Progesterone test is done to check the levels of this hormone in your blood stream. It is one of the steroid hormones, mainly produced in your ovaries during the luteal phase of the menstrual cycle. Luteal is the second phase of your cycle that starts after the ovulation. It is secreted by the corpus luteum of the ruptured follicle and plays an important role in your periods as well as the in supporting a pregnancy in its early stages.
If the egg is fertilized by the sperm in during any menstrual cycle, Progesterone comes into action and starts to thicken the endometrial lining to prepare for implantation of the embryo. As long as the body continues to produce progesterone, the uterine lining will not shed (no menstruation) and no ovulation will happen.
Once the embryo is implanted in the uterus, this hormone will encourage more blood supply to the endometrium to support the growing fetus.
If, however, there is no pregnancy or it is lost at some point, the corpus luteum in the ovaries will be broken and consequently the level of progesterone in the body will drop, triggering menstruation and the beginning of a new period cycle.
Although mostly produced in corpus luteum, small amounts of progesterone are also made by the ovaries and adrenal gland. During pregnancy, the placenta also produces it.
Progesterone in women also plays a role in breast development and breastfeeding, along with estradiol.
In men, a small amount of progesterone is produced and it helps with the development of the sperm.
Other names for the hormone are corpus luteum hormone and the hormone of pregnancy.
What is the use of this test?
This test is done to check:
- The possible cause of infertility in women
- If it is the reason for multiple miscarriages
- The possibility of an ectopic pregnancy
- If you are ovulating or have recently ovulated
- The reason for irregular or missed menstruation
- The health of placenta and the fetus in a high-risk pregnancy
Progesterone is usually tested along with other fertility tests such as follicle-stimulating hormone (FSH) and luteinizing hormone (LH) to check the reason for abnormal uterine bleeding in women who are not pregnant.
When should you do this test?
Progesterone test is recommended by the doctor in any of the below situations:
- During infertility work-up to see if your ovulation is normal. The level of progesterone varies throughout your menstrual cycle so the test may be done a few times a month to check the ovulation status.
- In pregnant women, if a possible miscarriage is suspected because of spotting or abdominal pain.
- You may also do this test to find out if you’re still ovulating.
- If you need hormone replacement or extra progesterone injections to maintain your pregnancy.
- If you have a high-risk or an ectopic pregnancy.
Progesterone testing details
When to get the test done?
Progesterone levels in women vary throughout the menstrual cycle, so the test is done at a specific time in your cycle. Usually they recommend day-3 testing for this hormone but most doctors will accept the results anywhere from day 2 to day 4.
Depending upon the reason why you’re doing it, the test may also have to be repeated a few times during your cycle.
Sample requirement?
The test is typically done by drawing a small amount of blood from your arm and may even be done by spot testing with a blood drop.
At-home Progesterone testing is available in some locations; get in touch to learn more.
Preparation before Progesterone test
Certain drugs such as birth-control pills, some hormone supplements, steroids, etc. can affect the level of Progesterone in your body, so you will be asked to stop taking such medications 3-4 weeks before doing the test.
You must discuss your current medications with your doctor to see which ones to stop before the doing this test.
How long will the results take?
Most labs will give you the test result within 1-2 days; some will even turn in back in a few hours.
What if my Progesterone is low?
Low levels may cause:
- Irregular, overly heavy, or missed periods
- Frequent miscarriages
- Early labor
- Spotting or abdominal pain during pregnancy
- Lack of ovulation
- Headaches, mood changes
- Low sex drive
- Fatigue
Low progesterone may result in overly high estrogen levels, which may cause slow metabolism, sugar cravings, weight gain, and reduced sex drive in women.
What if my Progesterone is high?
High levels are typically not associated with any negative effects on your health; they are usually a sign of pregnancy.
Some studies suggest there may be a small risk of developing breast cancer because of high Progesterone.
How does Progesterone work?
An egg is released from your ovaries at around day 14 of your menstrual cycle every month and the remains of ruptured follicle from where that egg releases, are called the corpus luteum. It means ‘yellow body.’
This ‘yellow body’ is responsible for secreting Progesterone and relatively smaller amounts of estradiol.
In the female body, it comes into action if an egg is fertilized and its main function is to support the pregnancy in its early stages.
By stimulating growth of blood vessels that supply the endometrium (lining of the uterus), Progesterone helps the lining to grow thicker to allow the embryo to implant and be nourished as it grows there.
