progesterone

[Janere]

I'm new here, but I have read posts for what seems like forever. Instead of searching through endless archives for answers I thought I would go ahead and ask.

DFlowers, congrats on your pregnancy! I wanted to find out from you what the side effects of the progesterone were for you? What is your dosage?

I'm 9 DPO and take 100 mg twice a day. So far I have had sore boobs, swollen boobs, cramping, dizziness, nausea, fatigue, elevated waking temps, and flushed face.

Did you have any of this?

Thanks!!

[Sav]

Recently, this is my second month taking Progesterone suppositories.

Last month I was on the prog supp that are coated in wax, I had a very bad allergic reaction to them so this month my RE switched me to the kind that are compounded with Cocoa Butter (which needs to be refrigerated) instead of wax. So far so good, they feel cool and are very soothing.

I have 2 questions

1.) My dose seems to be rather low compared to most of you ladies. I take 1
25mg supp twice daily. Does this seem too low???

2.) My appetite has been ravenous since I've been on prog. and I crave spicy and salty foods. Anyone else out there experience this?

Sav

[DFlowers]

Hi and thank you! Originally I was on 50mg per day the first 3 times. The last time they upped it to 100mg per day. I had some dizziness at night mostly. My boobs were not sore and I did not cramp. Remember, I was on a different dosage. I only took it for 5 days. There are sooooooooo many different side effects that you can get. Someone told me something once...."Just because it is not listed as a side affect on the side of the bottle doesn't mean it isn't one."

Looking back, My symptoms were very similar to how I feel now with pregnancy. Constantly hungry with nausea if I didn't eat something. Very bloated (I put on 10 pounds while on it the last time). Mood swings from hell (just ask DH). I did not have any of these symptoms on the lower dose so your higher dose can be doing a lot of things to you that did not happen to me.

I hope this helps. Good luck to you! I am now 10 1/2 weeks and it was worth all the tears and negative tests! Keep your head up and try to have a positive attitude. I know it is hard but it is necessary!

Keep me posted and let me know if you have anymore questions.

[Lauren2005]

Hi everyone,

I've taken 3 months of progesterone... the first month was oral pills. Here is what my experience looked like while on the pills:



Yup, that about covers it. I was exhausted and kept forgetting what I was doing/saying. Drove me crazy! Plus, I had my usual breakthru/early spotting anyway. Then I read several articles explaining that the pills raise progesterone blood levels extremely well, but may not actually impact the uterine lining. The various articles all concluded that natural progesterone suppositories are the way to go. There is also a gel suppository out there in addition to the kind I use now (the cocoa butter blend). I take 75mg 2x/day. I put it in and just lie there for at least an hour. I've had MUCH less exhaustion, and NO MORE SPOTTING.

I've included an exerpt from one of the articles below. Good luck and baby dust to everyone!

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Types of Progesterone:

Synthetic Progesterone (Provera)
Synthetic progesterone, which can be administered orally or via injection, is most commonly used to trigger menstruation. Because of its chemical makeup, it is less likely to cause some of the undesirable size effects of natural progesterone, such as sleepiness or dizziness. Unlike natural progesterone however, synthetic progesterone is generally *not* considered safe to use during pregnancy, which should be ruled out prior to its use.

The remaining types of progesterone, described below, are all natural forms.

Oral Progesterone
Natural oral progesterone, such as Prometrium pills, is used primarily as a supplement in the luteal phase for patients undergoing natural or IUI cycles. The primary advantage of oral progesterone is its convenience; patients do have not have to learn to give themselves injections or deal with the discharge that may occur with vaginal application. Despite its appeal, however, oral progesterone has several disadvantages. Most seriously, at least one study suggests that it may be associated with lower success rates than some other forms of progesterone; it has been hypothesized that oral progesterone may be more effective at raising serum progesterone levels than at raising the level of progesterone within the uterine lining itself, which is where its true effect occurs. Additionally, oral progesterone is metabolized by the liver, and the byproducts may cause side effects such as dizziness or sleepiness.

Recently, some doctors have begun to have patients administer these same progesterone pills vaginally. Few data are yet available on the efficacy of this approach.

Progesterone Suppositories
Progesterone suppositories are compounded by individual pharmacists and consist of natural progesterone suspended in a base similar to cocoa butter. Upon insertion, the warmth of the body causes the suppository to melt and release the progesterone. Since suppositories are vaginally administered, the liver does not produce the high number of side effect-causing metabolites that can occur with natural progesterones taken orally. The vaginal administration also allows the progesterone to be targeted more specifically to the uterine area. Many women, however, find the discharge associated with suppositories to be overly messy or uncomfortable and there is some question as to how long the progesterone is effective after insertion. Additionally, it can be difficult to find a pharmacy that will compound the suppositories, and the individualized process may cause a lower level of dosing accuracy and quality control. Finally, some women may be sensitive to the suspending substance.

