Progesterone: normal in women, symptoms ofincreased or decreased progesterone, causes of abnormalities

Update: October 2018

Progesterone – a unique female hormone, without which it is impossible
full life, successful conception and childbearing, as well as
breast milk feeding.

What is progesterone in the body?

All sex hormones perform many different functions.
Progesterone is synthesized in the ovaries, adrenal cortex, yellow
body and during pregnancy – the placenta. One of the most important
his tasks – the regulation of the menstrual cycle, or rather the alternation
ovulation and menstruation.

Classic normal menstrual cycle

On average, the duration of the cycle is 25-33 days, while
The main phases alternate:

  • follicular (proliferative) phase into which in the ovary
    matures the largest dominant follicle
  • ovulation when this follicle ruptures and exits
    eggs out
  • luteal (secretory) phase, when the endometrium is prepared for
    rejection and eventually comes out in the form of menstruation
  • menstruation (occurs after the fall of progesterone and
    estrogen)

It is this sequence that provides the woman with regular
monthly, updated endometrium and allows you to get pregnant.
The entire cycle is controlled by the hormones of the brain, ovaries and
some other bodies connected in a single system.

The main functions of progesterone

  • Preparation of the endometrium for implantation
  • Cervical mucus formation
  • Muscle relaxation of the uterus and genital tract
  • Stimulation of growth of mammary glands, preparation for development
    of milk
  • Antiestrogenic effects

The amount of hormone during and outside of pregnancy

The main thing you need to know about the amount of progesterone – it
constantly changing. Changes occur during the menstrual period.
cycle in non-pregnant, depending on the term of expectant mothers, and even
during the day. So, accurately measure the level of this important
substance is not possible. However, there are some
progesterone levels in women, accepted worldwide.

1-14 day MC 0.31-2.23 nmol / l (or until ovulation)
Ovulation 0.5-9.41 nmol / l
14-28 day MC 7.0 – 56.6 nmol / l (or from ovulation to menstruation)
In postmenopause (menopause) less than 0.6 nmol / l
In the 1st trimester of pregnancy 8.9 – 468.4 nmol / l
2 trimester 71.5 – 303.1 nmol / l
In 3 trimester 88.7 – 771.5 nmol / l

When does progesterone levels rise?

In some cases, the amount of hormone exceeds the norm for
this phase of the menstrual cycle. The reasons for this are like
variant of the norm, and a sign of pathology.

  • Pregnancy (normal)
  • VDCN (congenital dysfunction of the adrenal cortex)
  • Ovarian tumors
  • Bubble skid
  • Acceptance of progesterone drugs (Utrozhestan, Iprozhin)

The role of the hormone in the onset and maintenance of pregnancy

Pregnancy is considered to be a “progesterone-dominated” condition, then
there is a concentration of this hormone in the blood far exceeds
estrogen levels, at least up to a period of 34-36 weeks.

Progesterone provides endometrial preparation for attaching
of the ovum, and subsequently reduces the “reactivity” of the uterus, that is,
does not allow it to spontaneously decline under the action of estrogen. AT
As a result, a firmly attached embryo grows and develops.
right up to delivery. In addition, there is evidence of immunomodulatory
the properties of this substance, that is, the hormone indirectly protects
fetus from maternal immunity attack.

When a woman has progesterone elevation, the symptom
impaired digestion may appear already in the early stages. More often
total constipation occurs. This is a normal phenomenon.
changes in the work of the intestine under hormonal influence. With
deterioration of health usually help microclysters allowed for
pregnant women or taking Lactulose (Duphalac, etc.). After birth
baby digestion comes back to normal.

ATрожденная дисфункция коры надпочечников

ATДTOН или адреногенитальный синдром – наследственное заболевание,
which disrupts the synthesis of sex hormones in the adrenal glands.
Most cases of the disease are associated with mutations in the P450s21 gene,
this condition is inherited from both parents.

AT результате неправильной работы ферментов одни гормоны
the adrenal glands are not synthesized enough (cortisol, aldosterone), and
others are produced in excess (ACTH and sex hormones).

