Progesterone 76 but not pregnant. The hormone progesterone - its role in a woman’s body

Natural procreation would be impossible if female body the hormone progesterone was not produced. 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.

But still the main role hormone - maintaining 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 has occurred).

The “pregnancy hormone” (as progesterone is often called) performs 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 preparation pelvic bones women in labor for childbirth;
• maintains blood viscosity and blood sugar levels at a stable level 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:

• behind 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 in different periods life. It depends on the woman’s age and phase 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, the production of the hormone continues to increase and reaches a peak at III trimester e (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 and even 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 limit) for each phase of the menstrual cycle, 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 analysis and different methods 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 reception medicines, which are used by the expectant mother at the time of the test.

Causes of increased progesterone. How to downgrade

If a blood test for progesterone levels shows 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 is most often 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 hormone level increases when 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.

An increase in progesterone concentrations in women 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 (abstain from bad habits, establish a work-rest schedule) and pay attention to nutrition (reduce the proportion of protein foods and abandon foods high in saturated fats).

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 genitals;
• reception medicines, lowering 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. Quite a lot important has normalization psycho-emotional state in pregnant women, an increase in the number of hours of sleep and rest.

From folk remedies Plant infusions help increase progesterone levels:

• 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 reduced level hormone often leads to miscarriage - spontaneous abortion or miscarriage. This may also result in delays intrauterine development child 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:
• hirsutism (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 long-term 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 for diagnostic purposes endocrine pathologies In laboratories, tests are carried out to determine the level of free progesterone and the level of the hormone 17OH progesterone in the blood. These are two different hormones (despite 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 influence the normal functioning of the female reproductive system, so for full diagnostics If you have 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;
• suspicion of 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;
• at congenital pathologies 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 caesarean section to minimize negative consequences for fetal health.

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.

1. Blood testing for progesterone levels should only be done on an empty stomach. A 14-hour fast is recommended before taking the test. In extreme cases, the period without water can be 8 hours. During this period, you can only drink water. Juices, tea and other drinks are excluded.
2. 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.
3. 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.
4. The day before blood sampling, you should avoid heavy physical activity, do not be nervous and do not drink alcohol, strong coffee or tea.
5. 12 hours (or at least 2-3 hours before the test) stop smoking.
6. Immediately before donating blood, it is advisable to rest and relax for half an hour indoors medical institution(clinics, laboratories).

Women should donate blood for progesterone to certain days 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 at on a commercial basis or in government medical institutions that have laboratories that perform such research. In government institutions, a hormone test can be taken with a doctor’s referral free of charge on a first-come, first-served basis.

Under what circumstances can it be said that the hormone progesterone is normal in women? What function does this substance perform in the body and is it necessary to monitor its level? Such questions begin to worry the fair half only when the time has come to become a mother, but there are some problems. A detailed answer to this exciting question will be given in the article.

Special hormones in the female body

The main mission of a woman on Earth is the continuation of the human race. The man also makes his contribution, but the main process still occurs in the female body. Nature has taken care of the structure of the reproductive system and the influence of certain hormones on it, the level of which is constantly changing. The amount of hormonal substances is influenced by different circumstances and the woman’s age.

What is progesterone and what is its role in the reproductive process and in the life of the woman herself? It's simple. Progesterone - this is a special hormone that helps a woman’s fertilized egg attach to the walls of the uterine cavity and creates for the embryo comfortable conditions for further development. If progesterone levels are low, then attempts to become a mother without special therapy will end in failure for the woman.

The production of progesterone in a woman’s body is carried out by the ovaries, being the main supplier of progesterone. Additionally, progesterone is synthesized by the adrenal glands and pituitary gland. These are links of one chain, which under normal conditions works smoothly and every month a woman may experience pregnancy or menstruation.

The level of progesterone is important for a woman only when pregnancy occurs. If a woman’s plans do not include becoming a mother, then the girl is not very concerned about the normal indicators.

