Slight spotting. Please help. X-posted.

[Blessed_Mom]

Hi ladies,

Can I ask for some advice please? I had my first postpartum period on the 25th of last month. But even after the usual 5 -days I have been spotting. When I say "spotting" it seems like an exaggeration because it really has been one teensy tinsy drop every other day (a slight pink tinge on the tissue. Sorry for the TMI.)

Before my pregnancy I never ever spotted after my period was done.

I start my ovulation period as of today and I "spotted" yesterday too. Should I be worried? Did this happen to someone else too? Oh - I got my first AF 2 yrs after my daughter was born (so almost 3 yrs of no AF). Should I try and TTC (like we have been waiting to do?)

Please, any insights? Thanks so much.

[sraplayas]

I am in a similar situation.  I had my first PPAF (DS is 2.5yrs) at the end of May and had a full week of AF (from beginning to spotting at the end)--but then two days later I had pink-streaked ewcm.  Then nothing.  I was thinking maybe I was having ovulation spotting but it seemed a little early?  Maybe someone will have a brilliant insight!

[JMJ]

I'm not sure exactly what is happening, but I'm guessing it has to do with your hormones regulating as your fertility is returning.  Fertility is a continuum, not an on/off switch.  When you are breastfeeding after the birth of your baby, you reach a point that your hormones are working well enough that you start your cycle again, but in the first few cycles postpartum, it is quite common to have some wacky hormones.  It's hard to know if that would prevent you from conceiving immediately or not.  There are many women who are able to conceive quite quickly after they begin ovulating again.  Others have a few or even several cycles before their hormones regulate enough to get pregnant.  It is up to you if you want to go for it right away or if you want to chart for a bit and see if you can get some more information on if your body is ready.  I personally chose to chart and wait until I had a luteal phase that was at least 10 days.  I had 4 8-day luteal phases before it jumped to 11 days.

[JMJ]

Hmmm... I just checked in Marilyn Shannon's "Fertility Cycles and Nutrition," and she lists this symptom under luteal phase defects, usually low progesterone, a common problem amongst newly fertile postpartum moms.

[Blessed_Mom]

Low progesterone? Then should we postpone TTC? Or should we try anyway? And thanks for the info.

[JMJ]

That is a very personal and multifaceted question.  Are you charting?  If you chart for a cycle, you can tell how long your luteal phase is.  Low progesterone is common during the return to fertility while breastfeeding and often results in short luteal phases.  If your cycle is under 9 or 10 days, it is unlikely that you would end up pregnant (fertilization may occur, but your period would begin before implantation) even if you did TTC.  It may take a little time, but your cycle will eventually regulate.

If you want to push your cycle to regulate faster, many women have had success with vitamin B6, or you may choose to wait for it to regulate on its own.  I chose to eat foods containing B6 such as bananas and yellowfin tuna.  I don't know if it helped or if my body just clicked back into place on its own a month after I started targeting foods with B6.

Women conceive all the time with iffy hormones initially, and they go on to have healthy pregnancies.  In fact, it is quite common to conceive immediately after getting off of the BCP even though it takes most women some time for their hormones to regulate.  For other women, their hormone imbalance is enough to create problems for trying to conceive.  I can't tell you where you would be on that spectrum.

Basically, there is a chance that it could not be a problem, and there is a chance that it could make conception or implantation difficult or impossible.  I don't know what it would be for you.  If you want to shoot for whatever chance you've got and TTC now, I wouldn't discourage you.  If you want to wait and chart to give you more information, wait for your hormones to regulate, and increase your chances of getting pregnant, that is the choice I made.

If you want to talk to your physician to get more information s/he would probably know more than I do about how this would affect your ability to get pregnant.  If you go this route, I'd recommend a physician trained in NaPro technology because they tend to be the most knowledgeable about the connection between the signs in a woman's cycle and the affect that it has on your ability to conceive.  Do know that in all likelihood, this is not a sign that there is something wrong with you, just the natural, normal return to fertility after childbirth.  If not now, you should be able to conceive within the next several months.

[sraplayas]

Thans, JMJ--that makes alot of sense, especially since those were the two things that needed a little adjustment according to my labs earlier this year.  If it took this long for AF to return, I guess I should be patient with a funky cyle or two in the process!

 

Originally Posted by Blessed_Mom 

Low progesterone? Then should we postpone TTC? Or should we try anyway? And thanks for the info.

Blessed_Mom--I had some hormone tests run a few months ago and my progesterone was a bit low so I began taking it at intervals at the suggestion of my ND.  She has been super helpful.  I'd be glad to share more if you would like to pm me. :)

[Blessed_Mom]

I Love You!  :D

Originally Posted by JMJ 

That is a very personal and multifaceted question.  Are you charting?  If you chart for a cycle, you can tell how long your luteal phase is.  Low progesterone is common during the return to fertility while breastfeeding and often results in short luteal phases.  If your cycle is under 9 or 10 days, it is unlikely that you would end up pregnant (fertilization may occur, but your period would begin before implantation) even if you did TTC.  It may take a little time, but your cycle will eventually regulate.

If you want to push your cycle to regulate faster, many women have had success with vitamin B6, or you may choose to wait for it to regulate on its own.  I chose to eat foods containing B6 such as bananas and yellowfin tuna.  I don't know if it helped or if my body just clicked back into place on its own a month after I started targeting foods with B6.

Women conceive all the time with iffy hormones initially, and they go on to have healthy pregnancies.  In fact, it is quite common to conceive immediately after getting off of the BCP even though it takes most women some time for their hormones to regulate.  For other women, their hormone imbalance is enough to create problems for trying to conceive.  I can't tell you where you would be on that spectrum.