There are several forms of the disease, varying in degree.
severity and age of the first symptoms:

  • solter
  • simple virilna
  • non-classical

The first two forms are most often found immediately after birth.
With вирильной дисфункции у девочек имеется псевдогермафродитизм.
This change in the shape and size of the clitoris, sometimes even leading to
improper sex determination in the maternity hospital. With этом все внутренние
genitals (uterus, ovaries) have a normal structure. ATсем
patients need treatment, without which the primary develops
amenorrhea – that is, when puberty is reached, the periods are not
are coming.

The salt-loss form of the disease is even more severe. TO
pseudo-hermaphroditism increases electrolyte imbalance
– from the first days of life vomiting occurs, the body loses salt,
dehydration occurs. Without correct hormonal therapy baby
may die quickly.

Women with a third type of illness – non-classical form – usually
grow and develop perfectly normal. TO гинекологу или
endocrinologist is more likely to have a skin condition (acne), an increased
hair growth, rare menstruation and vain attempts to get pregnant.

Diagnosis – the main laboratory symptom of the disease, including
числе и неклассической формы (нATДTOН), является повышение уровня
17OH-progesterone. The rate for women is no more than 5 nmol / l. If this
value exceeds 15 nmol / l for 3-4 day cycle, then the diagnosis can be
put with high probability. With промежуточных значениях
additional samples with synacthen are often required when after
the introduction of 17OH-progesterone should not exceed 30 nmol / L.

We must not forget that 17OH progesterone may increase slightly
in the second phase of the menstrual cycle (after ovulation) and during
of pregnancy. Therefore, the definition of this substance in women in
position does not make any sense.

Лечение нATДTOН проводят только при выраженных косметических
defects (severe acne, for example) and with infertility. Usually
use oral contraceptives and corticosteroids. More
half of women with this non-classical form successfully conceive,
bear and give birth to children without any therapy.

With доказанной мутации необходимо проверить партнера на
similar violation. ATедь если дефект гена повторится у обоих
parents, the child may inherit including
the form of the disease is solitary.

Bubble skid

TO сожалению, уровень гормона увеличивается не только при
normal pregnancy, but also in a serious condition – blistering
skidding This happens if the egg is fertilized by two
sperm, or when the original maternal material
defective. AT этом случае ткани хориона активно «въедаются» в матку,
grow, secrete hCG. AT результате все гормоны беременности
repeatedly increased. This disease is usually easily diagnosed by
Ultrasound and the level of human chorionic gonadotropin. For treatment
successfully use chemotherapy, as there is a risk of rebirth
skidding in a malignant tumor.

Withем препаратов прогестерона

For treatment некоторых состояний или подготовке к ЭTOО часто
prescribe hormonal support. This may be an introduction.
progesterone or hCG drugs. And in fact, and in another case, the level
hormone in the blood plasma rises, so interpret it
can only a doctor.

TOогда снижается уровень гормона?

  • Threatened miscarriage
  • Galactorrhea-amenorrhea (absence of menstruation)
  • Failure of phase 2 of the cycle
  • Menopause

Threatened miscarriage

Failure in the development of the fetus immediately affects
hormonal background of a woman. With угрозе выкидыша плацента начинает
worse work, less secretes progesterone and other hormones.
Pregnancy and the onset of preterm labor can also
accompanied by a change in hormonal levels. But clear criteria,
by which you can distinguish between the rate and pathology, no. therefore
measurement of progesterone levels during pregnancy when there is
suspicion of threatened miscarriage, impractical. There are more
accurate and reliable methods (ultrasound, level
ХГЧ, TOТГ).

Galactorrhea amenorrhea

The combination of two main symptoms is cessation of menstruation and
выделение of milk из груди – обычно говорит о состоянии
hyperprolactinemia. This condition develops with tumors and
injuries of the pituitary gland, which leads to an increase in prolactin and a decrease in
sex hormones of the ovaries. Test data and MRI of the brain allow
confirm the diagnosis and prescribe treatment (bromkriptin).

Luteal (second) phase deficiency

Despite the different cycle length in women, its second phase is
The norm lasts 14 days. Exactly so much the yellow body lives after
ovulation. It is formed on the site of a torn follicle, actively
synthesizes progesterone up to its disappearance or transition
в желтое тело of pregnancy. Sometimes the luteal phase lasts less than 14
days, which leads to a shortening of the cycle and, possibly, problems with
carrying a child.

