People tend to underestimate the importance of hormones. But a slight excess or decrease in the concentration of these substances can have a tremendous impact on a person's life. In this article, we will talk about one of the main hormones in a woman's body - progesterone, how it affects pregnancy and what its normal amount should be in the body.
What it is?
Progesterone is a steroid hormone. It is also called a progestogen. He actively participates as an intermediary in the formation of other hormones, both sex and corticosteroids. Progesterone helps the brain function properly by acting as a neurosteroid.
The hormone is present in both men and women, however, in the female body, progesterone receives broader functions, combined with female sex hormones - estrogens. For men, this hormone helps in the implementation of the reproductive function - it affects the quality characteristics of sperm, providing them with greater mobility when passing through the path to the egg. For women, progesterone plays a critical role, allowing to bear and give birth to a child.
Progesterone regulates menstrual cycles. If the hormone level is low, then ovulation may not occur. It affects women's beauty, in particular, the health of the skin, its elasticity.
So, in menopause, when this substance in a woman's body becomes scarce, the skin begins to fade, age. Adequate hormone levels ensure sex drive.
Role in carrying a baby
It is no coincidence that progesterone is called the pregnancy hormone. Without this substance, the normal development of the embryo in the early stages would be impossible. After fertilization has taken place, the hormone takes over the function of the protector and "guardian" of the future baby. He prepares the walls of the uterus for implantation of the ovum, softens them, transfers them to the secretory stage.
At the same time, progesterone causes thickening of cervical mucus, tightly closing the entrance to the uterine cavity for both sperm and microbes. All these metamorphoses occur during the first 6-7 days after conception, while the fertilized egg has not yet completed its journey into the uterine cavity.
This entire process is repeated monthly, regardless of whether fertilization has occurred. If there is no pregnancy as such, the level of the hormone begins to decline and the next menstruation begins.
If fertilization has occurred, then the blastocyte will descend into the environment prepared for it, where it will be easier to gain a foothold (implant) and begin to develop rapidly.
From this moment, progesterone begins to perform its protective and protective functions. It is produced in large quantities and somewhat suppresses the woman's immune system so that it does not reject the embryo. In fact, the embryo is half foreign to the female body, and her immune defenses cannot ignore this. Progesterone has an immunosuppressive effect that helps preserve the baby.
All women know how dangerous is hypertonicity of the muscles of the uterus during pregnancy. A normal progesterone level can partially solve this problem. It relaxes the smooth muscles of the female genital organ, relieves spasms, and reduces the risk of abortion. At the same time, progesterone stimulates the physical growth of the uterus during the period of gestation.
When carrying a baby, progesterone "Inhibits" the production of breast milk. Nobody needs it yet, but a woman needs to accumulate reserves of vitamins and nutrients. Therefore, lactation is temporarily inhibited. After childbirth, when progesterone levels drop, the body receives a "signal" that lactation is no longer prohibited and milk begins to be produced.
"Pregnancy hormone" softens the pelvic muscles and ligaments before childbirth to facilitate the passage of the baby through the birth canal. Throughout pregnancy, the hormone has a significant effect on the woman's nervous system, and is also directly involved in the formation of certain tissues in the embryo.
All 9 months this important hormone stimulates appetite in pregnant women, promotes fat deposition, to provide mom and baby with a supply of nutrients. That is why the waist of expectant mothers increases in girth. The movement of food through the intestines slows down, again under the influence of progesterone, so that the female body has time to take from it as much nutrients, minerals and vitamins as possible.
Thus, a sufficient level of this hormone allows pregnancy to occur, proceed easily, without complications. Hormonal imbalance, lack or overabundance of a substance can have a negative effect on reproductive functions.
How is the analysis done?
The concentration of progesterone in the body of a pregnant and non-pregnant woman is determined by a blood test, which is carried out by the ELISA method. If a woman does not manage to get pregnant for a long time, the doctor will definitely offer such an analysis, because the low level of the hormone when planning pregnancy interferes with normal ovulation and implantation of a fertilized egg. For those planning a pregnancy, the doctor prescribes the day of blood donation, depending on the duration and characteristics of the cycle. Usually the analysis is done on days 21-23 of the cyclebut there may be exceptions. So, a woman who usually has very scanty periods can be prescribed an analysis from the 15th day of the cycle.
