The main goal of the hormonal circulation inthe 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 lobe of the pituitary: FSH and LH is regulated.
Formation of ovulation
In the pre-ovulatory stage of the menstruation cyclethe ovarian follicle undergoes certain transformations. These changes occur under the influence of FSH. After the follicle reaches a certain size, as well as functional activity, the LH forms an ovulatory peak. As a result, the "maturation" of the ovum (the first division of meiosis) is started. After this phase, a rupture in the follicle occurs, through which the egg leaves. The interval between the peak phase and ovulation is about 36-48 hours. During the postovulatory phase, the egg usually travels to the uterus through the fallopian tube. In the case of fertilization on the third or fourth day, the embryo penetrates into the uterine cavity. There is his implantation. If fertilization has not occurred, the egg within a day dies in the fallopian tube.
Substances involved in the life-sustaining reproductive function of women
Intersecretory glands formbiologically active compounds. They are called hormones. It is through them through the hypothalamic-pituitary-ovarian system that the active activity of reproductive organs occurs. Each connection performs certain 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 small amounts in the ovaries. The increase in the content of the substance coincides with the peak LH stage. After that, in the middle of the cycle, the concentration decreases for a short period. Progesterone in the follicular phase slows the proliferation of endometrium, stimulated by estrogen. As a result, the connection is transformed. The main cause of menstruation is the sudden cessation of production by the yellow body of progesterone 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 the changes occurring in early pregnancy. Progesterone provides regulation of the glands in the cervix, reduces the contractility of the cavity. The compound also suppresses menstruation.
Hormone 17-OH-progesterone. Description
It is the precursor of steroids.From it, in the adrenal glands, cortisol is formed under the influence of enzymes such as 11-b hydroxylase or 21-hydroxylase. 17-ON-progesterone in women can synthesize androstenedione. This substance is a precursor of testosterone and estradiol. It is formed in the ovaries and adrenal glands. In the blood, progesterone-17-OH is present in the free and transcortin-bound and albumin-bound proteins. In the absence of fertilization, the concentration of the substance is reduced. In the case of implantation of the ovum, the yellow body in the ovaries continues its production.
Concentration
17-OH-progesterone is elevated in the morning hours.The minimum content is found in the night. During the day, its level varies. The concentration of the compound is also different during the menstrual cycle. A significant increase in the level is noted the day before the peak of LG. After this, the phase of maximum concentration follows (in the middle of the cycle). During pregnancy, the content of the substance is significantly increased. 17-ON-progesterone, the norm of which is established according to age, in children is contained in a small amount. Large concentrations are noted only in the fertile period and immediately after birth. In preterm infants, its content is relatively higher. During the first week, the connection level drops. Progressive increase is noted during puberty. During this period, progesterone-17-OH in adolescents gradually reaches the same concentration as in adults.
Why do I need a blood test?
17-OH-progesterone is an intermediateproduct. However, its study is an important stage in the diagnosis of various pathologies. Indications for the study include infertility, hirsutism, cycle disorders. With hyperplasia of the adrenal glands as a treatment, patients are prescribed substitution therapy with steroids. To assess its effectiveness, an analysis is also assigned. 17-OH-progesterone is studied in newborns. Its concentration is studied in case of suspected deficiency of 21-hydroxylase. Deficiency of this enzyme is observed with adrenal hyperplasia of the congenital type.
Preparation for laboratory research
If the doctor did not specify a different time, then the bloodsurrenders on the third-fifth day of the cycle. The study is carried out on an empty stomach, in the morning. Do not use coffee or tea. It is allowed to drink plain water. From the last meal and until blood donation must pass at least eight hours. Experts consider it inexpedient to study the hormones of the second phase on the 20th-23rd day. If the duration of the cycle is 42 days, then blood sampling takes place on the 35th day. On the 23rd day, the first phase continues. The level of progesterone is lowered, but this does not indicate a lack of luteal phase or anovulation. It makes no sense to conduct a study of concentration during pregnancy and take any medications. In this case, high 17-OH-progesterone is the norm. Such maintenance during the prenatal period of therapy does not demand.
Interpretation of results
As mentioned above, the normal levelhormone progesterone-17-OH depends on age. The gender of the patient is also important. Concentration is determined in ng / ml. The optimal content for children up to a month - 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 acceptable 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 in 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 deficiency of enzymes participating in the synthesis of steroids. Lack of compounds may have varying degrees of severity. In infancy with congenital hyperplasia, virilization develops (the formation of male features in women). In severe cases, the lack of enzymes provokes serious disruptions in the synthesis of steroids, loss of salts, which can be life-threatening. Partial enzyme deficiency detected in adults may also be congenital. In this case, violations initially occur in a latent form and are not always detected in childhood. Impaired enzyme synthesis may be progressive. Under the influence of negative pathological factors, the likelihood of functional and morphological changes in the adrenal glands, similar to the manifestations of congenital syndrome, increases. 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 in the manifestation of male sexual characteristics in girls. Therefore, the study of its concentration is important in determining the effectiveness of the resulting therapy.
What is more dangerous deficiency of the enzyme 21-hydroxylase
Compound deficiency manifests itself reducedaldosterone formation. This adrenal hormone provides regulation of water-salt balance, retains salt in the body. Infants have a "crisis loss". For such a state is characterized by the accumulation of fluid in large volumes. At the same time the necessary salts are actively eliminated from the body. As a result, the potassium content begins to increase, and sodium - to decrease. Partial enzyme deficiency is characterized by an erased clinical picture. Suspicions of deficiency appear on the background of violations of puberty and growth in the pubertal period, in older age - with infertility and disturbed course of the menstrual cycle, among girls - with hirsutism.
Conclusion
Sex hormone activity is one ofdetermining factors not only in the functioning of the reproductive system in women. The interaction of compounds, their stable and normal activity, participation in different processes, as well as the presence in optimal concentration, affects the overall development of the body and health in general. 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 be examined. Some diseases have a latent form and, if not diagnosed late, lead to serious consequences. Of particular importance is the state of hormonal background for women.
