Elevated progesterone in women: causes, symptoms, treatment and consequences
The content of the article:
- Causes of increased progesterone in women
- Symptoms of elevated progesterone in women
- Analysis for progesterone: preparation, timing, normal values
- Treatment of elevated progesterone
- Consequences of elevated progesterone in women
Progesterone is a sex steroid hormone that regulates the menstrual cycle and pregnancy in women, as well as human embryonic development. In men, progesterone affects the function of the prostate gland. This hormone belongs to progestogens (progestins) and is the main progestin in the body. Progesterone acts as an intermediate in the production of other steroids (including sex hormones and corticosteroids), is of no small importance for the functioning of the brain (as a neurosteroid). It is produced by the adrenal glands, corpus luteum, and during pregnancy - by the placenta. In the blood, the hormone is in both free and protein-bound state. A significant part of it is metabolized in the liver and excreted in the urine in the form of pregnandiol (progesterone metabolism product). Some of the physiological effects of progesterone are enhanced in the presence of estrogens.
Progesterone is an antagonist of the mineralocorticoid receptor, binding to which the hormone prevents its activation. It also acts as a partial agonist of the glucocorticoid receptor, has a stimulating effect on some liver enzymes (for example, cytochrome P450), especially in women during pregnancy.
With an increase in the concentration of progesterone, the activity of aldosterone, which retains sodium, decreases, which contributes to natriuresis (excretion of sodium in the urine) and a decrease in the volume of intercellular fluid.
Elevated progesterone is a physiological norm during pregnancy, it contributes to its preservation
Progesterone is involved in the formation and development of the pelvic organs, regulates blood viscosity. In women, it affects the formation of the mammary glands, and also, together with prolactin, their lobuloalveolar development during pregnancy, to ensure breastfeeding after childbirth. The hormone affects the development of the ducts of the mammary glands, mainly by inducing the production of amphiregulin (growth factor), and prevents the development of mastopathy.
Since many of its functions are associated with the preparation of the woman's body for pregnancy and the development of the embryo, progesterone is called the "pregnancy hormone":
- contributes to the preparation of the endometrium for the implantation of a fertilized egg;
- affects the vaginal epithelium and cervical mucus, reducing its permeability to sperm;
- maintains the tone of the cervix;
- blocks the development of follicles in the ovaries;
- reduces the immune response of the woman's body, which prevents the rejection of the embryo;
- reduces the contractility of the smooth muscles of the uterus;
- inhibits lactation during pregnancy, a decrease in hormone levels after childbirth triggers the process of milk production.
If pregnancy does not occur, the concentration of progesterone decreases, menstruation begins. In the absence of ovulation and the formation of a corpus luteum, low levels of the hormone can lead to anovulatory uterine bleeding.
Progesterone receptors (like estrogen receptors) have been found in the skin. During menopause and postmenopause, a decrease in the concentration of female sex hormones causes a decrease in the strength and elasticity of the skin, as well as its atrophy and thinning, which leads to an increase in the number and depth of wrinkles.
The activity of progesterone increases in the luteal phase of the menstrual cycle, since the corpus luteum begins to form in the ovaries, which intensively produces it. The hormone is synthesized in the luteal phase under the influence of luteinizing hormone, and during pregnancy, its production is influenced by human chorionic gonadotropin.
Starting from the first trimester of pregnancy, there is an increase in the level of progesterone in the blood, which is characteristic of the normal course of gestation, while a low content of the hormone in the early stages of pregnancy can lead to miscarriage. Progesterone contributes to the preservation of pregnancy at all stages.
Progesterone is a marker of steroid hormone metabolism, pregnancy progression, disorders of the hypothalamic-pituitary-ovarian system. Determination of its level makes it possible to diagnose the congenital form of hyperplasia of the adrenal cortex, insufficiency of the luteal phase of the menstrual cycle, and also to evaluate the effectiveness of progesterone therapy.
Causes of increased progesterone in women
The physiological reasons for elevated progesterone in women include the period of pregnancy.
A pathological increase is observed in the following diseases / conditions:
- menstrual irregularities;
- uterine bleeding;
- corpus luteum cyst (luteal cyst);
- violation of maturation and formation of the placenta;
- cystic drift;
- benign or malignant tumors of the ovaries and uterus;
- dysfunction of the adrenal glands;
- renal and hepatic impairment.
A slight increase in progesterone in women can be observed when taking oral contraceptives and some other drugs. If progesterone is elevated in the follicular phase, as a rule, this is a consequence of irrational use of drugs.