The main role of progesterone is the following:

• Progesterone prepares the woman’s reproductive organs for conception, the entire period of pregnancy and a healthy delivery of the woman.
• Progesterone helps the fertilized egg attach to the walls of the uterus, eliminating the possibility of fetal rejection, which can be perceived by the immune system as foreign body. Progesterone blocks the activity of estrogen, which can cause miscarriage. Estrogen stimulates the growth of the endometrium in the uterus, its destruction and detachment, which is considered menstruation. Progesterone at normal pregnancy does not allow estrogens to perform their function before the woman gives birth.
• Progesterone stimulates the lining of the uterine cavity to increase in size as the fetus grows. If a woman's progesterone level is below normal, the embryo will not have enough room to grow due to lack of relaxation of the uterine walls.
• At normal course During pregnancy, progesterone helps the expectant mother’s nervous system adapt to a new state until childbirth and during breastfeeding.
• Progesterone in tandem with the hormone prolactin promotes normal formation mammary glands for lactation, eliminates the possibility of the formation of cysts in the milk ducts.
• A woman’s maternal instinct is also formed under the influence of progesterone on the body during pregnancy and after the birth of a baby.

These are the main functions of progesterone in the female body, but its role is important not only for the reproductive process:

• Progesterone is involved in normalization metabolic processes- controls blood sugar and converts internal fat into useful energy.
• Stimulates the functioning of the sebaceous glands.
• Increases blood pressure.
• Progesterone increases sexual desire, especially at the moment when there is normal conditions for conception. If pregnancy is not part of a woman’s plans, then she should be more careful during the period when progesterone levels increase.

The well-being and mood of most women in premenstrual period and during the onset of menopause - these are also tricks of progesterone.

If for a girl who has not reached the age of menopause, mood swings are the norm and do not last long, then for a mature woman such fluctuations in well-being cause serious discomfort. That's why normal level progesterone is a criterion good mood and normal health at different stages life.

What is considered normal for the female body in relation to progesterone?

A woman’s progesterone levels will differ in the first and second phases of the menstrual cycle, when using special drugs as contraception, or when she has some diseases. For a general understanding of what the norm of progesterone is in a woman, you can study the average indicators obtained during the examination of hormonal levels in women of different ages and in the presence/absence of pregnancy.

Normally, a woman’s menstrual cycle lasts from 25 to 33 days (these are individual indicators).

1. In the first phase of the cycle, the main follicle matures in the ovary, which, when fully matured, ruptures and the stage of ovulation begins - the finished egg is released.
2. The follicle produces corpus luteum, which begins to actively produce progesterone.

If you do an analysis of the level of progesterone in the blood in phase 1 of the menstrual cycle, only residual fragments will be detected, which is considered normal. Progesterone remained from the previous cycle. And only with the formation of the corpus luteum (at the onset of phase 2 of the cycle) will the values ​​begin to increase. The body prepares to maintain the pregnancy if fertilization occurs.

• If the egg is fertilized and pregnancy develops, then progesterone increases to the maximum possible levels.
• If conception does not happen, then the level of progesterone decreases, and the endometrium begins its rejection from the placental mucosa, and menstruation begins. This is the monthly norm for women who do not plan to become a mother.

The following tables will tell you what values ​​can be seen in the results of a blood test for progesterone content under various circumstances:

Norm of progesterone in the absence of pregnancy in women of childbearing age

The progesterone norms indicated in the table may change under the influence of contraceptive drugs, which a woman uses on the recommendation of a gynecologist.

These numbers will be lower due to the blocking of the ovulation process.

The same progesterone levels are considered normal during adolescent puberty, lactation and menopause. (progesterone norm 0.64 units/l) .

The norm of progesterone in a woman during pregnancy

The amount of progesterone in a pregnant woman varies different terms, but in the table you can see that the normal level ranges from minimum to maximum values.

It is very difficult for an ordinary person to understand the results and understand whether the level of progesterone in a pregnant woman is normal. Why is there such a large corridor from the minimum to the maximum indicator?

What is clear is that the highest concentration of progesterone is in the third trimester of pregnancy, when normal development of the fetus requires more nutrients, elasticity of the walls of the uterus and placenta. During this period, the formation of the mammary glands occurs, the load on the entire body increases, so the concentration of progesterone should be sufficient for all important processes.

Indicators of the norm of progesterone in a woman’s body are needed only by a gynecologist if the doctor has concerns about a decrease or excess in its concentration. The results obtained about the normality or pathology of progesterone synthesis influence the choice of therapy, if necessary.

