Norm 17 OH progesterone

The test rate for 17 oh progesterone varies depending on the gender and age of the patient, as well as on the duration of pregnancy in women. Table 1 shows the reference values ​​for 17-OH.

Table 1. 17 OH progestron, norm in men and women depending on age

In men over eighteen years of age, the norm ranges from 1.52 to 6.36 nmol/l.

In women, there is a correlation with the phase of the menstrual cycle:

• follicular 1.24–8.24 nmol/l;
• luteal 0.99–11.51 nmol/l.

Table 2 presents the reference values ​​of steroid content depending on the stage of pregnancy.

Table 2. 17 OH progesterone norm

Decoding the research results

When you have symptoms of adrenal pathology, you need to take a blood test. What can it reveal?

1. Normal hormone levels. If there are no deviations from the reference values, then there is nothing to be afraid of, there are no pathologies.
2. Slight increase in 17-OH concentration. This indicator is characterized by moderately severe adrenal hyperplasia. This disease is caused by pathological tissue growth. Enlargement of the adrenal glands threatens to disrupt the hormonal balance, which, in turn, entails a wide range of pathological abnormalities. It is extremely important to pay attention to this pathology when planning pregnancy. Congenital adrenal hyperplasia in children should be included in this category. For children with detected pathology, it is important to get tested for 17-OH periodically.
3. Significant increase in 17-OH concentration. It manifests itself mainly in newborns with prematurity or severe congenital adrenal hyperplasia. In this case, every effort must be made to reduce 17-OH levels.
4. Increased hormone levels can be observed in women with benign and malignant tumors. Such formations are usually localized in the ovaries or adrenal glands. It is important to pay attention to this group of pathologies, in which the following symptoms are detected: excessive hair growth, acne formation, menstrual irregularities. If such signs appear, it is recommended to be tested several times to monitor tumor growth and when planning pregnancy.

When 17 OH progesterone is elevated, in most cases it is necessary to undergo additional hormonal tests and prescribe treatment. Therapy for this pathological condition consists of taking hormonal drugs (dexamethasone, methylprednisolone). When consuming these medications, a slight weight gain is possible due to water retention in the body.

When a course of treatment with hormonal drugs is prescribed, it is important to repeat blood tests for 17 OH progesterone during pregnancy. This will help control the level of the steroid in the body and stop treatment in a timely manner when the norm is reached. When using hormonal therapy for pregnant women, it is important not to harm future children.

It is important to note that if the hormone level is elevated, a doctor of the appropriate profile should interpret the results and prescribe therapy. Self-administration of hormonal medications can not only lower steroid levels, but also cause significant harm to the body and lead to irreversible damage.

When is the test result downgraded?

• reduced 17-OH corresponds to the positive dynamics of treatment;
• Addison's disease (chronic adrenal insufficiency, often manifests itself in children), with this disease the adrenal glands lose the ability to produce hormones in the volume required by the body;
• pseudohermaphroditism in men (rare hormonal deviation).

When the test result is lowered, the main goal of therapy is to eliminate the source of the pathological decrease in the level of the steroid in the blood. Positive dynamics of the disease will allow the indicator to return to normal. Hormonal therapy in this case can only serve as support.

17-OH-progesterone is produced by the adrenal glands and is one of the regulators of sexual function and the menstrual cycle, affecting the ability to conceive and bear a child. Under normal conditions, its level in the blood is insignificant, and in the female body it is subject to significant fluctuations due to the menstrual cycle and pregnancy.

In the first phase of the cycle, 17-OH-progesterone is secreted by the ovaries in a small amount; by the middle of the cycle, its level increases slightly and remains unchanged throughout the second phase.

If fertilization and implantation of the embryo has occurred, the level of the hormone will begin to increase gradually, but if conception has not occurred, the value of 17-OH-progesterone will again decrease to a minimum at the beginning of a new phase of the cycle.

When is a test ordered?

Sometimes, if hormonal imbalances or hyperplasia (overgrowth) of the adrenal cortex are suspected, a blood test is prescribed to measure the level of 17-OH-progesterone.

This usually happens when:

• infertility in women with signs of hirsutism (increased body hair),
• for menstrual irregularities,
• if adrenal tumors are suspected.
• Sometimes a blood test is prescribed for children with suspected congenital adrenal hyperplasia (adrenogenital syndrome).

How the analysis is carried out

For women, a test for the level of 17-OH-progesterone is carried out in the first phase of the cycle, 3-5 days after the start of menstruation. Children are tested any day, in the morning, on an empty stomach.

