Progesterone Metabolites (Urine) - DUTCH
Performed by: Precision Analytical (DUTCH)
Progesterone is a key reproductive hormone that plays a central role in menstrual cycle health, fertility, and hormonal balance.
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In women, progesterone is secreted in significant amounts only after ovulation during the luteal phase.
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One of its main roles is to balance the effects of estrogen—helping support a healthy uterine lining, stabilizing mood, and promoting overall well-being.
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Adequate luteal-phase progesterone levels are essential for successful implantation and pregnancy.
Why Measure Progesterone Metabolites Instead of Progesterone Itself?
Only a very small amount of parent progesterone appears in urine.
Instead, the DUTCH test measures progesterone metabolites, which are breakdown products of progesterone in the body.
These metabolites provide a reliable estimate of circulating progesterone.
Advantages of urinary metabolites over single-time blood or saliva tests:
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A serum or saliva test shows progesterone at a single moment.
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A urinary metabolite result reflects an average production since the last urination, offering a broader view of hormone activity.
The Two Main Progesterone Metabolite Pathways
Progesterone is metabolized primarily through two pathways:
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5α-pregnanediol – the “alpha” pathway
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5β-pregnanediol – the “beta” pathway
Key points:
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In most women, each pathway accounts for about half of progesterone metabolism.
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Some women show a pathway preference, favoring alpha or beta more strongly.
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Hormonal patterns can influence this preference:
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PCOS: Women often push testosterone toward the alpha pathway (making more potent DHT) and tend to also push progesterone toward 5α-pregnanediol.
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Hypothyroidism: Often associated with a heavier preference for the 5β-pregnanediol pathway.
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Both progesterone metabolites measured by the DUTCH test have been shown to correlate well with serum progesterone values, making them a reliable reflection of luteal-phase hormone production.
Why This Matters
Knowing your progesterone metabolite levels helps determine:
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Whether ovulation has occurred
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If luteal-phase progesterone levels are sufficient to support fertility
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How your body’s metabolism may be influencing hormone balance
This information is especially important when evaluating menstrual irregularities, fertility concerns, perimenopause changes, or hormone therapy outcomes.
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Biomarkers included in this panel:
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” pregna
Learn moreThis 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” pregna
Learn moreThis 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” pregna
Learn morePregnanediol 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.
Learn morePregnanediol 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.
Learn morePregnanediol 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.
Learn moreNormally, cortisol levels rise within 10 to 30 minutes of waking to help boost energy levels and then drop throughout the day. This is known as the cortisol awakening response (CAR).
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