More often всего причиной такой дисфункции является нарушение обмена
substances. therefore дополнительно с бесплодием диагностируют
увеличение щитовидной железы (при гипотиреозе) или выделение of milk
from the chest (with hyperprolactinemia). These syndromes cause
hormonal failure, reducing the level of progesterone in the blood.

The main problem with NLF is a quick offensive
menses. That is, even if the egg is fertilized,
the ovum does not have time to attach to the uterus, as it rejects
together with the endometrium. Until now, scientists have not come to the final
concluding how badly defective the second phase reduces the percentage
successful conception. But if you suspect NLF along with the rest
hormones check and progesterone levels.

The diagnosis can be rejected if the gap from ovulation to
monthly lasts more than 11-14 days. With подозрении на НЛФ
in addition to the treatment of the underlying disease (thyroid,
hypophysis) may prescribe the administration of medicinal progesterone with
the purpose of the offensive and carrying of pregnancy.

Menopause

AT возрасте 45-55 лет в организме женщины происходят колоссальные
changes. Ovaries shrink, lose sensitivity
to hormones. AT результате снижается уровень эстрогенов и
progesterone. This leads to a change in mood, hot flashes,
decrease in libido, tendency to fractures and atherosclerosis.
The main symptom of menopause is the termination
menstruation. This age phenomenon is normal, but if
starts too early or is accompanied by a serious deterioration
If there is no risk of oncology, the doctor may prescribe
prescribes hormone replacement therapy with estrogen.

TOак сдавать анализ на гормон?

Despite the enormous role of progesterone in the body, the analysis on
it is still not very informative. The main problem is
daily variations and individual differences in the level of this
hormone.

It must be remembered that there are no exact signs of increase
уровня этого hormone. And if progesterone is lowered, the symptoms also
not. The numbers are not in the form of analyzes, but specific
signs of the underlying disease.

If the attending physician still prescribed a progesterone level test
in the blood, then for a reliable result you must comply
regulations:

  • With отсутствии других указаний анализ сдается на 22 день
    menstrual cycle
  • It is better to measure in the morning on an empty stomach (drink water
    permitted)
  • If it is not possible to donate blood in the morning, then before analysis
    It is advisable to abstain from eating for 6 hours, but not on the eve
    fatty foods

There are very clear indications for analyzing this hormone:

  • исследование гормонального профиля перед ЭTOО
  • absence of pregnancy for a year with suspicion
    luteal phase failure
  • 3 or more miscarriages with suspected progesterone deficiency

AT настоящее время определение уровня прогестерона чаще всего не
makes sense so you only need to apply this analysis
indications and recommendations by a specialist.

FAQ

At the gestational age of 9 weeks, I had a spot
spotting, after a day everything stopped. On ultrasound, everything in
norm The gynecologist says you need to take a progesterone test, and
with poor results, you should start using Utrozhestan in
candle light. Do you need this analysis?

Smearing spotting at this time may be
various reasons. If there was actually a threat of interruption,
especially with a normal ultrasound picture, then the analysis is not necessary.
Utrozhestan is prescribed in very limited cases, more often – with
habitual miscarriage. Half of women with threatened miscarriage successfully
continue pregnancy, while medicinal progesterone is not
plays no role.

Я на 6 неделе of pregnancy. ATчера и сегодня заметила снижение
basal temperature. Can this talk about the threat of miscarriage
(after all, progesterone levels have decreased, most likely)? TOакие меры
need to take?

Measurement of basal temperature in modern medicine does not have
no diagnostic value, like progesterone levels with
of pregnancy. The threat of interruption is manifested by clinical
symptoms: bleeding and abdominal pain. If in doubt, then
need to do an ultrasound. Most miscarriages at such an early date
not related to hormonal status, but occur due to
genetic damage in the embryo.

I am 28 years old. We are planning the first pregnancy. Do I need to take
hormonal profile? AT него в нашей лаборатории входят половые
hormones, TSH, LH, FSH and several others that need to be checked
on the 21st day of the cycle.

There is no need to be tested for hormones when planning.
(unless there are special, very narrow indications for this).
The only thing you need to see – the level of the TTG.

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