Progesterone (P4) belongs to a group of steroid hormones called the progestogens and it is the major progestogen in the body. Its main role is to maintain pregnancy and to regulate the female’s menstrual cycle. Its levels increase sharply during the luteal phase of the menstrual cycle as it works to thicken the lining of the uterus to prepare it for a fertilized egg each month.
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Progesterone is a hormone released by the corpus luteum in the ovary and plays an important role in regulating the menstrual cycle and in maintaining early stages of pregnancy. It may also be involved in the growth of certain cancers.
During a woman’s menstrual cycle, at ovulation, an egg is released from the ovary and the remnants of the ovarian follicle that enclosed the developing egg forms a structure called the corpus luteum. The corpus luteum releases progesterone and to a lesser extent, estradiol to prepare the body for pregnancy in the event that the released egg is fertilized. Progesterone’s function is to maintain the uterine lining throughout the pregnancy and the levels increase from 9 to 32 weeks. If no fertilized egg implants, progesterone levels drop and menstruation begins.
There is no medical consequence of producing too much progesterone, however high levels of progesterone are associated with various conditions including congenital adrenal hyperplasia and an increased risk for breast cancer. If progesterone is absent or its levels are too low, irregular and heavy menstrual bleeding can occur and an ovary may fail to release an egg at ovulation, which occurs in women with polycystic ovary syndrome. A drop in progesterone during pregnancy can also result in a miscarriage and early labor.
Progesterone diagnostic assays are useful to help determine the cause of infertility, track ovulation, help diagnose an ectopic or failing pregnancy, monitor the health of a pregnancy, monitor progesterone replacement therapy, and help diagnose the cause of abnormal uterine bleeding. A related progestogen steroid hormone is 17-Hydroxyprogesterone (17-OHP) which is synthesized from progesterone and 17-Hydroxypregnenolone. It functions as a precursor of cortisol in the adrenal glands or can be converted into androgenic and estrogenic hormones. Measurement of 17-OHP is used as an aid in the diagnosis and treatment of various disorders of the adrenal glands or the ovaries. It is also part of newborn screening in many countries used to detect congenital adrenal hyperplasia (CAH). Progesterone assays are usually quantitative and based on the competitive immunoassay format.
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