Under some circumstances, progesterone levels may be higher than normal at a certain stage. The reason lies in a serious pathology that needs to be excluded. A single analysis of the level of progesterone in a woman’s body may not be enough to determine the clinical picture. Therefore, the examination should be prescribed by a gynecologist, taking into account the general well-being of the patient.

Reasons for deviations from the norm

Not always the reason high level progesterone in a woman is pregnancy. Excess progesterone can be a symptom of pathology in reproductive system or organs accompanying the synthesis of progesterone:

It is possible to lower the concentration of progesterone in a woman if the cause is correctly determined by consulting a gynecologist.

A decrease in the level of progesterone in the body below normal is also dangerous for a woman, especially during pregnancy. Progesterone is responsible for the safety of the embryo, and its deficiency provokes the termination of this pregnancy. Any pathology in the fetus sends a signal to the placenta, which begins the process of rejection, provided by nature as a selection of the strongest.

A change in progesterone levels may indicate a missed pregnancy or premature birth, if a progesterone level test was done at this time. Only such a study is not informative in case of pathology and a pregnant woman is usually indicated by ultrasound or measurement of the level of hCG hormones, CTG.

Rules for testing progesterone levels

An analysis of the hormone progesterone in a woman is not included in the list mandatory studies, despite the fact that progesterone is important for the female body. The progesterone norm indicators in the tables are only generalized units.

A woman's progesterone level can fluctuate throughout the day and depending on when the blood was drawn, the numbers may be unreliable.

This examination is usually prescribed by a gynecologist if a woman has additional symptoms hormonal imbalances, for example, in case of problems with conception, failure of menstruation, when preparing for IVF, when choosing oral contraceptives.

1. It is advisable to do the test in the morning and on an empty stomach.
2. The last meal should be no later than 6–11 hours before the collection of biomaterial.
3. Accurate values ​​can be obtained on the 22nd day from the beginning of the menstrual cycle, provided that the entire cycle lasts 28 days. If the period is more than 32 days, then blood sampling is done on the 28th day.
4. At unstable cycle monthly progesterone tests are done repeatedly. To understand which day is better to take a test to determine the normal or pathological level of progesterone, you can measure the temperature rectally after waking up. If the hormone is elevated, then the temperature will be higher than usual. The test is done 6–7 days after the thermometer readings increase.
5. To determine the norm or deviations in the concentration of progesterone in a woman, blood is taken from a vein.

The results of the test for a woman’s progesterone level are deciphered by a gynecologist at her next appointment.

If the indicators are normal and pregnancy does not occur, the doctor prescribes additional examination. If progesterone levels are low, a woman is prescribed hormone replacement therapy, which should bring progesterone concentrations to normal.

Any deviations of progesterone from the norm can be compensated

If a woman has a deficiency or excess of progesterone, then to normalize the indicators, the doctor chooses the appropriate therapy:

• Drug treatment with tablets and injections according to an individual regimen.
• Using traditional medicine recipes. Infusions of boron uterus, plantain seeds, and mint leaves are popular and effective for normalizing progesterone in women.
• A diet rich in meat, high-fat dairy, eggs and legumes helps normalize progesterone.

Normalization of progesterone requires constant monitoring of hormone levels to exclude reverse effect therapy (increasing or decreasing progesterone levels).

Finally

Despite the fact that progesterone plays important role in the female body, it is difficult to determine the norm for a particular patient. There are only standards. With absence additional signs indicating a deficiency or excess of progesterone, there is no cause for concern. In the practice of gynecologists there are more precise methods diagnostics of women's problems, which give complete clinical picture than testing for progesterone levels in women by blood.

Progesterone (progestin) is a steroid hormone synthesized in male and female bodies. In men, progesterone is produced in the cells of the testicles, in women - in the ovaries, and in both sexes it is synthesized in small quantities by the adrenal cortex. Its main function is to regulate the condition of the inner layer of the uterus and prepare it for the fixation of a fertilized egg after ovulation. In men, progesterone is a precursor to other hormones (for example, testosterone). If the egg is successfully fertilized, the ovaries continue to produce the hormone for the active development of the placenta, which after a few weeks itself begins to synthesize progesterone. For this reason, progestin is called the pregnancy hormone.