Normal values ​​of 17-OH-PG

What do the results mean?

There may be three analysis options:

The level of 17-OH-progesterone is normal.

This means that hormonal abnormalities are not associated with the adrenal cortex or ovaries,

The hormone level is increased.

Hormone levels may increase with tumors of the ovary or adrenal glands.

Mild forms of hormone elevation usually result in menstrual irregularities and infertility.

An increase in the level of 17-OH-progesterone occurs with congenital adrenal hyperplasia in children and adults.

In children, this is usually a genetically determined pathology, transmitted in an autosomal recessive manner as a defect in one of the enzymes that allows hormones to be actively metabolized. As a result of a malfunction in this chain, testosterone synthesis and accumulation occurs. At birth, signs of virilization are revealed - an increase in male sexual characteristics in boys, with an enlargement of the penis and scrotum; in girls - signs of false hermaphrditicism - an increase in the clitoris and labia, mistakenly taken for the penis and scrotum. Children of both sexes also develop metabolic disorders with severe losses of potassium and sodium salts.

The level of 17-OH-progesterone is reduced.

This condition occurs with Addison's disease, congenital or acquired adrenal insufficiency. In addition, a decrease in the level of the hormone in men occurs in a state of false hermaphroditism - when the synthesis of progesterone is disrupted and because of this, the normal formation of the body according to the male type is disrupted.

General information about the hormone

17-OH-progesterone or hydroxyprogesterone is one of the intermediate products of hormone metabolism that belongs to the group of steroids.

It is formed from two precursors - progesterone and 17-hydroxypregnenolone, through complex transformations in the adrenal glands into the hormone cortisol.

Hydroxyprogesterone can also be produced in the placenta and genitals, where it is also converted into androstenedione (this substance is the starting point for the synthesis of either the male sex hormone testosterone or the female sex hormone -

Before donating blood for progesterone, preparation is important. Hormone levels can be affected by diet, stress, sexual contact, as well as bad habits and medications. All this should be excluded for the time being.

Why are women prescribed a blood test for progesterone levels?

A progesterone test is of great importance for determining the hormonal status of a woman planning a pregnancy. Progesterone is a female sex hormone. It prepares the uterus for the movement of a fertilized egg and the attachment of the fetus, being the key to a successful pregnancy. In addition, it adapts the pregnant woman’s nervous system to this period and to the birth of a child, helps the development of the mammary glands and the production of milk in them.

The concentration of the hormone increases rapidly during the ovulation phase until the follicle bursts and the egg is released. Next, the follicle transforms into the corpus luteum. The level of progesterone increases when the body is ready for the process of conceiving a child.

The amount of progesterone changes cyclically. It is observed when natural physiological processes occur, but it can also be the result of pathologies.

If the amount of progesterone increases sharply, this may indicate the following conditions:

• current pregnancy;
• the presence of a corpus luteum cyst;
• hydatidiform moles;
• failure of the kidneys and adrenal glands;
• malignant tumors;
• infertility;
• cirrhosis;
• obesity.

Some pathologies cause an increase in progesterone already in an advanced state, with long-term development, so such a symptom should under no circumstances be ignored.

If the hormone level has changed downward, this may mean the following:

• threat of abortion due to hormonal imbalances;
• likelihood of miscarriage;
• lack of ovulation;
• disturbance in the menstrual cycle;
• the appearance of severe bleeding from the vagina.

If a woman notices such symptoms, she needs to urgently consult a doctor, be examined and undergo the necessary tests.

A deviation in progesterone levels from the norm in men also means that not everything is in order in the body. Its increase is associated with infertility, testicular dysfunction, decreased libido and metabolic disorders.

Symptoms of high progesterone

Symptoms and signs of elevation may vary. They depend on the individual characteristics of the body, the general health of the patient and the degree of deviation from the norm. Typically the signs are expressed as follows:

• depressed state;
• constant fatigue;
• low blood pressure;
• painful sensations in the abdomen;
• absence of menstruation;
• headaches;
• obesity.

A similar clinical picture is possible with other disorders, therefore it is necessary to establish the exact cause of poor health. To do this, of course, you will need to undergo an examination. However, if pregnancy is confirmed, then such signs are normal.

Hormone functions

The adrenal glands and the corpus luteum of the ovaries synthesize the hormone progesterone. Under its influence, the endometrium is prepared to receive the embryo. The hormone is characterized by increased activity in the luteal phase, when the corpus luteum forms in the ovaries, which produces it. The body prepares for pregnancy, and if it does not, menstruation begins. The corpus luteum disappears without fertilization, and accordingly, the concentration of progesterone immediately decreases, whereas during conception its level increases tenfold.

