Evening Primrose Oil

nolanova85 · November 2014

Hi All -

I searched and found a few threads talking about cervix checking where EPO is mentioned, but now that many of us are at or approaching the final month of pregnancy, I thought it may be helpful to devote a thread.

My practice recommends taking 4500mg of EPO a day, starting at 36 weeks. I assume this means orally - but I'll confirm that at my appt on Wednesday (also the day I reach 36 weeks). I've already purchased the EPO and do plan to take it, especially since my OB said that the Leep I had a decade ago means that I may have great contractions and still not dilate, due to scar tissue

So I figure I'll do anything that might help.

What I'm wondering is if any STM+ have used EPO and if you think it worked for its intended purpose? Did you use it vaginally or orally? Has anyone else received info (good, bad, indifferent) from their practices regarding EPO or other cervix-prepping methods?

soulcupcake · November 2014

I started taking 2600mg orally at 34 weeks, and 2600 vaginally at 36 weeks. I apply it directly to the cervix when I self check. Vaginally is best at night for me. It can get messy.

I did EPO with #2, 3 and 4. But only did it orally with #3. Didn't get around to doing it vaginally yet. I followed the same regimen. It contains prostaglandin precursors and won't actually do anything the body isn't ready to do on its own. I have 1.5 cm of cervix left and it's super soft.

It's hard to know whether it's the EPO or a combination of things like EPO, RRL, other ripeners, and other exercises that encourage optimal positioning, which also facilitates dilation and effacement. I didn't take it with #1, and was 3 cm/80% effaced at 35 weeks, and 5 cm at 37 weeks. I was induced six days later. Made it to 7.5 cm before contractions started.

With #2, I took EPO both orally and vaginally and was 2 cm/70% at 37 weeks, and 3-4 cm at 39, at which point I had a sweep. That sweep got me to 6 cm with no contractions, before being induced. I actually didn't start labor until 8 cm. The midwife said I had a very pliable cervix.

With #3, I was soft, though not quite effaced (I had severe polyhydramnios, which usually means no effacement) and 4 cm when I was induced. I also had an irritable uterus. With #4, I was 1 cm/60% at 36 weeks, and then 4 cm/80% at 38. A couple days later I checked and was 5 cm. I stayed that way until started the induction a week later. I got to 6 cm easily with no contractions.

It isn't oxytocic, but it has helped a lot with ripening the cervix and facilitating effacement and dilation. Dilation occurs easier when the cervix is effaced, and in my previous births I make it pretty far dilation wise before labor/birth begins.

jessinaround · November 2014

I took it orally and did vaginal suppositories with DS. I feel like it helped. My water broke on it's own and my labor was fairly typical for a FTM. I didn't have any complications or stalling. But I have nothing to compare it to. I'm already 3cm dilated and 90% effaced at 35w4d, so I'll wait until 37 weeks to start taking it this time.

leoandethansmom · November 2014

Okay...I'm going to ask this but I might regret it. HOW THE HELL DO YOU CHECK YOUR OWN CERVIX?

Edit to add tag @metaphysique

[Deleted User] · November 2014

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2JEL · November 2014

I'm a FTM and don't have much to add, but my doctor seems indifferent to EPO and my doula (who is also a senior L&D nurse) is in favor of it-- so I've started taking 1300mg 2x daily at 36 weeks. I am now wondering if I should up my dose, I'll inquire when I next speak to them. The only negative thing I've heard (other than a handful of people who don't think it will help them) is that it may function as a blood thinner, so you'd ideally want to stop taking it if you knew you were scheduled for, or at risk of, a c-section and/or had other clotting issues. I personally am thinking of taking it week 36-38 and then stopping.

CandaceC1020 · November 2014

MissChristineMarie said:

I tracked my fertility and I never ever ever checked my cervix. In fact, the gals on TTGP flame ladies for doing that. I don't even know what I would be looking at if I tried. Although, I guess if I needed to, I would get a speculum and a mirror, right? But, that is one part of my vagina I don't need to know about... EPO or not.