Pregnant women can donate blood to determine the concentration of progesterone on any day. To get more accurate results, you need to prepare. 12 hours before visiting the laboratory, a woman should refrain from smoking and drinking alcoholic beverages, exclude physical activity and limit herself to food intake. If the woman is taking any medication, give them up in a few days. If this is not possible, then you should inform the laboratory assistant what medications are taken and in what dosage.
You should not take a blood test for progesterone immediately after ultrasound, fluorography, X-ray. You should go to the treatment room in the morning, on an empty stomach, after making sure that your health "will not let you down" - there is no temperature, intestinal disorders, respiratory symptoms that may indicate ARVI or another infection.
The amount of progesterone, especially in early pregnancy, can indicate the exact timing of the gestation of the baby, but usually this method of determining the date of conception is not used. There are simpler and more informative analyzes - hCG, for example. Blood for progesterone can be prescribed as a diagnosis:
- if you suspect an ectopic or frozen pregnancy;
- with the threat of miscarriage;
- when planning a pregnancy to establish the exact time of ovulation;
- in the treatment of infertility;
- with pathologies of the placenta in pregnant women (analysis in dynamics allows you to monitor the state of the "child's place");
- if a cyst or tumor is found in a woman on the reproductive organs, especially if the pathology is combined with pregnancy;
- before replanting and after embryo transfer with IVF;
- to control the condition after a woman has been treated with progesterone drugs.
Weekly rates
In different laboratories, the concentration of progesterone in a woman's blood is determined in different units. As a result of the analysis, after the numerical value can be "ng / ml" (nanogram per milliliter) or "nmol / L" (nanomole per liter). To get the value of progesterone in nmol / liter, you should carry out simple mathematical calculations - multiply the ng / ml value by 3.18.
To save our readers from having to calculate the dosage, we have compiled table of normal values of progesterone levels by week in two units:
Thus, on average, the norm in the first trimester of pregnancy is about 11.2-90.0 ng / ml, in the second - 25.6-89.4 ng / mg, and in the third - 48.4-422.5 ng / mg. For the period of ovulation, when planning pregnancy, a concentration of 0.8-3.0 ng / mg is considered normal.
Do not expect the laboratory assistant to write if there are deviations in the indicators of this hormone, and what they are associated with. Deciphering the analysis is the doctor's task.
Reasons for deviations
If during pregnancy or before the onset of the progesterone level differs from normal values, then this is a reason to look for the true cause and start treatment.
Elevated level
If the analysis showed that the progesterone in the pregnant woman is high, exceeding the norms indicated in the table, then there may be several reasons for this. An increased concentration of the hormone is observed in pregnant women with twins or triplets. It is clear that in the first days of pregnancy there will be no difference, but already at 4 months of pregnancy (from about 15-16 weeks), each fetus will "acquire" its own placenta, and each placenta will produce progesterone. There is nothing strange in the fact that the hormone in the woman's blood will be more.
Much depends on the period in which the child is bearing the increase in progesterone. For example, its insignificant excess at 5-6 weeks does not mean anything pathological, and at the end of the second and third trimester, high values may indicate that the placenta matures too slowly.
An increased level of progesterone may indicate the presence of tumors, neoplasms in the adrenal glands, ovaries, and also with cystic formations. Abnormally high progesterone levels early in pregnancy may be a sign of a hydatidiform mole. This term refers to abnormally past fertilization, in which cysts develop in the uterine cavity, resembling a bunch of grapes. This cluster grows rapidly, causing a significant rise in progesterone levels.
An excess of progesterone accompanies choriocarcinoma - a tumor of the uterus, which can develop after childbirth, with an ectopic pregnancy. Also, the level of the hormone will be increased in women who have taken or are taking hormonal drugs, for example, "Duphaston" to maintain pregnancy when threatened. An increased level of the hormone can also be found in pregnant women suffering from kidney and liver problems.