Basically, there is a chance that it could not be a problem, and there is a chance that it could make conception or implantation difficult or impossible.  I don't know what it would be for you.  If you want to shoot for whatever chance you've got and TTC now, I wouldn't discourage you.  If you want to wait and chart to give you more information, wait for your hormones to regulate, and increase your chances of getting pregnant, that is the choice I made.

If you want to talk to your physician to get more information s/he would probably know more than I do about how this would affect your ability to get pregnant.  If you go this route, I'd recommend a physician trained in NaPro technology because they tend to be the most knowledgeable about the connection between the signs in a woman's cycle and the affect that it has on your ability to conceive.  Do know that in all likelihood, this is not a sign that there is something wrong with you, just the natural, normal return to fertility after childbirth.  If not now, you should be able to conceive within the next several months.

[TenzinsMama]

JMJ, I was checking this thread out and just want to say how much I appreciate your information.  It's helpful to get another dose of affirmation that my body is indeed getting itself regulated after childbirth, and that maybe I just need to wait a bit longer for it to tweak itself a little more, and then maybe a bfp will head my way!  My LP has been short during my 5 PPAF, with the shortest being 8 days last month.  I decided to take 100 mg of Vitamin B6 for the past month, and yesterday, while discouraged because AF showed I was also encouraged because my LP was 12 days.  So I believe that the Vitamin B6 was a help (I also have been doing some acupuncture this last cycle).  I think I'm going to eat more bananas this next cycle-- thanks for that nugget!

[JMJ]

Blessed_Mom, best wishes as you navigate the full return of your fertility.

TenzinsMama, I had 4 8-day LP's before an 11 day one last cycle, so it sounds like we're in a similar spot there.  This is my first cycle TTC though.  Sorry to hear about AF, but a 12 day LP is exciting.  Here's hoping that we both get BFP's soon!

[Blessed_Mom]

Wow 100mg of Vit B6? Isn't 1 mg (or is it 2mg?) equal to 100%?

Is that Ok to take? Does anyone know? How much Vit B6 should we take each day to correct the low luteal phase (and low progesterone) deficiency?

[JMJ]

Originally Posted by Blessed_Mom 

Wow 100mg of Vit B6? Isn't 1 mg (or is it 2mg?) equal to 100%?

Is that Ok to take? Does anyone know? How much Vit B6 should we take each day to correct the low luteal phase (and low progesterone) deficiency?

Yes, 2mg is the RDA for breastfeeding moms.  I would add at least another .6mg if you are planning to be both pregnant and breastfeeding since that is the difference between the RDA for an adult woman normally and the RDA for a pregnant woman.  There aren't recommendations for pregnant + breastfeeding, so I think it is wise to think of RDA's as a baseline, and add whatever they suggest adding for pregnancy and whatever they suggest adding for breastfeeding if   you are planning to do both.The Tolerable Upper Limit for B6 for women 19 years or older is 100mg of supplemental B6.  It is recommended that you would take it as part of a B6 complex.

Prolactin and Progesterone work against each other.  High Prolactin levels cause low Progesterone.  This is a large part of why your body does not become fertile right away while breastfeeding and why it is common to show signs of low Progesterone while breastfeeding.  It is completely normal.  It is caused by the same hormone that is making milk for your little one and nothing to be concerned about.  High Progesterone levels also cause low Prolactin levels.  This is why many women loose their milk during pregnancy and even why you do not produce milk until you have your baby, and there is a sharp decrease in Progesterone and why pro-breastfeeding groups condemn the new recommendation that women get high-dose progestin contraceptives (such as the shot) immediately after giving birth.

High doses of Vitamin B6 appear to tip the balance some in favor of Progesterone.  There are some cases of non-lactating women producing some milk and having signs of low Progesterone, and B6 is an effective treatment for this.  In breastfeeding women who are trying to tip the balance in order to be able to conceive, large amounts Vitamin B6 is considered to be one of the safest ways of doing so.  Do realize that this is often done by supplementing amounts that you would never be able to get in food.  It would be very difficult to get more than about 10mg or so of Vitamin B6 in food.  If you take that much Vitamin B6, it is not that you are correcting a deficiency in your body.  You are taking pharmacological doses to use it as a more natural drug to change what your body is doing in attempt to be able to get pregnant.

I think that a lot of planning a family is doing what you feel called to do, and if a couple feels so called to have another child that they would like to use pharmacological doses of Vitamin B6 to do so, I think it's wonderful that we have that option.  I am completely in favor of using pharmacological doses of Vitamin B6 as a means of correcting a problem such as milk production in non-lactating women, but I have reservations about taking it myself to disrupt the natural hormonal process in breastfeeding in order to push my body to become more fertile before it is ready.  I would use it if I thought it might prevent miscarriage (though I'm not sure of a case that it would), but I am hesitant to use a drug to fix something that is right, not wrong.

However, I do a lot of research on nutrition, and when I ran some figures to see how much of different nutrients I was getting, Vitamin B6 was one I was marginal at best on.  It is my thinking that it would be good for me to be getting a healthy amount of Vitamin B6 in my diet (I'm probably getting 3-5mg/day) to allow my hormones to balance as needed.  It is how I feel called to allow natural processes to work into my family planning.  Of course I would support any woman who felt called to another path.

[Vegan Princess]

HI Blessed Mom: Coming over from the February 2009 thread. Just thought I'd add that after PPAF, my luteal phase went from 3 days up to 12 days in a period of about 7 or 8 months. B6 did not help me but it does help many. Turns out I have low progesterone issues even after weaning and need to be on prescription supplemental progesterone in order to sustain a pregnancy (though I did not have this problem prior to conceiving or while carrying DD). Anyway, I say go for it. If your luteal phase it too short, you might not get pregnant. But there is no harm in trying. I have also seen moms go from 4 day LP to pregnant the next month. So you just never know. 

Cindy