When you're desperate to have a baby you're willing to do just about anything .... TTGP may not be a board that is open to cervical checks while they're openly discussed on TTTC. You don't need a speculum and a mirror, just your hand and your vagina.

https://infertility.about.com/od/tryingtoconceive101/ht/cervixovulation.htm

Shortstack06 · November 2014

I am with @slaps and @MCM I can't imagine checking my own. It seems icky to me.

CandaceC1020 · November 2014

MissChristineMarie said:

And what exactly are you feeling for -- The sponginess of the tip of your nose or the firmness of your lips? WHAT THE WHAT? Both feel the same to me. I wouldn't even know what I am doing. I understand that when trying to get pregnant, you will try or do anything for that BFP. But, I just cannot imagine sticking my fingers up to my cervix and actually knowing what I am doing. To each their own...

Here's some explanation:

https://www.whattoexpect.com/preconception/fertility/five-ways-to-tell-you-are-ovulating.aspx

nolanova85 · November 2014

Regarding the cervix check - I didn't do it while TTC, but I know a lot of people do and it's mentioned in TCOYF (which I recommend to anyone TTC!).

Since I didn't do it while TTC, I can't imagine I'll do it while pregnant. Even with clean hands, I would worry more about the risk for infection with the LO up there.

In fact, I've heard a lot lately about even foregoing cervical checks by medical professionals in late pregnancy. My practice does them weekly starting at 36 weeks, but I'm thinking of asking for every other week. I am looking forward to Wednesday's appt to see if I have made any progress at all.

Thanks for your thoughts on EPO! I know it's different for everyone, but I'm kind of obsessed with birth stories and this is sort of in that vein - I'm just interested in other's experiences with it.

Eora3 · November 2014

Just wanted to say that I checked my own cervix while TTC (after five years and thousands of dollars of treatments/proceedures, I know that part of my body pretty well and my doctors encouraged it and discussed what I was looking for). It really wasn't any weirder to me than my husband jabbing my in the butt with a giant needle for my "trigger shots". But really it was all weird and invasive and uncomfortable so I guess maybe I am a little desensitized.

Back to the topic: I took EPO vaginally and orally with my first. I dilated pretty quickly during my induction but I had other complications that resulted in a c-section. With my second, I took EPO orally and used RRL tea even though I knew I would have a c-section. My thought was that it might signal to my body that birth was going to happen soon and help my body be more prepared for the sudden medical birth and post birth hormone changes.

RaeChay · November 2014

Hmm. Does anyone have access to any scientific studies regarding the use of EPO? (Here is where I miss gradschoolmom).

soulcupcake · November 2014

danisgossipgirl said:

I was directed to take it with my first when I hit my due date. I don't remember the dose but it was oral. I went 13 days past my due date. I'm sure these details are helpful. @leosmom25 same way you do when you're tracking fertility, it's just harder to reach.

Yep.

@leosmom25 - it's the same premise as with checking CP and CM when TTC (as mentioned in the oft-recommended TCOYF. I became familiar with that aspect of TTC 11 years ago on FF, where it's pretty much a given/customary part of the process. But self-checking during the last month is more common in the "crunchy" birthing community -- out-of-hospital birthers and midwives/nurses. I had a midwife friend that explained how to check when I was pregnant with #2, so I was already familiar with it by the time I had my others.

It can be more difficult to reach in pregnancy, especially if the cervix is high and/or posterior.

2JEL · November 2014

I actually spent some time looking on PubMed and there was not a lot of great stuff out there either way, e.g.:

"Most complementary and alternative medicines used for induction of labour are recommended on the basis of traditional knowledge, rather than scientific research. Currently, the clinical evidence is sparse and it is not possible to make firm conclusions regarding the effectiveness of these therapies. There is however some data to support the use of breast stimulation for induction of labour. Acupuncture and raspberry leaf may also be beneficial. Castor oil and evening primrose oil might not be effective and possibly increase the incidence of complications. There is no evidence from clinical trails to support homeopathy however, some women have found these remedies helpful. Blue cohosh may be harmful during pregnancy and should not be recommended for induction. Other complementary and alternative medicine (CAM) therapies may be useful but further investigation is needed."