Thus, exceeding the indicators must necessarily be considered by a doctor. To find out the exact reasons, a whole complex of additional examinations is prescribed - ultrasound of the pelvic organs, kidneys, liver, blood and urine tests, consultations of related specialists will also be required - a gastroenterologist, nephrologist, oncologist and reproductologist.
Reduced values
A low level of progesterone in comparison with the norms may be a sign of insufficiency of the corpus luteum if the analysis was carried out during the planning period of pregnancy or in the very first weeks after fertilization. Lack of the hormone prevents normal implantation, even if fertilization was quite successful. Even if the blastocyte can gain a foothold in the uterine wall, then there is no guarantee that a decrease in the hormone in the early stages will not lead to a miscarriage.
It is possible to become pregnant against the background of a reduced level of the hormone progesterone, but here it is not always possible to maintain a pregnancy without the help of doctors. At a later date, when the placenta is formed, an insufficient level of progesterone may indicate that the "child's place" is underdeveloped and does not cope well with its direct responsibilities - to nourish and protect the child. The lack of an increase in the level of the hormone may indicate a high probability of spontaneous abortion.
Lack of progesterone leads to uterine bleeding of varying intensity. A very slow growth of the hormone in the blood of a pregnant woman speaks of placental insufficiency, in particular, that the "baby's place" produces too little of the hormone that is so necessary for prolongation of pregnancy.
A reduced level of progesterone in a woman who is still preparing for a future pregnancy may indicate that ovulation does not occur, especially if estrogen levels are elevated. A disappointing result of the analysis also occurs in women with insufficiently developed sex glands, ovarian dysfunction.
If progesterone levels are below normal throughout pregnancy, this may indicate about fetal growth retardation. Such laboratory data are confirmed by the results of ultrasound - the baby in terms of fetometric indicators is far behind the values normal for a certain period of pregnancy. And a sharp drop in the level of progesterone occurs during a frozen pregnancy, when the fetus, under the influence of certain factors, stops growing, dies, and there is no miscarriage.
Antibiotics, oral contraceptives, epilepsy medications, and some hormonal medications can lower progesterone levels.
Symptoms
A pregnant woman herself may suspect a lack or excess of progesterone in the body herself, even before receiving a referral for a laboratory blood test. Many planning a pregnancy and women in the early stages measure the basal temperature daily. Lack of hormone may indicate low temperature in the rectum. Excess and deficiency of the hormone have their own symptoms.
Disadvantage
Progesterone deficiency is manifested by weight gain, especially fat is deposited in the abdomen. During menstruation before pregnancy, a woman with a reduced hormone level experiences quite severe menstrual pain.
With a lack of progesterone decreased sex drive, and headaches are often observed. A woman in the early stages may experience frequent severe mood swings. Lack of progesterone is inherent in a constant enduring feeling of fatigue, lethargy. Sleep can be disrupted, hair becomes oily, and ugly age spots and acne appear on the skin.
Insufficiency of the level of progesterone during pregnancy can be indicated by atypical for the "interesting position" bloody and bloody discharge from the genitals, edema, as well as polyhydramnios or oligohydramnios. The uterus in the early stages (up to 12 weeks) is in good shape, a woman may experience pain in the lower abdomen and lower back.
The reasons for progesterone deficiency can be poor nutrition of the expectant mother, a lack of vitamins and minerals, bad habits - smoking, alcohol or drugs, severe stress, anxiety, stopping hormonal contraceptives in the month preceding pregnancy.
Oversupply
An excessive amount of progesterone in the process of carrying a child in the earliest stages can be indicated by migraine-type headaches, decreased visual function, a feeling of severe fatigue and apathy. Quite often, an overdose of this substance is not felt by a woman at an early stage at all. And this is the main danger of the situation.
An excess of progesterone in the first weeks may indicate severe toxicosis, when a woman is not even sick of food, but only from its one smell.An unpleasant symptom such as hair loss in a woman, as well as too rapid weight gain, can indicate an elevated hormone level exceeding normal values. An increase in the hormone in the second and third trimester of pregnancy is especially dangerous, because this may be a sign of malfunctioning of the placenta.
High concentrations of progesterone in the middle and at the end of pregnancy can indicate premature aging of the "child's place", which means that the child does not receive the nutrients that he needs for growth and development. Aging prematurely, the placenta can even cause the death of the baby.
