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Pregnanediol is an inactive product that forms when the body breaks down the hormone progesterone. A test can be done to measure the amount of pregnanediol in urine. The urine test offers an indirect way to measure progesterone levels in the body.

A 24-hour urine sample is needed.

Your doctor may tell you to stop taking certain drugs that can affect the test. For example, ACTH may increase test measurements. Birth control pills or progesterone may decrease test measurements.

The test involves only normal urination, and there is no discomfort.

Before progesterone blood tests were available, this test was used to monitor pregnancies and check for possible problems with the ovaries or adrenal cortex.

In women, progesterone is produced mainly after the ovaries release an egg (ovulation). The main function of progesterone is to help the uterus prepare for possible implantation of a fertilized egg. After fertilization, progesterone is necessary for the development of the placenta, the organ that develops to nourish the growing baby. During pregnancy, most progesterone is produced by the placenta.

Some progesterone is also produced by the adrenal cortex. See: Adrenal glands

Currently there is little use for this test except in home ovulation predictor kits.

Normal values in women vary depending on when the test is done. Levels rise consistently during pregnancy and range from 40 milligrams to 100 milligrams in 24 hours.

Lower levels are found during certain phases of the menstrual cycle and after menopause.

In men, normal values range from 0.1 to 0.7 milligrams per 24 hours.

Higher-than-normal levels may be due to:

• Adrenocortical hyperplasia
• Arrhenoblastoma of ovary
• Choriocarcinoma of ovary
• Hyperadrenocorticism
• Ovarian cyst

Lower-than-normal levels may be due to:

• Amenorrhea
• Decreased ovarian function
• Fetal death
• Ovarian cancer
• Preeclampsia
• Threatened abortion
• Toxemia of pregnancy

There are no risks.

Lobo RA. Reproductive endocrinology: neuroendocrinology, gonadotropins, sex steroids, prostaglandins, ovulation, menstruation, hormone assay. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 4.

Lehmann HP, Henry JB. SI units. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 21st ed. Philadelphia, Pa: Saunders Elsevier; 2006:appendix 5.

Updated by: Linda Vorvick, MD, Family Physician, Seattle Site Coordinator, Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.