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Because the dynamic fluctuations in cycle hormones can rarely be adequately characterized by a single measurement, but repeated blood sampling can be onerous, salivary free progesterone (P<jats:sub>Free\u2010SAL<\/jats:sub>) concentration is widely used in both clinical and research contexts as an alternative to total progesterone concentration in venous blood samples (P<jats:sub>Total\u2010VEN<\/jats:sub>). However, some doubts have been raised about the use of P<jats:sub>Free\u2010SAL<\/jats:sub> because of suggestions that Bolivian and other populations and\/or individuals might differ markedly in the ratio of P<jats:sub>Free\u2010SAL<\/jats:sub> to P<jats:sub>Total\u2010VEN<\/jats:sub> (the apparent uptake fraction, UF). If there are such differences, several decades of comparative population research based on P<jats:sub>Free\u2010SAL<\/jats:sub> would require reconsideration, and a seemingly useful tool in both clinical and research contexts would be lost or require additional extensive pre\u2010use evaluations. Such impacts would fall disproportionally on clinical monitoring and research studies of menstruating persons, a segment of the population that has long been underrepresented in research and clinical trials, especially in low resource conditions. Therefore, we tested three hypotheses: (H1) UF differs by ovarian cycle phase; (H2) UF differs in Bolivian women from that of non\u2010Bolivian women; and (H3) within a population, UF is consistently higher or lower in some individuals than in most others.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We collected mid\u2010follicular and mid\u2010luteal near\u2010concurrent samples of venous blood and saliva from 36 healthy premenopausal Bolivian women. P<jats:sub>Total\u2010VEN<\/jats:sub> and P<jats:sub>Free\u2010SAL<\/jats:sub> were measured using commercial enzyme immunoassays. To test the study hypotheses, we used graphical and statistical methods to analyze these new data and to analyze data from several previously published studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In our study sample of Bolivian women, P<jats:sub>Free\u2010SAL<\/jats:sub> and P<jats:sub>Total\u2010VEN<\/jats:sub> concentrations (<jats:italic>n<\/jats:italic>\u2009=\u200966 pairs) were significantly and highly correlated (Spearman's rho\u2009=\u20090.858; mixed model: intercept\u2009=\u200977.4\u2009pmol\/L [(<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), <jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.0191 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001)]). An individual's follicular\u2010phase UF and luteal\u2010phase UF were not significantly correlated (rho\u2009=\u2009\u22120.19, <jats:italic>p<\/jats:italic>\u2009=\u20090.462). Median UF equaled 8.1% for follicular and 2.3% for luteal phase pairs and were comparable to published values for other populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:italic>Hypothesis 1 was supported.<\/jats:italic> Consistent with prior reports for other populations, in these Bolivian women UF was higher and more variable in the follicular than in the luteal phase. The source(s) of phase\u2010associated variation in UF deserves additional study, particularly the dynamic relationship to different conformers of corticosteroid\u2010binding globulin (CBG). <jats:italic>Hypothesis 2 was not supported.<\/jats:italic> Paired P<jats:sub>Free\u2010SAL<\/jats:sub> and P<jats:sub>Total\u2010VEN<\/jats:sub> were highly correlated, and UF in these Bolivians was comparable to published values for other populations. <jats:italic>Hypothesis 3 was not supported.<\/jats:italic> There was no evidence that some individuals have consistently higher (or lower) UF than most other persons. In sum, these findings do not support the suggestions that the physiology underlying the relationship between P<jats:sub>Free\u2010SAL<\/jats:sub> and P<jats:sub>Total\u2010VEN<\/jats:sub> differs substantially and inexplicitly between populations and individuals. These results also reinforce the critical roles of fastidious attention to sample collection and handling, judicious assessment of assay results, and appropriate statistical methods when using ovarian steroid data in any project. We suggest some guidelines for meeting these requirements. Used with due consideration for its advantages and limitations, P<jats:sub>Free\u2010SAL<\/jats:sub> reliably tracks P<jats:sub>Total\u2010VEN<\/jats:sub> during the menstrual cycle and is a useful option in the biomarker toolkit. Just as it is costly to continue our work with tools not up to the task, so is it costly to discard useful tools without good reason. The development (and improvement through replication) of a robust toolkit for assessing changes in and the impacts of menstrual cycle hormones is foundational to reducing gender\u2010based health disparities. (The linked file listed below under \u201cSupporting Information\u201d presents these findings in Spanish).<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajhb.70077","type":"journal-article","created":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T14:04:42Z","timestamp":1752069882000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Salivary\/Serum Progesterone Ratio Differs Between Menstrual Cycle Phases but Not Between Populations: Implications for Health, Reproductive, and Behavioral Research"],"prefix":"10.1002","volume":"37","author":[{"given":"Virginia J.","family":"Vitzthum","sequence":"first","affiliation":[{"name":"Department of Anthropology Indiana University  Bloomington Indiana USA"},{"name":"Department of Medicine Centre for Menstrual Cycle and Ovulation Research, University of British Columbia  Vancouver British Columbia Canada"},{"name":"BKIS Orchards  Thetis Island British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diva","family":"Bellido","sequence":"additional","affiliation":[{"name":"Instituto Boliviano de Biolog\u00eda de Altura (IBBA)  La Paz Bolivia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lourdes","family":"Echalar","sequence":"additional","affiliation":[{"name":"Instituto Boliviano de Biolog\u00eda de Altura (IBBA)  La Paz Bolivia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esperanza","family":"Caceres","sequence":"additional","affiliation":[{"name":"Instituto Boliviano de Biolog\u00eda de Altura (IBBA)  La Paz Bolivia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Thornburg","sequence":"additional","affiliation":[{"name":"BKIS Orchards  Thetis Island British Columbia Canada"},{"name":"Center for Spacetime Symmetries Indiana University  Bloomington Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"e_1_2_14_2_1","unstructured":"Abood N. 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