The balance of progesterone in the female body experiences significant fluctuations depending on the time of the cycle, age, and the level of other hormones. Therefore, it is important to plan the analysis taking into account menstruation.

The entire menstrual cycle in women is usually divided into four phases. The first is characterized by menstrual bleeding and lasts from 5 to 7 days. The second lasts until the middle of the cycle. The third (ovulatory) is caused by ovulation (the release of a finished egg). The fourth (luteal) completes the cycle. In the luteal phase, progesterone levels are higher than in other phases. In this phase, it is recommended to conduct a test for progesterone (19, 20, 21, 22, 23 days of the cycle).

Table 1 shows the reference values ​​of progesterone depending on the time of the menstrual cycle (the norm for men is 0.89–2.9 nmol/l). It is important to note that the data is given in nmol/L (nanomoles per liter). Some laboratories also use ng/ml (ng = gram/106). To convert ng/ml to nmol/l, you need to perform the calculation using the following formula: nmol/l = ng/ml * 3.18. For simplicity, the table shows data in both dimensions (the more common dimension is nmol/l).

Table 1. Progesterone, norm in women depending on the day of the cycle

As can be seen from this table, maximum level progesterone is detected in women in the luteal phase after ovulation on days 19, 20 and 21 of the cycle, remaining high on days 22, 23. For this reason, women are advised to have a progesterone blood test at this time. The standard for such a study is the progesterone norm on day 21 of the cycle. If you do this analysis at other times of the menstrual cycle (for example, immediately after menstruation in the follicular period), then it is likely false result due to the lack of sensitivity of the study.

It is worth noting that the hormone content on days 19, 20, 21, 22, 23 of the cycle is quite high. For this reason, self-diagnosis is not recommended. High performance may also indicate normality hormonal balance, and about pregnancy, and about pathologies.

If the level of progesterone in the luteal phase (after ovulation on days 19, 20, 21, 22, 23) is higher than normal, then this indicates pregnancy. With successful fertilization, the hormone content in the blood begins to increase every week, becoming higher and higher towards the end of pregnancy. The second table shows reference values ​​for progesterone in women depending on the week of pregnancy.

Table 2. Progesterone levels depending on the week of pregnancy

It is important to note that all hormone indicators depending on the week of pregnancy are approximate and individual for each woman. To control the pregnancy and proper development all systems of his body require consultation with a doctor of the appropriate profile.

Deviations from the norm of analysis parameters (above or below reference values) for progesterone in the luteal phase (19, 20, 21, 22, 23 days of the cycle) indicate hormonal imbalance in the body and the development of pathology.

It is worth noting that the doctor prescribes a progesterone test not only in the luteal phase. In rare cases, a test for hormone levels must be carried out in both the follicular, menstrual, and ovulatory periods of the cycle to monitor fluctuations in progesterone levels. Such tactics for monitoring hormonal balance make it possible to diagnose pathologies in the synthesis and activity of progesterone in the blood.

A test for progesterone levels in the luteal phase (after ovulation on days 19, 20, 21, 22, 23 of the cycle) is carried out using chemiluminescence immunoassay. To do this, a few ml are taken venous blood. To ensure that the results are not true or true, it is necessary to prepare for the study. For this:

• it is important to select the time of the study so that it falls on the 19th, 20th, 21st, 22nd, 23rd day of the menstrual cycle (luteal period);
• if you accept hormonal drugs, then the analysis should be carried out in consultation with the doctor (if necessary, stop taking medications);
• do the study on an empty stomach;
• avoid strong physical and emotional stress (in case of stress, the analysis result may be higher than the true values).

It is important to take the test several times (the second test in a month). This is done to monitor progesterone levels depending on the week of pregnancy. If the indicator is higher or lower than normal in a certain week, then this may indicate pathologies in the development of the fetus (ectopic pregnancy, developmental arrest).

(from Latin “pregnancy hormone”) is a female sex hormone that prepares a woman for pregnancy. In the female body, progesterone is produced in the ovaries, placenta and adrenal glands. Its main function is to ensure pregnancy and regulate menstruation.

