|3D model (Jmol)||Interactive image|
|Molar mass||314.46 g/mol|
|By mouth, topical/transdermal, vaginal, intramuscular injection, subcutaneous injection, subcutaneous implant|
|• Albumin: 80%
• CBG: 18%
• SHBG: <1%
• Free: 1–2%
|Hepatic (CYP2C19, CYP3A4, CYP2C9, 5α-reductase, 3α-HSD, 17α-hydroxylase, 21-hydroxylase, 20α-HSD)|
|OMP: 16–18 hours
IM: 22–26 hours
SC: 13–18 hours
Except where otherwise noted, data are given for materials in their standard state (at 25 °C [77 °F], 100 kPa).
|what is ?)(|
Progesterone (P4) is an endogenous steroid and progestogen sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans and other species. It belongs to a group of steroid hormones called the progestogens, and is the major progestogen in the body. Progesterone is also a crucial metabolic intermediate in the production of other endogenous steroids, including the sex hormones and the corticosteroids, and plays an important role in brain function as a neurosteroid.
- 1 Biological activity
- 2 Biological function
- 3 Biochemistry
- 4 Medical uses
- 5 Chemistry
- 6 History
- 7 References
- 8 External links
Progesterone is the most important progestogen in the body, the result of its action as a potent agonist of the nuclear progesterone receptor (nPR) (with an affinity of KD = 1 nM). In addition, progesterone is an agonist of the more recently discovered membrane progesterone receptors (mPRs), as well as a ligand of the PGRMC1 (progesterone receptor membrane component 1; formerly known as the σ2 receptor). Moreover, progesterone is also known to be an antagonist of the σ1 receptor, a negative allosteric modulator of the nACh receptors, and a potent antagonist of the mineralocorticoid receptor (MR). Progesterone prevents MR activation by binding to this receptor with an affinity exceeding even those of aldosterone and glucocorticoids such as cortisol and corticosterone, and produces antimineralocorticoid effects, such as natriuresis, at physiological concentrations. In addition, progesterone binds to and behaves as a partial agonist of the glucocorticoid receptor (GR), albeit with very low potency (EC50 >100-fold less relative to cortisol).
Progesterone and some of its metabolites, such as 5β-dihydroprogesterone, are agonists of the pregnane X receptor (PXR), albeit weakly so (EC50 >10 µM). In accordance, progesterone induces several hepatic cytochrome P450 enzymes, such as CYP3A4, especially during pregnancy when concentrations are much higher than usual. Perimenopausal women have been found to have greater CYP3A4 activity relative to men and postmenopausal women, and it has been inferred that this may be due to the higher progesterone levels present in perimenopausal women.
Progesterone modulates the activity of CatSper (cation channels of sperm) voltage-gated Ca2+ channels. Since eggs release progesterone, sperm may use progesterone as a homing signal to swim toward eggs (chemotaxis). As a result, it has been suggested that substances that block the progesterone binding site on CatSper channels could potentially be used in male contraception.
Progesterone has a number of physiological effects that are amplified in the presence of estrogens. Estrogens through estrogen receptors (ERs) induce or upregulate the expression of the PR. One example of this is in breast tissue, where estrogens allow progesterone to mediate lobuloalveolar development.
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, which 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 characterisation of the events occurring in sperm in response to progesterone has elucidated certain events including intracellular calcium transients and maintained changes, slow calcium oscillations, now thought to possibly regulate motility. It is produced by the ovaries. Interestingly, progesterone has also been shown to demonstrate effects on octopus spermatozoa.
Progesterone is sometimes called the "hormone of pregnancy", and it has many roles relating to the development of the fetus:
- Progesterone converts the endometrium to its secretory stage to prepare the uterus for implantation. At the same time progesterone affects the vaginal epithelium and cervical mucus, making it thick and impenetrable to sperm. Progesterone is anti-mitogenic in endometrial epithelial cells, and as such, mitigates the tropic effects of estrogen. If pregnancy does not occur, progesterone levels will decrease, leading, in the human, to menstruation. Normal menstrual bleeding is progesterone-withdrawal bleeding. If ovulation does not occur and the corpus luteum does not develop, levels of progesterone 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.
- Progesterone decreases contractility of the uterine smooth muscle.
- In addition progesterone inhibits lactation during pregnancy. The fall in progesterone levels following delivery is one of the triggers for milk production.
- A drop in progesterone levels is possibly one step that facilitates the onset of labor.
Progesterone plays an important role in mammary gland development in females. In conjunction with prolactin, it mediates lobuloalveolar maturation of the breasts during pregnancy to allow for milk production, and thus lactation and breastfeeding after childbirth. Estrogen is required for progesterone to mediate lobuloalveolar maturation, as it induces expression of the PR in breast tissue. Moreover, it has been found that RANKL is a critical downstream mediator of progesterone-mediated lobuloalveolar development. Knockout mice of RANKL show an almost identical mammary phenotype relative to PR knockout mice, including normal mammary ductal development but complete failure of the development of lobuloalveolar structures.
Though to a far lesser extent than estrogen, which is the major mediator of breast ductal development (via ERα, specifically), progesterone has been found to be involved in ductal development as well. PR knockout mice or mice treated with the PR antagonist mifepristone show delayed but otherwise normal ductal development at puberty. In addition, mice modified to have overexpression of PRA display ductal hyperplasia, and progesterone induces ductal growth in mouse mammary gland. Progesterone mediates ductal development mainly via the induction of amphiregulin, the same growth factor that estrogen primarily induces to mediate ductal development. These findings suggest that, while not essential for full ductal development, progesterone seems to play a potentiating or accelerating role in estrogen-mediated ductal development, at least in mice.
Progesterone also appears to be involved in the pathophysiology of breast cancer, though its role, and whether it is a promoter or inhibitor of breast cancer risk, has not been fully elucidated. In any case, while certain synthetic progestins with androgenic effects such as medroxyprogesterone acetate and 19-nortestosterone derivatives including norethisterone acetate, norgestrel, and levonorgestrel have been found to significantly increase the risk of breast cancer in postmenopausal women in combination with estrogen as a component of hormone replacement therapy, the combination of natural progesterone or the pure, non-androgenic progestin dydrogesterone with estrogen has been found not to do so. In fact, progesterone or dydrogesterone added to estrogen appear to decrease the risk of breast cancer relative to estrogen alone.
