Fz. Stanczyk et al., URINARY PROGESTERONE AND PREGNANEDIOL - USE FOR MONITORING PROGESTERONE TREATMENT, Journal of reproductive medicine, 42(4), 1997, pp. 216-222
OBJECTIVE: To compare progesterone (P) and pregnanediol glucuronide (P
DG) levels in urine with respect to their potential use for monitoring
luteal activity and P treatment. STUDY DESIGN: Two different experime
nts were carried out. In the first experiment, each of seven normal, o
vulatory women collected first morning urines daily throughout an enti
re menstrual cycle. The day of ovulation was determined by transvagina
l ultrasound scanning. P, PDG, estrone glucuronide, luteinizing hormon
e and creatinine were measured in each urine specimen. In the second e
xperiment, each of three normal, ovulatory women was given a single or
al dose of 200 mg of micronized P and, 2 days later, a single intramus
cular injection of 25 mg of P during days 2-5 of the cycle. Blood and
urine were collected prior to each treatment and 1, 4, 8, 12 and 24 ho
urs after treatment. P was measured in both serum and urine; PDG was q
uantified only in urine. RESULTS: The mean initial rises and peak days
, as well as the patterns of urinary excretion of P and PDG during the
menstrual cycles, were similar; however, the variability of PDG was m
uch greater. Concentrations of PDG were 1,000-4,000 times greater than
those of P. A significant correlation was observed between urinary P
and PDG. Following either intramuscular or oral P treatment, serum P l
evels rose rapidly and reached peak levels (7.0-11.8 ng/ML) by one hou
r. In contrast, both urinary P and PDG peaked considerably later (4-12
hours). Twenty-four hours after intramuscular treatment, serum and ur
inary P and urinary PDG were still elevated. Following oral treatment
the levels of these compounds decreased after peaking and were 10- to
20-fold lower at 24 hours. Also, after oral P treatment, urinary PDG l
evels were considerably higher and more variable as compared to urinar
y P levels. CONCLUSION: Urinary P appears to be as good a clinical mar
ker of luteal activity and therapeutic P administration as PDG and may
be measured in place of this metabolite. There appears to be greater
variability in urinary PDG as compared to urinary P when P is administ
ered.