IN male body significantly less progesterone is produced. It is synthesized by testicular and adrenal tissues. In men, testosterone and a number of other substances are produced on the basis of progesterone. important hormones, however, its role is less significant than that of women.

To test for progesterone, blood is taken from a vein. In the laboratory, blood serum is purified from blood cells and examined by immunochemical method. Modern analyzers allow you to get analysis results in a few hours. On average, the waiting period is 1 day.

The role of progesterone in a woman’s body

Progesterone is a steroid hormone. In the female body it is biological active substance is responsible for reproduction processes and influences processes occurring in many organs.

Progesterone deficiency in women can lead to serious consequences:

• before pregnancy - infertility associated with the fact that the endometrium of the uterus is not ready for the attachment of a fertilized egg;
• during pregnancy - spontaneous termination of pregnancy - miscarriage.

High progesterone in women also accompanied by unpleasant symptoms:

• visual impairment;
• acne;

Features of progesterone production

1. Progesterone in non-pregnant women Produced by the corpus luteum and to a small extent by the adrenal glands. Corpus luteum- this is temporary endocrine gland located in the ovary. Its name is explained by the color, which is due to big amount yellow pigment - lutein.
The activity of the corpus luteum, and therefore the synthesis of the hormone, is regulated by the immune system, ovarian and pituitary hormones.
The development cycle of the corpus luteum consists of 4 stages:

1. Proliferation. Every month, a follicle containing an egg matures in one of the ovaries. During ovulation, the follicle bursts and the egg is released into the abdominal cavity. After this, the walls of the follicle gather in folds and it “closes.” Hemorrhage occurs into the cavity, which provokes active division of granulosa cells lining the walls of the follicle.
2. Vascularization. Forms in the walls of the follicle a large number of blood capillaries. Thanks to their intensive work, the corpus luteum of the ovary has the most intense blood flow of all organs of the female body.
3. Heyday. The corpus luteum increases significantly in size to 2.3 cm and protrudes above the surface of the ovary. It increases progesterone synthesis 30 times compared to initial stage menstrual cycle. This phase should last about 12 days. If it decreases, then we talk about corpus luteum deficiency and the woman cannot become pregnant.
4. Fading. If pregnancy does not occur, the cells decrease in size and occur in the corpus luteum. dystrophic changes. It is gradually replaced by scar tissue, turning into white body. This is accompanied by a decrease in the concentration of progesterone in the blood.

2. Progesterone during pregnancy. When pregnancy occurs, the corpus luteum continues to synthesize the hormone for another 12 weeks, almost the entire first trimester. Its work is stimulated by the membranes of the embryo (chorion) through human chorionic gonadotropin. In the second trimester, the placenta takes over the function of producing progesterone.

The level of the hormone increases steadily from the 9th to the 32nd week of pregnancy. During this time, the concentration of progesterone in the blood increases 15 times compared to the body of a non-pregnant woman. This hormone controls not only the condition of the uterus, but also the entire metabolism of a pregnant woman. Thanks to progesterone, a woman absorbs maximum amount nutrients from foods, which is accompanied by the deposition of adipose tissue.

The effect of progesterone on a woman’s body

• On the mucous membrane of the uterus. The first 14 days of the menstrual cycle ( proliferation phase) the uterus is affected by estrogens produced by the growing follicle. They stimulate active division of endometrial cells. After ovulation, the follicle turns into the corpus luteum and produces progesterone. Begins secretion phase, the duration of which is also about 14 days (an increase or decrease by more than 2 days is pathology). In this phase, progesterone has direct influence on the endometrium, causing changes that create a favorable environment for the attachment of a fertilized egg and the development of the embryo. Secretion of the uterine glands, their secretion of mucous secretion containing glycogen and polysaccharides. The ducts of the glands twist and expand, which allows them to increase their area.
• Spiral twisting of blood vessels. The hormone makes them tortuous and full-blooded, which is important for the blood circulation of the unborn fetus.
• The stroma (loose connective tissue that fills the gaps between the endometrial glands) becomes swollen and accumulates fluid and nutrients.

A decrease in progesterone concentration at the end of the cycle causes: arterial spasm, deterioration of cell nutrition and melting of endometrial connective fibers. These changes make it easier to shed the mucous membrane during menstruation.