https://www.ncbi.nlm.nih.gov/pubmed/21524953

"However, most trials to date have significant methodologic flaws and must be considered preliminary. The use of evening primrose oil during pregnancy is not supported in the literature and should be avoided. Evening primrose oil is generally well tolerated, with reported minor adverse effects, including gastrointestinal upset and headaches. Optimal dosing standards and treatment regimens await clarification in adequately powered clinical trials."

https://www.aafp.org/afp/2009/1215/p1405.html

"The purpose of this study was to investigate the effect of oral eveningprimrose oil on the length of pregnancy and selected intrapartum outcomes in low-risk nulliparous women. A two group retrospective quasi-experimental design conducted on a sample of women who received care in a birth center, compared selected outcomes of 54 women taking evening primrose oil in their pregnancy with a control group of 54 women who did not. Findings suggest that the oral administration of evening primrose oil from the 37th gestational week until birth does not shorten gestation or decrease the overall length of labor. Further, the use of orally administered evening primrose oil may be associated with an increase in the incidence of prolonged rupture of membranes, oxytocin augmentation, arrest of descent, and vacuum extraction."

https://www.ncbi.nlm.nih.gov/pubmed/10380450

Ick. Having read them all together it seems like semen is really the safer alternative.

soulcupcake · November 2014

danisgossipgirl said:

I tracked my fertility and I never ever ever checked my cervix. In fact, the gals on TTGP flame ladies for doing that. I don't even know what I would be looking at if I tried. Although, I guess if I needed to, I would get a speculum and a mirror, right? But, that is one part of my vagina I don't need to know about... EPO or not.
Ok? Not sure what TTGP protocol has to do with it, but you can get some basic information from doing it, take it or leave it. You don't need equipment, just your hand. Maybe being in the medical field makes me immune to the weirdness of self-assessment, it's just another body part and I don't consider my vagina gross. It's much less invasive than having someone else's hand in there.

I think a lot of it has to do with familiarity with the idea of self-checking and knowing what to look for/how to assess. I'm not the least bit grossed out by such things. I know quite a few "crunchy" mamas that aren't comfortable with others checking, but have no problems with self-checking, especially since it is their body. It isn't that uncommon, and one's own gloved hand isn't different from another's gloved hand. It's just no big deal in most of the circles I've been in, but these are also mamas that are familiar and comfortable with it. *shrug*

I was a student midwife - LM when I was pregnant with #3, and I had diagrams and charts to look at in my materials and midwifery books. And when I checked with #4 I had my midwife assess and determine if our assessment was similar. She also trusted that I knew proper protocol. I also do garlic suppositories and eat yogurt with cultures during the last five weeks to keep a healthy balance and flora in the gut and vaginal tract, on top of the high dose of vit C to strengthen and protect the membranes.

RaeChay · November 2014

Anna930 said:

But @MissChristineMarie - the EPO is being used orally AND vaginally. You need to double your intake of semen... and choose more than 1 route.

rofl

BayCamp · November 2014

I have no issues with y'all checking your own cervix. I just want to know the logistics. I can barely reach my own vagina at this point, let alone hunch over far enough to stick my hand in there.

soulcupcake · November 2014

RaeChay said:

Hmm. Does anyone have access to any scientific studies regarding the use of EPO? (Here is where I miss gradschoolmom).

This goes into its history and uses.

https://www.instituteofmidwifery.org/MSFinalProj.nsf/a9ee58d7a82396768525684f0056be8d/f44c26c0836acbb585256dd1006b2a22?OpenDocument

I've also read that it's most effective in those deficient in EFA, and since it is not a prostaglandin itself (like Cervidil), only containing properties the body needs to make them, it may not "work" in the same way for everyone. One person can take it over weeks and see cervical ripening if the body was at the point of making prostaglandins, but if the body doesn't start making them until, say, 40w5d, then it won't "do" anything before that point.

Unlike semen, which actually contains prostaglandins, it will only do what the body is preparing to do already. It's an option for those who can't get readily available prostaglandins from semen.

mlee116 · November 2014

BayCamp said:

I have no issues with y'all checking your own cervix. I just want to know the logistics. I can barely reach my own vagina at this point, let alone hunch over far enough to stick my hand in there.

For real! I'm giving mad props to all the cervix checkers. I tried to look at an ingrown hair the other day and thought I was going to need CPR by the end of it.

