Progesterone

Synonym/Acronym

N/A

Rationale

To assess ovarian function, assist in fertility work-ups, and monitor placental function during pregnancy related to disorders such as tumor, cysts, and threatened abortion.

Patient Preparation

There are no food, fluid, activity, or medication restrictions unless by medical direction.

Normal Findings

Method: Immunochemiluminometric assay (ICMA).

Hormonal State	Conventional Units	SI Units (Conventional Units × 3.18)
Prepubertal males and females	Less than or equal to 0.35 ng/mL	Less than or equal to 1.1 nmol/L
Adult male	Less than or equal to 0.11 ng/mL	Less than or equal to 0.35 nmol/L
Adult female
Follicular phase	Less than 1 ng/mL	Less than 3 nmol/L
Ovulatory phase	Less than 13 ng/mL	Less than 41.3 nmol/L
Luteal phase	2–25 ng/mL	6.4–79.5 nmol/L
Pregnancy, first trimester	10–44 ng/mL	31.8–140 nmol/L
Pregnancy, second trimester	25–83 ng/mL	80–264 nmol/L
Pregnancy, third trimester	65–229 ng/mL	206.7–728.2 nmol/L
Postmenopausal period	Less than 1 ng/mL	Less than 3 nmol/L

Critical Findings and Potential Interventions ⬆ ⬇

Overview ⬆ ⬇

Study type: Blood collected in a gold-, red-, or red/gray-top tube; related body system: Endocrine and Reproductive systems.

Progesterone is a female sex hormone made by the corpus luteum and placenta. It is also produced by the adrenal glands in males and females, but hormone from this source is usually converted into other corticosteroids and androgens, except in the case of a progesterone-producing adrenal tumor. The function of progesterone is to prepare the uterus for pregnancy and the breasts for lactation. Progesterone testing can be used to confirm that ovulation has occurred and to assess the functioning of the corpus luteum. Serial measurements can be performed to help determine the day of ovulation.

Indications ⬆ ⬇

Assist in the diagnosis of luteal-phase defects (performed in conjunction with endometrial biopsy).
Evaluate patients at risk for early or spontaneous abortion.
Identify patients at risk for ectopic pregnancy and assessment of corpus luteum function.
Monitor patients ovulating during the induction of human chorionic gonadotropin (HCG), human menopausal gonadotropin, follicle-stimulating hormone/luteinizing hormone–releasing hormone, or clomiphene (serial measurements can assist in pinpointing the day of ovulation).
Monitor patients receiving progesterone replacement therapy.

Interfering Factors ⬆ ⬇

Factors That May Alter the Results of the Study

Drugs and other substances that may increase progesterone levels include clomiphene, corticotropin, hydroxyprogesterone, ketoconazole, mifepristone, progesterone, tamoxifen, and valproic acid.
Drugs and other substances that may decrease progesterone levels include ampicillin, danazol, epostane, goserelin, and leuprolide.

Potential Medical Diagnosis: Clinical Significance of Results ⬆ ⬇

Increased In

Chorioepithelioma of the ovary (related to progesterone-secreting tumor)
Congenital adrenal hyperplasia(related to excessive production of progesterone precursors)
Hydatidiform mole(related to progesterone-secreting tumor)
Lipoid ovarian tumor(related to progesterone-secreting tumor)
Ovulation (related to normal production of progesterone)
Pregnancy (related to normal production of progesterone)
Theca lutein cyst(related to progesterone-secreting cyst)

Decreased In

Galactorrhea-amenorrhea syndrome(progesterone is not produced in the absence of ovulation)
Primary or secondary hypogonadism (related to diminished production of progesterone)
Short luteal-phase syndrome (related to diminished time frame for production and secretion)
Threatened abortion, fetal demise, toxemia of pregnancy, pre-eclampsia, placental failure (related to decreased production by threatened placenta)

Nursing Implications, Nursing Process, Clinical Judgement ⬆

Before the Study: Planning and Implementation

Teaching the Patient What to Expect

Discuss how this test can assist in evaluating hormone level during pregnancy.
Explain that a blood sample is needed for the test.

After the Study: Implementation & Evaluation Potential Nursing Actions

Treatment Considerations

Reinforce information given by the patient’s health-care provider (HCP) regarding further testing, treatment, or referral to another HCP.
Instruct the patient in the use of home pregnancy test kits approved by the U.S. Food and Drug Administration.
Provide a nonjudgmental, nonthreatening atmosphere for exploring other options (e.g., adoption).
Provide contact information for access to counseling services, as appropriate.

Clinical Judgement

Consider which social service or spiritual support referrals would be the best fit for the expected clinical outcome.

Follow-Up and Desired Outcomes

Understands the clinical implications of the study results, including potential fetal death, and corresponding therapeutic interventions.