Progesterone question

[Nadenet1229]

I just wanted to ask a few questions that have been weighing on my mind.

My horomones are weird. I am currently 28 years old, but I had started birth control back when I was 17 to help regulate my cycles and it helped with the severe menstral pain I would suffer through. I was only on it for maybe 6 months, then stopped since I really didn't have a need for it. I started it up again when I was about 20. I wasn't sexually active until I was 21, with my now husband, and for the first several months it just painful. I saw my GYN about it and he stated that my birth canal was as smooth as the back of his hand, that it was suppose to be riveted. He explained that I needed more estrogen and that since my canal was like that, intercourse was causing friction which was in essence sort of tearing me up a bit. I was put on estrodial cream at the age of 21 and was flabbergasted. Now my doctor at the time wasn't the best at communicating information, but what I understood was that the birthcontrol was causing my estrogen to sort of shut down. Not sure if that is correct and if any of you may be more understanding of that situation please let me know if that sounds right.

Now my body, since I NEVER take medicines unless its last resort, does tend to overreact to anything out of the norm being introduced to my system. So, it sort of made sense to me. Well, between the birthcontrol and the estrodial creme, it was just ridiculous. I got fed up with it all and stopped using it. Its been about 3 or 4 years since I've used estrogen or BC, we just stuck to condoms, and my old GYN never brought up any issues with my canal since. When I got pregnant I switched to a new OB whom I love, and she did the first pelvic exam after the positive test and said everything looked fine. I asked my doctor to do an HCG check since I stopped having pregnancy symptoms in month 2. The blood work showed, for both draws, that my progesterone was very very low and I had to take Prometrium for the first 12 weeks of pregnancy.

I would also like to point out that I had used and ovulation kit for a month, just because of my estrogen issues before. The other women I knew that used them would register low doses of the luteal horomone (I think that was what it was called) through out the month, and then it would shoot up during ovulation. I registered NONE of the luteal horomone, at all until ovulation. Like, the little line never even showed up until so much time before my menstral cycle. And I dont remember my temperature elevating, but my thermometer at the time was giving me problems.

Okay, now that you know the history... Would it be possible that I have low progesterone issues and could that cause problems with implantation in the urterus? I'm understanding that for some Preeclampsia vicitims that sometimes the egg doesn't implant well and I'm wondering if this could be an issue. Is it possible if I took progesterone before hand it could help?

[riehlism]

I believe there is a study looking into this (the progesterone part of your question, not the LH). They are either currently recruiting participants, or they may have even started it already. Luteinizing Hormone, or LH is the hormone in charge of releasing the egg from the ovary. Problems with LH can cause problems with just plain old ovulation. The worry you mentioned about your OPK seems to be something common. There is always a certain amount of LH in your system, but it's not always detectable in the urine. When we get the LH surge, which is a sign that the egg is about to be released (ovulation) it can be picked up on a dipstick. Sometimes though, the LH surge only lasts for a short time. So while you may be vigilant about it peeing on sticks, you may have missed it while sleeping. I was doing the OPK thing for months and was never able to catch it.

What they think goes on in preeclampsia may be due to something going wrong in implantation. We know that progesterone helps to prep our uterus every month by thickening the endometrial lining. Some studies did note a trend that women with preeclampsia had low progesterone readings. So the study I'm referring to is looking to see if low progesterone at conception and throughout pregnancy may result in poor implantation. Progesterone is pretty important in pregnancy itself. Really low progesterone levels are also causes for why some miscarriages happen--the pregnancy just can't be sustainable on such low levels. In subsequent pregnancies, I have some women's signatures say that they are also on progesterone supplementation.

Any hoot, I guess the answer to your question is: Some really smart people are looking into it.

[jgrumet]

I was just going to ask this question.
We're done with having bio babies, but I still talk to my peri about HELLP.

He said my case is still odd to him.

I am still convinced my hormones played a roll. He thinks I'm on to something.

my testosterone, estrogen and progesterone were all completely off when I got pregnant. Plus I was getting synthetic hormones because my doctor at the time was confused why they were so "off" (it was because of another medication my dermatologist gave me)- I was a hormone mess.

Is there any research done on hormonal relation to PE and HELLP?

[jgrumet]

Oh and the synthetic hormone- provera, was only given to me for one week right before I got pregnant to try and start my absent period (didn't work). I stopped taking spironolactone (lowers testosterone) at that time (seasonale was stopped 7 months prior with no return of menses)- but my face started to break out furiously ( like my body was rebounding, making extra testosterone now that the meds stopped) and i started taking it again, unaware I was in early stages of pregnancy (implantation time) - my hormones were whacked.