Dr. Diana Fleischman, of the University of Portsmouth, and colleagues examined the relationship between progesterone and sexual attitudes. Their research was published in the Archives of Sexual Behavior. They found that women who have higher levels of progesterone are more likely to be open to the idea of engaging in sexual behaviour with other women. Similarly, when heterosexual men are subtly reminded of the importance of having male friends and allies, they report more positive attitudes toward engaging in sexual behaviour with other men. This pattern is particularly dramatic in men who have high levels of progesterone.
Progesterone, like pregnenolone and dehydroepiandrosterone (DHEA), belongs to an important group of endogenous steroids called neurosteroids. It can be synthesized within the central nervous system and also serves as a precursor to another major neurosteroid, allopregnanolone.
Neurosteroids are neuromodulators, and are neuroprotective, neurogenic, and regulate neurotransmission and myelination. The effects of progesterone as a neurosteroid are mediated predominantly through its interactions with non-nuclear PRs, namely the mPRs and PGRMC1, as well as certain other receptors, such as the σ1 and nACh receptors.
Since most progesterone in males is created during testicular production of testosterone, and most in females by the ovaries, the shutting down (whether by natural or chemical means), or removal, of those inevitably causes a considerable reduction in progesterone levels. Previous concentration upon the role of progestogens in female reproduction, when progesterone was simply considered a "female hormone", obscured the significance of progesterone elsewhere in both sexes.
The tendency for progesterone to have a regulatory effect, the presence of progesterone receptors in many types of body tissue, and the pattern of deterioration (or tumor formation) in many of those increasing in later years when progesterone levels have dropped, is prompting widespread research into the potential value of maintaining progesterone levels in both males and females.
Previous studies have shown that progesterone supports the normal development of neurons in the brain, and that the hormone has a protective effect on damaged brain tissue. It has been observed in animal models that females have reduced susceptibility to traumatic brain injury and this protective effect has been hypothesized to be caused by increased circulating levels of estrogen and progesterone in females.
The mechanism of progesterone protective effects may be the reduction of inflammation that follows brain trauma.
Damage incurred by traumatic brain injury is believed to be caused in part by mass depolarization leading to excitotoxicity. One way in which progesterone helps to alleviate some of this excitotoxicity is by blocking the voltage-dependent calcium channels that trigger neurotransmitter release. It does so by manipulating the signaling pathways of transcription factors involved in this release. Another method for reducing the excitotoxicity is by up-regulating the GABAA, a widespread inhibitory neurotransmitter receptor.
Progesterone has also been shown to prevent apoptosis in neurons, a common consequence of brain injury. It does so by inhibiting enzymes involved in the apoptosis pathway specifically concerning the mitochondria, such as activated caspase 3 and cytochrome c.
Not only does progesterone help prevent further damage, it has also been shown to aid in neuroregeneration. One of the serious effects of traumatic brain injury includes edema. Animal studies show that progesterone treatment leads to a decrease in edema levels by increasing the concentration of macrophages and microglia sent to the injured tissue. This was observed in the form of reduced leakage from the blood brain barrier in secondary recovery in progesterone treated rats. In addition, progesterone was observed to have antioxidant properties, reducing the concentration of oxygen free radicals faster than without. There is also evidence that the addition of progesterone can also help remyelinate damaged axons due to trauma, restoring some lost neural signal conduction. Another way progesterone aids in regeneration includes increasing the circulation of endothelial progenitor cells in the brain. This helps new vasculature to grow around scar tissue which helps repair the area of insult.
Progesterone enhances the function of serotonin receptors in the brain, so an excess or deficit of progesterone has the potential to result in significant neurochemical issues. This provides an explanation for why some people resort to substances that enhance serotonin activity such as nicotine, alcohol, and cannabis when their progesterone levels fall below optimal levels.
- Sex differences in hormone levels may induce women to respond differently than men to nicotine. When women undergo cyclic changes or different hormonal transition phases (menopause, pregnancy, adolescence), there are changes in their progesterone levels. Therefore, females have an increased biological vulnerability to nicotine’s reinforcing effects compared to males and progesterone may be used to counter this enhanced vulnerability. This information supports the idea that progesterone can affect behavior.
- Similar to nicotine, cocaine also increases the release of dopamine in the brain. The neurotransmitter is involved in the reward center and is one of the main neurotransmitters involved with substance abuse and reliance. In a study of cocaine users, it was reported that progesterone reduced craving and the feeling of being stimulated by cocaine. Thus, progesterone was suggested as an agent that decreases cocaine craving by reducing the dopaminergic properties of the drug.
- Progesterone also has a role in skin elasticity and bone strength, in respiration, in nerve tissue and in female sexuality, and the presence of progesterone receptors in certain muscle and fat tissue may hint at a role in sexually dimorphic proportions of those.[copyright violation?]
- During pregnancy, progesterone is said to decrease irritability.
- During pregnancy, progesterone helps to suppress immune responses of the mother to fetal antigens, which prevents rejection of the fetus.
- Progesterone raises epidermal growth factor-1 (EGF-1) levels, a factor often used to induce proliferation, and used to sustain cultures, of stem cells.
- Progesterone increases core temperature (thermogenic function) during ovulation.
- Progesterone reduces spasm and relaxes smooth muscle. Bronchi are widened and mucus regulated. (PRs are widely present in submucosal tissue.)
- Progesterone acts as an antiinflammatory agent and regulates the immune response.
- Progesterone reduces gall-bladder activity.
- Progesterone normalizes blood clotting and vascular tone, zinc and copper levels, cell oxygen levels, and use of fat stores for energy.
- Progesterone may affect gum health, increasing risk of gingivitis (gum inflammation).
- Progesterone appears to prevent endometrial cancer (involving the uterine lining) by regulating the effects of estrogen.
- Progesterone plays an important role in the signaling of insulin release and pancreatic function, and may affect the susceptibility to diabetes or gestational diabetes.
- Progesterone may play a role in male behavior, such as in male aggression towards infants.
Cholesterol undergoes double oxidation to produce 22R-hydroxycholesterol and then 20α,22R-dihydroxycholesterol. This vicinal diol is then further oxidized with loss of the side chain starting at position C22 to produce pregnenolone. This reaction is catalyzed by cytochrome P450scc.