• During pregnancy. Progesterone prepares the body for childbirth and stimulates fetal development.

• Stops the menstrual cycle;
• Provides growth of the uterus;
• Relaxes the muscles of the uterus, reducing its tone;
• Reduces the sensitivity of the uterus to substances that cause its contraction;
• Promotes the accumulation of fat to provide the fetus and mother with nutrients;
• Relaxes the ligaments, which facilitates the passage of the fetus through birth canal at the time of birth;
• Promotes the growth of mammary glands (alveoli and lobules), which is necessary for milk secretion.

• For metabolism.

• Stimulates appetite. This explains the fact that in women in the second half of the cycle, cravings for carbohydrate foods increase.
• Increases the ability to store fat - increases the body's chances of surviving in conditions of food shortage. Due to the presence of progesterone, fat is deposited in the waist area.
• Relaxes smooth muscles gastrointestinal tract. This slows down the movement of food and allows the body to absorb all the nutrients as much as possible. Side effects There may be fermentation of food in the intestines and increased formation of gases.
• Increases insulin production after meals. At the same time, progesterone reduces tissue sensitivity to insulin, increasing blood sugar levels. This property of the hormone is associated with increased cravings for sweets before menstruation and during pregnancy.
• Increases basal body temperature. Thanks to this property, it is possible to determine ovulation.

• On the musculoskeletal system.

• Split muscle tissue. Increases protein catabolism, which causes breakdown muscle cells. This fact is proven by an increase in urea in urine during periods high content progesterone in a woman's blood.
• Relaxation of ligaments and tendons. Connective tissue becomes more elastic. This makes the birth process easier, but increases the risk of injury in the second half of the menstrual cycle and during pregnancy.
• Improves bone tissue formation.

• On nervous system and to sleep. Progesterone breakdown products have a calming effect, similar in effect to barbiturates. It has both positive and negative effects. Positive effects:

• Improves blood circulation to the brain;
• Stimulates growth nerve cells;
• Prevents damage to neuron cell walls;
• Stimulates memory;
• Reduces the frequency of epileptic strokes and seizures;
• Has a calming and analgesic effect.

When progesterone concentration decreases before menstrual phase irritability and tearfulness increase, and sharp changes moods.

• On the immune system. Progesterone inhibits activity immune system, which avoids conflict between the body of the mother and the fetus, which contains a foreign protein (father's DNA). However, suppression of the immune system is accompanied by a number of unpleasant reactions: the appearance of acne, exacerbation of herpes and allergies, the appearance of condylomas, during periods high content progesterone.
• On the skin. The hormone stimulates sweating and active sebum production. For this reason, in the second half of the cycle, the skin becomes oily and inflammation occurs more often.

Why is a progesterone test prescribed?

Indications for prescribing a blood test for progesterone

• Suspicion of ectopic pregnancy. In this case, the level of the hormone will be lower than during normal pregnancy (at early stages about 30 ng/ml);
• Threat of miscarriage;
• The need to determine ovulation when planning pregnancy.
• Assessment of luteal phase deficiency in the diagnosis of infertility;
• Amenorrhea – absence of menstruation in non-pregnant women reproductive age;
• Violation of the activity of the corpus luteum;
• The need to monitor the condition of the placenta during pregnancy;
• Ovarian cyst or tumor detected on ultrasound;
• Adrenal tumors;
• Evaluation of the effectiveness of treatment with progesterone drugs;
• Children with congenital pathologies of the adrenal glands;
• For children with impaired production of steroid hormones, impaired puberty.

How to Prepare for a Progesterone Test

• 1-2 weeks in advance, stop taking medications that affect the release of progesterone (the list is given below). If this cannot be done, then it is necessary to provide the laboratory with a list of drugs indicating doses.
• 12 hours before the test, exclude:

• eating;
• alcohol;
• physical exercise;

• Taking tests to morning time up to 11. On an empty stomach.

It is not advisable to take the test immediately after:

• endoscopic examination;
• radiography;
• fluorography.

On what day of the menstrual cycle is blood taken for analysis?

