Progesterone – deficiency, excess. Progesterone in pregnancy [WE EXPLAIN]

In line with its mission, the Editorial Board of MedTvoiLokony makes every effort to provide reliable medical content supported by the latest scientific knowledge. The additional flag “Checked Content” indicates that the article has been reviewed by or written directly by a physician. This two-step verification: a medical journalist and a doctor allows us to provide the highest quality content in line with current medical knowledge.

Our commitment in this area has been appreciated, among others, by by the Association of Journalists for Health, which awarded the Editorial Board of MedTvoiLokony with the honorary title of the Great Educator.

Progesterone is a female sex hormone, secreted by the ovaries, adrenal glands, and the placenta. Progesterone has many functions in the body, including it is thanks to him that it is possible to implant the embryo in the uterus and maintain pregnancy. A decrease in its concentration with a properly prepared endometrium causes menstruation.

Progesterone belongs to a group of steroid hormones called progestogens. It is mainly secreted by the corpus luteum in the ovary during the second half of the menstrual cycle. Plays an important role in the menstrual cycle and in maintaining the early stages of pregnancy.

During the menstrual cycle, when the egg is released from the ovary during ovulation (around day 14), the debris of the follicle surrounding the developing egg forms a structure called the corpus luteum. This releases progesterone and, to a lesser extent, estadiol. Progesterone prepares the body for pregnancy if the released egg is fertilized. If the egg is not fertilized, the corpus luteum disintegrates, the production of progesterone decreases, and a new menstrual cycle begins.

If the egg is fertilized, progesterone stimulates the growth of the blood vessels that supply the lining of the womb (endometrium) and stimulates the glands in the endometrium to secrete nutrients that nourish the early embryo. The progesterone then prepares the lining of the womb to allow the fertilized egg to fertilize and helps maintain the endometrium throughout pregnancy.

In the early stages of pregnancy, progesterone is still produced by the corpus luteum and is needed for the maintenance of the pregnancy and the formation of the placenta. After this process, the placenta starts producing progesterone around weeks 8-12 of pregnancy. During pregnancy, progesterone plays an important role in the development of the fetus:

  1. stimulates the growth of maternal breast tissue,
  2. prevents lactation,
  3. strengthens the muscles of the pelvic wall in preparation for childbirth. 

The level of progesterone in the body rises steadily throughout pregnancy and right up to delivery. Although the corpus luteum in the ovaries is the main site of progesterone production in humans, progesterone is also produced in smaller amounts by the ovaries, adrenal glands, and, during pregnancy, the placenta.

Also read: How to help yourself during lactation?

The formation of the corpus luteum (which produces most of the progesterone) is triggered by an increase in the production of luteinizing hormone by the anterior pituitary gland. This usually happens around day 14 of the menstrual cycle and stimulates the release of an egg from the ovary and the formation of a yellow body. The corpus luteum then releases progesterone which prepares the body for pregnancy. If the egg is not fertilized and the embryo is not fertilized, the corpus luteum disintegrates and the production of progesterone decreases.

As the uterine lining is no longer supported by progesterone in the corpus luteum, it breaks down and menstrual bleeding occurs, signifying the start of a new menstrual cycle. However, if an ovulatory egg is fertilized and an embryo is formed, the cells surrounding that early embryo (intended to form the placenta) secrete human chorionic gonadotrophin (HCG).

This hormone has a very similar chemical structure to the luteinizing hormone. This means that it can bind to and activate the same receptors as luteinizing hormone, which means that the corpus luteum does not break down and instead produces progesterone until it produces a placenta.

See: When is the best time to do a pregnancy test?

Your doctor may check your blood for progesterone if:

  1. suspects the appearance of tumors secreting progesterone or placental gonadotropin in women and men,
  2. a pregnant woman requires administration of progesterone (assessment of the effectiveness of the treatment),
  3. wants to confirm ovulation or assess its occurrence after the implemented treatment,
  4. wants to monitor the course of pregnancy,
  5. there is a need to diagnose infertility,
  6. a healthy woman has irregular and abnormal menstrual bleeding,
  7. it is necessary to monitor the development of the placenta,
  8. differentiates hypogonadism in women,
  9. a woman complains of symptoms such as abdominal pain and vaginal bleeding,
  10. pregnancy is at risk.

The test consists of a single blood collection from the ulnar vein (the material for the test is serum) in the case of men, and several times of blood sampling in various phases of the cycle in women. The examined person should be fasting for at least eight hours.

Time to wait for the result: 1 Day.

See also: Irregular periods can herald heart disease

The role of progesterone during pregnancy is extremely important. Testing this hormone allows you to assess the development of the fetus and the function of the placenta. A constant supply of progesterone to the endometrium continues to help nurture the developing fetus throughout pregnancy. Following successful implantation, progesterone also helps maintain an environment that supports the developing fetus.

