Questions for Mama's who have been or are on progesterone.

[thefreckledmama]

When I was 5 1/2 weeks pregnant, I had bloodwork done, and my progesterone was 7.  My now former OB put me on 200mg oral progesterone once a day.  When I saw my primary doctor a few days later for an unrelated issue, she asked why I was on the progesterone, I explained, and she told me that she'd recently taken courses in this new technology and wanted to adjust my progesterone and start testing me herself since I was leaving my OB for a MW and wasn't seeing her for a few weeks.  She changed my oral dose to twice a day, and added in 200mg progesterone in oil injected twice a week. After two weeks, my progesterone level was 21.7 (at 8 weeks, after not taking any for 36 hours before the test.  She said that was still too low and now also added in vaginal suppositories.   She also said it's likely that I'll be on all these forms of progesterone my entire pregnancy.

Everything I've been able to find through talking to friends who have been on progesterone and online indicates that a level of 21.7 isn't all that low, and that even if progesterone supplimentation were necessary, once a day oral would be sufficient.  So really I'm just wanting to hear experiences from other moms who have been there and what their levels were and such, because this seems like an incredible amount progesterone for me to be taking.  

It wouldn't be as big of a deal, but the side effects are making it incredibly difficult for me to care for my four older children-none of which I ever needed progesterone supplimentation with, and I've never had a pregnancy loss. So I don't feel like there is a history to be especially over-zealous with precautionary measures.

[porcelina]

That is indeed curious that you have no history of losses and they are being so aggressive on the progesterone. There are clearly a lot of things that are going on, and for some women, the level 7 might be fine, but for others, maybe not. Same probably goes for levels up in the 20s. But, without a history of loss, I'm not sure why they have to be that aggressive -- I say avoid the injections if you can! The oral medication and suppositories can't hurt (this is what the medical community in general believes about progesterone supplementation in general), and clearly seems to be helping (because your levels are up). However, you could develop a reaction to the injections (I found a lot of cases) and it is no fun to stick yourself, plus, I don't see why on earth you would need that much!

I, on the other hand, have had 3 miscarriages (and 2 live births). Each time I used the progesterone supplement (oral for the first live birth, suppositories for the second live birth), I had a successful pregnancy. The times I didn't, I didn't make it past 6 weeks. I am currently 14 weeks pregnant. This time I saw a reproductive  endocrinologist. He wanted to keep my progesterone level above 36, which is indeed very high. He told me that oral is not the best way for the body to absorb progesterone, and that suppositories are better. I started with progesterone gel suppositories twice a day from 3 days after ovulation. My progesterone levels were in the high 30s and low 40s. One day before heading on a trip, the levels went down to 33, and he prescribed progesterone in oil injections every other day to get the levels up higher (since I wouldn't be around for treatment while I was gone). After about 10-14 days, I had an allergic reaction to the oil (apparently-- sesame oil), and developed hives on the injection area, so they told me to stop taking it. He then directed me to wean off the progesterone suppositories, to be finished around 14-15 weeks. I ended up deciding to wean off earlier, and finished by about 12 weeks. Your placenta takes over and the progesterone is not as crucial at that point, which can be as early as 8-9 weeks in some cases, perhaps later in others.

Unless you have had pre-term labor, there is no reason to keep taking the progesterone throughout your pregnancy. If you have gone into pre-term labor before, then progesterone supplements can prevent pre-term labor, which of course is a justified use of the supplements after the first trimester. I have heard of women using both suppositories and oil injections for this purpose.

Good luck!

[thefreckledmama]

Thank you for your reply!

I also have never had preterm labor in any of my previous pregnancies.

[-Resque-]

I lost two pregnancies to low progesterone. My levels were always low, and I was put on the pills for both pregnancies. Didn't up my levels at ALL.

This pregnancy, I was put on the suppository, and my numbers were great. I am now 16 weeks pregnant. I was taken off the progesterone at 12 weeks 6 days, and have been doing fine.

[pokeyAC]

I took 200 mg twice a day vaginally through the first trimester.  As was mentioned above, you usually don't need to take it after the first trimester because the placenta takes over production.  I had a history of low progesterone and went through fertility treatments, but my Dr. did not test my progesterone after I became pregnant. 

My thought would be that the oral could be making you feel yucky since it is going through your stomach and digestive system.  Vaginal suppositories go directly to the area where they are needed.  I have also heard that some forms of supplementation do not show up in blood work because the progesterone is being absorbed through your tissues and not through the blood. I am not a doctor, but 3 forms of supplementation sounds like a lot to me for someone who has no history of hormonal problems.