Swelling of the legs, ankles is the most common symptom of an increase in progesterone in the blood of a pregnant woman. That is why obstetricians-gynecologists are so attentive to the signs of gestosis. Oily acne, which covers the body and face of the expectant mother, as well as oily seborrhea, can also speak of an imbalance in the hormonal balance with an increase in progesterone. The mammary glands do not just swell and enlarge, which is typical for all pregnant women, they begin to hurt a lot. The woman has severe problems with the work of the intestines.
From the point of view of the impact on the psyche of the expectant mother, an excess of progesterone can make a quiet and peaceful woman an aggressive and unrestrained person - the hormone provokes bouts of anger, which are replaced by periods of apathy and unwillingness to see anyone, as well as panic attacks and depression.
The reasons for the increase in the level of the hormone in excess of the permissible norms during pregnancy can be severe stress, disturbances in the functioning of the kidneys and liver, problems with the thyroid gland... In any case, the approach to finding reasons is individual for each expectant mother.
Treatment
Insufficient progesterone levels are considered more dangerous than exceeding them, especially in early pregnancy. Therefore, a woman who wants to bear and give birth to a healthy child cannot do without medical assistance. Treatment in case of shortage and excess of the hormone is prescribed differently.
Failure
Regardless of the reasons why the level of progesterone was reduced, the woman is advised to calm down. And this is not a doctor's on-call advice "for all occasions." Stress in the body of a pregnant woman increases the level of another hormone cortisol, which is also called "stress hormone". He is a kind of "competitor" of progesterone, and begins to quickly suppress the production of his "opponent".
Women who are in a stressful situation (divorce, death of a loved one) are prescribed mild sedatives, herbal remedies.
With the threat of miscarriage, if the deficiency of progesterone is accompanied by obvious symptoms, the woman is hospitalized and treated in a hospital setting. Rest and maximum rest, full and long sleep are important. To replenish the insufficient level of the hormone, drugs are prescribed that contain the necessary substance - "Utrozhestan", "Dufaston" or "Endometrin"... The specific drug should be prescribed by the doctor, taking into account the severity of the progesterone deficiency.
At the same time, the treatment regimen includes preparations containing magnesium, zinc and vitamin B 6. This "trio", when interacting with each other, promotes the production of its own progesterone. To relieve the tone of the smooth muscles of the uterus, use antispasmodic drugs ("No-shpu", "Papaverine").
A blood test for the concentration of this hormone is carried out in dynamics - once a week or once every 2 weeks in order to track the slightest changes in the body of the expectant mother.
It is important for a pregnant woman with low progesterone during and after treatment to eat right, in no case overeat, do not eat large amounts of protein foods and carbohydrates, give up cakes and white muffins, as well as fatty foods. Products such as mackerel, pumpkin seeds, dairy products, spinach.
Increased concentration
With an excess of progesterone in early pregnancy, there is no need for specific therapy. Only symptomatic treatment is prescribed - sedatives for psychological instability, mood swings, depression, mild herbal laxatives to normalize the intestines. General recommendations include long walks in the fresh air, a balanced diet, taking vitamins, a good night's sleep, sufficient in time for the body of the expectant mother to have time to rest and recover.
If an excess of progesterone is detected in the second or third trimester, then the woman can be hospitalized in order to provide her with treatment under the constant supervision of qualified medical personnel. If the problem is left unattended, the baby will no longer receive enough nutrition and oxygen and may die.
A woman is prescribed drugs that improve uteroplacental blood flow - "Actovegin", "Curantil", they are often injected intravenously. The treatment regimen includes injections of B vitamins, as well as sedatives and antispasmodics.
With a post-term pregnancy, when after 40 weeks the hormone level continues to remain high and does not even try to decrease, the woman is hospitalized, if necessary, from 41-42 weeks, if labor has not begun, they are stimulated, including the introduction of hormonal drugs that lead to a drop in the level progesterone.
A post-term pregnancy can, by the way, be due to insufficient progesterone levels. In this case, stimulation is done with progesterone drugs, including "Progesterone" in ampoules.
For progesterone and its effect on the female body during pregnancy, see the following video.
