Optimal Result:
50 - 505 ng/mg Creat/Day.
5α-Pregnanediol is a urinary metabolite of progesterone formed primarily through the 5α-reductase pathway. After ovulation, the corpus luteum produces progesterone. Some of that progesterone is converted to 5α-dihydroprogesterone and the calming neurosteroid allopregnanolone, and then further reduced and conjugated for excretion as 5α-pregnanediol in urine.
On a HUMAP, 5α-pregnanediol helps you understand both overall progesterone output and whether your body favors the 5α-reductase route of progesterone metabolism.
In short: it’s a window into your luteal-phase progesterone status and your 5α-reductase activity.
Cycle health & ovulation: Adequate mid- to late-luteal progesterone supports a healthy cycle, implantation potential, sleep quality, and mood stability.
Neurosteroid balance: The 5α-pathway yields allopregnanolone, which can have calming, sleep-supportive effects. Too little may correlate with PMS/PMDD-type symptoms in some individuals.
Metabolic patterning: A “5α-dominant” pattern is often discussed in the context of steroid metabolism (more commonly with androgens), but it also applies to progesterone and can influence how you feel during the luteal phase.
HUMAP normalizes urinary steroid metabolites (often to creatinine). Because progesterone production varies across the cycle, interpretation depends on collection timing:
Best window: Mid-luteal (typically ~5–7 days after ovulation).
If collected outside the luteal phase: Results may look “low” even if ovulation and luteal function are normal. Always consider cycle day.
What it can suggest
Strong luteal progesterone production (e.g., robust corpus luteum output).
Relative 5α-reductase pathway dominance of progesterone metabolism.
Exogenous progesterone use (oral, transdermal, vaginal) or HRT/fertility support can raise downstream urinary metabolites.
Pregnancy (progesterone rises early and substantially).
Less commonly, shifts in liver/phase II conjugation that favor this excretion pathway.
Possible clues you might notice
Good sleep or a calmer mood in the luteal phase (consistent with higher allopregnanolone for some people).
If markedly high with symptoms (breast tenderness, bloating, somnolence), consider exogenous hormone exposure or timing (very late luteal).
Next steps to consider
Confirm context: Was the sample mid-luteal? Are you using progesterone, combined OCPs, or fertility meds?
Cross-check with other HUMAP markers:
Total progesterone metabolites (5α- and 5β-pregnanediol together).
5α- vs 5β-balance across steroids (does a 5α-tilt show up for androgens, too?).
Clinical tests when appropriate: Serum mid-luteal progesterone or a pregnancy test if timing/symptoms suggest it.
If symptomatic: Discuss dose/formulation/timing with your clinician if you’re on progesterone or HRT.
What it can suggest
Low luteal progesterone output (e.g., anovulatory cycle, short luteal phase, or suboptimal corpus luteum function).
Collection outside the luteal phase (follicular/early cycle).
Lower 5α-reductase activity specifically (you might still see some 5β-pregnanediol).
Over-dilution (very high fluid intake) can artifactually lower creatinine-normalized values; labs typically correct for this but extreme hydration can still blur interpretation.
Symptoms often discussed when luteal progesterone is low
PMS/PMDD-type mood shifts, sleep disturbance, breast tenderness variability.
Short cycles, spotting before menses, or difficulty with conception related to luteal support.
Next steps to consider
Verify timing: Was this truly mid-luteal (about 5–7 days after ovulation)?
Track ovulation: Use LH testing, basal body temperature, or fertility tracking apps to anchor sampling day next cycle.
Cross-check on HUMAP:
Look at total progesterone metabolites (5α + 5β).
Review androgen 5α-indicators (e.g., etiocholanolone/androsterone patterns) to see your global 5α/5β tendency.
Clinician testing: Consider serum mid-luteal progesterone confirmation.
Foundational factors:
Thyroid health, iron status, and prolactin can influence ovulation quality.
