So I am beginning to think I have low progesterone.... Seeking advice/experiences - All Welcome.

meredithcarole

*warning -some (failed) pregnancy details are mentioned below*




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So prior to TTC I went off the pill (last September) to let my cycles "regulate." I had most recently been on Loestrin FE and with that pill I really didn't get a period, just some minor spotting every 28 days. My un-medicated periods quickly went to 28 days with light spotting days 26 and/or day 27. I thought nothing of it as it was something that I recalled happening when I was on Ortho Tri Cyclen a few years ago and I did get periods. So in Jan when I spotted at CD24 I suspected implantation bleeding and lo and behold I got a BFP. I spotted 2 or 3 times during my pregnancy. Once after sex (it was a pretty clearly related) and then there was a little brown spotting around 8 weeks. At 9 weeks my back started hurting like menstrual cramps and we all know how the rest of that story goes.

So after my miscarriage I had a 21 day cycle followed by a 27 day cycle and then a 28 day. For those cycles there was no spotting before AF and I thought "great, back to 'normal' and no pre-AF spotting - hurrah!" Well that was too good to last because last month on day 25 I was getting cramps and on day 26 I spotted. AF showed the next morning. This month the same thing is happening. I Oed (based on an OPK) around CD16 or 17 so we are looking at a current LP of about 9 or 10 days.

I am calling Monday to make an appointment to see my OB. I have already decided I should get my fibroids out just in case they are interfering, but now I am also thinking that I should ask for my progesterone to be tested. I know they won't do extensive testing if I haven't had a second loss, but at this rate I think the odds of even getting pregnant are seriously limited with how my body is acting. I hope the cycle nonsense is enough to convince them to at least check my progesterone. Should I perhaps jump right to seeing an RE? I'm not sure we are there yet, but I also don't like the direction this is headed and at 35 I don't think I should chance it. What have your experiences been?

P.S. For all of you throwing your hands in the air saying "start temping" I have purchased a thermometer from Amazon and will start once it arrives. I will have 3 or 4 months on the bench to get good at it.

mrsjg2013

I'm far from an expert or highly-knowledgeably in regards to progesterone, but I can share the conversation(s) with my RE.  Before I jump into that, I don't know if spotting is at all concernable when it comes the day before AF?  I usually have just a bit of brownish discharge and/or incredibly light flow the day before AF (new since first loss).  I guess I figure it's my period starting.  **edit, did some research... seems that different types of spotting right before the period starts has mixed reviews about what it could mean.  I'd be interested in knowing what an OB/RE has said about this specifically**

My RE said that any type of progesterone testing wouldn't be effective while I'm not pregnant.  (In relation to pregnancy loss, not infertility.)  He put me on a suppository supplement as a "just in case" treatment; it doesn't cause harm if you don't need it.  I plan to be on it each pregnancy in the future b/c there is a slight trend in statistics that say if people with repeated pregnancy loss take it, there is an increase in the chances of a healthy birth.  Now, this could also be because chances are increased even without progesterone.  This being said, I will take it again when we are TTC, even though I had another loss while on it last time.  After three losses, I'll do anything that could have the slightest chance of helping, or even just to give myself some peace of mind.

I don't know anything about your OB, your insurance, or your financial situation, but I'm not sure an OB would refer you to an RE after one loss?  Even after two losses, when I first met my RE he said that he was happy to take me on as a patient and would do everything in his power to prevent another loss, but I was not his typical patient.  He said that most ladies don't come to see him until after three losses, not including any "chemical pregnancies." 

I'm currently 32, so not quite yet AMA, but I wonder if there are specialists in that area of OB medicine? 

Best wishes to you.

meredithcarole

My OB said their policy was 2 losses, AMA or not, for additional testing. I guess my main concern is the shortening cycle length coupled with a later O and how that will effect my chances. I might be jumping to conclusions. I am just feeling like something is "off."

ETA: They also said after 6 months of trying without a result since I am 35. We've had 4 (2 NTNP while I got myself into the idea of trying again), but since I hit my deductible for the year with the mc I feel like financially I should look into this now.

rslh10

Big hugs lady. I hope you get it figured out!

buggirl72

As long as I can remember, my normal cycle was 2 days of spotting before AF.  My progesterone has always been fine when it has been checked.

There are a lot of things that can cause spotting and fibroids are one of them. You know that you have that issue but that does not mean you should not ask your doctor about what they think this spotting might be from and if you should be concerned about it.  Also, you have been charting so you can show your doctor the day you O and when the first day of AF is.

I would ask if, because of your fibroids and wondering if you should have them removed, if you could have a referral to an RE now to discuss this with them. If your doctor is going to make you wait two more cycles, I would call the RE you are going to be referred to and ask how long their wait is for a first consultation that way, if they have a really long wait, you can get that appointment scheduled at your 6 cycle mark.

meredithcarole

buggirl72 said:

As long as I can remember, my normal cycle was 2 days of spotting before AF.  My progesterone has always been fine when it has been checked.

There are a lot of things that can cause spotting and fibroids are one of them. You know that you have that issue but that does not mean you should not ask your doctor about what they think this spotting might be from and if you should be concerned about it.  Also, you have been charting so you can show your doctor the day you O and when the first day of AF is.

