17-OH-progesterone (17-hydroxyprogesterone, 17-OGG, 17-oh-progesterone) is the precursor of hormones; a kind of "semi-finished product", from which various hormones (cortisol, estradiol, testosterone) are formed in the complex process of metabolic transformations.
The causes of increased 17-OH-progesterone
The reason for the increased level of 17-oh-progesterone is most often found in the adrenal glands or ovaries. Congenital adrenal cortex dysfunction (PDCN) is the most common cause of such an increase. Adrenal dysfunction is associated with a deficiency or lack of a specific 21-hydroxylase enzyme, which, together with 17-OH-progesterone, is involved in the synthesis of the hormone cortisol. The enzyme is absent or present in small amounts, in the meantime as the precursor of the hormones 17-OH-progesterone is actively produced up to the excess of the norm.
There are two forms of VDKN: classical and non-classical. Classical VDKN is determined in the first days / months of a child's life by external clinical signs of false hermaphroditism. To diagnose the nonclassical form of VDKN, as a rule, it is possible only in the adolescent (against the background: hirsutism, acne, acne, irregularities of the menstrual cycle) or in reproductive age (when women face problems of conception and gestation).
In addition, a blood test for determining the level of 17-OH-progesterone may show an excess of the norm if:
- polycystic ovary syndrome (PCOS);
- androgen-producing tumors of the ovaries or adrenal glands;
- illness or syndrome of Itenko-Cushing;
- hypothalamic syndrome;
- hyperprolactinemia ;
- and other diseases.
The normative values of 17-OH-progesterone
The norms of sex hormones, in particular their predecessor 17-OH-progesterone, may differ in different diagnostic laboratories. In the diagnosis should be guided by the reference indicators of a particular laboratory, they are usually indicated in the results of the analysis.
Authoritative doctors tend to believe that a slightly elevated level of 17-OH-progesterone in a healthy non-pregnant woman does not require treatment and is a variant of the norm. The limit of this increase is 5 nmol / L = 150 ng / dl = 1.5 ng / l.
Pregnant women do not make a blood test for 17-OH-progesterone, during pregnancy, the level of 17-GPG increases, this fact is a physiological norm. And the more so it is completely pointless to prescribe treatment at an elevated level of 17-OH-progesterone during pregnancy. The only exceptions are cases of classical VDKN.
How to reduce 17-OH-progesterone?
If, according to the results of the tests, the level of 17-OH-progesterone is increased, it is very important to understand the causes of violations before starting treatment. "Blind" treatment, practiced by a considerable number of doctors, relying on old standards of therapy, does not solve the problem, but often exacerbates it.
So, how to reduce the level of 17-OH-progesterone? Regardless of the factor that caused the increase, a woman is prescribed long-term use of COC - combined oral contraceptives (Jess, Yarin, Diana-3 or others). So, if a woman is diagnosed with PCOS, with the normal functioning of the adrenal glands of one COC-therapy before pregnancy is planned, it is usually enough.
If the cause of an elevated level of 17-OCG is a nonclassical VDKN, a comprehensive examination of the endocrinologist and genetics is necessary,
Elevated 17-OH-progesterone in the vast majority of cases is dangerous infertility. Dexamethasone, prednisolone or other glucocorticosteroids should be taken only in the case of a proven nonclassical PDCA and only provided that the pregnancy does not occur more than 1 year, and all other possible causes of infertility are excluded.