Progesterone Metabolites (Urine) - DUTCH

Progesterone is a very important hormone marker for overall cycle health.

Progesterone is only secreted in abundance after ovulation.

Progesterone helps balance the effects of estrogens.

Knowing whether a woman reaches healthy progesterone levels in the luteal phase is key to understanding her physical and emotional well-being, as well as her fertility.

Why measure metabolites?

Since very little parent progesterone hormone is present in urine, measurement of its metabolites is used to estimate progesterone present in circulation.

With urinary progesterone metabolites, the result reflects an average of her hormone production since her last urination. A serum or saliva sample only shows a progesterone level for a specific moment in time. A single urine result is an improvement on a single serum result, because it covers a longer span of time. 

Progesterone gets metabolized primarily down two pathways, creating a 5a-pregnanediol and 5b-pregnanediol metabolite. Both metabolites have been shown to correlate to serum values.

Each pathway (alpha and beta) represents about half of the progesterone being produced. One woman may heavily prefer the alpha pathway while another may push more heavily down the beta pathway. 

Women with PCOS, for example, tend to push testosterone down the alpha pathway towards the more potent DHT. These women will also tend to push progesterone down its alpha pathway. 

Patients with hypothyroidism, on the other hand, tend to push much more heavily down the beta pathway. Reporting both major progesterone pathways provides the most accurate hormonal representation.

a-Pregnanediol (luteal range)

Optimal range: 200 - 740 ng/mg

This test measures pregnanediol, a metabolite of progesterone. It is used in the evaluation and decision making in women who are having difficulty becoming pregnant or maintaining a pregnancy. It is also used to monitor “high-risk” pregnancies.


b-Pregnanediol (luteal range)

Optimal range: 600 - 2000 ng/mg

Pregnanediol is a metabolite of the molecule of progesterone, which is important for fertility and for menstruation. Pregnanediol levels increase after ovulation and when the placenta releases the hormone.