The conversion of pregnenolone to progesterone takes place in two steps. First, the 3β-hydroxyl group is oxidized to a keto group and second, the double bond is moved to C4, from C5 through a keto/enol tautomerization reaction. This reaction is catalyzed by 3β-hydroxysteroid dehydrogenase/δ5-4-isomerase.
Progesterone in turn is the precursor of the mineralocorticoid aldosterone, and after conversion to 17α-hydroxyprogesterone, of cortisol and androstenedione. Androstenedione can be converted to testosterone, estrone, and estradiol.
The metabolism of progesterone is rapid and extensive and occurs mainly in the liver, though extrahepatic tissues are also involved. Progesterone has a terminal half-life of only approximately 5 minutes in circulation. The metabolism of progesterone is complex, and it may form as many as 35 different unconjugated metabolites when it is ingested orally. Progesterone is highly susceptible to enzymatic reduction via reductases and hydroxysteroid dehydrogenases due to its double bond (between the C4 and C5 positions) and its two ketones (at the C3 and C20 positions).
The major metabolic pathway of progesterone is reduction by 5α-reductase and 5β-reductase into the dihydrogenated 5α-dihydroprogesterone and 5β-dihydroprogesterone, respectively. This is followed by the further reduction of these metabolites via 3α-hydroxysteroid dehydrogenase and 3β-hydroxysteroid dehydrogenase into the tetrahydrogenated allopregnanolone, pregnanolone, isopregnanolone, and epipregnanolone. Subsequently, 20α-hydroxysteroid dehydrogenase and 20β-hydroxysteroid dehydrogenase reduce these metabolites to form the corresponding hexahydrogenated pregnanediols (eight different isomers in total), which are then conjugated via glucuronidation and/or sulfation, released from the liver into circulation, and excreted by the kidneys into the urine. The major metabolite of progesterone in the urine is the 3α,5β,20α isomer of pregnanediol glucuronide, which has been found to constitute 15 to 30% of an injection of progesterone. Other metabolites of progesterone formed by the enzymes in this pathway include 3α-dihydroprogesterone, 3β-dihydroprogesterone, 20α-hydroxyprogesterone, and 20β-hydroxyprogesterone, as well as various combination products of the enzymes aside from those already mentioned. Progesterone can also first be hydroxylated (see below) and then reduced.
Relatively small portions of progesterone are metabolized via 17α-hydroxylase and 21-hydroxylase into 17α-hydroxyprogesterone and 11-deoxycorticosterone (21-hydroxyprogesterone), respectively, and pregnanetriols are formed secondarily to 17α-hydroxylation.
In addition to the above pathways, progesterone can also be metabolized in the liver by cytochrome P450 enzymes. 6β-Hydroxylation, which is catalyzed mainly by CYP3A4, is the major transformation, and is responsible for approximately 70% of cytochrome P450-mediated progesterone metabolism. Other routes include 6α-, 16α-, and 16β-hydroxylation. Treatment of women with ketoconazole, a strong CYP3A4 inhibitor, had minimal effects on progesterone levels, producing only a slight and non-significant increase, and this suggests that cytochrome P450 enzymes play only a small role in progesterone metabolism.
|Person type||Reference range for blood test|
|Lower limit||Upper limit||Unit|
|Female - menstrual cycle||(see diagram below)|
|Female - postmenopausal||<0.2||1||ng/mL|
|Female on oral contraceptives||0.34||0.92||ng/mL|
|Males ≥16 years||0.27||0.9||ng/mL|
|Female or male 1–9 years||0.1||4.1 or 4.5||ng/mL|
In women, progesterone levels are relatively low during the preovulatory phase of the menstrual cycle, rise after ovulation, and are elevated during the luteal phase, as shown in diagram below. Progesterone levels tend to be < 2 ng/ml prior to ovulation, and > 5 ng/ml after ovulation. If pregnancy occurs, human chorionic gonadotropin is released maintaining the corpus luteum allowing it to maintain levels of progesterone. Between 7–9 weeks the placenta begins to produce progesterone in place of the corpus luteum, this process is named the luteal-placental shift.
After the luteal-placental shift progesterone levels start to rise further and may reach 100–200 ng/ml at term. Whether a decrease in progesterone levels is critical for the initiation of labor has been argued and may be species-specific. After delivery of the placenta and during lactation, progesterone levels are very low.
Progesterone levels are relatively low in children and postmenopausal women. Adult males have levels similar to those in women during the follicular phase of the menstrual cycle.
Blood test results should always be interpreted using the reference ranges provided by the laboratory that performed the results. Example reference ranges are listed below.
Progesterone is produced in high amounts in the ovaries (by the corpus luteum) from the onset of puberty to menopause, and is also produced in smaller amounts by the adrenal glands after the onset of adrenarche in both males and females. To a lesser extent, progesterone is produced in nervous tissue, especially in the brain, and in adipose (fat) tissue, as well.
During human pregnancy, progesterone is produced in increasingly high amounts by the ovaries and placenta. At first, the source is the corpus luteum that has been "rescued" by the presence of human chorionic gonadotropin (hCG) from the conceptus. However, after the 8th week, production of progesterone shifts to the placenta. The placenta utilizes maternal cholesterol as the initial substrate, and most of the produced progesterone enters the maternal circulation, but some is picked up by the fetal circulation and used as substrate for fetal corticosteroids. At term the placenta produces about 250 mg progesterone per day.
An additional animal source of progesterone is milk products. After consumption of milk products the level of bioavailable progesterone goes up.
In at least one plant, Juglans regia, progesterone has been detected. In addition, progesterone-like steroids are found in Dioscorea mexicana. Dioscorea mexicana is a plant that is part of the yam family native to Mexico. It contains a steroid called diosgenin that is taken from the plant and is converted into progesterone. Diosgenin and progesterone are also found in other Dioscorea species, as well as in other plants that are not closely related, such as fenugreek.
Another plant that contains substances readily convertible to progesterone is Dioscorea pseudojaponica native to Taiwan. Research has shown that the Taiwanese yam contains saponins — steroids that can be converted to diosgenin and thence to progesterone.
