If you are trying to get pregnant, you have probably heard of progesterone. This powerful hormone is critical when trying to conceive — without enough of it, it can be more difficult to get pregnant!
Since progesterone is so important, you may be wondering how to know you have enough. Keep reading to learn how you can take a progesterone at home test!
What is progesterone?
Progesterone is one of the two main female sex hormones and, together with estrogen, it helps regulate your cycle and has a big impact on your overall health. During the first half of the cycle (the follicular phase), progesterone levels are low while estrogen is elevated. Estrogen acts to thicken the uterine lining in preparation for conception.
Then, after ovulation, the empty follicle from which the egg was released (also called the corpus luteum) starts producing progesterone during the second half of your cycle, the luteal phase.
Progesterone is responsible for stabilizing the already thick uterine lining in order to make it “sticky” enough to allow an embryo to implant (given conception occurred that cycle). It also creates a healthy uterine environment in which an embryo can thrive.
If conception occurs, the embryo implants and progesterone levels remain elevated in early pregnancy to prevent premature uterine contractions and to provide the growing fetus with nutrients. On the other hand, if you do not conceive that cycle, progesterone levels drop towards the end of your luteal phase, your uterine lining starts to shed, and your period begins.
Is it important to measure my progesterone levels?
Measuring your progesterone levels can help you better understand if your body is prepared for conception. After all, without enough progesterone it can be more difficult to get pregnant! Additionally, low levels of progesterone can negatively affect implantation and the receptivity of the uterine lining, or even cause early miscarriage.
In fact, progesterone is so important that recent studies show that progesterone supplementation may prevent thousands of miscarriages per year. These studies showed it was especially beneficial for women who experience bleeding in early pregnancy or recurrent early losses.
So, is it important to measure progesterone levels? Yes, here’s why:
- The presence of certain levels of progesterone confirms ovulation. And without ovulation, there’s no chance of conception.
- Progesterone levels need to rise and remain elevated on days 7-10 after peak fertility (also known as the implantation window) in order for you to have the best possible chance at conception.
But progesterone matters for more than just your reproductive health. It can have positive impacts on your overall health! Here are just a few examples:
- It’s common for women to have hormonal imbalances between estrogen and progesterone but, left untreated, it may increase your risk of endometrial cancer and blood clots.
- Low progesterone may be a sign of anovulation and ovulation is a sign of overall health, regardless of the fact that you are trying to get pregnant or not.
- Progesterone helps reduce your PMS (premenstrual syndrome) symptoms
- Low progesterone plays an important part in mood changes, anxiety, depression, headaches/migraines, and irregular periods.
How is progesterone typically measured?
Until recently, the only way how to measure progesterone levels was via a blood test, typically on cycle day 21. This involves getting the blood test ordered by your doctor and going to a lab to have your blood drawn.
Serum progesterone blood tests give exact numerical progesterone measurements, which are very precise and widely used by doctors. However, there are a few drawbacks to serum progesterone testing.
First, a blood test date of cycle day 21 is chosen as this is about 7 days past ovulation, when progesterone should be elevated. This assumes that all women ovulate exactly on cycle day 14, which we know isn’t true!
Every woman is different and it’s incredibly common to ovulate before or after day 14. If this is the case, a cycle day 21 blood draw may show low progesterone levels even though, in reality, you just ovulated a little later than cycle day 14 so your levels are still rising. This can lead to inaccurate assumptions about your progesterone.
The other drawback is that serum blood tests only show progesterone levels at one point in time. This can be an issue for two reasons, the first being that (as we’ve seen) progesterone levels need to remain elevated for several days during the luteal phase to allow for the best possible chance at conception.
The way around this, of course, is to get multiple blood draws over the course of your luteal phase and take the average of these results. But who wants to be poked multiple days in a row?!
The second reason a one-point-in-time blood test can be an issue is that studies have shown serum progesterone levels fluctuate day by day — even hour by hour in some cases! This means that a blood draw taken in the afternoon could give you a very different assumption than a blood draw taken in the morning.
By now you may be wondering, Is there a better way to track progesterone? The answer is, yes! There is! In fact, you can monitor your levels from the comfort of your own home.
How do I test my progesterone levels at home?
