The Daily News

LFCA Latest Issue: Friday, September 25, 2009.

Latest Post on BlogHer: Parenting after Infertility.

My Status: Fed Josh's almonds to the squirrels. They needed them very badly.

Monday, August 28, 2006

Got Prometrium?

There are the amusing Google searches (amusing, at least, to me) that lead to my blog: pee in my ass (as well as knowing that the next time someone conducts this search, they will find my blog at the top of the page).

There are the bizarre Google searches that leave me puzzled over their intended meaning: stirrups insert slowly speculum.

And then there are the Google searches that make me run onto Blogger to post some additional information and ask the rest of the Stirrup Queens to chime in some more with their own experience.

There has been a heavy run on Prometrium questions as of late, especially ones connected to Prometrium affecting betas and periods. This is my own understanding/experience: Prometrium does not affect a beta whatsoever or a pee stick. A beta is measuring the level of hcG in the blood and a home pregnancy test measures the amount of hcG in the urine. While a trigger shot of Novarel (hcG) would affect this test, Prometrium or any extra progesterone would not.

I'm not sure if Prometrium can delay a period. The first time I took Prometrium, I got pregnant and promptly miscarried, so yes, my period was late. But it was because I was pregnant. That one particular cycle, I was taking Prometrium with the directions to keep taking it until I got my period. I assume from these directions that if your period was meant to come, it will come and you will have break-through bleeding. At the same time, after that initial cycle, I started seeing an RE and he told me to come in for a beta, stop the Prometrium if I wasn't pregnant, and I would get my period a few days later. Which sort of flies in the face of that whole idea that Prometrium wouldn't affect your period. Why not just have a person keep taking it? Why do a blood test? my humble opinion, Prometrium probably could delay a period.

I also believe this next fact is the fault of Prometrium (though my RE has said this isn't possible). Almost every natural cycles (non-medicated) that I've had after taking Prometrium has been anovulatory. So I'd take Prometrium one cycle, not get pregnant, and then not ovulate the next cycle. Strange coincidence. This, obviously, wasn't the case when I was doing a medicated cycle because the drugs overrode my body's tendency towards anovulation.

Another problem with Prometrium is that the day after I went off of it each month, I had terrible mood swings. Terrible anger and deep sadness. Not that any day is a holiday with infertility, but I truly felt more out-of-control emotionally on that day after I went off of it. Be forewarned. And it wasn't just because I had gotten a negative beta the day before or because my period was coming. I was just extremely emotional for a day or two and it felt hormonally-driven rather than circumstances.

Lastly, if you are pregnant, you will keep taking Prometrium through the first trimester. Around week 12, you stop taking it. I was a huge freak about my pregnancy and I asked my OB if there was any problem in taking it for a few more weeks. He said I didn't need it anymore and I repeatedly asked if there was a problem if I took it for a few more weeks--any detriment to the babies. When he finally gave into the fact that I am a freak, he admitted that there was no problem in taking it if it made me comfortable. So I stayed on it for another three weeks. Just wanted to make sure those babies were in there--good and tight.

Anything else I'm leaving out, Stirrup Queens? And for anyone who is searching--check the side bar under Operation Heads Up. Kris wrote a great write-up about Prometrium with pictures and more how-to information.


Jenn said...

Prochieve (another version of supplement progesterone) had a kooky effect on me too. I went exactly 18 dpo with no positive HPT and only once I stopped the supplement did my period ever show. I guess I wanted so badly for that 18 dpo to mean that I was pregnant. Four months of that and I was done with it. No doubt about it, progesterone supplements will mess with your body and your mind.

Piccinigirl said...

Jenn I concur, I take prochieve/crinone when I do Clomid cycles and the woman who would have LP bleeding every month (normally starting about 7dpo) would NOT spot. To be honest the first month I did the clomid/estogen/prochieve (eons ago) I was SURE I was PG, because I was not spotting , it was 18 dpo and there was no sign of brown, pink or red. (Cramps were still there but no colors) I have had lots of cycles since then, the one in April I had a 22 day LP because I refused to stop the progesterone convinced that I HAD to be PG, I never would have lasted this long without bleeding. Obviously I was not, but it does go to show that Progesterone in any form can hold off the red tide if your body is so inclined.

joan said...

