The main goal of the hormonal cycle in the body of a woman during the menstrual cycle is ovulation. The course of this process is under the control of the hypothalamus. At the same time, the production of substances that are secreted in the anterior pituitary gland: FSH and LH is regulated.
Ovulation formation
In the pre-ovulatory phase of the menstruation cycle, the ovarian follicles undergo some transformations. These changes occur under the influence of FSH. After the follicle reaches a certain size, as well as functional activity, an ovulatory peak is formed in LH. As a result, the "maturation" of the egg starts (the first division of meiosis). After this phase, a rupture in the follicle forms, through which the egg leaves. The interval between the peak phase and ovulation is about 36-48 hours. During the post-ovulatory phase, the egg usually moves to the uterus through the fallopian tube. In the case of fertilization on the third or fourth day, the embryo enters the uterine cavity. There is his implantation. If fertilization has not occurred, then the egg dies in the fallopian tube within 24 hours.
Substances involved in the life support of the reproductive function of women
In the intracretory glands, biologically active compounds are formed. They are called hormones. It is thanks to them through the hypothalamic-pituitary-ovarian system that the active activity of the genital organs is ensured. Each connection performs specific tasks. One of the substances involved in the processes in the reproductive system is 17-OH-progesterone. The follicular phase proceeds with a significant increase in its concentration. This compound is synthesized in a small amount in the ovaries. The increase in the content of the substance coincides with the peak stage of LH. After that, in the middle of the cycle, the concentration decreases for a short period. Progesterone in the follicular phase inhibits estrogen-stimulated endometrial proliferation . As a result, the compound undergoes transformation. The main cause of menstruation is the sudden cessation of progesterone production by the corpus luteum at the end of the cycle. In the case of artificial prolongation of the luteal phase in the stroma of the endometrium, a decidual reaction is formed. It is similar to changes occurring at the beginning of pregnancy. Progesterone provides regulation of the activity of the glands in the cervix, reduces the contractility of the cavity. The compound also suppresses menstruation.
Hormone 17-OH-progesterone. Description
It is a precursor to steroids. Cortisol is formed from it in the adrenal glands under the influence of enzymes such as 11-b hydroxylase or 21-hydroxylase. 17-OH-progesterone in women can synthesize androstenedione. This substance is a precursor to testosterone and estradiol. It is formed in the ovaries and adrenal glands. In the blood, progesterone-17-OH is present in the form of transcortin and albumin free and associated with carrier proteins. In the absence of fertilization, the concentration of the substance decreases. In the case of implantation of the egg, the corpus luteum in the ovaries continues its production.
Concentration
17-OH-progesterone is elevated in the morning. Its minimum content is detected at night. During the day, its level varies. The concentration of the compound is not the same during the menstrual cycle. A significant increase in the level is observed the day before the peak of LH. This is followed by the phase of maximum concentration (in the middle of the cycle). During pregnancy, the content of the substance increases significantly. 17-OH-progesterone, the norm of which is set in accordance with age, in children is contained in a small amount. High concentrations are observed only in the fertile period and immediately after birth. Moreover, in premature infants, its content is relatively greater. During the first week, the level of connection drops. Progressive increase is noted during puberty. During this period, progesterone-17-OH in adolescents gradually reaches the same concentration as in adults.
What is a blood test for?
17-OH-progesterone is an intermediate. However, its study is an important stage in the diagnosis of various pathologies. The indications for the study include infertility, hirsutism, cycle disorders. With adrenal hyperplasia, steroid replacement therapy is prescribed to patients as a treatment. An analysis is also assigned to evaluate its effectiveness. 17-OH-progesterone is being studied in newborns. Its concentration is studied in cases of suspected 21-hydroxylase deficiency. Deficiency of this enzyme is observed with congenital adrenal hyperplasia.
