Saliva
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Hormones · Saliva
Progesterone
The free progesterone in saliva; varies greatly with the cycle and cannot be compared one to one with progesterone in blood.
At a glance
- Measured in saliva
- In 2 test panels
- Check the preparation
Explanation
Progesterone: what is measured?
After ovulation, progesterone is made by the corpus luteum in the ovary and prepares the lining of the uterus for a pregnancy. Saliva contains only the free part that is not bound to proteins in the blood. The value is low in the first half of the cycle, rises after ovulation and falls again just before menstruation. The value also fluctuates over the day.
What can it detect?
- A rough indication of whether ovulation has taken place, although progesterone in blood in the second half of the cycle says more about this
- Use of progesterone or progestogens, for example as a cream
Result
What does the result mean?
Progesterone too high
A higher value in the second half of the cycle and in pregnancy is normal. A very high value is often due to progesterone cream or gel: this is absorbed through the skin and ends up in saliva in much higher concentrations than in blood, or contaminates the sample via the hands. Bleeding gums and eating or drinking just before collecting can also raise the result.
Progesterone too low
A low value is normal in the first half of the cycle, after menopause, in men and when taking the pill. In the second half of the cycle, a low value can fit a cycle without ovulation, which happens occasionally in every woman. Often the sample was also collected at the wrong moment in the cycle. With an irregular cycle, the right moment is hard to determine.
After an abnormal result
With problems getting pregnant or an irregular cycle, the GP usually has progesterone measured in blood, about a week before the expected period, and FSH, LH and estradiol if needed. An abnormal saliva value without symptoms usually does not lead to further tests.
Reliability
How reliable is the test?
The value in saliva cannot be compared one to one with blood, and there are few agreed cut-off values for saliva. The meaning of an abnormal saliva value has been little studied, and when progesterone cream is used, saliva often gives a much higher value than blood. The result depends strongly on the cycle day and the time of collection. According to the Dutch GP guideline (NHG) on subfertility, whether ovulation takes place is better assessed with progesterone in blood about a week before the expected period, or from a regular cycle.
What can affect the result?
- Cycle day and time: the result can only be interpreted if the moment in the cycle is known, preferably about 7 days before the expected period, at the agreed time of day.
- Collection: do not eat, drink, smoke or brush your teeth just before collecting; brushing your teeth and blood from the gums can strongly disturb the result. Rinse your mouth with water about ten minutes beforehand.
- Progesterone cream, gel and vaginal progesterone can contaminate the sample or give a falsely high saliva value; the pill suppresses the body's own production.
- Measurement methods for saliva are not standardized; reference values differ between laboratories.
Preparation
- Fill the first tube straight after waking up and the next ones after 30 and 60 minutes. Do you have a cycle and not use the pill? Do the test on day 19, 20 or 21 (with a cycle of 26 to 29 days). If you use the pill, do the test at the start of your pill-free week.
- Do not eat, drink, smoke or brush your teeth until after the third tube. Do not use mouthwash or dental floss that day.
- Do you use hormone preparations such as hydrocortisone or progesterone? Then stop 48 hours beforehand, in consultation with your doctor.
- Stop supplements that affect hormones, such as maca, 5 days beforehand.
Who it is for
Who is the test useful for?
Useful for
For the question of whether ovulation takes place, with irregular periods or with problems getting pregnant, progesterone in blood, at the right moment in the cycle, says more than a saliva value. Not suitable for establishing a 'progesterone deficiency' or 'estrogen dominance': these are not recognized diagnoses. In people without symptoms, an abnormal value says little.
How common is it?
About 10 to 15 in 100 couples are not pregnant after a year of trying; absent ovulation is one of the causes. A cycle without ovulation occasionally occurs in every woman. How often an abnormal progesterone in saliva occurs in women without symptoms is not known.
NHG guideline on subfertility
Drawbacks and risks
- An abnormality without symptoms means little, but can cause unnecessary worry or wrongly be seen as a reason for progesterone cream or supplements.
- A low value due to collecting at the wrong moment can wrongly cause worries about fertility.
Get tested
Progesterone: test panels
Progesterone is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.
Evidence
Sources
This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.
More about risks and results