Energy availability (adequate calories), protein, and healthy fats support steroid hormone synthesis.
Micronutrients: vitamin B6, magnesium, vitamin C, and zinc are commonly discussed for luteal support.
Stress/sleep: chronic stress can alter ovulation and luteal adequacy.
Enzyme: 5α-reductase converts progesterone to 5α-dihydroprogesterone (and does the same with androgens).
Influencers: Genetics, insulin signaling, androgen milieu, local tissue factors, and some medications can tilt 5α activity up or down.
Medications: 5α-reductase inhibitors (e.g., finasteride, dutasteride) can reduce 5α-pathway products. Exogenous progesterone increases downstream metabolites, including 5α-pregnanediol.
Time it right: Aim for mid-luteal (≈ day 19–23 in a 28-day cycle, or ~5–7 days after documented ovulation).
Record cycle day and any hormones/meds on the requisition—vital for interpretation.
Hydration: Follow lab instructions; avoid extreme fluid intake before collection.
Look at the whole picture: Always interpret 5α-pregnanediol alongside 5β-pregnanediol, total progesterone metabolites, and other sex-steroid pathways.
Anchor to ovulation: Use LH strips or a wearable to identify ovulation, then plan HUMAP collection mid-luteal next cycle if timing was uncertain.
Discuss with your clinician if results don’t match symptoms—consider serum mid-luteal progesterone for confirmation.
Support ovulation quality:
Prioritize nutrition (adequate calories, protein, and fats), sleep, and stress management.
Address under-recovery from intense training if cycles are irregular.
Investigate thyroid, iron, and prolactin when cycles or symptoms suggest a problem.
Medication/hormone review: If you’re on progesterone, OCPs, or fertility meds, bring those details to your interpretation—these can significantly shift metabolite results.
Symptom tracking: Pair your lab report with a cycle-tracking journal to see how changes in sleep, mood, cramps, spotting, or breast tenderness relate to hormone patterns over time.
5α-Pregnanediol reflects luteal progesterone output and 5α-reductase metabolism.
Elevated values often indicate robust luteal production, 5α-dominance, pregnancy, or exogenous progesterone exposure.
Decreased values may reflect low luteal progesterone, off-timing collection, or lower 5α activity.
Best interpretation comes from cycle-aware sampling and viewing this marker with companion metabolites and your clinical picture.
An elevated 5α-pregnanediol suggests strong luteal progesterone output and/or a shift toward the 5α-reductase pathway of progesterone metabolism. In practical terms, your body may be producing plenty of progesterone after ovulation, and more of it is being processed along the 5α route (which also generates the calming neurosteroid allopregnanolone).
Common reasons for elevation
Mid-luteal robustness: A healthy, active corpus luteum producing ample progesterone.
5α-dominant metabolism: Your enzymes favor the 5α pathway (sometimes seen elsewhere with androgens too).
Exogenous progesterone/hormones: Prescription progesterone (oral, transdermal, vaginal), luteal support in fertility treatment, or certain HRT formulations.
Pregnancy: Progesterone rises substantially early in pregnancy.
Timing & physiology: Late-luteal collection or individual differences in liver/phase-II conjugation.
How you might feel
Some people report calmer mood and better sleep mid-luteal when this pathway is active. If values are very high, you could also notice classic high-progesterone symptoms (e.g., breast tenderness, bloating, sleepiness).
Before you read too much into it
Confirm collection timing: Best is 5–7 days after ovulation; outside this window, results can look higher or lower than expected.
Account for medications: Note any progesterone, OCPs, or fertility meds—they meaningfully raise downstream metabolites.
Check companion markers: Review total progesterone metabolites (5α + 5β) and compare with 5β-pregnanediol to understand overall production vs. pathway preference.
Smart next steps
Verify mid-luteal timing using LH testing, basal body temperature, or a tracker; repeat in the correct window if timing was uncertain.