[flori]

This is very interesting. During my first round of Clomid my progesterone was tested to see if I ovulated and it was very low. When I conceived Gracie the next cycle I had it tested again about 8 weeks into the pregnancy. It was still very low so I was prescribed vaginal suppositories, mostly due to my own insistence.

If low progesterone is a possible cause for preeclampsia, is there a way (natural or not) to ensure progesterone is at optimum levels during conception?

[jgrumet]

My peri was saying that the theory makes a lot of sense.

A lot of the underlying disorders (PCOS, autoimmune disorders, even hypertension) have a connection too estrogen dominance, testosterone dominance, or general low progesterone.

Also, obesity is one of the risk factors and estrogen is stored in fat cells. That means that a lot of women are at risk for estrogen dominance that are obese. That is why they tell you to get to a healthy weight to lower your chance of breast cancer.

[jgrumet]

Hmm this is interesting- both of testosterone and progesterone were both VERY low at the time of conception and implantation (perhaps the entire pregnancy)- There has to be a link. I'm sure of it. I hope they continue studying this as one of the reasons.
http://www.medicaljournal-ias.org/Belgelerim/.../IouUAJEWSXHQV82842.pdf
SUMMARY : The purpose of the study was to determine whether maternal serum levels of androgen and
progesterone, are higher in patient with preeclampsia than in matched control subjects.
Serum progesterone, total testosterone, free testosterone and dehydroepiandrosterone levels were measured
in 19 subjects in third trimester of pregnancy with documented preeclampsia and 17 healthy normotensive
women with similar maternal and gestational ages. All subjects were primigravida women with singleton pregnancy
who were visited in Kosar Medical center in Uromiyeh.
There were no significant differences between two groups in maternal age, gestational age and body mass
index. Progesterone and free testosterone levels were significantly lower (p=0.01) in patients with preeclampsia
(75.1 ± 8.6 ng/dL and 2.27 ± 1.71 pg/dL, respectively) than in control group (111.6±9.71 ng/dL and 3.73±1.31
pg/dL, respectively). There were no significant differences in total testosterone and dehydroepiandrosterone
levels between cases (1.02 ± 0.10 ng/dL and 0.99 ± 0.13 μg/dL, respectively) and controls (1.37 ± .019 ng/dL and
0.98 ± 5.15 μg/dL, respectively).
Accentuated sex hormone binding globulin increase in preeclampsia is the cause of significant decreased
free testosterone of preeclamptic cases. Levels of progesterone were pathologically and significantly lower in
preeclamptic cases than control women with similar age, gestational age and body mass index. This difference
raises the possibility for a role of progesterone in the pathogenesis of preeclampsia.
Key Words : Preeclampsia, androgen, progesterone.

[caryn]

There's been a lot of work into progesterone, and while preeclamptics have low levels late in pregnancy, that's probably because of other changes in hormone levels triggered by the placenta, rather than preexisting low levels. Aspirin might affect this - aspirin does stuff to progesterone cascades - and the known benefit from aspirin is very small, so it's not likely to be relevant to most women. There's a known connection between infertility and preeclampsia, but many women who aren't infertile still develop it. (My hormones were fine, and I still got it.)

Progesterone competes with aldosterone for a receptor that's involved in maternal volume expansion and they're not entirely sure what it means to give it to preeclamptics, so it's definitely something to bring up with your docs for anyone taking supplemental progesterone because hers is low. So far as I know at the moment they're not thinking progesterone injections have much to do with affecting later PE, but there's been debate about this in the past and the studies aren't the highest quality.

[jgrumet]

I am convinced this is what caused it for me....not just progesterone, but an artificially created hormone imbalance on every level. I remember after taking spironolactone the first time (which I permenantly stopped somewhere between implantation and very early pregnancy) I had a rebound effect and my testosterone shot up (it is naturally very low)....so I went from no testosterone to high high levels in my pregnancy. And I'm curious what there was to implant into after seven months of not having a period and not having it started with provera a week early (not even a spot).....My peri said it is common sense at this point that there was a bad implantation involved, but why it progressed to HELLP we don't know.

I just had my levels tested because I was having weird symptoms (twitching was the most unsettling)- I'm breastfeeding a three-year-old ...so they expected my estrogen to be low, but I am basically perimenopausal and I have no testosterone in my body. My OB said that it is ridiculously low and my cortisol levels are screwy. He said I must have just enough to keep things working when I'm not pregnant (which makes sense looking at the history of the women in my family) and breastfeeding completely throws it off of my little body. So when I was on all that medication- who knows what it was doing.

My mom says she blames everything (from aches and pains to moodiness) on hormones. I think I'm just going to start pointing the finger on them, too...because they can't fight back