Low Pogesterone

[KimberlyP822]

I'm 40 y/o and am now 8wks 6dys pregnant. This is my 7th pregnancy, I've had 1 child/5 M/C to date. This time around my doctor decided to do hormone testing on me. I found out I was pregnant at 5.5 weeks hcg was 2019, progesterone was 8.2. Two days later hcg was 3059 & progesterone was still 8.2 So my doctor put me on progesterone suppository supplements 50 mg once daily. A week later my hcg was in the 11,000's but progesterone had dropped to 5. So, my doctor changed my supplements to 50 mg twice daily (1 - morning/1- night). My next test a week later came back, chg ( he didn't do), my progesterone had dropped even more to 4.7 at 8wks 4 dys. I also had an ultrasound that showed the fetus measures out at 8wks 4 dys with a heartbeat of 158 bpm. I've been spotting for the last 7 days red to brown to red to brown again.  Dr. tells me not to worry, we have an ultrasound showing a great growth rate and heartbeat and everything looks good so far. I asked about upping my progesterone again (I've been reading numerous posts all over the net of women starting off on as much as 200 mg 2x per day which makes my 50 mg 2x daily (that doesn't seem to be doing much of anything) seem very low. He said it wouldn't help.?.?.  Just stay positive he says and repeats growth rate and heart rate again is good. "So!" I have 5 M/C between the 10th and 12th weeks (all with good growth and heart rates)that clearly prove neither of those two things mean much of anything in my case. Plus I'm "STILL" spotting. I'm not finding there's much of anything to be positive about at this point. Sit and do nothing didn't work before, why would it now? My doctor is now patronizing me with stupid comments of C'mon, staying positive, spotting is normal. To top it off now, after clearly stating 5 was the lowest "text book" level of progesterone that can sustain a pregnancy is going on to tell me "he's seen" for himself his own patients with levels as low as 3 & 4 go on to have healthy babies and other women with levels of 12 have problems. WTF? if you're at 8 weeks with a level of 12 (which is pretty low, should be more like in the 20's) problems are more likely to happen. But, at 8 wks 4 days with a level of 4.7 problems WILL happen. Especially when your doctors answer is the equivalent to clicking your heels together 3 times and repeatedly say "I do believe in fairies, I do believe in fairies,I do believe in fairies." I'm so frustrated by this and all the B/S do nothing, just smile be happy.  I just don't see how staying positive while he wont or can't do anything more is going to make it any easier when I end up holding this fetus in my hand trying to remember how I need to store it for farther testing like the others?Has anyone ever had a good out come with progesterone levels this low? Any advise or suggestions of what I might try that may help me now?

Thank you in advance,
Kimberly

[KimberlyP822]

Thank you for the tips and information chinesebones, I'll be going today to pick up more Omega 3,6 & 9, hopefully they'll carry  Emerita ProGest cream there too and I can get it at the same time. Doctors shouldn't make getting the help we need from them so hard. Congratulations on your baby girl! Best wishes to you both. ~ :o)

[chinesebones]

Kimberly, I also have problems with low progesterone and recurrent m/c.  I know how frustrating it is to have to fight your doctor for the medicine that could save your baby!  This time I had to "prove" I was pregnant with two rising hcg tests before they'd even consider giving me progesterone... meanwhile I was spotting and bleeding and freaking out because I knew I needed it.  
Since I didn't have the suppositories, I started using Emerita ProGest cream the day after ovulation.  I chose that one because it was a concentrated cream that had an easily measured dose (by the tsp I think.)   I ordered it online from vitacost but have also seen it at health food stores.  You'd have to use tubes of it to get 200 mg a day, but it would be helpful for augmenting the suppositories.  I think you're supposed to rub it into your inner elbow- I switched sides to maximize absorption.
I can't find the paper where I wrote down my levels, so I can't help you there.  I know mine stayed low even with the suppositories, but I read somewhere that since it goes right to the uterus, it sometimes doesn't show up in the blood levels???  Also, I did have some spotting that I think was caused by the progesterone irritating my cervix.
BTW, progesterone keeps the uterine lining from breaking down, so you're right, it's the glue that keeps the baby in place.  When it drops in a normal cycle it causes menstruation to start.  Once the placenta is well developed (somewhere between 10-13 weeks) it starts making progesterone... until then it's up to the mama.
Best wishes with your new OB!

