Possible Progesterone Deficiency/LPD and dealing with Tricare, though any input is appreciated - Mothering Forums

Forum Jump: 
 
Thread Tools
Old 07-31-2009, 09:25 AM - Thread Starter
 
Bazile's Avatar
 
Join Date: May 2008
Location: Prattvile, AL
Posts: 49
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Cross-posted in Infertility.
DH and I have been officially trying to conceive since about Christmas. When we made the decision, I think I had already ovulated that cycle. I've been off Birth Control Pills since last June when my prescription ran out. From June until January we weren't trying, but we weren't preventing either. I started charting in January.
What I thought were textbook perfect 28 day cycles, turned out to not be so perfect. While I do have fairly consistent give or take a day cycles, I don't ovulate until CD 17 or 18. Since I've started charting my LP has averaged about 10 days. I've had one 14 day LP last month when I'm about 75% sure I had an early miscarriage, and one 9 day LP though I think I ovulated 2 days earlier than FF does. Best I can tell, depending on who you ask 10 days is either the very lowest level of normal or too short.
Progesterone deficiencies run in my family. My mother and maternal aunt both had them' it's suspected that my maternal grandmother did as well. My mom had four very early miscarriages (between about 5 and 8 weeks) and one still birth (6 1/2 months) in about 2 years before she got pregnant with me. After the third miscarriage, they started running tests on my parents, but no one thought to check Progesterone levels until she was pregnant with me.This started in 1982, and I was born in September of 1985. When my aunt got pregnant for the first time in 1998, she started spotting at about 6 weeks. My mother told her to go to the doctor and keep saying "my sister had a progesterone deficiency" until someone ran some tests. Problem was discovered, and she had a healthy baby boy in July of 1999.


Because of this past cycle where I had plenty of pregnancy symptoms (overwhelming fatigue, extremely tender breasts, nausea and vomiting to the point that couldn't keep much down beside ginger ale, heartburn, gas, etc) before getting a late period, I decided (with a lot of encouragement from my mom who didn't want me to deal with everything she did) to call the Base Clinic to see if they could run some tests or refer me to someone who could off-Base. The Base we're at currently is small, and the Clinic doesn't provide any ob/gyn services much beyond pregnancy tests and pap smears. The latter of which are handled by family practitioner. Took almost two days to get an appointment scheduled with the women's health nurse, but I did hoping that maybe now I might could at least get some answers.
The appointment was both useless and completely frustrating. My appointment was at 11, and I was back in the car at 11:30. That half hour includes scheduling another appointment in a few weeks. The nurse who took my vital signs spent more time with me than the Women's Health Nurse. Though the first nurse did have to take my blood pressure twice because it was unusually high the first time due to being nervous. The Women's Health Nurse took my charts which I had printed off, including the wonky ones from when we were moving cross-country and when my great-grandmother died, but told me she didn't look at charts often and wasn't very sure how to interpret them. Despite me trying to get her to focus on them, she ignored them other than to tell me my cycle length was good. She, and the person I scheduled the appointment were both preoccupied with whether or not I'd seen an infertility specialist. I'm not sure why, since as far I know I need a referral to see someone off-Base unless I want to pay for things completely out of pocket.
I asked if she thought my suspicions were correct based on my symptoms if I had suffered an early miscarriage, and she told me she couldn't tell me that. Asked me how old my husband was, though I'm not sure why that mattered, fussed at me for not having had a pap smear since 2007. Though I told her the truth that I didn't see any point in going last year since I didn't want my Birth Control Prescription renewed. She also told me that Tricare would do little beyond testing, and that really, they needed to do a Sperm Analysis on my husband before running any tests on me. And that they couldn't test my Progesterone levels on base anyway.
She finished up by telling me to come back in six months, to try and lose a little weight, that everyone has unusual cycles occasionally, and that I should try not to get stressed over it. She then gave me a memo on infertility, and told me to schedule a pap smear before I left. This whole thing took at most 10 minutes. Probably less.

I feel like I'm rambling, and if I'm not making any sense, I apologize. I've just gotten now to the point (I think) that I can speak without screaming. I say think because I thought I was at that point at about 2 when I called my mom, but as soon as I started telling her I started crying again, and screaming.

