Nearly 1 in 5 pregnancies ends in miscarriage. For a woman trying to conceive, those odds can feel daunting. You want to do everything you can to help your pregnancy stick. That’s why more and more doctors are recommending progesterone supplements to support early pregnancy.
Today, I want to tackle a crucial question: should you take progesterone if you are trying to get pregnant? Will it really help prevent miscarriage and ensure a healthy, full-term pregnancy? The answer, like many things in medicine, is nuanced.
What is Progesterone?
Progesterone, often referred to as the “pregnancy hormone,” plays a crucial role in preparing your body for conception and nurturing a healthy pregnancy. Think of progesterone as the silent protector in your pregnancy journey. It works behind the scenes, orchestrating changes in your body to create a welcoming environment for a growing baby.
How Progesterone Works?
First, let’s understand how progesterone naturally works in your cycle. Unlike what many believe, your body doesn’t have consistent progesterone levels throughout the month. It’s a dynamic dance!
- Estrogen dominance: The first half of your cycle is primarily driven by estrogen, which prepares the uterine lining for a potential pregnancy. Progesterone is minimal during this phase.
- Progesterone rise: After ovulation, around day 14, the dominant follicle transforms into the corpus luteum, which starts producing progesterone. This “luteal phase” prepares your body for implantation and sustains an early pregnancy.
- Variable levels: Progesterone levels fluctuate in the luteal phase, ranging from 3 to 40 nanograms depending on where you are in your cycle and LH pulses from the brain.
- Pregnancy boost: If you conceive, the embryo’s HCG hormone stimulates continuous progesterone production, which is crucial for maintaining the pregnancy.
When is supplementing not recommended?
Despite the crucial role of progesterone in pregnancy, supplementing isn’t always the answer. In fact, it can sometimes be harmful:
- Misinterpreting blood tests: A single progesterone blood test isn’t very informative. Levels naturally fluctuate, and “low” progesterone during the first half of your cycle doesn’t mean you need supplementation.
- Blocking implantation: Taking progesterone before ovulation can close the implantation window, hindering pregnancy. Remember, progesterone works in the “second half” of the cycle.
- Disrupting hormonal balance: Daily progesterone can suppress your brain’s natural hormonal signals, potentially creating further issues.
When might supplementation be helpful?
In some cases, progesterone supplementation can be beneficial for pregnancy:
- Luteal phase defect: If you have confirmed low progesterone levels after ovulation, progesterone supplements may help support a pregnancy. However, diagnosis should be done by a qualified healthcare professional.
- Recurring miscarriages: If you’ve had recurring miscarriages and your doctor suspects progesterone deficiency, they might recommend supplements after ovulation.
Should You Take Progesterone If You Are Trying to Get Pregnant?
In most cases, no, you shouldn’t take progesterone if you’re trying to get pregnant.
- Your body naturally produces progesterone after ovulation. Taking it before ovulation can close the implantation window.
- Self-treating can be harmful and interfere with your natural cycle.
- Supplementing is only recommended in specific cases (luteal phase defect, recurrent miscarriages) by a qualified healthcare professional.
When Should You Start Taking Progesterone?
The optimal time to start progesterone during pregnancy is after ovulation during what’s known as the luteal phase of your menstrual cycle. This is typically about 5-7 days after the LH surge that triggers ovulation.
Progesterone helps prepare the endometrium or uterine lining for implantation of the fertilized egg. Starting progesterone in the luteal phase helps mimic the natural rise in progesterone that occurs after ovulation.
It’s important not to start too early before ovulation, as excess progesterone could actually prevent successful ovulation. Starting too late after ovulation can result in poor endometrial receptivity and lower chances of implantation.
The goal is to start progesterone at the key moment when your body would be ramping up progesterone naturally. This supports early pregnancy by providing the progesterone needed to maintain a healthy uterine lining and avoid abnormal bleeding or spotting.
Talk to your doctor about using ovulation prediction kits or tracking basal body temperature to help time the start of progesterone at the right point in your cycle after ovulation occurs. This will give you the best chance of getting pregnant and supporting a healthy pregnancy.
What Are the Benefits of Progesterone During Pregnancy?
Progesterone offers several benefits during pregnancy including:
Improves Uterine Lining
Progesterone helps prepare the uterus for pregnancy by thickening the uterine lining. This provides a nurturing environment for the fertilized egg to implant and develop. Progesterone makes the uterine lining more vascular and dense with glycogen, giving the embryo the nutrients it needs to grow.
Taking supplemental progesterone, especially in early pregnancy, can help strengthen the uterine lining if it is thinner than normal. This provides support and stability for the developing embryo.
Prevents Preterm Birth
Progesterone helps relax smooth muscle tissue throughout the body, including the uterus. This prevents premature contractions and early labor.
Progesterone also limits immune responses that can trigger preterm birth. It helps balance the ratio of anti-inflammatory to pro-inflammatory hormones.
Multiple studies have shown progesterone supplementation during pregnancy can reduce the risk of premature delivery. It’s especially helpful for women with a history of preterm birth.
Progesterone provides key benefits for both mom and baby during pregnancy. Consult your doctor about whether progesterone could be helpful for you.
What Are The Risks of Taking Progesterone?
While progesterone is generally considered safe during pregnancy, there are some potential side effects to be aware of:
- Headaches – Some women report headaches after taking progesterone, especially with suppositories. They tend to be mild and often subside over time.
