A friend of mine has been taking the progesterone only pill due to having issues with periods but it hasn't helped so the doctor recommended her the contraceptive implant instead. As both are just progesterone delivery devices I was wondering is there a way of monitoring the progesterone levels via PdG testing and a smartphone app while she is taking the pill to determine if maybe a personalised mini Pill dosage adjustment would work instead. Most of what I find online in relation to PdG testing is just about trying to get pregnant should this work in theory?

Your friend should consult with her physician.  Not you.

Obviously however I am curious why no testing device seems to exist? Surely if diabetics need a monitor for insulin levels because getting the right dosage is complicated and can even change shouldn't the same hold true for other drugs?

4 hours ago, fiveworlds said:

Obviously however I am curious why no testing device seems to exist? Surely if diabetics need a monitor for insulin levels because getting the right dosage is complicated and can even change shouldn't the same hold true for other drugs?

I found this paper, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8867790/ suggesting there has been some work on a dipstick type test for progesterone. No idea how close to commercialisation such a concept may be. One  issue may be that, as I understand this,  it needs to be semi-quantitative, rather than a simple go/no go (like a Covid test for instance), as one needs to know whether the level of progesterone in the blood is above a certain threshold, rather than simply whether it is present or not.

Developing tests like this with the necessary degree of reliability for use by non-professionals is not straight forward and the commercial incentive/clinical need  may not be sufficient to support the effort.

ELISAS are the standard for such tests. They can be ordered by health provided, but are not that well suited for home use.

On 4/12/2024 at 5:02 PM, fiveworlds said:

A friend of mine has been taking the progesterone only pill due to having issues with periods but it hasn't helped so the doctor recommended her the contraceptive implant instead. As both are just progesterone delivery devices I was wondering is there a way of monitoring the progesterone levels via PdG testing and a smartphone app while she is taking the pill to determine if maybe a personalised mini Pill dosage adjustment would work instead. Most of what I find online in relation to PdG testing is just about trying to get pregnant should this work in theory?

In a practical sense there is no role for level testing in your friend's case. Since the Pill is being written for symptom improvement, if the symptom is improved to her satisfaction the dosage is "effective" or "correct", regardless of what her serum level might be. Similarly, if she is having side effects she doesn't like, her dosage is "too high", again, regardless of her serum level.

 

Level testing is valuable in very specific situations such as replacing hormone levels in those with a deficiency, or in preventing a condition so detrimental that you can't tolerate a single episode, such as seizures.