BdblZ · November 2014

Any other medical-ish people see the abbreviation EPO and think erythropoetin? (Its a hormone our kidneys make to signal the body to make more Red Blood Cells). Some of the posts were really confusing to me when read under the other context....

Shortstack06 · November 2014

danisgossipgirl said:

I tracked my fertility and I never ever ever checked my cervix. In fact, the gals on TTGP flame ladies for doing that. I don't even know what I would be looking at if I tried. Although, I guess if I needed to, I would get a speculum and a mirror, right? But, that is one part of my vagina I don't need to know about... EPO or not.
Ok? Not sure what TTGP protocol has to do with it, but you can get some basic information from doing it, take it or leave it. You don't need equipment, just your hand. Maybe being in the medical field makes me immune to the weirdness of self-assessment, it's just another body part and I don't consider my vagina gross. It's much less invasive than having someone else's hand in there.

I don't find my vagina gross (pshh masturbating is 100% easier than sex right now), I find the idea of checking my cervix icky. I really would prefer it not be checked by someone else's hand either.

RayRay007 · November 2014

BayCamp said:
I have no issues with y'all checking your own cervix. I just want to know the logistics. I can barely reach my own vagina at this point, let alone hunch over far enough to stick my hand in there.

I can't reach anything right now. And I've done checks when ttc so know what I'm looking for. Still can't find it. Which is information in itself I guess- it's high and posterior.

MaineMama · November 2014

BdblZ said:

Any other medical-ish people see the abbreviation EPO and think erythropoetin? (Its a hormone our kidneys make to signal the body to make more Red Blood Cells). Some of the posts were really confusing to me when read under the other context....

HA! @Bbdlz, I'm glad I'm not the only one

And FFMC- I'm not bendy enough, even when not pregnant, to check my own cervix...

2JEL · November 2014

metaphysique said:

Unlike semen, which actually contains prostaglandins, it will only do what the body is preparing to do already. It's an option for those who can't get readily available prostaglandins from semen.

Sigh, thank you so much for the clarification @metaphysique -- wish I'd seen it stated this clearly a few weeks ago, I blame my pregnancy brain for thinking that EPO is "almost" as good as semen-- I thought it had prostaglandins, just not the same quantity as semen. Sounds like it's time for semi-frequent extremely awkward sex to become more frequent awkward sex-- any bets as to whether DH will find this good news or bad? I honestly can't predict.

gdaniels77 · November 2014

2JEL said:

metaphysique said:

Unlike semen, which actually contains prostaglandins, it will only do what the body is preparing to do already. It's an option for those who can't get readily available prostaglandins from semen.

Sigh, thank you so much for the clarification @metaphysique -- wish I'd seen it stated this clearly a few weeks ago, I blame my pregnancy brain for thinking that EPO is "almost" as good as semen-- I thought it had prostaglandins, just not the same quantity as semen. Sounds like it's time for semi-frequent extremely awkward sex to become more frequent awkward sex-- any bets as to whether DH will find this good news or bad? I honestly can't predict.

Hah I was just thinking the same thing when I read that. I'm sure MH would not mind actually getting propositioned by me, but once he finds out it's for some weird pregnancy purpose that may be an instant mood killer.

2JEL · November 2014

gdaniels77 said:

metaphysique said:

Unlike semen, which actually contains prostaglandins, it will only do what the body is preparing to do already. It's an option for those who can't get readily available prostaglandins from semen.

Sigh, thank you so much for the clarification @metaphysique -- wish I'd seen it stated this clearly a few weeks ago, I blame my pregnancy brain for thinking that EPO is "almost" as good as semen-- I thought it had prostaglandins, just not the same quantity as semen. Sounds like it's time for semi-frequent extremely awkward sex to become more frequent awkward sex-- any bets as to whether DH will find this good news or bad? I honestly can't predict.
Hah I was just thinking the same thing when I read that. I'm sure MH would not mind actually getting propositioned by me, but once he finds out it's for some weird pregnancy purpose that may be an instant mood killer.