Many other Dioscorea species of the yam family contain steroidal substances from which progesterone can be produced. Among the more notable of these are Dioscorea villosa and Dioscorea polygonoides. One study showed that the Dioscorea villosa contains 3.5% diosgenin. Dioscorea polygonoides has been found to contain 2.64% diosgenin as shown by gas chromatography-mass spectrometry. Many of the Dioscorea species that originate from the yam family grow in countries that have tropical and subtropical climates.
Progesterone is a pregnane (C21) steroid and is also known as pregn-4-ene-3,20-dione. It has a double bond (4-ene) between the C4 and C5 positions and two ketone groups (3,20-dione), one at the C3 position and the other at the C20 position.
An economical semisynthesis of progesterone from the plant steroid diosgenin isolated from yams was developed by Russell Marker in 1940 for the Parke-Davis pharmaceutical company. This synthesis is known as the Marker degradation. Additional semisyntheses of progesterone have also been reported starting from a variety of steroids. For the example, cortisone can be simultaneously deoxygenated at the C-17 and C-21 position by treatment with iodotrimethylsilane in chloroform to produce 11-keto-progesterone (ketogestin), which in turn can be reduced at position-11 to yield progesterone.
A total synthesis of progesterone was reported in 1971 by W.S. Johnson. The synthesis begins with reacting the phosphonium salt 7 with phenyl lithium to produce the phosphonium ylide 8. The ylide 8 is reacted with an aldehyde to produce the alkene 9. The ketal protecting groups of 9 are hydrolyzed to produce the diketone 10, which in turn is cyclized to form the cyclopentenone 11. The ketone of 11 is reacted with methyl lithium to yield the tertiary alcohol 12, which in turn is treated with acid to produce the tertiary cation 13. The key step of the synthesis is the π-cation cyclization of 13 in which the B-, C-, and D-rings of the steroid are simultaneously formed to produce 14. This step resembles the cationic cyclization reaction used in the biosynthesis of steroids and hence is referred to as biomimetic. In the next step the enol orthoester is hydrolyzed to produce the ketone 15. The cyclopentene A-ring is then opened by oxidizing with ozone to produce 16. Finally, the diketone 17 undergoes an intramolecular aldol condensation by treating with aqueous potassium hydroxide to produce progesterone.
The hormonal action of progesterone was discovered in 1929, following that of estrogen in 1923. By 1931–1932, nearly pure crystalline material of high progestational activity had been isolated from the corpus luteum of animals, and by 1934, pure crystalline progesterone had been refined and obtained and the chemical structure of progesterone was determined. This was achieved by professor Adolf Butenandt at the Chemisches Institut of Technical University in Gdańsk, who extracted this new compound from several thousand liters of urine.
Chemical synthesis of progesterone from stigmasterol and pregnanediol was accomplished later that year. Up to this point, progesterone, known generically as corpus luteum hormone, had been being referred to by several groups by different names, including corporin, lutein, luteosterone, and progestin. In 1935, at the time of the Second International Conference on the Standardization of Sex Hormones in London, England, a compromise was made between the groups and the name progesterone (progestational steroidal ketone) was created.
- Adler N, Pfaff D, Goy RW (6 Dec 2012). Handbook of Behavioral Neurobiology Volume 7 Reproduction (1st ed.). New York: Plenum Press. p. 189. ISBN 978-1-4684-4834-4. Retrieved 4 July 2015.
- "progesterone (CHEBI:17026)". ChEBI. European Molecular Biology Laboratory-EBI. Retrieved 4 July 2015.
- Stanczyk FZ (September 2002). "Pharmacokinetics and potency of progestins used for hormone replacement therapy and contraception". Reviews in Endocrine & Metabolic Disorders. 3 (3): 211–24. doi:10.1023/A:1020072325818. PMID 12215716.
- Simon JA, Robinson DE, Andrews MC, Hildebrand JR, Rocci ML, Blake RE, Hodgen GD (July 1993). "The absorption of oral micronized progesterone: the effect of food, dose proportionality, and comparison with intramuscular progesterone". Fertility and Sterility. 60 (1): 26–33. doi:10.1016/S0015-0282(16)56031-2. PMID 8513955.
- Fritz MA, Speroff L (28 March 2012). Clinical Gynecologic Endocrinology and Infertility. Lippincott Williams & Wilkins. pp. 44–. ISBN 978-1-4511-4847-3.
- Marshall WJ, Marshall WJ, Bangert SK (2008). Clinical Chemistry. Elsevier Health Sciences. pp. 192–. ISBN 0-7234-3455-7.
- Yamazaki H, Shimada T (October 1997). "Progesterone and testosterone hydroxylation by cytochromes P450 2C19, 2C9, and 3A4 in human liver microsomes". Archives of Biochemistry and Biophysics. 346 (1): 161–9. doi:10.1006/abbi.1997.0302. PMID 9328296.
- McKay GA, Walters MR (6 February 2013). Lecture Notes: Clinical Pharmacology and Therapeutics. John Wiley & Sons. p. 33. ISBN 978-1-118-34489-7.
- Zutshi (1 January 2005). Hormones in Obstetrics and Gynaecology. Jaypee Brothers Publishers. p. 74. ISBN 978-81-8061-427-9.
- Cometti B (November 2015). "Pharmaceutical and clinical development of a novel progesterone formulation". Acta Obstetricia et Gynecologica Scandinavica. 94 Suppl 161: 28–37. doi:10.1111/aogs.12765. PMID 26342177.
- King TL, Brucker MC (25 October 2010). Pharmacology for Women's Health. Jones & Bartlett Publishers. pp. 372–373. ISBN 978-1-4496-5800-7.
- Baulieu E, Schumacher M (2000). "Progesterone as a neuroactive neurosteroid, with special reference to the effect of progesterone on myelination". Steroids. 65 (10-11): 605–12. doi:10.1016/s0039-128x(00)00173-2. PMID 11108866.
- Josimovich J (11 November 2013). Gynecologic Endocrinology. Springer Science & Business Media. pp. 9, 25–29. ISBN 978-1-4613-2157-6.
- Thomas P, Pang Y (2012). "Membrane progesterone receptors: evidence for neuroprotective, neurosteroid signaling and neuroendocrine functions in neuronal cells". Neuroendocrinology. 96 (2): 162–71. doi:10.1159/000339822. PMC . PMID 22687885.