- Breast tenderness – Progesterone can make breasts feel fuller, heavier, or more tender. This tends to improve after stopping progesterone.
- Mood changes – Some women notice changes in mood, including irritability or depression. These symptoms should go away after progesterone is finished.
- Sleepiness – Progesterone can cause drowsiness or sleepiness in some women. Taking progesterone before bedtime may help.
- Spotting – Light spotting between periods can occur when starting progesterone. This is usually temporary.
- Nausea – Some women have mild nausea after taking progesterone, especially with the oil injections. Taking progesterone with food can help.
- Bloating – Bloating, fluid retention, and constipation are possible short-term side effects. Staying hydrated may help relieve bloating.
- Fatigue – Some women report increased tiredness while taking progesterone. Resting more may be needed.
- Decreased libido – Progesterone may temporarily decrease sex drive in some women. This should resolve after stopping the medication.
If any symptoms are severe or concerning, be sure to contact your doctor right away. Most side effects are mild and resolve quickly once progesterone treatment is complete. Talk to your doctor about any side effects you experience.
How Do You Take Progesterone?
Progesterone is available in different forms and dosages. Here’s a quick overview of the common ways to take progesterone during pregnancy:
Progesterone capsules are taken by mouth. The typical dosage is 100-200 mg 2-3 times per day. It’s important to take the capsules with food to increase absorption.
Progesterone suppositories or gel are inserted vaginally. The typical dosage is 90 mg gel or 100-200 mg suppository once or twice a day. This allows the progesterone to be absorbed directly into the uterine area.
Progesterone oil can be given by intramuscular injection, typically every 3-5 days. Common dosages range from 25-100 mg. While shots provide a high level of progesterone, they can be uncomfortable.
Vaginal pessaries are solid dissolvable capsules inserted into the vagina. These provide a sustained release of progesterone directly where needed. Dosages are typically 100-200 mg per day.
When taking progesterone, it’s important to follow your doctor’s specific instructions for dosage, timing, and administration. Let your doctor know if you have any side effects. Routine monitoring of progesterone levels is also commonly done.
Tips for Taking Progesterone
Taking progesterone properly is important for it to be effective. Here are some tips:
- Set a daily reminder to take your progesterone at the same time each day. Consistency is key.
- Take progesterone with food to help minimize side effects like nausea.
- If you forget to take your dose, take it as soon as you remember. However, skip the missed dose if it’s almost time for your next one.
- Don’t stop taking progesterone suddenly. Follow your doctor’s instructions for tapering off.
- Stay hydrated and drink lots of water, as progesterone can cause constipation.
- To deal with bloating or gas, avoid foods that make it worse.
- Light exercise like walking can help manage headaches, breast tenderness, fatigue and mood changes.
- Wear loose, comfortable clothing if you experience bloating.
- Get enough sleep and rest when possible. Fatigue is a common side effect.
- Use a heating pad on your abdomen or back to relieve cramps or pain.
- Try natural remedies like ginger or peppermint to relieve nausea.
- If side effects are severe, talk to your doctor about adjusting your dosage.
- Track your symptoms and report any severe or concerning side effects to your doctor promptly.
Let me know if you would like me to expand or modify the section in any way.
When to Seek Medical Advice
Although progesterone is generally safe during pregnancy, there are times when you should contact your doctor right away. Seek medical advice if you experience any of the following signs of potential complications:
- Severe abdominal pain
- Heavy vaginal bleeding or bleeding that contains clots
- Sudden, severe headaches
- Blurred vision or vision changes
- Shortness of breath
- Chest pain
- Severe swelling in your legs and hands
- Vomiting and nausea that prevents you from keeping anything down
- High fever
- Contractions or cramping
- Signs of miscarriage like passing fetal or embryonic tissue
- Leaking fluid from the vagina
These symptoms can indicate more serious issues like ectopic pregnancy, miscarriage, preterm labor, or other complications. It’s important to monitor your health closely and contact your healthcare provider if you have any concerns while taking progesterone or experience any alarming symptoms. Don’t hesitate to call your doctor’s office if you feel like something may be wrong.
Progesterone supplementation can be an important part of fertility treatment and support a healthy pregnancy, but it’s not right for every woman.
Key takeaways include:
- Progesterone helps thicken the uterine lining and support implantation and early pregnancy. It may be especially helpful for women with a history of miscarriage or luteal phase defect.
- Talk to your doctor about when to start progesterone and at what dose. Many doctors prescribe it after a positive pregnancy test or after ovulation.
- Oral, vaginal, and injected progesterone are all options. Side effects are usually mild but may include breast tenderness, bloating, and sleepiness.
- Vaginal suppositories are generally preferred over oral progesterone for pregnancy support.
- Progesterone is usually taken until 10-12 weeks of pregnancy, but some women may need to continue longer. Never stop suddenly.
- Make sure you are being monitored with blood tests. Too much progesterone can have risks. Stay in close contact with your healthcare provider.
- If you have concerns about progesterone or trouble taking it, speak up. Your doctor can adjust the dose or form to make it more tolerable.
- Progesterone is not right for every woman. Work with your doctor to decide if you need progesterone support for a healthy pregnancy.
- Don’t self-diagnose or self-treat with progesterone. Consult a healthcare professional experienced in reproductive health.
- Be wary of products claiming to boost fertility through hormonal manipulation. They can disrupt your natural cycle and cause more harm than good.