Results obtained in different days cycle, can differ tens of times. Therefore, for a correct assessment, it is necessary to strictly adhere to the deadlines for taking the test indicated by the doctor. He makes a decision based on the length of the menstrual cycle.
In non-pregnant women, blood for progesterone is usually taken on days 21-23 of the cycle. (The first day of the cycle is considered the first day menstrual bleeding). For oligomenorrhea (scanty periods) - starting from the 15th day of the cycle with an interval of 3 days. During pregnancy on any working day.

Normal progesterone values

When evaluating the analysis, it is necessary to take into account that normal (reference) values ​​in different laboratories may differ significantly. Therefore, a gynecologist or endocrinologist should decipher the analysis.

Period	Progesterone level ng/ml
	Women	Men
Under 13 years old	0,2 – 1,5	0,2 – 1,4
Over 13 years old		0,2 – 0,9
Follicular phase	0,2 – 1,5
Ovulation	0,8 – 3,0
Luteal phase	1,7 – 27,0
I trimester of pregnancy	11,2 – 90,0
II trimester of pregnancy	25,6 – 89,4
III trimester of pregnancy	48,4 – 422,5
Postmenopause	0,1 – 0,8

Some laboratories report progesterone levels in nanograms per milliliter(ng/ml), as presented in the table, and others in nanomoles per liter(nmol/l). In order to convert ng/ml to nmol/l, you must multiply by a factor of 3.18.

In what pathologies are progesterone levels elevated?

• progesterone and its synthetic analogues;
• antifungal – Ketoconazole;
• hormonal - Mifepristone, Clomiphene, Corticotropin;
• antiepileptics - valproic acid, Depakine.

In what pathologies are progesterone levels reduced?

• antibiotics – Ampicillin;
• oral contraceptives;
• antiepileptic drugs – Carbamazepine, Phenytoin;
• hormonal drugs - Danazol, Goserelin, Cyproterone, Leuprolide, Estriol, Prostaglandin E2.

Progesterone is a steroid hormone produced by the female body. Has important reproductive functions. Progesterone in a woman's body Produce: adrenal cortex, ovaries, corpus luteum and placenta.

Which important functions Progesterone performs in the female body:

• trains reproductive organs women for conception, trouble-free pregnancy and childbirth;
• with its help, the fertilized egg is implanted into the uterine mucosa;
• progesterone suppresses biological rejection of the fetus, relieves tension in the muscles of the uterus;
• helps the uterus expand as the child grows;
• participates in processes that prepare the mammary glands for feeding a child;
• prevents menstruation during pregnancy;
• has a beneficial effect on the mother's nervous system, preparing her for for a long period pregnancy and subsequent childbirth, stimulates the emergence of maternal instinct;
• prevents the development of fibrous cysts in the breast;
• normalizes sugar levels;
• slightly increases arterial blood pressure.

The norm of progesterone in the female body

The concentration of progesterone will vary depending on the day of the monthly cycle or the stage of pregnancy.

With the onset of the post-climactic period, the level of the hormone progesterone is set at 0.64 nmol/l.

Symptoms of deficiency and excess of progesterone in the blood

Both excess and lack of progesterone can indicate poor health. Signals from the body can be:

• bleeding in the middle of the cycle;
• cycle disruption;
• sudden change of mood;
• breast soreness.

How and when to take a progesterone test?

Note. Identifying increased or decreased concentrations of progesterone in the body, even after taking the test, is not an easy task. This is due to daily changes and individual characteristics the body of every woman.

Indications for taking a progesterone test may be:

• studying the hormonal map before planning IVF;
• lack of conception for 12 months with suspicion of insufficient production in the luteal phase of the cycle;
• more than 3 unauthorized terminations of pregnancy (miscarriages), the cause of which may be a lack of progesterone.

• If there are no other indications, you need to take the test on days 21-23 with a 28-day monthly cycle. Or on day 28-29 with a 32-25 day cycle. If monthly cycle disturbed and irregular, several laboratory tests will have to be carried out;
• For analysis, venous blood is taken in the morning on an empty stomach, drinking water is allowed. Before donation, you must eliminate fatty foods.

Increased progesterone levels - normal and pathological

Usually increased progesterone among women happens during pregnancy. Such an increase is normal and indicates the correct course of pregnancy and the absence of pathology.