- Meyer C, Schmid R, Schmieding K, Falkenstein E, Wehling M (February 1998). "Characterization of high affinity progesterone-binding membrane proteins by anti-peptide antiserum". Steroids. 63 (2): 111–6. doi:10.1016/s0039-128x(97)00143-8. PMID 9516722.
- Maurice T, Urani A, Phan VL, Romieu P (November 2001). "The interaction between neuroactive steroids and the sigma1 receptor function: behavioral consequences and therapeutic opportunities". Brain Research. Brain Research Reviews. 37 (1-3): 116–32. doi:10.1016/s0165-0173(01)00112-6. PMID 11744080.
- Johannessen M, Fontanilla D, Mavlyutov T, Ruoho AE, Jackson MB (February 2011). "Antagonist action of progesterone at σ-receptors in the modulation of voltage-gated sodium channels". American Journal of Physiology. Cell Physiology. 300 (2): C328–37. doi:10.1152/ajpcell.00383.2010. PMC . PMID 21084640.
- Rupprecht R, Reul JM, van Steensel B, Spengler D, Söder M, Berning B, Holsboer F, Damm K (October 1993). "Pharmacological and functional characterization of human mineralocorticoid and glucocorticoid receptor ligands". European Journal of Pharmacology. 247 (2): 145–54. doi:10.1016/0922-4106(93)90072-H. PMID 8282004.
- Elger W, Beier S, Pollow K, Garfield R, Shi SQ, Hillisch A (2003). "Conception and pharmacodynamic profile of drospirenone". Steroids. 68 (10-13): 891–905. doi:10.1016/j.steroids.2003.08.008. PMID 14667981.
- Attardi BJ, Zeleznik A, Simhan H, Chiao JP, Mattison DR, Caritis SN (2007). "Comparison of progesterone and glucocorticoid receptor binding and stimulation of gene expression by progesterone, 17-alpha hydroxyprogesterone caproate, and related progestins". Am. J. Obstet. Gynecol. 197 (6): 599.e1–7. doi:10.1016/j.ajog.2007.05.024. PMC . PMID 18060946.
- Lei K, Chen L, Georgiou EX, Sooranna SR, Khanjani S, Brosens JJ, Bennett PR, Johnson MR (2012). "Progesterone acts via the nuclear glucocorticoid receptor to suppress IL-1β-induced COX-2 expression in human term myometrial cells". PloS One. 7 (11): e50167. doi:10.1371/journal.pone.0050167. PMID 23209664.
- Paul SM, Purdy RH (March 1992). "Neuroactive steroids". FASEB Journal. 6 (6): 2311–22. PMID 1347506.
- Kliewer SA, Goodwin B, Willson TM (2002). "The nuclear pregnane X receptor: a key regulator of xenobiotic metabolism". Endocr. Rev. 23 (5): 687–702. doi:10.1210/er.2001-0038. PMID 12372848.
- Lehmann JM, McKee DD, Watson MA, Willson TM, Moore JT, Kliewer SA (1998). "The human orphan nuclear receptor PXR is activated by compounds that regulate CYP3A4 gene expression and cause drug interactions". J. Clin. Invest. 102 (5): 1016–23. doi:10.1172/JCI3703. PMC . PMID 9727070.
- Meanwell NA (8 December 2014). Tactics in Contemporary Drug Design. Springer. pp. 161–. ISBN 978-3-642-55041-6.
- Legato MJ, Bilezikian JP (2004). Principles of Gender-specific Medicine. Gulf Professional Publishing. pp. 146–. ISBN 978-0-12-440906-4.
- Lemke TL, Williams DA (24 January 2012). Foye's Principles of Medicinal Chemistry. Lippincott Williams & Wilkins. pp. 164–. ISBN 978-1-60913-345-0.
- Estrogens—Advances in Research and Application: 2013 Edition: ScholarlyBrief. ScholarlyEditions. 21 June 2013. pp. 4–. ISBN 978-1-4816-7550-5.
- Strünker T, Goodwin N, Brenker C, Kashikar ND, Weyand I, Seifert R, Kaupp UB (March 2011). "The CatSper channel mediates progesterone-induced Ca2+ influx in human sperm". Nature. 471 (7338): 382–6. doi:10.1038/nature09769. PMID 21412338. Lay summary – Nature News.
- Lishko PV, Botchkina IL, Kirichok Y (March 2011). "Progesterone activates the principal Ca2+ channel of human sperm". Nature. 471 (7338): 387–91. doi:10.1038/nature09767. PMID 21412339.
- Kastner P, Krust A, Turcotte B, Stropp U, Tora L, Gronemeyer H, Chambon P (May 1990). "Two distinct estrogen-regulated promoters generate transcripts encoding the two functionally different human progesterone receptor forms A and B". The EMBO Journal. 9 (5): 1603–14. PMC . PMID 2328727.
- Hallam SZ, Osuch JR (1 January 2006). Hormones and Breast Cancer in Post-Menopausal Women. IOS Press. p. 69. ISBN 978-1-58603-653-9.
- Johnson LR (2003). Essential Medical Physiology. Academic Press. p. 770. ISBN 978-0-12-387584-6.
- Coad J, Dunstall M (2011). Anatomy and Physiology for Midwives,with Pageburst online access,3: Anatomy and Physiology for Midwives. Elsevier Health Sciences. p. 413. ISBN 0-7020-3489-4.
- Landau RL, Bergenstal DM, Lugibihl K, Kascht ME (October 1955). "The metabolic effects of progesterone in man". The Journal of Clinical Endocrinology and Metabolism. 15 (10): 1194–215. doi:10.1210/jcem-15-10-1194. PMID 13263410.
- Correia JN, Conner SJ, Kirkman-Brown JC (May 2007). "Non-genomic steroid actions in human spermatozoa. "Persistent tickling from a laden environment"". Seminars in Reproductive Medicine. 25 (3): 208–19. doi:10.1055/s-2007-973433. PMID 17447210.
- Kirkman-Brown JC, Bray C, Stewart PM, Barratt CL, Publicover SJ (June 2000). "Biphasic elevation of [Ca(2+)](i) in individual human spermatozoa exposed to progesterone". Developmental Biology. 222 (2): 326–35. doi:10.1006/dbio.2000.9729. PMID 10837122.