My mom told me that I really need to see an ob/gyn because they'd be more likely to take me seriously, and be familiar with some of the issues I've been having. As opposed to telling me that since I have 28 day cycles, then it's probably just stress. Which brings me to Tricare. In order to see an ob/gyn and/or an RE, I would need to switch from Prime to Standard. It seems to me that if we haven't been using any birth control for a year, that should be enough warrant seeing a specialist. Seeing a specialist would a)give me some answers and let me know how to proceed. Even if it something that Tricare won't cover fixing, at least we'd know. And b) when/if I do get pregnant, I'd already have a relationship with the person who would be helping me deliver my baby. (I'd prefer a midwife for prenatal care and a homebirth, but AL laws make midwifes and assisted homebirths about an inch shy of being illegal. And with DH in the Air Force, I don't want to break any laws.)

So, I guess my questions are:
Do y'all think that despite what the Base nurse told me, I really need to see a specialist now?
I have an appointment August 11th for a Pap Smear, since according to the nurse that's my biggest problem. That appointment is with a Family Practitioner. Should I take my charts back over there, and see if he might have a different opinion, and possibly give me a referral?
and/or
For those of you with Tricare experience, would you switch to standard? DH is currently an E4, and he's waiting until this fall to find out he passed the Staff Sergeant exam and will be promoted to E5 if that makes a difference.

I apologize for the length, and thank in advance for your help.

Married to my Airman since 12-23-06. Cloth diapering, baby wearing, breastfeeding AP mama to DD born 2/24/11

Bazile is offline  
Sponsored Links
Advertisement
 
Old 07-31-2009, 09:52 AM
 
Peace+Hope's Avatar
 
Join Date: Jul 2009
Posts: 2,152
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Bazile,

regardless, sounds like you would benefit from different caregivers! i'm so sorry you had to go through this! that nurse may not be to blame for her training, but she sure could have actually listened to you and realized she was in above her head rather than giving you bad info! with your family history, i sure hope you can get some bloodwork that helps you figure this out soon. do you know the family practitioner? hopefully s/he will be more attentive and helpful.

meantime, have you considered a natural progesterone cream (NPC)? you use it once you've ovulated, and until AF starts. if you become pregnant, you need to keep using it, so that your progesterone doesn't fall.

i heard about it on this message board, where it's been discussed. so maybe you'll get other or better info. i spoke w/ a natural pharmacist who said NPC was good, but the progesterone suppositories are better - you have to have a prescription for those.

i can honestly say i do not know if NPC would be recommended for you if you have a "diagnosed" progesterone difficiency. i just think knowledge is power

i don't have diagnosed low progesterone, or any reason to think i am low, but after my chemical pregnancy, i did some reading and considered ordering from http://www.oasisserene.com/faqs/

i hope you get lots of great ideas here - i know you'll get support!

p&h

me+him for 15 yrs, welcomed our little one march 25th, 2010.

Peace+Hope is offline  
Old 07-31-2009, 10:02 AM
 
YummyYumYumMama's Avatar
 
Join Date: May 2007
Location: greater bahston
Posts: 2,755
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
it sounds like you've been through a lot of frustration! i'm not sure if i'll be of much help, but here are the things that struck me in your post.

first of all, there's nothing wrong with Oing CD17-18. if you read soulcysters.net, some of the women on there with PCOS have ovulated after day 30 and STILL gotten pregnant. that's not likely or anything, but i'm just saying, 17-18 is totally normal. when i conceived DD i O'd CD22. i just ovulate late... it doesn't mean i can't conceive! i also had 10 day LPs (i even had some 5-9 day ones) and i still conceived. 10 is considered borderline. the embryo can implant up to 12 days past ovulation, but i think it usually does by 10 (correct me on that if i'm wrong, someone), so that's why less than 10 can be an issue.

as for a possible progesterone deficiency, the fact that you had pregnancy symptoms last cycle means that you had an elevated level of progesterone, actually! that's what causes all those symptoms like nausea and breast tenderness. isn't it a TOTAL pain?? i also get nausea like whoa before my period, and it's totally new for me. what a fricking pain... i got my hopes up so much before i realized that this is just a new normal for me. it is true that having a wonky cycle every now and then is totally normal, so see if this keeps happening and then talk to someone about it.

in the meanwhile, there are things you can do on your own. look into using natural progesterone cream between ovulation and your period. if you conceive, don't stop using the cream unless a doctor orders it, because a sudden drop in progesterone is what triggers your period, so suddenly stopping it in pregnancy may cause miscarriage. but using this can help lengthen your luteal phase. the other thing that can help, although it can take 3 months to see an effect, is vitex/chasteberry. a lot of stores that carry a large range of vitamins carry this - i got mine at whole foods and am ordering more thru amazon.com because it's cheaper. anyway, vitex can help regulate your cycle and lengthen the luteal phase. so those are two very easy natural options that you can start on your own while waiting for a doctor to take you seriously, and they work great for a lot of people. if you do searches on this forum for vitex or progesterone cream you should find some good info - or just make a new thread!

