17-ON-progesterone elevated - treatment

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:

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, re-determination of the level of 17-OH-progesterone, if necessary, MRI of the Turkish saddle and other diagnostic measures. It is impossible to get rid of non-classical VDKN and, contrary to generally accepted opinions, elevated 17-OH-progesterone does not require corticosteroid treatment.

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.