17-OH progesterone

General Information

Adrenocorticotropic hormone (ACTH, corticotropin) is released from the pituitary gland and stimulates the adrenal cortex. As a result, the adrenal gland secretes glucocorticoids, mineralocorticoids, and androgenic hormones.

The synthesis of these three types of hormones starts from a common substance and goes through several stages.

17-hydroxyprogesterone (17-OHPG or 17-OH-progesterone) is a steroid hormone that plays an important role in these processes. It produces cortisol (glucocorticoid hormone) through a series of transformations. Several enzymes are involved in this process, the most important of which is 21-hydroxylase.

17-OH progesterone is synthesized in the adrenal gland, testes, ovaries, and corpus luteum during pregnancy. This test is mainly used to detect congenital adrenal hyperplasia.

This disease includes a number of conditions associated with inherited pathology of cortisol synthesis.

The most common cause (over 95%) is 21-hydroxylase enzyme deficiency. This deficiency leads to the accumulation of 17-OH progesterone, which can be detected through diagnostic tests.

When should we take the test?

The 17-OH progesterone test is used to make a presumptive diagnostics of congenital adrenal hyperplasia. Along with cortisol and androstenediol, it can be used for disease screening.

Its classic form is most often caused by 21-hydroxylase deficiency and the accumulation of 17-OH progesterone.

Accordingly, it is not converted into cortisol, so the steroid synthesis is switched to the production of androgens and male hormones.

The disease is manifested in childhood with characteristic symptoms:

• Increased size of female genitals in young girls;
• male genitalia in girls,
• Early appearance of genital hair;
• lack of energy
• Disappearance of the desire to eat.

Determination of 17-OH progesterone levels is used in patients with hirsutism and infertility with later adrenal hyperplasia.

When the disease develops at a later age, it is milder and characterized by:

• Irregular menstruation or absence of menstruation;
• hirsutism; growth of facial hair in girls,
• Pronounced acne;
• Low and muffled voice;
• Infertility.

When the above symptoms appear in newborns or girls, it is recommended to test the level of 17-OH progesterone.

The doctor can prescribe other hormonal and diagnostic tests

How to prepare for the test?

Venous blood is required for analysis. The test should be done in the morning on an empty stomach. Since the level of hormones in women affects the menstrual cycle, it is recommended to perform the test during its follicular phase (3-7 days).

Possible interpretation of the results:

High levels of 17-OH progesterone indicate congenital adrenal hyperplasia.

The diagnostics of this disease is always made by examining several hormones.

In patients with 21-hydroxylase deficiency, 17-OH progesterone levels are recurrently high.

They also have high levels of androstenedione and low levels of cortisol.

In other rare forms of congenital adrenal hyperplasia, 17-OH progesterone levels may be low, but mineralocorticoids such as 18-hydroxycorticosterone are elevated.

Sometimes high levels of 17-OH progesterone can be a sign of an adrenal tumor, which can also affect hormone levels.