[KimberlyP822]

no apologies needed, :) I did find an OB specializing in high risk pregnancy and was able to get an appointment scheduled for this upcoming Tuesday.  I made it to 9 weeks as of today! I was told I'd be having an ultrasound at this visit just to make sure everything's still going good. What's to come with these next few ultrasounds scares the crap out of me, I'll either hear "oh there's the heartbeat" or the tech will say, "hold on let me go get the doctor" and then my heart will drop like a lead balloon. I'm afraid anything that could or should of been done to insure this pregnancy will stay alright, should of been done already. I had read progesterone is like the glue that holds the baby in place?  I'm pretty new to this whole hormones & the role they play in pregnancy thing. This is the first time a doctor has ever bothered testing them. What frustrates me most is that he did test them, seeing they're not right, does the least possible to correct them, sees it's not enough then, decides to take a lets just wait and see position on it. I could of gotten the same having never seen any doctor at all to be honest, I might of been better off being ignorant to having a 4.7 progesterone level or not knowing what that meant altogether.  I'm going to be driving myself crazy these next few weeks, I wish they could induce a medical coma till it was all clear. lol
Thanks again for your reply and advice, I truly appreciate it.

Sincerely,
Kimberly

[adgal]

BTW, I apologize for my first post about all being well with a healthy heartbeat and growth.  I had somehow missed the part in your original post about losing your little ones between 10 and 12 weeks.  I truly can understand your fear. Perhaps a second opinion (as soon as possible) might be best.

The other thing is that we have to be our own advocates.  If you want an increase in your progesterone supplements, be very forceful in asking.  They work for us, not the other way around.  I will be thinking about you!!

[adgal]

My heart also goes out to you.  I can tell you I worried every second of my 6th pregnancy, but here he is safe and sound.  If you are not feeling confident, please seek a second opinion.  I am no Dr. and honestly don't know a lot about progesterone levels.  And at any rate, even if everything is perfectly find, I know well what peace of mind does for us.  

In all honesty, my OB has never tested my progesterone.  I go on supplements as soon as I get my BFP, and from there she just doesn't bother. I have always taken 3X100 mg a day, orally.  She took me off of them at 13 weeks.

In my case I have full confidence in my OB.  She also had her children in her 40's and had also experienced m/c, so that increases my confidence level.  She knows full well what these babies mean to us.

Most OB's and RE's prescribe progesterone because it can't hurt anything.  The generally accepted belief amongst most is that miscarriage is not caused by low progesterone, but that low progesterone is a result of miscarriage.  At this stage all is well, and that is why I say I would not be overly concerned.

I am not you though, and what matters is how YOU feel.  If I were in your shoes, feeling the way you are, I would most definately seek a second opinion.  You need to feel confident in this issue as the worry you automatically carry given your history is bad enough.

Hope that helped a bit and I truly wish you well.

[KimberlyP822]

Hi adgal and thank you , I wish I could be as confident as you're being that all is and will continue to be just fine (my doctor would love you. lol) I hope and pray every day you're both right but, as i mentioned before, with my history of good growth rates and strong heartbeats for the first 10 - 12 weeks, followed by unexpected & unexplained losses. 5 out of 7 times seems like anything but slim odds.  I'm very sorry to learn you've also experienced 5 m/c yourself (my heart goes out to you). If you don't mind me asking what was the lowest progesterone level you had while pregnant and what dose were you prescribed to supplement?  Do you know of anyone who's carried a successful pregnancy with a level of 4.7 or there abouts?

Thank you,
Kimberly

[adgal]

I didn't read all the other comments, so forgive me if I repeat anything already said.  

