Hydroxyprogesterones
Hydroxyprogesterones are hormones formed by adding a small oxygen and hydrogen group to progesterone. Two of them matter in reproductive health.
The first is 17-alpha-hydroxyprogesterone (17-OHP). The body makes it as a step toward cortisol. A high blood level of 17-OHP is the main screening sign of a mild adrenal gland condition. This condition is non-classic congenital adrenal hyperplasia (CAH), and it starts later in life.1 It usually results from a lack of the enzyme 21-hydroxylase. It can cause excess male-type hormones (androgens), irregular cycles, and acne. These signs can closely resemble polyendocrine metabolic ovarian syndrome (PMOS), formerly polycystic ovary syndrome (PCOS). Testing 17-OHP helps rule out CAH before high androgen levels are blamed on PMOS / PCOS.
The second is 17-alpha-hydroxyprogesterone caproate (17-OHPC). It is a synthetic hormone injection, once sold as Makena. It was meant to prevent preterm (early) birth in women who had given birth early before. A large follow-up trial found that it did not lower the rate of preterm birth.2 In April 2023, the FDA withdrew its approval.3 Restorative care favors support with progesterone that matches the body's own, rather than a synthetic version.
Cited in this entry
- Speiser PW, Arlt W, Auchus RJ, et al. Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018. https://pubmed.ncbi.nlm.nih.gov/30272171/
- Blackwell SC, Gyamfi-Bannerman C, Biggio JR Jr, et al. 17-OHPC to prevent recurrent preterm birth in singleton gestations (PROLONG study): a multicenter, international, randomized double-blind trial. Am J Perinatol. 2020. https://pubmed.ncbi.nlm.nih.gov/31652479/
- U.S. Food and Drug Administration. FDA commissioner and chief scientist announce decision to withdraw approval of Makena. 2023. https://www.fda.gov/news-events/press-announcements/fda-commissioner-and-chief-scientist-announce-decision-withdraw-approval-makena
This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.