- Kirkman-Brown JC, Barratt CL, Publicover SJ (March 2004). "Slow calcium oscillations in human spermatozoa". The Biochemical Journal. 378 (Pt 3): 827–32. doi:10.1042/BJ20031368. PMC . PMID 14606954.
- Harper CV, Barratt CL, Publicover SJ (October 2004). "Stimulation of human spermatozoa with progesterone gradients to simulate approach to the oocyte. Induction of [Ca(2+)](i) oscillations and cyclical transitions in flagellar beating". The Journal of Biological Chemistry. 279 (44): 46315–25. doi:10.1074/jbc.M401194200. PMID 15322137.
- Marieb, Elaine (2013). Anatomy & physiology. Benjamin-Cummings. p. 903. ISBN 9780321887603.
- Tosti E, Di Cosmo A, Cuomo A, Di Cristo C, Gragnaniello G (May 2001). "Progesterone induces activation in Octopus vulgaris spermatozoa". Molecular Reproduction and Development. 59 (1): 97–105. doi:10.1002/mrd.1011. PMID 11335951.
- Bowen R (2000-08-06). "Placental Hormones". Retrieved 2008-03-12.
- Patel B, Elguero S, Thakore S, Dahoud W, Bedaiwy M, Mesiano S (2014). "Role of nuclear progesterone receptor isoforms in uterine pathophysiology". Human Reproduction Update. 21 (2): 155–73. doi:10.1093/humupd/dmu056. PMID 25406186.
- Macias H, Hinck L (2012). "Mammary gland development". Wiley Interdisciplinary Reviews. Developmental Biology. 1 (4): 533–57. doi:10.1002/wdev.35. PMC . PMID 22844349.
- Hilton HN, Graham JD, Clarke CL (September 2015). "Minireview: Progesterone Regulation of Proliferation in the Normal Human Breast and in Breast Cancer: A Tale of Two Scenarios?". Molecular Endocrinology. 29 (9): 1230–42. doi:10.1210/me.2015-1152. PMID 26266959.
- Strauss JF, Barbieri RL (13 September 2013). Yen and Jaffe's Reproductive Endocrinology. Elsevier Health Sciences. pp. 236–. ISBN 978-1-4557-2758-2.
- Scaling AL, Prossnitz ER, Hathaway HJ (June 2014). "GPER mediates estrogen-induced signaling and proliferation in human breast epithelial cells and normal and malignant breast". Hormones & Cancer. 5 (3): 146–60. doi:10.1007/s12672-014-0174-1. PMC . PMID 24718936.
- Aupperlee MD, Leipprandt JR, Bennett JM, Schwartz RC, Haslam SZ (2013). "Amphiregulin mediates progesterone-induced mammary ductal development during puberty". Breast Cancer Research. 15 (3): R44. doi:10.1186/bcr3431. PMC . PMID 23705924.
- Kuhl H, Schneider HP (August 2013). "Progesterone--promoter or inhibitor of breast cancer". Climacteric. 16 Suppl 1: 54–68. doi:10.3109/13697137.2013.768806. PMID 23336704.
- Fournier A, Berrino F, Clavel-Chapelon F (2008). "Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study". Breast Cancer Res. Treat. 107 (1): 103–11. doi:10.1007/s10549-007-9523-x. PMC . PMID 17333341.
- Campagnoli C, Clavel-Chapelon F, Kaaks R, Peris C, Berrino F (July 2005). "Progestins and progesterone in hormone replacement therapy and the risk of breast cancer". The Journal of Steroid Biochemistry and Molecular Biology. 96 (2): 95–108. doi:10.1016/j.jsbmb.2005.02.014. PMID 15908197.
- King SR (9 November 2012). Neurosteroids and the Nervous System. Springer Science & Business Media. pp. 44–46. ISBN 978-1-4614-5559-2.
- Homosexuality may help us bond University of Portsmouth UoP News
- Having homosexual thoughts 'is an essential part of human evolution' study suggests The Telegraph
- Homosexuality May Have Evolved In Humans Because It Helps Us Bond, Scientists Say Huff Post
- Schumacher M, Guennoun R, Robert F, Carelli C, Gago N, Ghoumari A, Gonzalez Deniselle MC, Gonzalez SL, Ibanez C, Labombarda F, Coirini H, Baulieu EE, De Nicola AF (June 2004). "Local synthesis and dual actions of progesterone in the nervous system: neuroprotection and myelination". Growth Hormone & IGF Research. 14 Suppl A: S18–33. doi:10.1016/j.ghir.2004.03.007. PMID 15135772.
- Roof RL, Hall ED (May 2000). "Gender differences in acute CNS trauma and stroke: neuroprotective effects of estrogen and progesterone". Journal of Neurotrauma. 17 (5): 367–88. doi:10.1089/neu.2000.17.367. PMID 10833057.
- Pan DS, Liu WG, Yang XF, Cao F (October 2007). "Inhibitory effect of progesterone on inflammatory factors after experimental traumatic brain injury". Biomedical and Environmental Sciences. 20 (5): 432–8. PMID 18188998.
- Luoma JI, Stern CM, Mermelstein PG (August 2012). "Progesterone inhibition of neuronal calcium signaling underlies aspects of progesterone-mediated neuroprotection". The Journal of Steroid Biochemistry and Molecular Biology. 131 (1-2): 30–6. doi:10.1016/j.jsbmb.2011.11.002. PMC . PMID 22101209.
- Stein DG (March 2008). "Progesterone exerts neuroprotective effects after brain injury". Brain Research Reviews. 57 (2): 386–97. doi:10.1016/j.brainresrev.2007.06.012. PMC . PMID 17826842.
- Espinoza TR, Wright DW (2011). "The role of progesterone in traumatic brain injury". The Journal of Head Trauma Rehabilitation. 26 (6): 497–9. doi:10.1097/HTR.0b013e31823088fa. PMID 22088981.
- Herson PS, Koerner IP, Hurn PD (May 2009). "Sex, sex steroids, and brain injury". Seminars in Reproductive Medicine. 27 (3): 229–39. doi:10.1055/s-0029-1216276. PMC . PMID 19401954.