The functions of the hormone are as follows:

• preparing the endometrium of the uterus for a new cycle or pregnancy;
• proliferation of the mucous layer of the fallopian tubes;
• auxiliary value in preparation for lactation;
• influence on the development of all organs of the child;
• suppression of the mother's immunity to prevent fetal rejection.

Progesterone is necessary for regular menstruation without disturbances and for the safe bearing of a child. It also participates in the intrauterine maturation of the baby. In addition, the hormone protects against mastopathy and also affects the breasts, or rather, their development.

Blood test for progesterone

Poor health, disrupted cycles, heavy menstrual periods and can warn of hormonal imbalance. You should definitely go to an endocrinologist or gynecologist-endocrinologist.

After a general examination, the woman is usually sent to the laboratory to donate blood for hormone levels. The decoding of the analysis, the results of which show progesterone differs from the norm, should be carried out by a doctor. He will evaluate not only this indicator, but the entire clinical picture as a whole.

Preparation

How to submit? It is recommended to do this on day 22 of the cycle. If you have irregular periods, it is best to consult a specialist. Typically, venous blood is donated after ovulation. To obtain accurate data on the time of egg maturation, you need to do an appropriate test.

When a woman is recommended to undergo a progesterone test, the doctor should tell her how to take it and how many days in advance to start preparing. Blood is always donated on an empty stomach after an eight-hour fast. It is noteworthy that this rule also applies to pregnant women.

How to prepare for the procedure? All medications are temporarily discontinued. The use of hormonal contraceptives is also prohibited. If medications cannot be discontinued due to general health, then their names and dosage should be indicated. This will help you know the result more accurately. Two days before donating blood, it is important to avoid sex, physical activity and stress.

If you suspect pregnancy, it is advisable to check the result again with a standard test. If it is confirmed, you should check with your doctor whether it is advisable to undergo the test.

You cannot donate blood after ultrasound, radiography, or fluorography procedures.

Determination of progesterone concentration is carried out using the enzyme-linked immunosorbent assay (ELISA). It is considered quite accurate. You can donate blood at any clinic; for this it is important to take a coupon or sign up in advance so that you don’t have to stand in line. Typically, several studies are carried out over the entire cycle, since the level of the hormone is very variable.

Analysis results

Based on the results of the progesterone test, which are obtained within an hour after donating blood, the gynecologist will accurately indicate the content and determine the period of pregnancy, if any. The attending physician must decipher the examination data and interpret their results, since he has complete data on the state of health, medical history, and the results of other examinations of his patient.

The follicular phase is characterized by 0.32-2.23 nmol/liter. During ovulation, the content changes and falls within the range from 0.48 to 9.41 nmol/liter. The luteal phase is marked by the highest values ​​- from 7.02 to 57 nmol/liter.

Normal values ​​vary greatly at different periods of the cycle and depend on the stage of pregnancy. When carrying a child, progesterone increases tens and hundreds of times. If the test does not reveal this during the expected pregnancy, it is better to retake it.

When progesterone levels suddenly drop, there is a risk of miscarriage.

In addition, a decrease in this hormone is manifested by a delay in intrauterine development of the child, diagnosed with postterm pregnancy, insufficient functioning of the placenta and corpus luteum, and inflammatory processes. Low progesterone levels during pregnancy are dangerous because they can cause hypoxia or lack of oxygen in the child, poor fetal development, and premature birth.

Experts, taking into account the results of laboratory diagnostics, can prescribe certain medications to replenish hormone levels in a certain period of the cycle or even during pregnancy.

Conclusion

Testing for the hormone progesterone is very important, especially for pregnant women. It provides body functions associated with childbirth, so its quantity must be carefully monitored to prevent the development of pathologies in the woman and the unborn child.

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Description

Determination method Immunoassay.

Material under study Blood serum

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17-OH progesterone is an intermediate product of cortisol synthesis in the adrenal glands.

17-OH-progesterone (17-hydroxyprogesterone) is a steroid produced in the adrenal glands, gonads and placenta, a product of metabolic transformations of progesterone and 17-hydroxypregnenolone. In the adrenal glands, 17-OH-progesterone (with the participation of 21-hydroxylase and 11-b-hydroxylase) is further converted into cortisol. In both the adrenal glands and the ovaries, 17-OH-progesterone can also be converted (under the action of 17-20-lyase) into androstenedione, a precursor of testosterone and estradiol.

