17 OH Progestron in Dehradun

What is a 17 OH Progestron?

17-hydroxyprogesterone is an intermediate in the pathway by which the adrenal glands manufacture cortisol. Its usefulness comes from what happens when that pathway is blocked. In congenital adrenal hyperplasia, the commonest form of which is 21-hydroxylase deficiency, the enzyme converting 17-OHP onward to cortisol is deficient, so the intermediate accumulates and the raw material is diverted instead into androgen production. The result is a characteristic combination: low or absent cortisol, and excess male hormones. In its severe classical form this presents in newborns with ambiguous genitalia in girls and, dangerously, with salt-wasting adrenal crisis in the first weeks of life, which is why it features in newborn screening programmes. In its milder non-classical form it presents much later, typically in adolescence or adulthood, with irregular periods, excess facial and body hair, acne and difficulty conceiving, a picture that overlaps almost exactly with polycystic ovary syndrome and is frequently misattributed to it. Distinguishing the two matters because treatment differs.

Why take this test?

17-OHP is advised in the assessment of a woman with irregular or absent periods, unwanted facial or body hair, persistent acne or difficulty conceiving, specifically to distinguish non-classical congenital adrenal hyperplasia from polycystic ovary syndrome, which it closely resembles. It is indicated in a child showing early signs of puberty, rapid growth with advanced bone age, or ambiguous genitalia at birth, and in a newborn with an abnormal screening result or with a family history of the condition. It is also used to monitor treatment in someone already diagnosed. Timing is important for a reliable result: levels are highest in the early morning and vary through the menstrual cycle, so an early-morning sample in the first week of the cycle is preferred. A borderline result frequently requires a stimulation test to settle the question, which your endocrinologist will arrange.

• Irregular periods with excess hair growth or persistent acne
• Distinguishing non-classical CAH from polycystic ovary syndrome
• Difficulty conceiving with signs of androgen excess
• A child with early puberty or rapid growth with advanced bone age
• Ambiguous genitalia at birth, or an abnormal newborn screen
• Monitoring treatment in diagnosed congenital adrenal hyperplasia

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