Progesterone is a steroid hormone involved in the female menstrual cycle, pregnancy (supports gestation ), and embryogenesis of humans and other species.
Progesterone belongs to a class of hormones called progestogens and is the major naturally-occurring human form in this category. Progesterone exerts its primary action through the intracellular progesterone receptor, although a distinct, membrane-bound progesterone receptor has also been postulated.
Functions of Progesterone
Progesterone has a number of physiological effects that are amplified in the presence of estrogen. Estrogen, through estrogen receptors, upregulates the expression of progesterone receptors. Also, elevated levels of progesterone potently reduce the sodium-retaining activity of aldosterone, resulting in natriuresis and a reduction in extracellular fluid volume. Progesterone withdrawal, on the other hand, is associated with a temporary increase in sodium retention (reduced natriuresis, with an increase in extracellular fluid volume) due to the compensatory increase in aldosterone production. This combats the blockade of the mineralocorticoid receptor by the previously-elevated level of progesterone.
Progesterone has key effects via non-genomic signalling on human sperm as they migrate through the female tract before fertilization occurs, though the receptor(s) as yet remain unidentified. Detailed characterization of the events occurring in sperm in response to progesterone has shed light on intracellular calcium transients, maintained changes, and slow calcium oscillations, now thought to possibly regulate motility.
Progesterone is sometimes called the “hormone of pregnancy” and has many roles relating to fetal development. It converts the endometrium to its secretory stage to prepare the uterus for implantation. At the same time, it affects the vaginal epithelium and cervical mucus, making them thick and impenetrable to sperm.
If pregnancy does not occur, progesterone levels will decrease, leading to menstruation. Normal menstrual bleeding is progesterone-withdrawal bleeding. If ovulation does not occur and the corpus luteum does not develop, its levels may be low, leading to anovulatory dysfunctional uterine bleeding. During implantation and gestation, progesterone appears to decrease the maternal immune response to allow for the acceptance of the pregnancy and decrease contractility of the uterine smooth muscle.
In addition, progesterone inhibits lactation during pregnancy. A drop in its levels is facilitates the onset of labor. Another drop following delivery is one of the triggers for milk production. The fetus metabolizes placental progesterone in the production of adrenal steroids.