In my case, DH is super super excited and impatient for arrival of LO, so I don't think he'll object to the motivation-- however, the strings attached are that I generally feel like some sort of hippo manatee hybrid, I'm achey and exhausted and self-loathing and the getting propositioned by me will look like this "ok, you need to figure out how to turn yourself AND me on sufficiently that it works and get this whole thing over with ASAP before LO starts moving/reflux starts happening/hips start aching/etc., enjoy!"

soulcupcake · November 2014

2JEL said:

metaphysique said:

Unlike semen, which actually contains prostaglandins, it will only do what the body is preparing to do already. It's an option for those who can't get readily available prostaglandins from semen.

Sigh, thank you so much for the clarification @metaphysique -- wish I'd seen it stated this clearly a few weeks ago, I blame my pregnancy brain for thinking that EPO is "almost" as good as semen-- I thought it had prostaglandins, just not the same quantity as semen. Sounds like it's time for semi-frequent extremely awkward sex to become more frequent awkward sex-- any bets as to whether DH will find this good news or bad? I honestly can't predict.

Sex is definitely best for the prostaglandins and contractions orgasms induce, but it hasn't been going on here. It has been uncomfortable these last couple months. I'm also holding out a few more days when I'll be 37 weeks when my midwife can legally attend a homebirth. I've been having prodromal labor contractions for about a week and don't want to overexcite things too much yet. At this point missionary with my pelvis propped with pillows is the only position that isn't as uncomfortable.

feeshah · November 2014

DH is going to be so happy in two weeks. Bi-weekly awkward sexy time instead of....basically no sexy time.

misteezagirl · November 2014

Hi, I ingested starting 36 weeks last week then ingested 2 capsules a day at 38 wks and inserted 2capsules at night before bed ( make sure to pin prick them before inserting), not sure if it helped. My labor was much faster than with my first . It is a natural prostaglandin so I don't see any harm in not doing it. Anything to help speed up labor and get the cervix ripe

drpayne · November 2014

danisgossipgirl said:

MissChristineMarie said:
I tracked my fertility and I never ever ever checked my cervix. In fact, the gals on TTGP flame ladies for doing that. I don't even know what I would be looking at if I tried. Although, I guess if I needed to, I would get a speculum and a mirror, right? But, that is one part of my vagina I don't need to know about... EPO or not.
Ok?

Not sure what TTGP protocol has to do with it, but you can get some basic information from doing it, take it or leave it. You don't need equipment, just your hand. Maybe being in the medical field makes me immune to the weirdness of self-assessment, it's just another body part and I don't consider my vagina gross. It's much less invasive than having someone else's hand in there.

This. Certain types of NFP use cervical info. Unless you check it daily, it would be hard to recognize subtle differences/changes.

There is no way I could reach my cervix right now.

I used EPO with my first 2. DS1 was 9 days late and DS2 was 5 days late. I do dilate quickly once in labor. My first labor was long because baby wouldn't descend. My second labor was pretty quick.

ColeyCannoli · November 2014

BayCamp said:

I have no issues with y'all checking your own cervix. I just want to know the logistics. I can barely reach my own vagina at this point, let alone hunch over far enough to stick my hand in there.

This.

Plus, I can see how checking your cervix works for TTC because it's either high/low soft/not soft. But how on earth does it work with pregnancy? Do you stick a ruler up there to check dilation? How do you know 60% from 80% effacement? Doctors/nurses/midwifes check 100 people a day, and even they can vary what they tell you. I just don't *get* how this works. I'm intrigued and confused is all :P

soulcupcake · November 2014

ColeyCannoli said:

BayCamp said:

I have no issues with y'all checking your own cervix. I just want to know the logistics. I can barely reach my own vagina at this point, let alone hunch over far enough to stick my hand in there.

This.

Plus, I can see how checking your cervix works for TTC because it's either high/low soft/not soft. But how on earth does it work with pregnancy? Do you stick a ruler up there to check dilation? How do you know 60% from 80% effacement? Doctors/nurses/midwifes check 100 people a day, and even they can vary what they tell you. I just don't *get* how this works. I'm intrigued and confused is all :P

Haha. There are actual models that med students/residents, nurses and student midwives use in the beginning. But assessments can vary from practitioners based on the size of their fingers. Smaller fingers may yield a bigger dilation assessment. It's not uncommon for one medical professional to say a patient is 4 cm and another to say she's 6 cm.

