Androgens & Progesterones Profile

What this laboratory test evaluates

ProgesteronesProgesterone (P4) is primarily produced in the corpus luteum following ovulation in women, and to a lesser degree in the adrenal glands in both sexes. In urine, progesterone is a clinical marker of luteal activity and therapeutic oral progesterone administration. The most important progesterone metabolite, pregnanediol (PD), is a marker of endogenous progesterone levels and an indicator of ovulation. PD exists as two isomers, 5α-pregnanediol (5A-PD), and 5β-pregnanediol (5B-PD). 5B-PD represents the majority endpoint of endogenous progesterone metabolism and appears to have little physiological activity, while 5A-PD, the lesser metabolite of PDL, can cross the blood-brain barrier and has been shown to partially agonize GABA-A receptors, perhaps due to its role as an immediate precursor to allopregnanolone. Allopregnanolone (ALLOP) is a potent neuroactive steroid capable of binding the GABA-A receptor contributing to a sedative and anxiolytic effect. This calming action is seen with orally supplemented progesterone, as it is metabolized to neuroactive steroid ALLOP in the liver.

AndrogensAndrogens play a significant role in structure and function of muscle, bone, and connective tissue, metabolic homeostasis and reproduction in both men and women. When evaluating the androgens, it is important to assess unconjugated hormones, enzymes, metabolites, and clinical symptoms to gain an understanding of the complete clinical picture. The key areas of focus within the androgen pathway are androstenedione, DHEA, testosterone, 5-alpha and 5-beta reductase. Testosterone is derived from androstenedione and DHEA. 5α-reductase converts testosterone into the metabolite 5α-DHT which is three times more potent than testosterone. Symptoms associated with higher androgen levels (thinning hair, acne, etc) are often seen when levels of 5α-reductase and its corresponding metabolites are elevated. 5b-reductase and its corresponding metabolites are much less androgenic. The assessment of 5 alpha and 5 beta metabolisms can be understood by following the metabolism of androstenedione to etiocholanolone (5α) and androstenedione to androsterone (5β). The relative ratio between these two pathways and the amounts of 5α androstanediol and 5β-androstanediol may give insight into the full androgenic picture. Androgen deficiency symptoms can be caused by lower levels of DHEA, testosterone, or 5α metabolites.

Additional test information

Androgens and progesterone are tested together due to their proximity to each other on the hormone cascade. The Androgens and Progesterones Profile combines unconjugated steroid hormones and their metabolites, providing insight into the efficiency of the enzymes that metabolize them. This non-invasive test requires only 4 or 5 separate urine collections.

This profile is a consideration for baseline or follow up testing for patients with concerns that are particular to androgens and progesterones and/or monitoring for harmful metabolites due to the influence of HRT/BHRT.

Collection and processing

• Sample type: Urine
• Fasting: No
• Estimated laboratory processing: Results should arrive 5 to 7 days after the lab receives samples.

How Sunridge uses laboratory information

Sunridge considers the medical question, symptoms, history, medications, prior results, and whether the finding could change care before recommending testing. A laboratory result is not interpreted in isolation and does not establish a diagnosis by itself.

Before requesting this test

Availability, collection requirements, eligibility, and processing estimates can change. Sunridge reviews each request and, when appropriate, creates the order through Fullscript. Follow the current instructions supplied with the approved order.