Is progesterone low and progesterone supplementation a century misunderstanding?

Progesterone, also known as progesterone, is a natural progesterone secreted by the corpus luteum of human ovary. In the second half of the menstrual cycle of non-pregnant women, progesterone begins to act on the endometrium. Progesterone improves pregnancy reserve If the fertilized egg is compared to a seed, then estrogen is responsible for making the endometrium hyperplasia and thickening, just like making the soil thicker. Progesterone acts on the endometrium, Promote the proliferation of endometrial blood vessels and glands, In the future, oxygen and nutrition will be provided to embryos. Like irrigating and fertilizing seeds, Prepare the uterus for implantation and development of fertilized eggs. Progesterone provides a stable environment and, Progesterone can also inhibit uterine contraction and create a safe and stable growth environment for embryos. Therefore, progesterone is essential for the healthy development of embryos. It must be maintained at a level above which to successfully support the healthy development of fetuses. Too low a level will lead to abortion in early pregnancy and premature delivery in late pregnancy. Does low progesterone definitely lead to abortion? To understand the causes and results of low progesterone levels, It is necessary to explain how progesterone is produced. After the fertilized egg successfully takes root in the mother’s body, The embryo begins to secrete chorionic gonadotropin (hCG) (yes, The hCG used to detect pregnancy), hCG stimulates the ovaries to produce large amounts of progesterone, To provide adequate nutrition and security for embryos. Therefore, The level of progesterone is stimulated by the hormone secreted by the embryo. If the embryo develops abnormally or even spontaneously, It has its own problems, The levels of hCG and progesterone naturally dropped significantly. In other words, In most cases, Low levels of progesterone are the result of miscarriage, Not the cause of miscarriage. 1. Not all miscarriages have low progesterone. Some studies have tested progesterone in pregnant women within 18 weeks of gestation who have developed vaginal bleeding. Only 87.6% of them were found to have decreased progesterone levels, Another 12.4% of the progesterone level tests are normal. 2. Not all pregnant women with low progesterone will miscarry. For those who have vaginal bleeding and are found to have low progesterone levels, It’s not that you’re going to miscarry, Studies show that more than 10% of fetuses are still fine. 3. Due to individual differences in progesterone levels, And is highly volatile, The levels may vary from day to day. So, There is no direct relationship between progesterone level and abortion outcome. Occasionally, a low progesterone level does not mean that an abortion has occurred or will definitely occur. If the body does not have abnormal feelings, such as vaginal bleeding and abdominal pain, it is only an abnormal examination result, so there is no need to be nervous. Must progesterone be supplemented? Progesterone supplementation is no longer meaningful for those pregnant women who have miscarried due to embryonic dysplasia and have low progesterone. Can progesterone supplementation prevent possible abortion in cases where progesterone deficiency may be caused by the mother? In theory, If the embryo develops normally, Inadequate maternal progesterone secretion can lead to miscarriage, Progesterone supplementation is likely to maintain pregnancy. However, the World Health Organization (WHO) comment on [progesterone prevents abortion] clearly points out: [Progesterone treatment does not prevent miscarriage from early to second trimester pregnancy]. In other words, Even if it is true that progesterone is low due to maternal corpus luteum dysfunction, there is no reliable evidence to prove that progesterone supplement is effective in reducing abortion, so progesterone supplement is not helpful to protect the fetus. The World Health Organization recommends that [progesterone should be removed from the list of therapeutic drugs to prevent abortion.] Progesterone is low, what should we do next? < < Corpus Luteum Support and Progesterone Supplement Consensus > > pointed out: Traditionally, On the basis of fully explaining the causes and risks of abortion to pregnant women, It is suggested that they pay attention to rest, Avoid emotional stress, At the same time, psychological treatment should be given until the symptoms disappear. There is an international controversy over whether progesterone supplementation is needed for threatened abortion. At present, there is no sufficient evidence to support that progesterone supplementation can reduce the probability of threatened abortion patients eventually having miscarriage. However, in actual work, If it is not easy to conceive, clinicians can only cooperate with sisters who are willing to take risks to try progesterone to protect the fetus even if the embryo development may be abnormal. Why is progesterone low? As mention earlier, Abortion in the first trimester of pregnancy is mostly due to abnormal embryo itself, About 50-60%, that is to say, low progesterone may be the result of abortion, not the cause. There are many other causes that can lead to abortion, of which only a few are caused by insufficient maternal progesterone secretion: maternal endocrine abnormalities such as corpus luteum insufficiency (leading to insufficient progesterone secretion), poor diabetes blood sugar control, etc. Pregnant women suffer from serious diseases, such as serious liver and kidney diseases, severe anemia, etc. Uterine abnormalities, such as uterine malformation, uterine leiomyoma, cervical internal orifice relaxation, etc.; Physical and psychological stimulation, such as abdominal impact, mental trauma, etc.; Abnormal immune function of the mother leads to rejection of the fetus by the mother. Others include excessive smoking, alcohol abuse, drugs, exposure to poisons and radioactivity. In addition, chromosomal abnormalities in father’s sperm are also one of the causes of abortion. Is it harmful to supplement progesterone more? The problem is somewhat complicated, In the minority view, Progesterone can make the placenta grow too strong, During childbirth, The placenta is not peeled off, May be one of the causes of massive hemorrhage. Progesterone is a hormone, It affects the fetus, It may feminize the male fetus, Female fetuses are too high in estrogen. However, WHO believes that Past evidence is not sufficient to confirm the potential risk of progesterone supplementation, So those expectant mothers who have taken progesterone supplements need not worry too much. However, one fact should be pointed out that cannot be ignored. Progesterone used to be a common practice in the world to treat abortion. With the progress of medical research, mainstream medical circles no longer believe that progesterone can prevent and treat abortion. The United States, Japan and other countries have already deleted progesterone from drug instructions for preventing and treating abortion. Should progesterone be checked in what? It is not necessary for normal pregnant women to routinely check progesterone. As mentioned earlier, If miscarry, Mostly because there is something wrong with the embryo itself, It is wise to eliminate it. It is natural. But if the symptoms described below occur, Especially in the early stages of pregnancy, It’s time to go to the hospital for help, Doctors will combine hCG, progesterone, B-ultrasound and other examination results, To determine if the fetus is still developing normally, So as to make corresponding processing: One of the most common manifestations is vaginal bleeding, Most of them are accompanied by abdominal pain. Another symptom is breast tenderness. Slight stimulation can cause pain. There are also lower back pain, vaginal dryness, sexual intercourse pain, fatigue, insomnia and other symptoms, and even depression in severe cases. Of course, some of these manifestations can also occur during normal pregnancy, so when you suspect that you have the above symptoms, it is better to consult a professional, not blindly doubt.