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.
When pregnanediol levels fall during a menstrual cycle, it means that progesterone levels are less than ideal. It results in symptoms during the luteal phase.
During the adaptation of the body to menopause, progesterone levels fall and estrogen dominance begins. That’s when progesterone supplements may be offered to manage the symptoms. Some of the symptoms include hot flashes, vaginal dryness, mood instability, low sex drive, sleep problems, brain fog, hair loss, loss of muscle mass and strength, weight gain and anxiety.
Various normal ranges*:
*the Luteal Range is the premenopausal range. When patients are taking oral progesterone this range for progesterone metabolites is not luteal and reflects the higher levels expected when patients take oral progesterone. This test is intended to be taken in the luteal phase of the menstrual cycle (days 19-22 of a 28 day cycle) for premenopausal women.
Low or low-normal levels of pregnanediol signal less than optimal progesterone. This commonly results in an increase in symptoms occurring in the luteal phase. In the perimenopausal years, progesterone levels tend to fall faster than estrogens, resulting in a relative estrogen dominance. Botanicals or supplemental progesterone can be useful for managing symptoms. Low levels are commonly associated with sleep disturbances, anxiety, stress, and edema.
In postmenopausal women the level of pregnanediol is expected to be much lower than in premenopausal women with optimal luteal ovarian function.
Possible causes of low levels:
- Progesterone is made by the placenta during pregnancy. Pregnanediol is a metabolite of progesterone, which is decreased when placental viability is threatened.
- Ovarian neoplasm: Ovarian epithelial cancers can destroy functional ovarian tissue. Progesterone levels may decrease.
- Amenorrhea, Ovarian hypofunction: Without ovulation, a corpus luteum will not develop. Progesterone will not be secreted, and progesterone and pregnanediol levels will be lower than expected.
High levels of pregnanediol are associated with the following:
- Breast or ovarian cancer
- Adrenal gland dysfunction
- High levels of oral progesterone
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