I would ask if, because of your fibroids and wondering if you should have them removed, if you could have a referral to an RE now to discuss this with them. If your doctor is going to make you wait two more cycles, I would call the RE you are going to be referred to and ask how long their wait is for a first consultation that way, if they have a really long wait, you can get that appointment scheduled at your 6 cycle mark.

you are right that the spotting could be the fibroids. And I am glad to hear that others have the pre-AF spotting. I think the plan for asking who the referral will be for and getting on a waiting list for an appointment is a good idea. Thanks, Bug!

[Deleted User]

No advice, but huge ((((Hugs))))

jjbmstinco

no advice but I just wanted to say I hope you get some answers!  

I'll be thinking about you!

yellowcat10

I am sorry you are dealing with all of this.  I also have spotting before AF but usually this is about 8-10 hours before.  But I did have a short LP (9-10 days) for awhile.  When my progesterone was tested it came back within normal ranges. My OB recommended B vitamins which helped.  My progesterone never really changed after that but now I am a steady 13-14 days.  I also used vitex (with doctor approval) for a while.  But, I had no other issues (fibroids, cysts, etc) so I do not know if this is something you could/should try.   With that my o date moved from 17/18 to CD13/14 and has stayed that way after 6 months of no supplements (including B vitamins and post loss).

If you can, I would move to an RE.

Elliecat17

sarcaztic10 what you have to say regarding low progesterone is interesting, because I am wondering if this is not my problem too. My LP has been as short as 8 before, and I was going to have my OB check since the last 2 positive HPTs I got came 2 days (or less) before the losses. Not even enough time to set up an appointment! So thanks for the info! 

mrsjg2013

@sarcaztic10 said:

mrsjg2013 said:

***snip****

My RE said that any type of progesterone testing wouldn't be effective while I'm not pregnant.  (In relation to pregnancy loss, not infertility.)  He put me on a suppository supplement as a "just in case" treatment; it doesn't cause harm if you don't need it.  I plan to be on it each pregnancy in the future b/c there is a slight trend in statistics that say if people with repeated pregnancy loss take it, there is an increase in the chances of a healthy birth.  Now, this could also be because chances are increased even without progesterone.  This being said, I will take it again when we are TTC, even though I had another loss while on it last time.  After three losses, I'll do anything that could have the slightest chance of helping, or even just to give myself some peace of mind.

*snip*

In regards to the bold. If you do truly have low progesterone that statement would be incorrect (I do realize that that statement was in relation to you personally this is just another side of the story). Progesterone supplementation does help prior to getting pregnant for women with true low progesterone. Lots of Dr's and RE's prescribe progesterone to women who do not have low progesterone or have not been tested with a "may help cant hurt" attitude and in that case it may not really matter. However for the women with LP issues and low progesterone it can help by lengthening the LP and giving a fertilized egg enough time to implant.

For instance, I have proven low progesterone and a 10-ish day LP while not being treated. My RE attributes 2 of my previous losses to the low progesterone because the fertilized egg did not get a chance to implant properly before my lining starts sloughing off. So I end up spotting/bleeding and then getting a positive HPT and finding out that my progesterone is low too late. By the time I was tested and placed on progesterone for those I had already started to miscarry. So, for women with low progesterone waiting to test until they get a positive HPT may be too late.  

OP, I do not have any experience being AMA but you should discuss your concerns with your Dr. and get their opinion. I do not spot at all before my period but I know that it is common, it could be the fibroids. My RE was very concerned with break through (mid cycle) bleeding in relation to my low progesterone but I also do not have that. Keep us updated on what your Dr says (((hugs))).

Thanks for sharing your experiences!!  Like I said, my knowledge of progesterone is very limited, so I appreciate the information. 

meredithcarole

@GLB30‌ O was CD16 or 17 and mucusy, bloody spotting was CD25 so it looks like a current LP of <10 days.

BookishMomma

sarcaztic10 said:

For instance, I have proven low progesterone and a 10-ish day LP while not being treated. My RE attributes 2 of my previous losses to the low progesterone because the fertilized egg did not get a chance to implant properly before my lining starts sloughing off. So I end up spotting/bleeding and then getting a positive HPT and finding out that my progesterone is low too late. By the time I was tested and placed on progesterone for those I had already started to miscarry. So, for women with low progesterone waiting to test until they get a positive HPT may be too late.  

This is very similar to my situation. When I'm not on progesterone, my LP tends to be 10 days and my cycles are around 25 days.

My first two losses were very early, right around 5 weeks. For my second one, I asked my OB to test my progesterone and, when it came back low, she gave me a prescription for supps. But, like sarcaztic said, I am convinced that it was already too late. My beta was quite low on the same day that my progesterone was drawn and came back low. I started bleeding shortly thereafter.

For my third loss, I was on progesterone supps from 3dpo until my BFP and beyond. I was meant to take it throughout the first tri. That pregnancy went very differently from the prior two. My betas were great out of the gate and doubled like they should, and we saw a heartbeat around 6 weeks. Sadly, we lost that one to a chromosomal abnormality (45x). I think being on the progesterone from just after O helped things get off to a good start and got us "out of the woods" in terms of very early loss like my last 2, and I have a feeling things would have continued to progress fine if it were not for the 45x. So I am very pro-progesterone if you think it is an issue.

I'm AMA, too, by the way. 

eta: clarify

meredithcarole

Thanks for your thoughts and experiences everyone!  I have made an appointment for Sept. 3rd to talk with my OB.  We shall see where it goes from there.