Bioadhesive Gel (Crinone)
Crinone gel is also applied vaginally. In contrast to suppositories, however, the progesterone is suspended in a bioadhesive gel (sold without progesterone under the brand name Replens) and is packaged in a tampon-like applicator. Crinone gel is highly efficient at the uterine level; in fact, the progesterone stays so concentrated in the uterus that Crinone often has minimal impact on serum progesterone levels. Crinone is frequently used as a progesterone supplement in IUI and IVF cycles.

This uterine level impact is one of the primary advantages of Crinone, as is the fact that many patients only need to apply it once a day. For many women, Crinone is far better at delaying premature onset of menstruation than are suppositories or oral progesterone. Some women do, however, find that the suspension gel accumulates in the vagina and may need to be removed every couple of days; additionally, patients occasionally experience vaginal irritation as a result of the build-up.

Injectible Progesterone
Injectible progesterone consists of progesterone suspended in an oil, commonly sesame or peanut. Used most frequently in IVF cycles, progesterone in oil is normally injected intramuscularly once a day, most commonly in a dose of one cubic centimeter (cc).

Progesterone in oil is highly effective at the uterine level; many physicians consider it to be the gold standard for progesterone supplementation, particularly in high stakes in vitro fertilization cycles. Additionally, unlike Crinone, progesterone in oil supplementation is also reflected in serum tests, allowing levels to be more easily, albeit indirectly, monitored. The once a day dosing is convenient for patients, and the cost is quite low, often only several dollars a day for a patient taking 1 cc.

For many women, the primary disadvantage of progesterone in oil is the manner in which it is administered. In addition to being intramuscular, progesterone injections must be performed using a 20 or 22 gauge needle to accommodate the relatively high viscosity of the oily solution. This gauge is larger than that used for most other infertility medications, and patients often find the change intimidating. Additionally, like progesterone suppositories, progesterone in oil normally has to be compounded by a specialty pharmacy or mail ordered. Finally, some women may be allergic to the oil in which the progesterone is most commonly suspended.

What about Progesterone Creams?
In contrast to the above products, progesterone creams are available over the counter. These products deliver a small amount of supplemental progesterone, and absorption may vary significantly from person to person. These creams may provide a bit of “insuranceú to a woman with a fairly normal cycle, but the dosages are not high enough to treat significant hormonal issues. When you are trying to conceive, it is always a good idea to consult a knowledgeable professional about the use of any drug that might affect fertility.

What is the Best Form?
As is often the case, there is no one single treatment that is best for all women. Although oral progesterone may be sufficient for some women, Crinone and progesterone in oil do appear to be the most effective at the uterine level. The issue of whether either of these two supplementation forms is superior to the other remains unresolved. Some preliminary research suggests that progesterone in oil is superior at preventing bleeding in pregnancy, but that it may also delay bleeding in some cases where genetically abnormal pregnancies ultimately result in blighted ova. Definitive research is, however, yet to be done.

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[BC-SgtMom]

Lauren - great info - thanks!

I am on the 200mg supps once a day (at night) and last mo af still broke through. But first I had two days of intense bloating and cramping and continued to have it for another few days (worst af in a while). So, I'm not sure it did it's job and yet I am on it again! I also had the sore boobs, moodiness during the 2ww. This kinda sux, esp if it's not really helping. Does anyone get their prog blood level checked after IUI to see if they need the prog? I may ask for that next time. They only started me on p4 because my af came early (11dpiui), but since it still did, I dont see the point of the suffering.

Take care,
Kate

[little miracle]

For me prog supp means: cry for everything, bad mood and hot flashes, I just hope we wouldn't have side effects

[Pspring]

I just wanted to pipe in because I've had a different experience.

I'm taking PIO in the morning and supps at night since retrieval. I've been surprised by how little it seems to effect me. I had much more of an emotional response during IUI cycles when I didn't use prog at all. Only in the last day or (I've been on them now for 15 days) have I become emotionally on edge, and I kind of think it's because it's almost beta-day + hormones. But it's not so-so bad. And I know how it feels! Crying over a sad looking tree out the window. Crying over your DH saying you look beautiful. But the prog. hasn't really had that effect on me.

Maybe I've been tired, but I have made a point of sleeping about 10 hours every night since the transfer. I'm a big sleeper anyway.

The worst of it has been sore in the injection area a few hours after the shot.

I'm sorry you all are having such a rough time of it, and I hope this time it works so I don't have to find out about it the hard way, but for women who are reading this before taking the prog, wait and see. You might be lucky!

[melissam4000]

I just started using Progesterone Suppositories at night to support my pregnancy. Every night I put the suppository in then go to bed, but I wake up about 2 hours later to pee-do you think I am peeing out the cream?

[little miracle]

melissa,

not to worry, each time you go to the bathroom maybe some cream may come out, however the majority of the cream stays in.

[melissam4000]

Thank god I have been so worried!