- Li Z, Wang B, Kan Z, Zhang B, Yang Z, Chen J, Wang D, Wei H, Zhang JN, Jiang R (January 2012). "Progesterone increases circulating endothelial progenitor cells and induces neural regeneration after traumatic brain injury in aged rats". Journal of Neurotrauma. 29 (2): 343–53. doi:10.1089/neu.2011.1807. PMC . PMID 21534727.
- Lynch WJ, Sofuoglu M (December 2010). "Role of progesterone in nicotine addiction: evidence from initiation to relapse". Experimental and Clinical Psychopharmacology. 18 (6): 451–61. doi:10.1037/a0021265. PMC . PMID 21186920.
- Cosgrove KP, Esterlis I, McKee SA, Bois F, Seibyl JP, Mazure CM, Krishnan-Sarin S, Staley JK, Picciotto MR, O'Malley SS (April 2012). "Sex differences in availability of β2*-nicotinic acetylcholine receptors in recently abstinent tobacco smokers". Archives of General Psychiatry. 69 (4): 418–27. doi:10.1001/archgenpsychiatry.2011.1465. PMC . PMID 22474108.
- Mello NK, Knudson IM, Kelly M, Fivel PA, Mendelson JH (October 2011). "Effects of progesterone and testosterone on cocaine self-administration and cocaine discrimination by female rhesus monkeys". Neuropsychopharmacology. 36 (11): 2187–99. doi:10.1038/npp.2011.130. PMC . PMID 21796112.
- Sriram, D (2007). Medicinal Chemistry. New Delhi: Dorling Kindersley India Pvt. Ltd. p. 432. ISBN 81-317-0031-3.
- Blackburn S (14 April 2014). Maternal, Fetal, & Neonatal Physiology. Elsevier Health Sciences. pp. 92–. ISBN 978-0-323-29296-2.
- Physiology: 5/5ch9/s5ch9_13 - Essentials of Human Physiology
- Hould FS, Fried GM, Fazekas AG, Tremblay S, Mersereau WA (December 1988). "Progesterone receptors regulate gallbladder motility". The Journal of Surgical Research. 45 (6): 505–12. doi:10.1016/0022-4804(88)90137-0. PMID 3184927.
- "Hormones and Oral Health". WebMD.
- Picard F, Wanatabe M, Schoonjans K, Lydon J, O'Malley BW, Auwerx J (November 2002). "Progesterone receptor knockout mice have an improved glucose homeostasis secondary to beta -cell proliferation". Proceedings of the National Academy of Sciences of the United States of America. 99 (24): 15644–8. doi:10.1073/pnas.202612199. PMC . PMID 12438645.
- Brănişteanu DD, Mathieu C (March 2003). "Progesterone in gestational diabetes mellitus: guilty or not guilty?". Trends in Endocrinology and Metabolism. 14 (2): 54–6. doi:10.1016/S1043-2760(03)00003-1. PMID 12591170.
- Schneider JS, Stone MK, Wynne-Edwards KE, Horton TH, Lydon J, O'Malley B, Levine JE (March 2003). "Progesterone receptors mediate male aggression toward infants". Proceedings of the National Academy of Sciences of the United States of America. 100 (5): 2951–6. doi:10.1073/pnas.0130100100. PMC . PMID 12601162.
- Häggström, Mikael; Richfield, David (2014). "Diagram of the pathways of human steroidogenesis". WikiJournal of Medicine. 1 (1). doi:10.15347/wjm/2014.005. ISSN 2002-4436.
- Bewick PM (2002). Medicinal natural products: a biosynthetic approach. New York: Wiley. p. 244. ISBN 0-471-49641-3.
- Duport C, Spagnoli R, Degryse E, Pompon D (February 1998). "Self-sufficient biosynthesis of pregnenolone and progesterone in engineered yeast". Nature Biotechnology. 16 (2): 186–9. doi:10.1038/nbt0298-186. PMID 9487528.
- Progesterone - Drugs.com, retrieved 2015-08-23
- Tommaso Falcone; William W. Hurd (2007). Clinical Reproductive Medicine and Surgery. Elsevier Health Sciences. pp. 22–. ISBN 0-323-03309-1.
- Perry T. Cupps (20 February 1991). Reproduction in Domestic Animals. Elsevier. pp. 101–. ISBN 978-0-08-057109-6.
- Stanczyk FZ (2003). "All progestins are not created equal". Steroids. 68 (10-13): 879–90. PMID 14667980.
- Frank J. Dowd; Bart Johnson; Angelo Mariotti (3 September 2016). Pharmacology and Therapeutics for Dentistry. Elsevier Health Sciences. pp. 448–. ISBN 978-0-323-44595-5.
- Kuhl H (2005). "Pharmacology of estrogens and progestogens: influence of different routes of administration". Climacteric. 8 Suppl 1: 3–63. doi:10.1080/13697130500148875. PMID 16112947.
- Tony M. Plant; Anthony J. Zeleznik (15 November 2014). Knobil and Neill's Physiology of Reproduction. Academic Press. pp. 304–. ISBN 978-0-12-397769-4.
- Nanette F. Santoro; Genevieve Neal-Perry (11 September 2010). Amenorrhea: A Case-Based, Clinical Guide. Springer Science & Business Media. pp. 13–. ISBN 978-1-60327-864-5.
- Reddy DS (2010). "Neurosteroids: endogenous role in the human brain and therapeutic potentials". Progress in Brain Research. 186: 113–37. doi:10.1016/B978-0-444-53630-3.00008-7. PMC . PMID 21094889.
- Etienne-Emile Baulieu; Paul A. Kelly (30 November 1990). Hormones: From Molecules to Disease. Springer Science & Business Media. pp. 401–. ISBN 978-0-412-02791-8.
- Beranič N, Gobec S, Rižner TL (2011). "Progestins as inhibitors of the human 20-ketosteroid reductases, AKR1C1 and AKR1C3". Chem. Biol. Interact. 191 (1-3): 227–33. doi:10.1016/j.cbi.2010.12.012. PMID 21182831.
- James M. Greenblatt; Kelly Brogan (27 April 2016). Integrative Therapies for Depression: Redefining Models for Assessment, Treatment and Prevention. CRC Press. pp. 201–. ISBN 978-1-4987-0230-0.