The use of progesterone supplements is controversial.  Many in the medical field don't believe they make any difference at all.  My OB is sceptical about them, but prescribes them anyway as she says they certainly won't hurt. (I too have 1 child and have had 5/c).  The thing is, your situation looks fantastic!!  A nice healthy heartbeat with baby measuring as he/she should.  Don't put too much emphasis on the bleeding/spotting.  Many of us do and it's not an issue.  I did the whole time with my son.  He is fine.

I suspect the reason your OB is not changing your progesterone is because everything is fine, and he may very well be in the camp that supplements don't do anything.  

It's up to you if you want to switch, but if this were me I wouldn't be worried.  Your chances of a loss at this stage with a nice healthy heartbeat and good growth are pretty slim.  At the end of the day though, you need to have peace of mind and feel good about the fact that your OB is addressing your concerns.  If something did happen, you need the peace of mind that you did all you could.  Again though, it is now quite unlikely you will experience another loss.  Follow your heart..if your instincts tell you to get a second opinion, then that is what I would do.

Congrats on your pregnancy, and good luck to you!!

[trying43]

They have one at walmart, its for menopause but it is a progesterone cream.  Its called menoease, I think.  I dont know if its good or not but I do know they have it and at least you could get it now and get started because everything else you have to order online and wait for.  I didnt do IVF with any of my pregnancies but was still given supplements even with my level being 74 with this pregnancy. I would see about changing drs. ASAP.  He doesnt seem in tune with your needs at all.  And you are so right if your levels have dropped, there is a problem he is not willing to address.  Call around to other obs in your area, explain what is going on and maybe one can get you in.  I hope all goes well, good luck.

[KimberlyP822]

Hi trying43, thank you for the suggestions. I usually go to bed at 10:30 p.m. and use one 50 mg suppository at that time(usually stay asleep until about 1:00 a.m. then have to get up to pee. ; ), Then my husband gets up at 4:30 a.m. for work, gets me up and I do  another 50 mg morning dose and go back to sleep till 8:00 a.m. This is the best way I can insure I absorb as much of the meds as possible. I've asked for a stronger dose and was given a long talk about how it can cause serious health issues for me like blot clots in the lungs, stroke and a list of other issues. But, I keep reading how you can never have too much, it can't hurt you or your baby and there are woman out there with natural levels as high as 53 or more that aren't even pregnant?  I told him how I keep reading all these other posts by other women being started off on a much higher dose 200mg 2x daily, 400mg 2x daily and he said he doesn't know if these woman are IVF or what their history's are or if they are taking pills, creams or what but, that he's never prescribed anyone more than 100mg a day claiming that's a very high dose and worked well for his other patients. (I'm so tired of hearing about his other patients and what's worked for them, if I'm dropping down to 4.7 on 100mg per day it's obviously NOT working great for me!)  I'd be more than willing to increase my dose on my own but, he only writes the prescriptions for 60 50mg suppositories at a time. I'm trying to fine out about a good progesterone cream I can by on my own and use along with his prescription? Any information on that? I've read allot of them are usless but that there are some good ones out there I don't need a prescription for.  

[KimberlyP822]

Thanks for your reply Lisa, I did ask about injections, he said the suppositories were a stronger dose and the most direct delivery system to where it's needed most because it's absorbed right in to the uterus. I even asked about using injections in addition to the suppositories (figured if one method wasn't working maybe another would?) He said it wasn't necessary. Just keep doing what I'm doing. (Which feels usless and like a whole lot of nothing.)

[trying43]

  Maybe try using it at night only at bedtime so none leaks out.  But I would definately call the dr and ask why not more.  If they wont up your dose up it yourself!  I just dont think 100mg daily is enough but then again im not a dr.  I know when my level was low with my first son, I was on 400mg.   With this pregnancy I was again on 400 mg but it was not for low levels it was just a precaution.  At 10 weeks the placenta will take over but the key is getting to 10 weeks.  Good luck to you.

[LisaL18]

I had low progesterone levels in my first pregnancy and did the suppositories and they did not rise the levels enough and the RE put me on progesterone injections.  Now this was a few years ago, but it seemed to work.  Maybe check into the injections?  They were a pain, literally, but whatever it takes.