17-OH-progesterone is characterized by ACTH-dependent diurnal fluctuations (similar to cortisol, maximum values ​​are detected in the morning, minimum values ​​at night). In women, the production of 17-OH-progesterone in the ovaries fluctuates during the menstrual cycle. The day before the peak of luteinizing hormone (LH), there is a significant rise in 17-OH-progesterone, followed by a peak that coincides with the LH peak in the middle of the cycle, after which there is a short-term decrease, followed by a rise that correlates with the levels of estradiol and progesterone. The content of 17-OH-progesterone increases during pregnancy. 17-OH-progesterone levels are age dependent, with high levels observed during the fetal period and immediately after birth (premature neonates have relatively higher 17-OH-progesterone concentrations). During the first week of life, 17-OH-progesterone levels fall and remain persistently low during childhood and rise progressively during puberty, reaching adult concentrations.

Deficiency of enzymes involved in the synthesis of steroids (in 90% of cases this is 21-hydroxylase deficiency) causes a decrease in the levels of cortisol and aldosterone and the accumulation of intermediate products, which include 17-OH-progesterone. A decrease in cortisol levels through feedback mechanisms causes increased production of ACTH, which in turn causes increased production of precursor molecules, as well as androstenedione, since the course of synthesis is shifted (“shunted”) in the direction of this, not blocked, metabolic pathway. Androstenedione in tissues is converted into active androgen - testosterone. Determination of 17-OH-progesterone (basal and ACTH-stimulated levels) is mainly used in the diagnosis of various forms of 21-hydroxylase deficiency and monitoring of patients with congenital adrenal hyperplasia (congenital adrenogenital syndrome).

Congenital adrenal hyperplasia is a genetically determined, autosomal recessive disease that develops in most cases due to deficiency of 21-hydroxylase, as well as due to deficiency of other enzymes involved in the synthesis of steroids. Enzyme deficiency can vary in severity. With congenital adrenal hyperplasia in infancy, virilization develops due to increased production of androgens by the adrenal glands; impaired aldosterone synthesis can be partially compensated by activation of regulatory mechanisms. In more severe cases, 21-hydroxylase deficiency causes profound disruption of steroid synthesis, aldosterone levels are reduced, and salt loss is potentially life-threatening. Partial enzyme deficiency observed in adults may also be hereditary, but it is initially minor and not clinically apparent (“hidden”). A defect in enzyme synthesis can progress with age or under the influence of pathological factors and cause functional and morphological changes in the adrenal glands, similar to the congenital syndrome. This causes disturbances in sexual development in the prepubertal period, and can also be the cause of hirsutism, cycle disorders and infertility in postpubertal women.

Limits of detection: 0.1 nmol/l-606 nmol/l

Preparation

Strictly on an empty stomach after an overnight period of fasting from 8 to 14 hours.

On the eve of the study, it is necessary to exclude increased psycho-emotional and physical stress (sports training), alcohol intake, and smoking an hour before the study. For women with an intact menstrual cycle, the study is performed on days 2-4 of the menstrual cycle, unless other conditions are specified by the attending physician.

When using the test for the purpose of dynamic monitoring of glucocorticoid therapy, it is advisable to adhere to the same period after taking the drug.

Indications for use

• Diagnosis and monitoring of patients with congenital adrenal hyperplasia and other forms of 21-hydroxylase and 11-hydroxylase deficiency.
• Hirsutism.
• Cycle disorders and infertility in women.
• Adrenal tumors.

Interpretation of results

Interpretation of research results contains information for the attending physician and is not a diagnosis. The information in this section should not be used for self-diagnosis or self-treatment. The doctor makes an accurate diagnosis using both the results of this examination and the necessary information from other sources: medical history, results of other examinations, etc.

Units of measurement in the INVITRO Independent Laboratory: nmol/l.

Alternative units: ng/ml.

Conversion of units: ng/ml x 3.03 ==> nmol/l.

Reference values

Level Up:

1. congenital adrenal hyperplasia caused by deficiency of 21-hydroxylase or 11-b-hydroxylase;
2. some cases of adrenal or ovarian tumors.

Note. It should be taken into account that 17-OH-progesterone is one of the metabolites of progesterone and its concentration may, to a certain extent, truly increase during the use of progesterone preparations.

Downgrade:

Addison's disease;

pseudohermaphroditism in men (17a-hydroxylase deficiency).