- Charles Graham (2 December 2012). Reproductive Biology of the Great Apes: Comparative and Biomedical Perspectives. Elsevier. pp. 179–. ISBN 978-0-323-14971-6.
- Carla de Azevedo Piccinato (2008). Regulation of Steroid Metabolism and the Hepatic Transcriptome by Estradiol and Progesterone. ProQuest. pp. 24–25. ISBN 978-1-109-04632-8.
- Akalin S (1991). "Effects of ketoconazole in hirsute women". Acta Endocrinol. 124 (1): 19–22. PMID 1825737.
- Progesterone Reference Ranges, Performed at the Clinical Center at the National Institutes of Health, Bethesda MD, 03Feb09
- Converted from mass values using molar mass of 314.46 g/mol
- Csapo AI, Pulkkinen MU, Wiest WG (1973). "Effects of lutectomy and progestreone replacement therapy in early pregnancy patients". Am J Obstet Gynecol. 115: 759–65.
- NIH Clinical Center (2004-08-16). "Progesterone Historical Reference Ranges". United States National Institutes of Health. Retrieved 2008-03-12.
- Häggström, Mikael (2014). "Reference ranges for estradiol, progesterone, luteinizing hormone and follicle-stimulating hormone during the menstrual cycle". WikiJournal of Medicine. 1 (1). doi:10.15347/wjm/2014.001. ISSN 2002-4436.
- Goodson III WH, Handagama P, Moore II DH, Dairkee S (2007-12-13). "Milk products are a source of dietary progesterone". 30th Annual San Antonio Breast Cancer Symposium. pp. abstract # 2028. Retrieved 2008-03-12.
- Pauli GF, Friesen JB, Gödecke T, Farnsworth NR, Glodny B (March 2010). "Occurrence of progesterone and related animal steroids in two higher plants". Journal of Natural Products. 73 (3): 338–45. doi:10.1021/np9007415. PMID 20108949.
- Applezweig N (May 1969). "Steroids". Chemical Week. 104: 57–72. PMID 12255132.
- Noguchi E, Fujiwara Y, Matsushita S, Ikeda T, Ono M, Nohara T (September 2006). "Metabolism of tomato steroidal glycosides in humans". Chemical & Pharmaceutical Bulletin. 54 (9): 1312–4. doi:10.1248/cpb.54.1312. PMID 16946542.
- Yang DJ, Lu TJ, Hwang LS (October 2003). "Isolation and identification of steroidal saponins in Taiwanese yam cultivar (Dioscorea pseudojaponica Yamamoto)". Journal of Agricultural and Food Chemistry. 51 (22): 6438–44. doi:10.1021/jf030390j. PMID 14558759.
- Hooker E (2004). "Final report of the amended safety assessment of Dioscorea Villosa (Wild Yam) root extract". International Journal of Toxicology. 23 Suppl 2: 49–54. doi:10.1080/10915810490499055. PMID 15513824.
- Niño J, Jiménez DA, Mosquera OM, Correa YM (2007). "Diosgenin quantification by HPLC in a Dioscorea polygonoides tuber collection from colombian flora". Journal of the Brazilian Chemical Society. 18 (5): 1073–1076. doi:10.1590/S0103-50532007000500030.
- Myoda T, Nagai T, Nagashima T (2005). Properties of starches in yam (Dioscorea spp.) tuber. Current Topics in Food Science and Technology. pp. 105–114. ISBN 81-308-0003-9.
- Marker RE, Krueger J (1940). "Sterols. CXII. Sapogenins. XLI. The Preparation of Trillin and its Conversion to Progesterone". J. Am. Chem. Soc. 62 (12): 3349–3350. doi:10.1021/ja01869a023.
- Numazawa M, Nagaoka M, Kunitama Y (September 1986). "Regiospecific deoxygenation of the dihydroxyacetone moiety at C-17 of corticoid steroids with iodotrimethylsilane". Chemical & Pharmaceutical Bulletin. 34 (9): 3722–6. doi:10.1248/cpb.34.3722. PMID 3815593.
- Heyl FW (1950). "Progesterone from 3-Acetoxybisnor-5-cholenaldehyde and 3-Ketobisnor-4-cholenaldehyde". Journal of the American Chemical Society. 72 (6): 2617–2619. doi:10.1021/ja01162a076.
- Slomp G (1958). "Ozonolysis. II. 1 The Effect of Pyridine on the Ozonolysis of 4,22-Stigmastadien-3-one 2". Journal of the American Chemical Society. 80 (4): 915–921. doi:10.1021/ja01537a041.
- Sundararaman P, Djerassi C (October 1977). "A convenient synthesis of progesterone from stigmasterol". The Journal of Organic Chemistry. 42 (22): 3633–4. doi:10.1021/jo00442a044. PMID 915584.
- "Nova Transcripts: Forgotten Genius". PBS.org. February 6, 2007.
- "Giants of the Past". lipidlibrary.aocs.org.
- Johnson WS, Gravestock MB, McCarry BE (August 1971). "Acetylenic bond participation in biogenetic-like olefinic cyclizations. II. Synthesis of dl-progesterone". Journal of the American Chemical Society. 93 (17): 4332–4. doi:10.1021/ja00746a062. PMID 5131151.
- Coutinho EM, Segal SJ (1999). Is Menstruation Obsolete?. Oxford University Press. pp. 31–. ISBN 978-0-19-513021-8.
- Walker A (7 March 2008). The Menstrual Cycle. Routledge. pp. 49–. ISBN 978-1-134-71411-7.
- Piosik R (2003). "Adolf Butenandt und sein Wirken an der Technischen Hochschule Danzig". Chemkon. 10 (3): 135. doi:10.1002/ckon.200390038.
- Ginsburg B (6 December 2012). Premenstrual Syndrome: Ethical and Legal Implications in a Biomedical Perspective. Springer Science & Business Media. pp. 274–. ISBN 978-1-4684-5275-4.
- Sir Humphry Davy Rolleston (1936). The Endocrine Organs in Health and Disease: With an Historical Review. Oxford University Press, H. Milford. p. 406.
- Allen WM (October 1970). "Progesterone: how did the name originate?". Southern Medical Journal. 63 (10): 1151–5. doi:10.1097/00007611-197010000-00012. PMID 4922128.