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Hormones

17-OH-progesterone in men: CAH, fertility and the limit per age

17-OH-progesterone is an intermediate product in the adrenal cortex, the outer layer of the adrenal gland, on the way to the hormone cortisol. When the making of cortisol in the adrenal gland is blocked, the hormone corticotropin drives the adrenal cortex harder according to the Endocrine Society guideline, and cortisol precursors pile up.

Congenital adrenal hyperplasia (CAH) is, according to the guideline, a group of inherited conditions in which the making of cortisol falls short, and in CAH 17-OH-progesterone in the blood can be raised. Only a blood test measures how much 17-OH-progesterone is in the blood.

17-OH-progesterone is expressed in nanomoles per litre (nmol/L), and Star-SHL's upper limit for men rises from < 3.44 nmol/L at age 20 to 30 to < 4.05 nmol/L at age 40 to 50. From age 50, Star-SHL uses < 3.93 nmol/L for men.

Doctor's Assessment Included

17-OH-progesterone is an intermediate step in the making of cortisol in the adrenal gland, and the standard measurement for establishing congenital adrenal hyperplasia (CAH). The limit differs per laboratory, age, sex and cycle phase.

  • The Endocrine Society guideline advises drawing blood before 8 am, and in women who menstruate early in the follicular phase.
  • In the luteal phase the value is higher: Diagnostiek voor U then uses < 8.78 nmol/L, against < 2.12 nmol/L in the follicular phase.
  • A value measured at a random time can be normal in the mild form of CAH.

Reference Ranges

Male
nmol/L
Low 1 Normal 10 High

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

Check your own value

17-OH Progesterone: what Dutch laboratories use

Reference ranges by group, in nmol/L
Star-shl · Male · 20–29 years · a limit, not a range < 3.44 nmol/L
3.44
Star-shl · Male · 30–39 years · a limit, not a range < 3.84 nmol/L
3.84
Star-shl · Male · 40–49 years · a limit, not a range < 4.05 nmol/L
4.05
Star-shl · Male · 50 years and older · a limit, not a range < 3.93 nmol/L
3.93
Unilabs · Male · 18 years and older 1.0–7.5 nmol/l
1 7.5
Certe · Male · 20–40 years 1.83–6.47 nmol/L
1.83 6.47
Certe · Male · 40–79 years 1.30–7.62 nmol/L
1.3 7.62
Diagnostiek voor U · Male · 20–29 years · a limit, not a range < 3.44 nmol/L
3.44
Diagnostiek voor U · Male · 30–39 years · a limit, not a range < 3.84 nmol/L
3.84
Diagnostiek voor U · Male · 40–49 years · a limit, not a range < 4.05 nmol/L
4.05
Diagnostiek voor U · Male · 50 years and older · a limit, not a range < 3.93 nmol/L
3.93
0 8.38 nmol/L

Source: Star-shl

Source: Unilabs

Source: Certe

Source: Diagnostiek voor U

Each value as the laboratory itself publishes it, retrieved in 2026.

17-OH Progesterone: what this test measures

A 17-OH-progesterone test measures the concentration of 17-hydroxyprogesterone in serum, in nanomoles per litre. Star-SHL outsources the determination to the Algemeen Medisch Laboratorium, which measures with LC-MS/MS, liquid chromatography coupled to tandem mass spectrometry. In newborn screening, immunoassays, which measure with antibodies, give more false-positive results according to the Endocrine Society guideline.

17-OH Progesterone: why this value matters

17-OH-progesterone is the standard measurement for establishing CAH, and in men with CAH fertility is often impaired according to the Endocrine Society guideline. As common causes, the guideline names testicular adrenal rest tumours (TARTs), lumps of adrenal tissue in the testis, suppressed gonadotropins, the brain hormones that steer the testes, and failure of the testes.

17-OH Progesterone: how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

17-OH Progesterone: when is testing worthwhile?

Blood for a 17-OH-progesterone test is preferably drawn before 8 am: the Endocrine Society guideline advises this for people with symptoms past infancy, because the mild form of CAH can give a normal result at another time of day.

In boys and men with CAH, TARTs become more common after age 10 according to the guideline, and the guideline advises checking the testes with ultrasound from adolescence onwards.