as for taking your charts to a family prac, you should make sure they know something about charting. i had a cyst last cycle, and when i was well past my typical LP with no BFP and high temps, i knew something was up. i remembered that in TCOYF it said that if this happens you may have a cyst. i brought my chart to the midwife, who barely glanced at it with a confused expression and kept insisting that maybe i ovulated later than i thought and was pregnant. i was like, DUDE. LOOK AT MY CHART. it's not like i'm randomly guessing i O'd on some random day - my chart really looked like i O'd when i thought i did. we did an ultrasound and i did end up having a cyst and was not pregnant, and on my way out the midwife was like "by the way, we don't always ovulate when we think we do, so you might have ovulated late and could still be pregnant." i was like "oh okay thanks" even though i knew that she was wrong and just didn't know how to read my chart. i don't know if you'll have luck finding a doctor who can read charts at this link or not - it depends on your area and your insurance.

it sounds like your cycles are regular and you're ovulating regularly, which is GREAT. and your LP isn't so short that pregnancy would be impossible, but it's worth it to try to lengthen it. so yeah, i think vitex and/or progesterone cream might be able to help you with that.

i hope at least some of this was useful to you!

eta: ha, p&h... i was typing while you were responding. jinx on the prog cream suggestion!

fuzmalesling.giffemalesling2.GIF mama to my spunky little girl, m, born 12/10/07 blahblah.gif, and my sweet little guy, k, born 10/27/10 babyf.gif
nocirc.gif familybed2.gif cd.gif homebirth.jpg nak.gif
YummyYumYumMama is offline  
Old 07-31-2009, 10:09 AM
 
Peace+Hope's Avatar
 
Join Date: Jul 2009
Posts: 2,152
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
1-2-3-4-5-6-7-8-9-10, you owe me a coke, yummyum!


bazille, i asked you if you know your family practitioner exactly b/c of what yummyum said! even midwives and women's health nurses, who you'd think would be intimately aware of "real" women's cycles AND accepting/encouraging of you knowing what you're talking about when it comes to your own body, can be discouraging an unsupportive. maybe the specialists are better, i just don't know....

me+him for 15 yrs, welcomed our little one march 25th, 2010.

Peace+Hope is offline  
Old 07-31-2009, 10:17 AM
 
YummyYumYumMama's Avatar
 
Join Date: May 2007
Location: greater bahston
Posts: 2,755
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
: there's your coke. HA, i started drinking it!

fwiw, i've met midwives - as well as OBs and doctors - who happened to know at least a little bit about charting. but unless you know that the doc you're going to understands FAM and charting, then you don't really know if they'll have useful info for you based on your chart.

fuzmalesling.giffemalesling2.GIF mama to my spunky little girl, m, born 12/10/07 blahblah.gif, and my sweet little guy, k, born 10/27/10 babyf.gif
nocirc.gif familybed2.gif cd.gif homebirth.jpg nak.gif
YummyYumYumMama is offline  
Old 07-31-2009, 01:52 PM
 
MaerynPearl's Avatar
 
Join Date: Jun 2008
Location: Hubert NC
Posts: 14,501
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
We are waiting on hearing about staff sergeant too! Good luck.

Personally... I would go to the practitioner with my charts and hope they are one that understands how accurate temping can be and that 12 months without birth control without conception is a bad thing especially when you are actively trying... and actually DO something about it.

Of course, if not, then I would switch and go to someone more qualified.

I agree CD 17-18 O isnt bad, I O at cd16... and a 10 day lp is only just over borderline, you could still totally get pregnant just more likely to have chemical pregnancies first.

I think it would be worth trying progesterone cream if you cannot get in to see anyone for a while (some have a fairly long waiting list) but do NOT use it the month that you go in for your appointment because if you have the progesterone in your system and they do progesterone tests... its going to be incorrect.

Personally I go to a general practitioner (family practitioner) for EVERYTHING... she knows I chart, she knows its accurate. If I have problems conceiving when DF comes home and I am still going to her... she will have no problem believing me.

Artist, photographer, stay-at-home-mom and Marine wife. Mom to 4; a boy and three little girls.
MaerynPearl is offline  
 
User Tag List

Thread Tools


Forum Jump: 

Posting Rules  
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off