I believe there is some link between progesterone and bleeding/not bleeding. In spite of having severe endometriosis & only one fallopian tube I have managed to conceive naturally four times. Each time, my RE put me on progesterone suppositories as soon as the beta came back positive. He said it was to give the pregnancy an extra boost. (Since I wasn't an IVF patient, I hadn't been on it up to that point.) The two times when the betas went south, they had me stop the progesterone so that nature could take its course. With the current pregnancy (9w, 6d, fingers still crossed), I had light bleeding in the first few days that stopped as soon as I started using the suppositories. I also have a friend (non-IVF) who was prescribed progesterone suppositories for first trimester bleeding of undetermined origin. So I don't know that progesterone will prevent a miscarriage, but it does seem to delay bleeding.

Teendoc said...

Prometrium is one of the many forms of progesterone designed to mimic what the corpus luteum will produce or support pregnancy until the placenta begins producing adequate progesterone.

Clearly since a low level of progesterone is needed before menses can take place, taking progesterone does delay the onset of menses. I'm not sure why most doctors aren't explaining this simple correlation to their patients.

However for people who have built up a very thick lining, these women can bleed through while still on progesterone.

And taking progesterone does not throw off natural ovulation. I use it in my adolescents all the time without incident. However if you already have a tendency to anovulation due to age, other medical/reproductive issues, you tend to notice your anovulation more after a progesterone cycle.

The Town Criers said...

And there you have it from an actual doctor (Teendoc is a doctor for teens--not a female Doogie Howser). Thank you!


Jackie said...

Progesterone affects the uterus in several known ways during the luteal phase of the menstrual cycle. In addition to promoting uterine quiescence, it also promotes changes in the lining of the uterus that make it more receptive to the embryo dropping in from the tubes or being transferred. When implantation has occurred the hCG released by the embryo will stimulate the corpus luteum to grow and produce even more progesterone which keeps the uterus quiet, staving off AF. If receptivity is an issue from the beginning, then quiescence is a moot point unfortunately.
I'm currently trying my first course of Prometrium. I was prescribed enough for only 10 days with the assumption that receptivity or implantation is the issue. This is such a tricky area because it seems to be a relatively unexplored field and so complicated. And as the RE says, the course of treatment would be the same regardless...

Anonymous said...

I would like to say that Prometrium does effect ovulation kit tests. It gives false positives. My experience was with the Answer Ovulation test predictor kit..the one that comes with 20 test sticks (for ladies that don't really know when they ovulate. I got a positive test result the day after i started taking my 10 day cycle of Prometrium. I got excited but I figured it out once the test came positive 7 days in a row! Just thought I'd let ya'll know FYI!)

sio said...

Anonymous, I am sure it wasnt the prometrium that caused the false plus on the answer test strips. If you do a search you will find those tests are NOT accurate. I can literally Pee and dip a strip and it be really negative and wait a half hour and use another and it be blaring positive. Those tests STINK!

Anonymous said...

I have to say this is the first site which gave me some answers...though I am still not sure what I should do. I have had 3miscarriages and now we are ttc again. My doc put me on prometrium and asked me to stop if I don't get a positive preggo test. Mine usually never comes up in the urine test and I didn't know if going off prometrium would induce a period. (My doc didn't tell me to take it till I got my period)

Jill said...

My recent experience says that prometrium used as suppositories definitely does stop your period. I was on prometrium supp 2 three times daily and did not get my period by 18 days past retrieval (even though my usual luteal phase is only 12 days). My previous cycle I had crinone gel, and despite this my period came anyway, on day 14 past retrieval. Both cycles were completely negative, no HCG or miscarriage causing the difference.