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Signs & Symptoms of Low Hydroxyprogesterone

You could have low levels of hydroxyprogesterone and not be aware of it--there are no apparent signs or symptoms to watch for. In various circumstances, your doctor may test your levels (it can be useful in some fertility discussions) but the more promising news is that there is a very positive effect of using the synthetic version of this naturally occurring hormone to help to decrease the incidence of preterm labor and treat a variety of menstrual disorders. No longer commericially available in the United States, researchers are studying the positives and the negatives in an effort to understand how it works and if the risk outweighs the reward.

  1. What is It?

    • Hydroxyprogesterone (often referred to as 17a Hydroxyprogesterone caproate) naturally occurs in the body as progesterone is metabolized. Both are produced in substantial volumes during pregnancy (mainly from the placenta). Clinical uses include the treatment of amenhorrea (absence of a period), dysfunctional uterine bleeding (like that which could be caused by uterine cancer or fibroid tumors) and to prevent preterm labor for women with a history of miscarriage or preterm delivery prior to 37 weeks of pregnancy.

    The Facts

    • Hydroxyprogesterone stimulates growing endometrial tissues and has antineoplastic activity; therefore, it has had a positive effect on endometrial cancer (although research is ongoing to better understand how this works). What we do know is that the majority of mammals rely upon naturally occurring progesterone to maintain an inactive uterine state during pregnancy. Prior to giving birth, it's usual for progesterone levels to drop. This is not to say that all preterm labor results from an early drop in progesterone levels (there are many other causes that are still being researched).

    Low Levels Linked to Preterm Labor in Some Women

    • In women who have a history of preterm labor, there has been some success in weekly intramuscular injections with a synthetic form of hydroxyprogesterone between 16 and 36 weeks of gestation. There are still risks involved for the fetus (like ambiguous genitalia) and the drug is classified as a category D for pregnancy, meaning that the benefit of use may outweigh the potential risks. The theory behind the use is to balance the hydroxyprogesterone levels in high-risk women to maintain a calm, inactive uterus.

    Studies on Hydroxyprogesterone

    • Studies are ongoing to determine the therapeutic effects of hydroxyprogesterone. One such study took a group of women who had had a history of preterm delivery and randomly assigned them to either receive injections of hydroxyprogesterone or a placebo. The results were promising and the patients receiving the hormone saw a risk reduction of 18.6 percent as compared to those receiving the placebo.

    Considerations

    • While there are no specific signs or symptoms of low levels of hydroxyprogesterone, using the synthetic version as a treatment seems to hold promise for treating various menstrual disorders and helping to prevent preterm labor in some women with a history of the occurrence.

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