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Progesterone
Reproductive
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No Fasting Required
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Steroid hormone produced mainly by the corpus luteum in the ovary after ovulation
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Progesterone Test Information Guide
- Why is it done?
- Measures the level of progesterone, a hormone produced primarily by the ovaries in women and in smaller amounts by the adrenal glands and testes in men
- Assesses fertility and ovulation status in women trying to conceive, including confirmation of ovulation timing
- Evaluates irregular menstrual cycles, amenorrhea, and abnormal uterine bleeding to identify hormonal imbalances
- Monitors progesterone supplementation during hormone replacement therapy (HRT) or fertility treatments
- Diagnoses luteal phase defect or corpus luteum insufficiency affecting pregnancy maintenance
- Evaluates polycystic ovary syndrome (PCOS) and other endocrine disorders affecting reproductive health
- Monitors pregnancies at risk for miscarriage or ectopic pregnancy in early gestation
- Typically performed during the luteal phase (7 days after ovulation) or as specified by the healthcare provider for accurate interpretation
- Normal Range
- Women (Follicular Phase): Less than 1 ng/mL (or less than 3.2 nmol/L)
- Women (Luteal Phase): 5-20 ng/mL (or 16-64 nmol/L); levels peak at ovulation
- Postmenopausal Women: Less than 0.5 ng/mL (or less than 1.6 nmol/L)
- Men: 0.1-0.8 ng/mL (or 0.3-2.5 nmol/L)
- First Trimester (Pregnant Women): 10-50 ng/mL (or 32-160 nmol/L) and increases throughout pregnancy
- Normal progesterone indicates proper ovulation, adequate luteal phase function, and appropriate hormonal balance for reproductive health
- Measured in nanograms per milliliter (ng/mL) or nanomoles per liter (nmol/L); laboratory reference ranges may vary slightly
- Low progesterone suggests anovulation, insufficient luteal phase, or hormonal imbalance; elevated levels may indicate pregnancy, ovarian cysts, or excessive supplementation
- Interpretation
- Low Progesterone (<5 ng/mL in luteal phase): May indicate anovulation (no ovulation occurred), luteal phase defect, inadequate corpus luteum function, or early pregnancy loss risk. Requires further evaluation of fertility status and consideration of supplementation
- Normal Progesterone (5-20 ng/mL in luteal phase): Confirms ovulation occurred and adequate luteal phase function. Generally associated with normal menstrual cycles and appropriate hormonal environment for pregnancy
- Elevated Progesterone (>20 ng/mL when not pregnant): May suggest pregnancy, ovarian cyst (particularly luteal cyst), adrenal tumor, or excessive hormone supplementation. Warrants pregnancy test and additional imaging if indicated
- Progesterone Level >10 ng/mL in luteal phase: Generally considered confirmation of adequate ovulation with sufficient luteal function
- Very Low Progesterone (<0.5 ng/mL) at any time in non-menopausal women: Suggests absence of ovulation or ovarian dysfunction; may indicate PCOS, hypothyroidism, or other endocrine disorders
- Factors affecting results: Timing of menstrual cycle, pregnancy status, hormonal contraceptives, HRT, stress levels, body weight, medications (corticosteroids, anticonvulsants), and lab assay methodology
- Clinical significance of patterns: Progressive increase in progesterone across multiple cycles suggests ovulation; persistently low levels indicate anovulation or hormonal dysfunction requiring investigation
- Associated Organs
- Primary organs involved: Ovaries (corpus luteum) in women, adrenal glands (both sexes), and placenta during pregnancy
- Hypothalamic-pituitary-ovarian axis: Central control system regulating progesterone production through luteinizing hormone (LH) stimulation
- Common conditions associated with abnormal results:
- Polycystic ovary syndrome (PCOS) - presents with absent or low progesterone due to anovulation
- Luteal phase defect - inadequate progesterone production affecting endometrial development and implantation
- Ovarian insufficiency or premature ovarian failure - reduced ovarian follicles and progesterone production
- Thyroid disorders - hypothyroidism can impair ovulation and progesterone synthesis
- Adrenal insufficiency - reduced hormone production affecting progesterone from adrenal glands
- Functional ovarian cysts - can produce excess progesterone or interfere with normal ovulation
- Diseases diagnosed or monitored: Infertility, unexplained recurrent miscarriage, ectopic pregnancy, gestational trophoblastic disease, adrenal carcinoma, and reproductive endocrine disorders
- Potential complications of abnormal progesterone: Infertility, recurrent pregnancy loss, irregular bleeding, endometrial hyperplasia, unopposed estrogen effects, and increased risk of endometrial cancer if prolonged estrogen dominance
- Follow-up Tests
- Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) to assess pituitary-ovarian axis function if ovulation is uncertain
- Estradiol levels to evaluate overall reproductive hormone status and menstrual cycle phase
- Thyroid function tests (TSH, free T4) to rule out thyroid disorders affecting ovulation and progesterone production
- Testosterone and androstenedione if PCOS or hyperandrogenism is suspected
- Prolactin levels if amenorrhea or anovulation is present, as elevated prolactin inhibits ovulation
- Transvaginal ultrasound to visualize ovarian structure, confirm ovulation, detect cysts, and assess endometrial thickness
- Human chorionic gonadotropin (hCG) if pregnancy is suspected to confirm early pregnancy status
- Basal body temperature charting or ovulation predictor kit testing to correlate with serum progesterone results
- Semen analysis if male factor infertility evaluation is indicated alongside female progesterone assessment
- Repeated progesterone testing in subsequent cycles to establish pattern and confirm diagnosis, particularly for fertility assessment
- Monitoring frequency: For fertility patients, monthly testing during luteal phase until conception; for early pregnancy, serial progesterone measurements every 48-72 hours to assess viability
- Complementary tests for endocrine evaluation: Cortisol, ACTH, and imaging (CT or MRI) if adrenal pathology is suspected
- Fasting Required?
- Fasting: No - Fasting is not required for the progesterone blood test. The test can be performed at any time of day without food or beverage restrictions
- Special timing instructions: Test should be drawn 7 days after ovulation or 7 days before expected menstruation (approximately day 21 of a 28-day cycle) for accurate assessment of luteal phase progesterone
- Medications to avoid: No specific medications must be avoided; however, inform healthcare provider of all medications including hormonal contraceptives, HRT, anticonvulsants, corticosteroids, and progesterone supplements as these may affect results
- Other patient preparation requirements:
- Bring menstrual cycle calendar or documentation of ovulation date if known (from ovulation predictor kit or ultrasound)
- Wear comfortable clothing with easily accessible arms for blood draw
- Remain calm and relaxed before blood draw as stress can affect hormone levels
- Schedule test in morning if possible, as some hormonal variations occur throughout the day
- Inform phlebotomist and healthcare provider of pregnancy, if possible, as early pregnancy may elevate progesterone levels
- No exercise restrictions or activity limitations are required before or after the test
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