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What is a Progesterone test? 
Progesterone is a female hormone produced by ovaries that is responsible for maintaining the menstrual cycle in females and preparing the womb for pregnancy. Some amount of progesterone is also produced by the placenta in pregnant women.
The levels of this hormone increase in the female body after ovulation, ie in the second half of the menstrual cycle. During this time, the lining inside the womb thickens to receive a fertilised embryo. If conception does not occur, progesterone levels fall, and menstruation occurs. However, in case conception occurs, progesterone levels continue to increase and fluctuate during pregnancy. Therefore, a doctor may recommend checking the progesterone levels several times in the reproductive life of a woman.
The levels of progesterone in the blood at a particular time can be indicative of ovulation, ectopic pregnancy (unusual place of implantation in the womb) or failing pregnancy. They could also correlate with the mother's health and thus help in providing specific treatments for pregnancy-related conditions.

  1. Why is a Progesterone test performed?
  2. How do you prepare for a Progesterone test?
  3. How is a Progesterone test performed?
  4. What do Progesterone test results indicate?

A doctor may suggest a progesterone test for assessing the following situations: 

  • To confirm if the woman is ovulating
  • To check the status of the pregnancy if a woman has a history of miscarriages
  • To determine the reason for infertility, if any
  • To diagnose any suspected cancers or problems with the adrenal gland
  • To check the progress of infertility treatments

Sometimes, progesterone can be produced abnormally due to the presence of tumours in women as well as men. Therefore, a progesterone test may also be suggested for men. As it is a hormone mainly responsible for the maintenance of pregnancy, assessing its levels in high-risk pregnancies is useful for preventing miscarriage.

As many steroid supplements and birth control pills can interfere with the results of this test, you must inform your doctor if you are taking any supplements and medicines. This includes herbal supplements and over the counter medicines as well as other illegal drugs. Do not change the course of the medicines or supplements without the knowledge of the doctor.

Also, let the doctor know the date of your last menstrual cycle, as they may want to assess the levels of progesterone hormone in your blood at a particular phase of your cycle.

If you have undergone any thyroid or bone scans in the previous week, it is best to inform the doctor about it, as results can vary depending on this information.

It is a simple blood test which involves the collection of a blood sample from a vein in the arm.

  • First, an elastic band will be tied around your arm to make a vein prominent 
  • Then, using a sterile solution of alcohol, a site on the arm will be cleaned and sanitised
  • Blood will be collected from the vein using a sterile needle. At this point, some people tend to feel a slight stinging sensation due to the needle, which will fade away soon
  • At the end of the test, the blood sample will be collected in a clean tube, and a cotton gauze will be applied on your arm at the site of the puncture to stop bleeding
  • Finally, a bandage will be placed on the arm and the blood sample will be sent for further testing

Normal results: Results for a progesterone test are given in terms of nanograms per millilitre (ng/mL). The values vary according to the different phases of reproductive cycle. The following list gives details of phases and the corresponding normal values associated with them:

  • Prepubescent: 0.1-0.3 ng/mL
  • Adult, preovulatory phase: 0.1-0.7 ng/mL
  • Adult, postovulatory phase: 2-25 ng/mL
  • Pregnancy, first trimester: 10-44 ng/mL
  • Pregnancy, second trimester: 19.5-82.5 ng/mL
  • Pregnancy, third trimester: 65-290 ng/mL
  • Postmenopausal: less than 1 ng/mL

The abovementioned values may differ slightly from one laboratory to the other. Your doctor can explain what the values mean based on your age, background, gender, etc. Progesterone is mainly secreted in females only. Men have undetectable levels of progesterone. 

Abnormal results:

  • Higher than normal progesterone levels in a non-pregnant woman indicates the risk of a type of tumour in ovaries called chorionepithelioma or lipid ovarian tumour. Tumours of the adrenal gland could also be present
  • Higher than normal values in a pregnant woman could indicate the conception of twins or chances of abnormal growth in the womb, leading to molar pregnancy
  • Lower than normal values during pregnancy could be a sign of probable miscarriage or death of the foetus 
  • Lower than normal values in non-pregnant females could mean the absence of ovulation or menstruation (amenorrhoea); this could be due to a condition called hypogonadism.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.  

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References

  1. UF Health. [Internet] University of Florida Health, Florida, U.S. Serum progesterone
  2. Gerard J. Tortora, Bryan Derrickson. Principles of anatomy and physiology 12th ed. Wiley Publication; 2014. Chapter 28, Page no: 1069-1073
  3. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; Progesterone
  4. William J. Marshall, S. K. Bangert. Clinical Biochemistry: Metabolic and Clinical Aspects 3rd Edition Churchill Livingstone: Elsevier; 2014, Page no: 436-448
  5. UW Health. [Internet] UW Hospital and Clinics, University of Wisconsin Hospital and Clinics, Madison, Wisconsin. Progesterone
  6. UCSF health. [Internet] University of California.Serum progesterone