Preparation for laboratory research
If the doctor has not indicated another time, then the blood is donated on the third or fifth day of the cycle. The study is carried out on an empty stomach in the morning. It is not allowed to drink coffee or tea. Allowed to drink plain water. At least eight hours should elapse from the last meal to the blood donation. Experts consider it inappropriate to study hormones of the second phase on the 20th-23rd day. If the cycle duration is 42 days, then blood sampling is carried out on the 35th day. On the 23rd day, the first phase continues. At the same time, the level of progesterone is reduced, but this does not indicate a luteal phase insufficiency or anovulation. It makes no sense to conduct a concentration study during pregnancy and take any medications. In this case, high 17-OH-progesterone is the norm. Such maintenance in the prenatal period does not require therapy.
Interpretation of Results
As mentioned above, the normal level of the hormone progesterone-17-OH depends on age. The gender of the subject also matters. Concentration is determined in ng / ml. The optimal content for children up to a month is 0-16.63; 1-2 months - 1.8-9.7; 3 months - 0.07-1.7. For patients up to a year - 0-1.65; up to 3 years - 0-0.99; from 3 to 10 - 0.07-1.69. The permissible level for men is 0.5-2.1. For women in the follicular phase - 0.41-2.72; ovulatory - 0.33-2.8; luteal - 0.33-2.8. In the first trimester of the prenatal period, progesterone-17-OH should be present at a concentration of 1.17-5.62; in the second, 1.17-6.7; in the third - 1.24-11. In the postmenopausal period, the optimal content is 0.13-0.51.
Adrenal hyperplasia
This is a congenital autoimmune pathology. It develops, as a rule, as a result of a deficiency of enzymes involved in the synthesis of steroids. The lack of compounds can have varying degrees of severity. In infancy, congenital hyperplasia develops virilization (the formation of male features in women). In severe cases, an enzyme deficiency provokes serious impairment in the synthesis of steroids, loss of salts, which can be life-threatening. Partial enzyme deficiency detected in adults can also be congenital. In this case, initially violations occur in a latent form and are not always detected in childhood. Disturbed synthesis of enzymes can be of a progressive nature. Under the influence of negative pathological factors, the likelihood of functional and morphological changes in the adrenal glands increases, similar to manifestations of the congenital syndrome. As a result, the sexual development of adolescents is impaired. In large quantities, progesterone-17-OH directs its activity to the synthesis of androgens. These compounds circulate from infancy and provoke the manifestation of male sexual characteristics in girls. Therefore, the study of its concentration is important in determining the effectiveness of the received therapy.
What else is dangerous 21-hydroxylase enzyme deficiency
The lack of connection is manifested by reduced formation of aldosterone. This hormone of the adrenal glands provides regulation of the water-salt balance, retains salts in the body. In infants there is a "crisis loss". This state is characterized by the accumulation of liquid in large volumes. In this case, the necessary salts are actively excreted from the body. As a result, the potassium content begins to increase, and the sodium begins to decrease. Partial enzyme deficiency is characterized by an erased clinical picture. Suspicions of deficiency appear against the background of puberty and growth disorders in the puberty, at an older age - with infertility and an irregular menstrual cycle, in girls - with hirsutism.
Conclusion
The activity of sex hormones is one of the determining factors not only in the functioning of the reproductive system in women. The interaction of the compounds, their stable and normal activity, participation in various processes, as well as their presence in the optimal concentration, have an effect on the overall development of the body and overall health. At the same time, experts warn that any deviations from existing standards in medicine are not always a sign of pathology. In this regard, not every case requires treatment. However, doctors recommend regularly donating blood for laboratory analysis, to undergo examinations. Some diseases have a latent form and if untimely diagnosis lead to serious consequences. Of particular importance is the state of the hormonal background for women.
Undetected violations in childhood progress with age, causing malfunctions in the functioning of the reproductive and other systems in the body. In some cases, infertility - one of the most pressing problems today - is the result of untimely diagnosis. For patients receiving replacement therapy, regular examination and blood analysis are also required. The research results allow not only to evaluate the therapeutic efficacy of drugs, but also to adjust the scheme of their use.