Progesterone and is responsible for approximately 70% of cytochrome P450-mediated progesterone metabolism. Other routes include 6α-, 16α-, and 16β-hydroxylation. However, 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. 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 less than 2 ng/mL prior to ovulation, and greater
Pharmacokinetics of progesterone half-life of progesterone in the circulation is very short at a range of about 3 to 90 minutes. Previous studies using RIA have reported an overestimated half-life of oral progesterone of about 16 to 18 hours. A subsequent, reliable study using high-performance liquid chromatography–tandem mass spectrometry (HPLC–MS/MS) reported a half-life of oral progesterone of about 4.6 to 5.2 hours when it was taken with food. Due to the short half-life and duration of action of oral progesterone, it is often taken in divided doses of two or three times per day. Because of studies that used RIA, it was incorrectly