17-OH Progesterone: symptoms of a high or low value

Low Levels

A low 17-OH-progesterone lies within the reference values for men at Star-SHL, because Star-SHL publishes only an upper limit for adult men. The Endocrine Society guideline, which is about CAH, lists no symptoms that go with a low value.

High Levels

A high 17-OH-progesterone from the severe form of CAH goes together with too little aldosterone, a second adrenal hormone, in 75% of cases according to the Endocrine Society guideline. That shortage leads to salt wasting, poor growth and a potentially life-threatening fluid shortage.

17-OH Progesterone: causes of a low or high value

What raises the value

  • Congenital adrenal hyperplasia from 21-hydroxylase deficiency

    According to the Endocrine Society guideline, CAH is caused in about 95% of cases by a fault in the gene for 21-hydroxylase; that enzyme converts 17-OH-progesterone, and with a shortage 17-OH-progesterone builds up.

  • Mild (nonclassic) CAH

    In the mild form, a 17-OH-progesterone measured at a random time can be normal; that is why the guideline advises blood drawn before 8 am.

  • Other adrenal enzyme shortages

    According to the guideline, 17-OH-progesterone can also be raised with a shortage of 11-beta-hydroxylase and, more rarely, of 3-beta-hydroxysteroid dehydrogenase or P450 oxidoreductase.

  • Pregnancy

    According to the guideline, 17-OH-progesterone in the mother is raised in a normal pregnancy.

  • Second half of the menstrual cycle

    In the luteal phase the value is higher: Unilabs then uses 1.0 to 8.5 nmol/l, against 0.45 to 3 nmol/l in the follicular phase, for women aged 18 to 50.

17-OH Progesterone: lifestyle and this value

Which treatment follows a raised 17-OH-progesterone depends on the cause a doctor establishes. For most adult men with the mild form of CAH, the Endocrine Society guideline suggests generally not prescribing daily glucocorticoids, medicines that resemble cortisol. As exceptions to the advice to generally not prescribe daily glucocorticoids to men with the mild form of CAH, the guideline names infertility, TARTs (lumps of adrenal tissue in the testis), adrenal tumours and a picture between the classic and the mild form.

17-OH Progesterone: frequently asked questions

How common are TARTs in boys with CAH?

TARTs, lumps of adrenal tissue in the testis, occur in 21% to 28% of boys aged 2 to 18 with classic CAH, an inherited adrenal condition with a high 17-OH-progesterone, according to studies cited in the Endocrine Society guideline. In men with the mild form, the available data the guideline cites indicate that TARTs are extremely rare, and the guideline notes that few studies have described them.

Is the limit for 17-OH-progesterone higher in men than in women?

At Star-SHL the upper limit for 17-OH-progesterone is higher for adult men than for women in every age group, from age 50 for example < 3.93 nmol/L against < 2.05 nmol/L. Diagnostiek voor U does use < 8.78 nmol/L for women in the luteal phase, higher than any limit for men.

What follows a borderline 17-OH-progesterone?

After a borderline 17-OH-progesterone, the Endocrine Society guideline advises a complete profile of adrenal hormones after a stimulation test with cosyntropin, to tell a 21-hydroxylase shortage apart from other enzyme shortages. In people with CAH, the guideline suggests genetic testing only when the profile after the stimulation test gives no clear answer, when the stimulation test cannot be done properly, or for genetic counselling.

17-OH Progesterone: sources

  1. Star-shl, Labbepalingen (referentiewaarden per bepaling), star-shl.nl, geraadpleegd 2026-10-01 (retrieved 2026) star-shl.nl
  2. Unilabs, Bepalingenklapper (referentiewaarden per bepaling), bepalingenklapper.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenklapper.nl
  3. Certe, Bepalingenwijzer (referentiewaarden per bepaling), bepalingenwijzer.certe.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenwijzer.certe.nl
  4. Diagnostiek voor U, eLabgids (Referentiewaarden DvU), diagnostiek.getincontrol.eu, geraadpleegd 2026-10-01 (retrieved 2026) diagnostiek.getincontrol.eu
  5. Speiser PW et al. Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2018;103(11):4043-4088. (retrieved 2026) pmc.ncbi.nlm.nih.gov

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