But the fingers are used, and how far apart the index and forefinger can spread, or how many fingers can fit in the cervix, determines dilation. The cervix is roughly 1.5" long/thick, and effacement is assessed also by centimeters. Midwifery/obstetric diagrams and charts give visuals to get an idea of what to feel for. If there's less than an inch of cervix left then that's 50%. 1 cm of cervix can be 75%.

Hope this helps:

https://www.operationalmedicine.org/ed2/Enhanced/LandD/DilatationandEffacement.htm

2JEL · November 2014

Thanks for the additional information metaphysique! If say one was told throughout most of pregnancy hypothetically speaking that their cervix was nearly 4" would effacement be relative to initial length or still go off average length?

True story re: variability of assessment from doctor to doctor: I went to L&D late october and during a scare caused by a fainting spell I woke to a cervical check being done by attending OB, I was told I was fingertip dilated and 20% effaced, the day before I'd been told by OB that there was no sign of dilation or effacement... then 10 days later was back in OBs office requested a cervical check (b/c I like to party) and was told that I was neither dilated nor effaced... hence the projected uptick in my sex life.

JunkieBrewster · November 2014

late to this, but because I have PCOS, I cannot use ovulation strips accurately. My only ways of knowing if I was about to ovulate, over temperature tracking and cervical checks. If my temperature dipped, and my cervix was open, then I knew it was time to get up on it.

eventually, we just moved onto ultrasounds and trigger shot, so I did not have to check any longer

amedbery · November 2014

gdaniels77 said:

Hah I was just thinking the same thing when I read that. I'm sure MH would not mind actually getting propositioned by me, but once he finds out it's for some weird pregnancy purpose that may be an instant mood killer.

Haha - propositioning MH for some weird pregnancy purpose is what got me here in the first place! But yeah, staring down the barrel of a six-month drought, I'm sure most of our husbands will willingly give it up. Sounds (slightly) less awkward than vaginal supplements to me.

nolanova85 · November 2014

amedbery said:

Hah I was just thinking the same thing when I read that. I'm sure MH would not mind actually getting propositioned by me, but once he finds out it's for some weird pregnancy purpose that may be an instant mood killer.
Haha - propositioning MH for some weird pregnancy purpose is what got me here in the first place! But yeah, staring down the barrel of a six-month drought, I'm sure most of our husbands will willingly give it up. Sounds (slightly) less awkward than vaginal supplements to me

**QUOTE BOX FAIL**

I wrapped my arms around DH this morning and talked about the benefits of sex as we get closer to delivery date. He hasn't touched me since August (he's been affectionate, but anything remotely sexual freaks him out. Quote - "that's my son's home!" I have tried to explain that it doesn't really work that way, but I digress... anyway, doesn't look like my DH will be be one of the willing. EPO it is

ColeyCannoli · November 2014

nolanova85 said:

amedbery said:

Hah I was just thinking the same thing when I read that. I'm sure MH would not mind actually getting propositioned by me, but once he finds out it's for some weird pregnancy purpose that may be an instant mood killer.
Haha - propositioning MH for some weird pregnancy purpose is what got me here in the first place! But yeah, staring down the barrel of a six-month drought, I'm sure most of our husbands will willingly give it up. Sounds (slightly) less awkward than vaginal supplements to me

**QUOTE BOX FAIL**

I wrapped my arms around DH this morning and talked about the benefits of sex as we get closer to delivery date. He hasn't touched me since August (he's been affectionate, but anything remotely sexual freaks him out. Quote - "that's my son's home!" I have tried to explain that it doesn't really work that way, but I digress... anyway, doesn't look like my DH will be be one of the willing. EPO it is

"That's my son's home" is both kind of adorable and really ridiculous. Remind him that your son is renting that "home" and has to get a move on eventually.

2JEL · November 2014

nolanova85 said:

I wrapped my arms around DH this morning and talked about the benefits of sex as we get closer to delivery date. He hasn't touched me since August (he's been affectionate, but anything remotely sexual freaks him out. Quote - "that's my son's home!" I have tried to explain that it doesn't really work that way, but I digress... anyway, doesn't look like my DH will be be one of the willing. EPO it is

Pshaw, at best it's like his driveway.

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