If increased concentration progesterone (hyperprogesteronomia) is observed in the 3rd phase of the cycle or in all phases of the cycle, the presence of the disease should be suspected. The reason for the violation may be:

• intrauterine bleeding of a pathological nature;
• absence of menstruation;
• cystic formations in the pelvic organs;
• malignant tumors of the uterus or ovaries;
• hepatic or;
• malfunction of the adrenal glands.

If hyperprogesteronomia is detected, it is necessary to undergo an examination under the supervision of a doctor.

Important! Some medical hormonal drugs, which cannot be avoided when treating some serious illnesses, cause an increase in progesterone. After completing the course hormonal background returns to normal.

Symptoms of high progesterone levels:

• sudden mood changes;
• chronic feeling of fatigue;
• irregular monthly cycle or no menstruation;
• may appear on the face and body;
• lower abdominal pain;
• migraine;
• decline ;
• speed dial weight;
• breast tenderness;
• problems with the gastrointestinal tract.

If tests show elevated progesterone levels

As with any hormone imbalance, you should consult an endocrinologist. Because the effect of progesterone on a woman’s body directly related to reproductive system, consultation with a gynecologist-endocrinologist is also necessary. After a thorough examination, the doctor will select a treatment regimen.

Methods to help reduce progesterone levels:

• special diet;
• drug therapy;
• physiotherapy;
• surgical intervention.

Decreased progesterone levels - normal and pathological

Lack of progesterone in women often resembles other health problems and may be accompanied by:

• increased blood pressure;
• sudden weight gain;
• causeless irritability;
• rapid fatigue;
• depression;
• menstrual irregularities.

Particularly dangerous lack of progesterone in women during pregnancy. The fertilized egg cannot properly attach itself in the uterus, the body is not ready for gestation, and a new one begins. As a result, the egg is rejected.

A decrease in progesterone after ovulation can cause some disorders:

• bleeding, except menstruation;
• rejection of a fertilized egg;
• the function of the corpus luteum is impaired;
• placental function is impaired;
• inflammation of the reproductive system, often chronic;
• pathologies of intrauterine development;
• post-term pregnancy.

How to normalize low progesterone

The method is selected by the doctor based on a detailed examination and identification of the root cause. How to increase progesterone in women:

• administration of progesterone solution intramuscularly or subcutaneously;
• taking oral medications in the form of tablets or capsules. The dosage and duration of the course are determined individually;
• use of vaginal hormonal cream and tablets.

Note. A slight deviation may normalize itself if you avoid stressful situations, get good sleep, reconsider your diet, spend more time on the move.

What is OH-progesterone

It is also called 17-OPG, 17-alpha-hydroskyprogesterone, 17-OH-progesterone and is not a hormone. OH-progesterone is a metabolic product from which hormones are formed. An increase or decrease in OH-progesterone during pregnancy is not a deviation from the norm.

Normal concentration of OH-progesterone in the blood

The analysis is prescribed on days 4-5 of the new cycle. Before the test, you should not eat for at least 8 hours. Normally its concentration will be:

• V follicular phase– 1.24-8.24 nmol/l;
• V ovulatory phase– 0.91-4.24 nmol/l;
• in the luteal phase – 099.11.51 nmol/l.

A decrease in He-progesterone occurs as the body ages. With the onset, its concentration can range from 0.39 nmol/l to 1.55 nmol/l.

An increase in 17-OH-progesterone is observed during pregnancy:

• up to week 13 its concentration is 3.55-17.03 nmol/l;
• from 14 weeks to 27 weeks – 3.55-20 nmol/l;
• from 28 to 40 weeks – 3.75-33.33 nmol/l.

Lack of OH-progesterone

Consequences of hormone deficiency can be:

• pseudohermaphrodism in boys, which is determined by pathology of the external genital organs;
• development of Addison's disease (adrenal cortex insufficiency).

Increased concentration of OH-progesterone

With an increase in 17-OH-progesterone, the following may develop:

• imbalance in the functioning of the adrenal cortex;
• neoplasms in the adrenal glands;
• ovarian tumors.

If an increase or decrease in the level of OH-progesterone is detected, the help of a specialist is necessary. This is the only way to avoid negative consequences and prevent the development of many diseases.