Progesterone Test and Its Importance in Female Fertility

A progesterone test checks the levels of progesterone in your body. You might need to go through this test as a part of a fertility test if you are having trouble getting pregnant. A progesterone test is the best way to check if you are ovulating. The level of progesterone is highest after ovulation. Therefore, it is usually checked either 18 to 24 days after the first day of your menstrual period or seven days before your next expected menstrual cycle.

If you are already pregnant, you may need this test to check how your pregnancy is going. Depending on the accepted normal levels of progesterone, a doctor checks if your progesterone level falls under the normal range or not. If you’ve suffered a miscarriage, stillbirth, or unusual bleeding, your doctor may also check your progesterone level to identify the cause, as it’s also known to support a healthy pregnancy.

A progesterone test is a simple blood test where the medical staff will take a blood sample from a vein in your arm, with the help of a small needle. After the needle is inserted, a little amount of blood will be collected into a test tube or vial. You may feel a little sting on your arm when the needle goes in or taken out. This process usually takes less than five minutes of time.

You don't need to take any special preparations for a progesterone test. But you can ask the doctor if you need to stop eating and drinking before coming for the test. Also, if you are taking any kind of medication, let your doctor know prior to the test. They will let you know if you have to stop the medication before the test or not.

The levels of progesterone vary according to your age, gender, health conditions, and at which stage of pregnancy you are getting it checked. The normal levels of progesterone (nanograms per milliliter (ng/mL)) at different stages in females are [2]:

In men, progesterone is found in much lower levels, the testes produce progesterone. Men need progesterone hormone to produce testosterone. The normal range of progesterone in men is 0.13–0.97 ng/ml

The doctors routinely check the progesterone level during fertility treatment and in early pregnancy to monitor the treatment and progress of ongoing pregnancy.

At present, there is not much evidence of side effects or conditions occurring due to high levels of progesterone. But it is believed that high levels of progesterone are responsible for symptoms of premenstrual syndrome (PMS) like mood swings, feeling bloated, and breast tenderness [3]. A recent study has also concluded that high levels of progesterone can cause issues with the fertilized egg attaching itself to the uterus and decidualization (the process where the uterine lining prepares itself for pregnancy) [4].

Moreover, high progesterone levels can also be a sign of certain disorders like Congenital adrenal hyperplasia (CAH), Certain ovarian tumors (ovarian cancer), Hydatidiform mole (a type of abnormal pregnancy-molar pregnancy), Ovarian cysts. If you are pregnant, a high level of progesterone either indicates twin pregnancy or molar pregnancy (pregnancy that takes place out of the uterus, it results in the death of the fetus or miscarriage).

Low progesterone levels, when you are not pregnant, indicate hypogonadism (a medical condition where ovaries are not properly functioning and are unable to produce sex hormones). It can cause many problems with your fertility and your conception. In pregnant women, low progesterone levels may lead to spontaneous miscarriage.

Yes, even though progesterone is often talked about in context with women, it is present in men as well. Men need this hormone to preserve their masculinity. Progesterone helps keep the estrogen levels in men balanced. Low levels of progesterone in men can lead to the following issues:

• Gynecomastia (man-boobs)
• Impotence
• Erectile dysfunction
• Reduced sex drive
• Weight gain
• Depression
• Fatigue

After ovulation, the corpus luteum (remains of the egg after ovulation) starts secreting progesterone that thickens the inner lining of the uterus and prepares it for implantation. When a fertilized egg reaches the uterus and attaches itself to the wall of the uterus, progesterone not only helps with the implantation but also maintains the lining throughout the pregnancy. The lining of the uterus is necessary as it produces essential fluids to nourish a pregnancy until the formation of placenta. It helps maintain a supportive environment for the growing fetus. In between the 8 to 10 weeks of pregnancy, the placenta takes over the production of progesterone from your ovaries and increases the production of progesterone as per the need during that stage of pregnancy [5]. Furthermore, progesterone is also necessary for the development of breasts and milk production.

Females who have low levels of progesterone hormone in their body may have irregular periods indicating irregular or absence of ovulation and struggle to get pregnant. Without the progesterone hormone, the body cannot prepare for implantation, making it difficult to conceive. Low progesterone levels during pregnancy increase the risk of pregnancy loss or miscarriage (sudden abortion).

If you notice spotting and bleeding during pregnancy, you need to consult your doctor immediately. Your doctor will conduct a blood test to check your progesterone levels. If progesterone level comes too low, you won’t be able to carry the baby to term.

Low progesterone level in the body is highly treatable. There are many ways your doctor can treat insufficient ovulation. If you are trying to get pregnant, then hormone therapy can be a good choice. Hormone therapy can increase the level of progesterone in your body, and it can also help thicken the lining of the uterus. It can improve your chances of having a healthy pregnancy and prevents miscarriage. It can also help with irregular periods and abnormal bleeding. Hormone replacement therapy can be taken as oral medicine or can be directly inserted into the vagina. Hormone Therapy includes-

• Oral Medications and Capsules: These medications are taken orally once a day.
• Injections: They are the oldest and most widely supplements. The solution is oil-based progesterone, and it is injected into the body through the buttocks once a day.
• Vaginal Gel: It can be used once a day. Many doctors prescribe it during IVF and other ART treatments.
• Vaginal Suppositories: These are solid medications that can be inserted directly into the vagina. They can be used 2 to 3 times a day as prescribed.

All IVF procedures involve giving the woman supplemental progesterone. Most of the time in IVF, progesterone is given via intramuscular injection or vaginally. The amount of progesterone and its duration depends on the patient.

There are some ways through which you can manage the levels of progesterone from home. You can introduce these ways in your daily lifestyle to improve your progesterone levels.

Avoid Overexercising:

Exercising too much can elevate the levels of stress hormones which in turn can lower the levels of progesterone in your body. Hence keep the exercising to a limit.

Manage Stress:

As mentioned earlier, high stress can cause progesterone levels to go down. Hence manage your stress levels. Try being in a stress-free environment and do activities like yoga and swimming. You can also try acupuncture as it is known to reduce stress to a good extent.

Add foods that help maintain the progesterone levels in the body:

Although food doesn’t contain progesterone in them, there are some foods that can stimulate the body’s production of progesterone. They are:

• Whole grains
• Cauliflower
• Beans
• Brussels sprouts
• Spinach
• Kale
• Broccoli
• Cabbage
• Nuts
• Pumpkin