Give advice on women's health concerns.

Progesterone Levels in Early Pregnancy

Knowing How Progesterone Levels Affect a Woman in Early Pregnancy

The hormone progesterone plays a significant role during pregnancy and its levels keep rising throughout the pregnancy. Read the article to know how does it affect a woman during her early pregnancy.
Saptakee Sengupta
Last Updated: Mar 6, 2018
Progesterone is a steroid hormone, produced by the ovaries every month, after ovulation. It also controls body temperature during ovulation. Besides regulating the menstrual cycle of a woman, it also plays a significant role during pregnancy. The level of progesterone produced in the body, is of high significance all throughout the gestational period.
If its levels drop during early pregnancy, it results in miscarriage, whereas, in the later stages of pregnancy, it can cause preterm delivery. The level of progesterone keeps increasing throughout the pregnancy, however, high levels in the initial stages of pregnancy can indicate multiple pregnancy.
Role of Progesterone in Early Pregnancy
Usually when an egg is released from the ovary, but fails to culminate in a pregnancy, the progesterone levels fall. The dip in progesterone levels results in menstrual flow. However, during pregnancy, when the egg gets fertilized, the corpus luteum (follicle that released the egg) in the ovary produces more progesterone to maintain the pregnancy.
Higher levels of progesterone signal thickening of the uterine lining, prevention of ovulation during gestational period, and preparation of uterus for implantation of the fertilized egg. During early pregnancy, the level of progesterone is around 9-47 ng/ml, with an average oscillating between 12-20 ng/ml. However, this is just an approximate. The levels vary from one woman to another, one pregnancy to another. Women with levels lower than 9 ng/ml, and higher than 47 ng/ml, have also been seen to deliver successfully. More than the reading, what matters most is steady rise in progesterone levels during the course of pregnancy.
The progesterone produced during early pregnancy is very important, because it prevents the contraction of the uterus, which can result in a miscarriage. Women with low levels of progesterone are seen to have miscarriages in the first 3 months. The corpus luteum continues to produce progesterone until the 10th week, after which the newly-formed placenta takes control of progesterone production till the end of the gestational period. It is this increased levels of progesterone that spearheads initial pregnancy symptoms like nausea, morning sickness, headaches, breast tenderness, etc.
Human chorionic gonadotropin (hCG) hormone plays an important role as well. This hormone maintains the corpus luteum during the initial phase of pregnancy. Thus, hCG controls the development of the fetus during pregnancy. hCG levels are high during the initial months of pregnancy, and presence of this hormone is what gives the positive result in a pregnancy test. Besides hCG, the hormone estrogen also plays an important role in maintaining pregnancy, along with progesterone.
Low Progesterone Levels during Early Pregnancy
About 30-35% pregnancies are associated with low progesterone levels. Miscarriage takes place mainly because the uterine lining is not well-developed or ready for the fertilized egg. The person may experience vaginal bleeding, abdominal pain, or even cramps. Low levels of progesterone are observed when:
➡ Corpus luteum fails to produce adequate amounts of progesterone.
➡ Placenta fails to produce required levels of progesterone.
Women who are resistant to insulin and have high levels of estrogen are more prone to having low progesterone. It can also be due to effect of certain drugs and unhealthy lifestyle. Stress, malnutrition and insufficient exercise also contribute to low progesterone levels in early pregnancy. A progesterone level test will help find out if the levels of progesterone produced are below required levels.
Progesterone supplements in the form of oral supplements, vaginal suppositories, progesterone injections, are available today. However, this kind of progesterone supplementation is recommended for only those with infertility issues, history of miscarriages or pre-term birth, etc. Women undergoing IVF are given progesterone supplementation, because during egg removal, progesterone levels drop.
Supplementation continues till about the 12th -16th week of pregnancy. Since the body is not naturally producing enough progesterone, the supplementation will supply the deficit, thereby enabling proper development of the endometrium (uterine lining).
This hormone supplementation has not been approved by FDA, however, has proven effective in preventing miscarriage due to progesterone drop. Nevertheless, there is still no recommendations, regarding optimal dosage of progesterone supplements, their timing, etc. Moreover, progesterone supplementation has its limitations. It is mainly used for sustain single baby pregnancies, and not used to sustain multiple pregnancies.
High Progesterone Levels during Early Pregnancy
High levels of progesterone are favored in pregnancy, but what can very high levels of progesterone mean? Higher levels of progesterone in the initial weeks of pregnancy, can be an indicator of a multiple pregnancy. An hCG test and an ultrasound will help confirm the multiple pregnancy. However, very high levels of progesterone can also point to molar pregnancies, ovarian cysts or even ovarian cancer.
Appropriate progesterone levels are required for sustaining a pregnancy. However, this hormone does not work alone! Progesterone, along with hCG hormone and estrogen together work towards the growth and development of a fetus!