Discuss meds and dosing with your clinician if you use progesterone or HRT and results don’t match how you feel.
Rule out pregnancy when applicable.
Cross-check clinically if needed: a serum mid-luteal progesterone can corroborate urinary findings.
Track symptoms across cycles: Sleep, mood, breast tenderness, spotting, and cycle length help connect numbers to how you feel.
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Healthmatters is a personal health dashboard that helps you organize and understand your lab results. It collects and displays your medical test data from any lab in one secure, easy-to-use platform.
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Healthmatters.io personal account provides in-depth research on 4000+ biomarkers, including information and suggestions for test panels such as, but not limited to:
You can combine all test reports inside your Healthmatters account and keep them in one place. It gives you an excellent overview of all your health data. Once you retest, you can add new results and compare them.
If you are still determining whether Healthmatters support your lab results, the rule is that if you can test it, you can upload it to Healthmatters.
While we work with many popular labs, we welcome reports from lots of other places too.
It's as simple as this: if you can get a test done, you can upload it to Healthmatters and we can interpret results from any lab out there. If laboratories can analyze it, we can interpret it.
If you're on the hunt for a specific biomarker, contact us and we'll add it to our database. Anything from blood, urine, saliva, or stool can be uploaded, understood, and tracked with your Healthmatters account.
The Complete Plan ($15/month) is perfect for individuals who want ongoing access to their health data. It includes unlimited lab imports, visual tracking, custom ranges, result explanations, full account exports, and secure sharing — all with a simple monthly subscription. You can cancel anytime and restart your plan whenever you're ready — your data will still be there waiting for you. You can also upgrade to the Unlimited Plan at any time, with the cost prorated based on what you've already paid.
The Unlimited Plan ($250 one-time) is also designed for individuals but offers lifetime access with no ongoing subscription. You'll get all the same features as the Complete Plan, plus a larger initial data entry allowance (10 reports), making it a great choice if you prefer a one-time payment and long-term use without monthly fees.
In short:
There are two ways to add your test reports to your Healthmatters account. One option is to input the data using the data entry forms. The other method is to utilize our "Data entry service."
Our data entry forms offer an easy, fast, and free way for you to input the reports yourself. Self-entry allows you to add an unlimited number of reports at no cost. We make the self-entry process user-friendly, providing dozens of templates that pre-populate the most popular laboratory panels and offering instant feedback on entered values.
For those who prefer assistance, we offer a "Data entry service" to help you input your data. Simply attach an image or file of your lab test results, and a qualified team member from our data entry team will add the results for you.
We support various file types, including PDFs, JPGs, or Excel. This service is particularly useful if you have many reports to upload or if you're too busy to handle the data entry yourself.
Our Data Entry Service is for when you don't want to manually type in your lab results yourself. You simply upload your report (PDF, image, or screenshot), and our trained team enters the information into your Healthmatters account for you — accurately and neatly organized, ready to view in graphs, tables, and timelines.
The $15 per report covers the time and care it takes for a real person to review your file, make sure each result is entered correctly, and double-check for accuracy. This ensures your health data is precise and easy to work with — without you having to spend the time doing it yourself.
Prefer to do it yourself? You can always use our free self-entry tool to add results manually — it just takes a bit more time and attention.
For users on the Complete monthly plan, the first report is entered free of charge, and each additional report incurs a fee of $15.
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The Pro Monthly plan is priced at $45 per month and does not include a data entry service. Self-entry is free for an unlimited number of reports, and you can opt for the data entry service at a fee of $15 per report.
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We've crafted multiple ways for you to navigate your data, whether you're glancing at a single report or delving into your historical test reports.
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Yes, you can. When entering values for the biomarker, you will see an "Edit Range" button. Click this button, and you'll have the option to enter a custom range.
A personal account is all about keeping your own lab test results in check. It's just for you and your personal use.
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To learn more about Healthmatters Pro, please refer to the professional page.
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