progesterone testing is conducted for pregnancy preparation and assisted reproductive techniques, as well as to monitor the future mother’s condition during pregnancy; detect hormonal disorders; determine the cause of menstrual disorders and ovulation failure; diagnose infertility and miscarriage; diagnose ovarian and adrenal conditions when suspected of tumor processes; and evaluate the effectiveness of hormone therapy. Progesterone testing is also necessary for pregnant women suspected of abnormal medical conditions concurrent with chorionic gonadotropin (HCG) hormone testing.

Progesterone analysis is performed on venous blood, with serum separated, and the result is read using solid-phase chemiluminescent immunoassay.

Preparation for the Test:

Preparation for analysis is done in women on days 21-23 of the menstrual cycle, calculated from the beginning of the last menstruation. In some cases, these periods may be adjusted. Medications containing progesterone, corticotropin, and tamoxifen can affect hormone levels, and patients taking these medications should inform their treating physician and refrain from taking them if allowed.

The test is performed on an empty stomach, with food allowed up to 8-12 hours before blood collection. Water can be consumed without restrictions. Alcohol consumption, smoking, and physical exercise should be avoided on the day before the analysis.

Normal Concentration:

  • Measurement units: nanomoles per liter (nmol/L).

Reference Values:
Reference values for women depend on the menstrual cycle stage. At age 18 and under, values also vary at different stages of sexual maturity.

Age/StageMaleFemale
Less than 7 years<1.1<1.1
7-12 years<1.1<1.1
12-13 years<1.1<1.8
13-15 years1.10.3-14.4
15-16 years<3.50.3-41.6
16-18 years0.3-30.41.9–9.6 (40.3 – 203.5)
Adults0.3-2.2
Follicular phase0.3-2.2
Ovulatory phase0.5-9.4
Luteal phase7.0-56.6
Postmenopausal<0.6
Pregnancy – 1st trimester8.9-468.4
Pregnancy – 2nd trimester71.5-303.1
Pregnancy – 3rd trimester88.7-771.5

Please note that the reference values are based on measurements in nanomoles per liter (nmol/L).

Analytical Result:

Elevated values may indicate:

  • Adrenal hypertrophy.
  • Tumor or cyst in the ovary or testicle.
  • Pregnancy.
  • Dysfunctional uterine bleeding.
  • Progesterone output disorders in cases of kidney disease.

Decreased hormone levels may result from:

  • Pregnancy problems (risk of early miscarriage, ectopic pregnancy, preeclampsia).
  • Hormonal insufficiency in the ovary.
  • Absence of menstrual cycle.
  • Insufficient development of reproductive organs.

The use of hormone-containing medications, especially oral contraceptive methods, is accompanied by changes in hormone levels.

Additional Testing in Case of Progesterone Level Deviation:

In case of deviation from reference values, additional tests are recommended to achieve an accurate diagnosis. These tests include:

  1. Pregnancy test (determining beta-HCG hormone levels).
  2. Estradiol.
  3. Thyroid-stimulating hormone (TSH).
  4. Free T-4.
  5. 17-OH-progesterone.
  6. Prolactin.
  7. Testosterone.

These additional tests will provide a comprehensive assessment of the hormonal status and guide treatment if necessary. Additional tests are determined based on the context of symptoms and the individual’s medical history.

Sources:

  • R.R. Tukhvatshin, Zh.A. Maripova, A.A. Isupova, A.K. Derkembaeva, T.A. Sovostyanova, F.R. Shervanskaya. The influence of environmental factors on the level of progesterone in pregnancy pathology // Bulletin of KazNMU. 2013. No. 5-1.
  • Tatiana Vyacheslavovna Khapova, Anton Sergeevich Olenev, Vadim Mikhailovich Shuravin, Olga Alexeevna Kuznetsova, Tatiana Viktorovna Smirnova. Preterm labor. Diagnosis. Prevention // Bulletin of RUDN. Series: Medicine. 2013. No. 5.