Introducing PdG (Pregnanediol Glucuronide): the urine metabolite of progesterone. After progesterone circulates through your bloodstream, it gets metabolized by the liver and excreted from the body in the form of PdG in your urine.
Studies have shown that PdG levels in urine correlate to progesterone levels in blood. In fact, PdG levels in first morning urine after at least a 6 hour hold show an average of all your progesterone levels from the day before (as you’ll remember that progesterone levels can fluctuate drastically). PdG is not subject to the same fluctuations as progesterone.
PdG tests offer a non-invasive, at-home alternative to how to check progesterone levels. Since PdG tests allow you to test levels over multiple days, you can get a more complete picture of your levels throughout your luteal phase.
Proov PdG tests are the first and only FDA cleared PdG test to confirm successful ovulation at home. Proov PdG tests are designed to turn positive when there is 5 ug/ml of PdG present in urine which studies show leads to the highest chance of successful pregnancy. In fact, a recent clinical study* showed that elevated PdG levels after ovulation during the implantation window can increase pregnancy rates by up to 75%!
The Proov testing protocol recommends testing PdG levels daily on days 7-10 after peak fertility (i.e. a positive LH test). While a single positive Proov PdG test confirms ovulation, we like to see 3-4 positives on these days (with a positive on day 10 past peak fertility) to confirm that successful ovulation did in fact occur. Successful ovulation refers to an ovulatory event in which an egg is released and PdG levels remain elevated for long enough to allow for the best possible chance at conception.
If you get anything less than 3 positive Proov PdG tests or your day 10 past peak fertility test is negative, this means your PdG levels are low and could be making it more difficult for you to conceive. If this is the case, we recommend consulting your doctor for further treatment. Often, natural remedies can do the trick!
PdG testing makes it easy to monitor your progesterone levels and luteal phase from the comfort of your home so that you can get pregnant faster!
The Accuracy and Reliability of At-Home Testing for Progesterone Levels
This all sounds great, but how do we know these PdG tests are accurate? Thankfully, third party researchers have begun studying the effectiveness of these tests to see if they are accurate and really worth using. One such study found that ovulation was detected in 82% of test cycles!
This is great news, especially for those hoping to use PdG testing to evaluate their chances at pregnancy. Since progesterone levels are important for both implantation and continuing pregnancy, it’s critical for early evaluation. Unlike what you may think, most of progesterone side effects are positive ones!
This early study suggested that more ovulations would be identified if PdG testing limits were even lower, but considering low PdG is a concern to early pregnancies, even the 18% of ovulations that were not detected still point to a real concern for these cycles, and can be beneficial information for medical collaboration.
Additional studies have shown that PdG testing for at least three consecutive days after suspected ovulation can give even better results. In this study, 100% of ovulations were confirmed! This goes to show that PdG is best tested over the course of a few days after expected ovulation, in order to track the rise and strength of the progesterone production.
What are the potential drawbacks of testing at home?
Like with any other new tool, there can be a learning curve when trying out something for the first time. That means there could be a degree of user error to consider when first getting started. It’s possible that new users may:
- Take the test incorrectly
- Take the test on the wrong day of their cycle
- Mot understand the results of their test
Because of that, you’ll find that we have created resources to help you feel confident when you use our at-home hormone testing for the first time.
For example, knowing when to take your PdG tests are important for accurate results. If testing is done before ovulation, no information will be provided and, if this error wasn’t realized, could lead to incorrect information about whether or not you’re ovulating.
Another potential drawback is that having new hormonal information may feel overwhelming to some users. What do you do once you know you have low PdG levels, for instance? Instead of feeling alone with the results, they may be helpful to share with your doctor to jumpstart the healing process.
The best way to make the most of your PdG testing is to be knowledgeable about your menstrual cycle, prepare yourself with our resources and tips, and collaborate with your doctor about testing and results. With these tools, you’ll be more informed and proactive about your cycle health than ever before!
*Amy Beckley, Joshua Klein, John Park, Aimee Eyvazzadeh, Gary Levy, Alexandra Koudele. The predictive value of urinary progesterone metabolite PdG testing in pregnancy outcomes. Obstetrics and Gynecology Research 5 (2022): 194-198.