After 8 to 10 weeks of pregnancy, the placenta takes over the production of progesterone from the ovaries and greatly increases the production of progesterone. It is worth bearing in mind that too little progesterone often leads to miscarriages. Progesterone testing in conjunction with beta HCG testing is performed when diagnosing an ectopic pregnancy or its loss.

progesterone-normal

The norms of progesterone for healthy women are as follows:

  1. follicular phase: 0,057-0,893 ng/ml,
  2. ovulatory phase: 0,121-12,0 ng / ml,
  3. faza lutealna: 1,83-23,9 ng/ml,
  4. after menopause: <0,05-0,126 ng / ml.

Progesterone in pregnancy – norms:

  1. I trimester: 11,0-44,3 ng/ml,
  2. II trimester: 25,4-83,3 ng/ml,
  3. III trimester: 58,7-214 ng/ml.

Progesterone reference values ​​depend on many factors, e.g .:

  1. study population,
  2. age,
  3. gender,
  4. determination methods.

Each test result should contain the reference range for a specific assay. The analysis of the results also depends on the phase of the cycle in which it was performed and whether the woman is pregnant. During ovulation and early pregnancy, progesterone levels increase.

See also: What Happens at 34 Weeks of Pregnancy?

Progesterone – Interpretation of Results

Progesterone may be too high or too low. Very high progesterone concentration occurs:

  1. in multiple pregnancy,
  2. in pregnancy complicated by a mole,
  3. in people with liver failure,
  4. in the case of ovarian cysts,
  5. with a tumor of the adrenal glands, testicles and ovaries,
  6. in PCOS (polycystic ovary syndrome),
  7. as a symptom of adrenal-genital syndrome,
  8. sometimes in ovarian cancer.

High progesterone levels usually do not cause any negative health effects. Nevertheless, in pregnancy, it can cause mood swings, stuffy nose, constipation, breast tenderness, and overall body fatigue.

Read: Constipation in pregnancy – how to deal with it?

Low levels of progesterone in pregnancy (as previously mentioned) increase the risk of miscarriage or may indicate an ectopic pregnancy. However, the lack of changes in its concentration during the menstrual cycle means that ovulation does not occur. In women in late pregnancy, low progesterone levels may be associated with pregnancy poisoning or pre-eclampsia. Placental abnormalities as well as ovarian or testicular non-deformation are also mentioned among other causes of low progesterone.

After all, too little progesterone leads to infertility. The skin becomes dry and the hair falls out excessively. Insulin levels fluctuate, making it difficult to maintain a healthy body weight. Women who have low levels of this hormone have a higher risk of PMS (premenstrual syndrome).

A large drop in progesterone can be observed in women during the menopause, i.e. the period in which the female body prepares for the loss of ovarian function. It is associated with many unpleasant symptoms, incl. nervous tension, problems with defecation, swelling, palpitations, headaches and breast pains or discomfort in the lower abdomen.

During the climacteric period, menstruation is long, heavy and irregular. In addition, women suffer from bothersome hot flashes and vaginal dryness, which is unfortunately accompanied by decreased libido.

Low Progesterone – Hormone Therapy

Low progesterone levels may not produce any symptoms. However, if your progesterone levels are below normal in your tests and you are planning a pregnancy, hormone therapy may be useful. Hormone therapy increases progesterone levels and can help thicken the lining of the uterus, which increases your chances of becoming pregnant.

Moreover, thanks to this therapy, irregular menstruation can be normalized. For severe menopausal symptoms, hormone therapy usually involves a combination of estrogen and progesterone. Women taking estrogen without progesterone have an increased risk of developing endometrial cancer.

Treatment options for progesterone supplementation include:

  1. creams and gels that can be used topically or vaginally,
  2. suppositories,
  3. oral medications.

Hormone therapy (estrogen only or a combination of estrogen and progesterone) can help relieve symptoms such as:

  1. hot flushes,
  2. night sweats
  3. vaginal dryness

In some women, progesterone improves mood. Oral progesterone may have a sedative effect and make it easier to fall asleep.

However, it’s important to remember that hormone therapy can increase the risk of:

  1. heart attack and stroke
  2. blood clots
  3. gallbladder problems
  4. breast cancer.

Hormone therapy is inadvisable if you are struggling or have had in the past:

  1. breast cancer
  2. endometrial cancer
  3. liver disease
  4. thrombotic disease.

Natural remedies that can raise low progesterone levels include:

  1. increasing the consumption of vitamins B and C, which are necessary to maintain the proper level of progesterone,
  2. foods rich in zinc,
  3. controlling stress levels, because when we are stressed, the body releases cortisol instead of progesterone.

Progesterone is generally not replenished in women who experience menopausal symptoms of a hormonal imbalance. This is because menopausal symptoms are most often caused by low estrogen levels.

Progesterone in men

In men, progesterone is produced in small amounts by the testes and adrenal glands. Its test is usually performed to diagnose congenital adrenal hyperplasia (then there is an increase in progesterone) and in the case of damage to the pituitary or hypothalamus (then its concentration is reduced).

Standards: 0,2-1,38 ng/ml.

The content of the medTvoiLokony website is intended to improve, not replace, the contact between the Website User and their doctor. The website is intended for informational and educational purposes only. Before following the specialist knowledge, in particular medical advice, contained on our Website, you must consult a doctor. The Administrator does not bear any consequences resulting from the use of information contained on the Website.

Leave a Reply