The hormone also prevents the body from ovulating (releasing new eggs) and the uterus from contracting, so it is easy for the embryo to implant.
Once you are pregnant, this also helps with the development of placenta, which in turn starts to secrete more progesterone to support the pregnancy further.
The levels of this hormone keep rising through the pregnancy as it further supports in:
- Development of maternal breast tissue
- Strengthening of the pelvic muscles
- Prevention of lactation
If there is no fertilization, the corpus luteum sheds, progesterone drops, and your period cycle begins again.
Besides the corpus and the placenta, it is also produced by the ovaries and adrenal gland.
The oral contraceptive pill that women take is made of Progesterone (sometimes in combination with estrogen), which prevent ovulation and hence, conception. It is also used in menopausal women to relieve the symptoms.
What are normal levels of Progesterone?
Serum progesterone levels are typically in the below ranges:
| Girls before puberty | 0.1 – 0.3 ng/ml |
| At the beginning of period cycle | 0.1 – 0.7 ng/ml |
| After ovulation (luteal phase) | 2 – 24 ng/ml |
| First trimester of pregnancy | 10 – 44 ng/ml |
| Second trimester of pregnancy | 22 – 83 ng/ml |
| Third trimester of pregnancy | 290 ng/ml |
| Post-menopausal women | < 0.2 ng/ml |
| Men | < 0.3 ng/ml |
Different labs may have different methods for doing this test and the results may vary. Discuss your results with your doctor to ensure you have an accurate understanding of what they mean.
What is the ideal level of Progesterone for IVF?
Typically, the expected level on the day of embryo transfer is around 10 – 12 ng/ml. Serum Progesterone levels above 20 ng/ml on ET day are associated with reduced birth rates.
What are the reasons for low Progesterone?
This hormone is produced in the body after ovulation, so anovulation is the main cause of low Progesterone. Other reasons include:
- PCOS: In severe cases of PCOS, ovulation may be impaired, hence, Progesterone remains low
- Hypothyroidism: This suppresses the ovarian function, affecting normal ovulation and hence, the production of this hormone
- Too little fat in females: Heavy exercise and a high-protein diet may result in unnatural fat-loss in the female body, which causes a hormonal imbalance, light or missing periods, anovulation resulting in low Progesterone
- Obesity: Even having too much fat throws off the hormonal imbalance, causes excessive estrogen production and low progesterone
- Stress induced amenorrhea: Chronic stress may cause lack of menstruation and ovulation and thus affect the level of progesterone in your body
What are the reasons for high Progesterone?
- Pregnancy: This is the most common reason for rising Progesterone levels, as the body needs this hormone to prepare your endometrium and stop further ovulation for a few months.
- Ovarian cyst: sometimes cysts are formed on the ovaries in the very follicle that ruptured to release the egg. This is known as the corpus luteum cyst and it may contain some blood. Such a cyst releases Progesterone, causing its levels to rise.
- Stress and adrenal problems: Chronic stress causes constant stimulation of your adrenal gland. It also affects the normal hormone production as hypothalamus perceives stress and reduces the stimulation of pituitary, which down-regulates the normal production of reproductive hormones. Some studies have suggested that post-stress measurement of Progesterone may not be accurate as stress causes the levels of this hormone to rise. Sometimes, during chronic stress, the body may start converting progesterone to cortisol.
- Molar pregnancy: This is an unusual situation in which the trophoblasts (precursor cells of the placenta) start growing abnormally, which causes higher-than-normal levels of progesterone in the female. This is a rare condition which usually occurs due to chromosomal abnormalities in the fetus.
- Ovarian cancer: Some tumors of the ovaries secrete high amounts of progesterone, which may be an indicator of a developing cancer.
For more information and to book your Progesterone test, get in touch using the red contact button on this page.
Resources:
University of Rochester Medical Center, Progestoerone, https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=progesterone
Kofinas, J. D., Blakemore, J., McCulloh, D. H., & Grifo, J. (2015). Serum progesterone levels greater than 20 ng/dl on day of embryo transfer are associated with lower live birth and higher pregnancy loss rates. Journal of assisted reproduction and genetics, 32(9), 1395–1399. https://doi.org/10.1007/s10815-015-0546-7
Herrera, A. Y., Nielsen, S. E., & Mather, M. (2016). Stress-induced increases in progesterone and cortisol in naturally cycling women. Neurobiology of stress, 3, 96–104. https://doi.org/10.1016/j.ynstr.2016.02.006