Symptoms of elevated progesterone in women
The main symptoms of elevated progesterone include:
- fatigue, lethargy, chronic fatigue;
- lowering blood pressure;
- swelling;
- headaches, migraines;
- dizziness;
- rashes on the skin of the face and trunk;
- deterioration of hair, seborrhea of the scalp;
- increased sweating;
- menstrual irregularities;
- swelling and soreness of the mammary glands;
- pain in the lower abdomen;
- disorders of the gastrointestinal tract (flatulence, constipation, diarrhea or their alternation);
- sharp weight gain.
In addition, women with an increased concentration of progesterone often have problems with concentration and memory, depression, neurosis, emotional lability, and panic attacks.
In some cases, there are no clinical signs of an increase in progesterone levels.
Analysis for progesterone: preparation, timing, normal values
If you suspect a deviation in the amount of progesterone, a laboratory blood test is prescribed to determine the level of the hormone.
To obtain reliable results for the analysis, you must properly prepare. Women should agree with the doctor on the day of blood sampling, depending on the phase of the menstrual cycle or the duration of pregnancy. On the eve of the study, fatty foods and alcohol are excluded from the diet. Blood should be donated in the morning (preferably before 11:00) on an empty stomach, after the last meal, at least eight hours should pass.
Antiestrogenic drugs increase the level of progesterone, decrease - combined hormonal contraceptives, some antibacterial drugs, prostaglandins. In case of taking any medication, it is necessary to inform the doctor about this before conducting the study.
Normal values of progesterone before age 18 are in the range of 0.15-28 ng / ml and depend on the Tanner stage or the phase of the menstrual cycle.
In women of reproductive age, the rate of progesterone in the blood depends on the phase of the menstrual cycle:
- 0.15-1.4 ng / ml - in the folliculin phase;
- 3.34–25.6 ng / ml - in the luteal phase;
- 0.34-0.92 ng / ml - when taking oral contraceptives.
In postmenopausal women, normal progesterone levels do not exceed 0.73 ng / ml.
In pregnant women, the rate depends on the duration of pregnancy:
- 11.2–90 ng / ml - in the first trimester;
- 25.6–89.4 ng / ml - in the second trimester;
- 48.4-422 ng / ml - in the third trimester.
In addition to the analysis for progesterone, a laboratory determination of the concentration of other hormones (prolactin, estradiol, testosterone, luteinizing and follicle-stimulating hormone, aldosterone, cortisol, adrenocorticotropic hormone), as well as a biochemical blood test, general blood and urine analysis, ultrasound examination of the pelvic organs, abdominal cavities, kidneys, adrenal glands.
Treatment of elevated progesterone
The choice of a treatment regimen for elevated progesterone in women depends on the reasons that caused it.
Medical correction is carried out strictly under medical supervision, self-medication is fraught with adverse health consequences. Most often, with elevated progesterone, oral contraceptives are used, which suppress the action of the hormone and reduce its level.
If a corpus luteum cyst is detected, a wait-and-see tactic can be chosen, in other cases, drug therapy is carried out (anti-inflammatory, absorbable drugs, vitamin therapy). In some cases, it becomes necessary to surgically resect a cyst or the entire affected ovary. As a rule, such treatment is resorted to in the presence of concomitant pathology or a high risk of complications.
Malignant neoplasms of the ovary are subject to surgical removal, followed by chemotherapy and / or radiotherapy.
Since increased progesterone is often accompanied by increased body weight, dietary adherence is recommended
A slight increase in progesterone can be corrected by diet. In addition, increased progesterone is often accompanied by an increase in body weight, which means that the diet should be aimed at normalizing it. Patients are advised to limit the consumption of milk, cottage cheese, hard cheese, meat, legumes, nuts, seeds, rice, sugar, flour products and fatty foods. You must eat enough vegetables (carrots, potatoes, onions, beets, parsley, green peas, bell peppers, cucumbers), fruits and dried fruits.
In addition to the main treatment, herbal medicine can be prescribed. With increased progesterone, decoctions and infusions of red rowan berries, wild carrot seeds, and peppermint are shown. Skin rashes are treated with a decoction of leaves, flowers or buds of carnations, chamomile flowers, etc.
Consequences of elevated progesterone in women
Treatment with elevated progesterone should be started immediately after the pathology is detected, since this condition can lead to the development of inflammatory kidney diseases, pathologies of the cardiovascular system, and osteoporosis.
With timely diagnosis and correction of elevated progesterone, the prognosis is favorable. If the level of progesterone is elevated for a long time, this can cause the development of obesity, infertility, neoplasms of the pelvic organs (lipid cell tumors, chorionepithelioma), adrenal diseases.
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Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
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