Using Progesterone Cream with new BFP!

[WendyJo410]

Hi Mamas,

I just got a BFP at 12 DPO and have been spotting since 8DPO. I am currently nursing my 10 month old DS and my midwife suggested to start using progesterone cream to up my progesterone levels and stop the spotting. I have purchased Progestelle and Emerita Pro-Gest Natural Progesterone Cream. If you've ever used progesterone creams - have they been successful? What is/was your dosing?

I don't have a history of miscarriages and this is my 3 cycle TTC while nursing.

TIA!
Wendy

[Jaimee]

Congrats!!!   Have you been spotting prior to AF before this cycle?

[WendyJo410]

Thanks Jaimee!

No, I didn't spot with DS and I cycled twice before the BFP and I did not spot any of those times either. I'm 13DPO today and haven't spotted at all since 7pm yesterday.

[Jaimee]

Hmm... well, it seems to me then (though I'm no doctor) that your spotting is not indicative of low progesterone.  If your previous cycles have had regular length LP's without spotting then it seems odd that this one would suddenly have spotting from low progesterone.  I don't imagine that supplementing a bit would hurt in any way, but I'm not sure that you need it either, especially since you have now stopped spotting and AF would be on her way right about now anyway, right?

But I'm no expert on progesterone supplementation and if your care provider recommended it, then you might feel more secure taking it.  I know there are plenty of women on this board that have used NPC successfully.  There are a few threads on it that you can search for and read what dosages they took.  Good luck!

[WendyJo410]

Jaimee - Although I do see your point, this is kind of how I'm looking at it:

1) I wasn't pregnant the last cycles, obviously not needing more progesterone that the fetus is requiring.

2) My LP was only 8 and 9 days (respectively) the last 2 cycles, indicative of low progesterone.

3) AF would have been here about 4-5 days ago according to my last cycles, which is what I thought was happening when the spotting began.

4) My midwife typically veers on the side of less is more - so I do trust her judgment and if progesterone will help sustain this pregnancy, I'm definitely going to do my research and look into it!

Thanks again for your advice. I appreciate the feedback!

BTW - according to your profile, you have another birth coming up soon! Good luck!

[Jaimee]

Spotting around the time of expected AF when pregnant is pretty common breastfeeding or not, so I'm inclined to think that's exactly what that was.  And I've personally not heard that an embryo requires higher progesterone levels so much as the embryo needs to signal the corpus luteum to remain intact so that it can continue to produce progesterone until the placenta takes over.  I've read that progesterone levels during the LP are similar to levels in the first trimester of pregnancy- though sometimes they get much higher when pregnant. I'm sure there are many individual differences.  One study concluded that progesterone in the first tri does not fall below 11 ng/mL.  You could get your levels tested.  I would assume that once the placenta takes over low progesterone would no longer be an issue. 

But in the end the important thing is to go with your gut!   And it sounds like you're doing that.      Thanks for the well wishes!  Almost full term now!  And FWIW, I had only had one cycle prior to conceiving this baby and my LP was only 4 days long!  Sometimes LP's go from infertile to perfectly fertile in one cycle!

[WendyJo410]

Wow - I like your point of view on this. I wonder now too if progesterone levels are higher when pg?! So, basically, if the corpus luteum doesn't stay intact, progesterone cream won't do much good, will it?

Blood is never a good thing when you're trying to have a baby, which is why I'm trusting my midwife's judgment on this one (and going with my gut).

Any other advice? Have you spotted with successful pregnancies?

[Jaimee]

Yes, I spotted around the time of my expected AF with my first pregnancy and again about week later.  I recall my mw at the time telling me that spotting during pregnancy is not uncommon and if I was starting to m/c there wasn't anything that anyone could do about it, so I should just try and relax.     It's also why care providers often don't bother with prenatal appointments until about 10 weeks.  But as it turned out, the pregnancy was just fine.  I didn't spot with either of my other two pregnancies.
 

Originally Posted by WendyJo410 

I wonder now too if progesterone levels are higher when pg?! So, basically, if the corpus luteum doesn't stay intact, progesterone cream won't do much good, will it?

Well, progesterone does climb as you progress in the pregnancy; I assume this is because the placenta takes over around the end of the first tri.  If the corpus luteum does not stay intact prior to the placenta taking over, then yes, the uterine lining will be shed and the embryo will be shed with it.  I am NO expert on progesterone supplementation and how exactly it helps the corpus luteum.  It makes sense to me that progesterone supplementation would keep everything intact long enough for your hCG levels to build high enough that the corpus luteum knows to stay intact.  But I'm not sure the timing on that and it probably differs for each embryo and woman.  I would have assumed it would only be necessary through the time of expected AF, but I also know that many women take NPC through the first tri, so perhaps it is necessary until the placenta is up and running despite hCG levels.  I may have to look for some journal articles on this now!  My curiosity is peaked!