A mother asks: I do have a quick question for you—I mentioned before that my fertility has returned (at 6 mos postpartum), confirmed by a full thermal shift in temps. I wasn’t able to figure out my luteal phase with the first cycle (I stopped temping for a couple weeks and when I started again, my temps were very high and then I had my period a week later). But, I just finished my second cycle and was concerned to see that my luteal phase was only 9 days long. Progesterone was a concern for me in the past so I am naturally wondering about miscarriage risk should we get pregnant soon.
My question is, do you routinely see short luteal phases when cycles return (even after just 6 mos of breastfeeding infertility)? My worry is that we would get pregnant this month (or in the next few months) and not have enough progesterone to sustain the pregnancy. Thank you for your replies re: progesterone when fertility is returning. It was very helpful.
John’s Response:
I would suggest that you get one of the late Dr. John Lee’s books dealing with menopause and premenopause. (What Your Doctor Won’t Tell You About Menopause published by Warner Books). These should be widely available in public libraries or online. He was a great advocate of natural progesterone administered transdermally. His interest was in building bone density in older women, but what he has to say about natural progesterone has a wider applicability. Since it is biologically the same as your own progesterone, he says it can be taken safely when pregnant and, I imagine, while nursing. The idea in a case like yours would be to start it on the first day of temperature elevation and then continue it for two weeks, tapering off the dosage gradually the last few days. As he notes in one of his books, suddenly stopping the dosage could “trick” your body into thinking it should menstruate, and that could cause a miscarriage. So I have recommended tapering down over 3 or 4 days. Then if you don’t have a period, you can assume pregnancy and resume the treatment and take it all during pregnancy. Administered according to his directions, it mimics the daily secretion during the luteal phase. I don’t know if greater amounts would be needed during pregnancy if your placenta was not doing its job. That’s where the medical use of vaginal natural progesterone suppositories can be helpful, but that’s beyond my competence. Because of stories we have heard, we are not fans of the Hilgers system of using progesterone injections in the butt. I am told it works, but we question its invasiveness in the light of alternative therapies.
Questioner’s response:
I did want to comment about what John said about the pg shots in the behind. I did this with my first pregnancy and it was effective but if I had known there was an easier, alternative therapy I would have jumped at the possibility. Not only did I have to drive a distance to get the shots, they were very painful and caused extreme tiredness for the rest of the day. Most of the physical maladies I had during my first trimester were due not to morning sickness (although I did have it) but rather tiredness from the shot.
Many of my friends have low pg and get put on the shot (we are in Creighton territory) and it is the same story every time. Wonderful that the Creighton docs know how to help when progesterone is low, but sad that they’re not open to the creams and suppositories. I would venture to say it’s simply because they are not taught about it at the Creighton classes, and this in turn is due to a lack of knowledge in Omaha. I worked for Fertility Care Services so I do know a bit about the inner workings of the Creighton method. I switched back to the STM method after I couldn’t make sense of my fertility using mucus alone after having my first baby. Taking temps again was just what I needed to know what was going on.
Thanks again for all you do.
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John F. Kippley