Too much progesterone -- looks like fibroid grew
I'm still recovering from my miscarriage post d&c and I'm thinking that my uterus is mostly back down to its smallest size, wrapped around my fibroid. I had a feeling that my fibroid grew during the early weeks of pregnancy but since the uterus was enlarged it was hard to be sure. Now though, when I lay on my stomach (doing some exercises on the floor last night) I can feel my uterus/fibroid as I lay there. Big bummer eh? (I had a 6x7cm single intramural fibroid on the right side of my uterus)
My doctor put me on supplemental progesterone since my levels tend to be low, 50 mg of progesterone via vaginal suppositories twice daily. The progesterone actually made me feel like I was on a roller
coaster -- I felt horrible. I only know it was the progesterone since I stopped taking it when we found out our embryo wasn't developing and I felt so much better.
My progesterone level when checked last fall was 9.4 ng/ml, when it
was checked when I got pregnant (about twice the number of days from
ovulation as when I had the previous test) it was 19.8 -- so it had
doubled in twice the amount of time. Studies have shown lower
progesterone levels have been linked to higher miscarriage rates
(http://www.inciid.org/fertinews/progthresh.html), although there is
some disagreement in the medical community as to whether or not
supplementing progesterone will help keep women from miscarrying.
So, I'm not sure if I just have lower progesterone and that's normal for me and it will be fine, or if it might have contributed to our loss (one can only speculate at this time). I imagine that it is possible that my progesterone was low and I needed supplemental but maybe not as much as I was given, or that maybe just the fact that my fibroid is present means that the extra progesterone is going to cause growth regardless and unless it is removed it will always cause the same problem. Hormone levels in early pregnancy aren't that high, so it is possible that this was more progesterone than I could handle and that it wasn't balanced out with the estrogen.
I'll let you know if I learn any more, if my fibroid shrinks any or
if there are new numbers from the ultrasounds I had in the past month about the size change from early June.
Friday, July 30, 2004
Wednesday, July 28, 2004
A message to another woman going through a miscarriage:
I found out on July 1 that we had a blighted ovum, so there wasn't a baby but just a gestational sac. I was deeply sad the first few days about not getting to be a mother. My doctor had us do a follow up u/s the next week which confirmed that no baby was present.
I was offered d&c or to miscarry naturally, I also looked into mifepristone (RU-486) but my doctor said since I have a large fibroid that he didn't think it was a good idea. My doctor was out of town the following week and I opted to have the d&c on July 19th. I figured I was giving my body a good chance to figure it out on its own by waiting.
Well, nothing changed while I waited and it just got kind of frustrating in a way that my body was spending so much energy on a pregnancy that wasn't going anywhere. I would see pg women on the bus or walking downtown and think "I'm pregnant too, but with nothing" and I hated having that in common with them. I also found that I couldn't talk to most people about what had happened, since it wasn't over yet. People heard about our failed pregnancy but didn't quite understand that I was still pregnant.
I had the d&c a week ago on Monday and it wasn't that bad. My doctor is an RE and did an u/s guided procedure to just remove the products of conception and not disturb the endometrium. The full on scrape out type of d&c can lead to scarring. [link=http://worthwhile.blogspot.com/2004/07/im-back-and-i-survived.html]You can read about my d&c here[/link].
The d&c is just helping move along the process of ending the pregnancy. The body has one way to recover from pregnancy and it uses it for miscarriage as well as normal delivery. I'm sure the resulting symptoms are stronger the longer one has been pregnant since the hormone levels only get higher.
[b]I'm someone who likes to know the details about what is going on so I'm sharing my experience with early pregnancy loss with you but skip if you don't want to know[/b]
There isn't a lot of information about what happens post d&c and I don't want to freak you out but in order to prepare you (and others) I will describe what I experienced (and other may have different experiences):
Day 1: (day of procedure) Feeling a little out of it and tired the rest of the day.
Day 2: I went back to work but couldn't really do anything. I felt kind of numb about the experience. Some cramps and very light spotting. A hot water bottle helped.
Day 3: Felt very tired in the afternoon. Still light spotting and occasional cramping. Fairly productive at work. In the afternoon I started feeling really sleepy. I felt sick in the evening which I think was a combination of a 24-hour virus coupled with a big hormonal shift. I got bloated and had a fever overnight (probably unique to my experience).
Day 4: Headache, neck and backache. Stayed home. Still had a fever for part of the day. Slept in the afternoon.
Day 5: Still felt a headache, stayed at home. Cramps all day long. Around 4pm they started getting worse. I tried laying down but they were overwhelming. I had really intense cramping which hurt from just below my ribcage to halfway down my thighs. I took ibuprofen but it didn't really help. Red wine and a hot water bottle offered the best relief. I started bleeding finally around 10pm. The labor like cramps went on until 2:30am at which time I guess they subsided or something because I fell into a deep sleep.
Day 6&7: More cramping, headache, backache and now sadness. Sadness and anger at having to go through this experience.
Day 8: Back to work. Very weepy. Still uncomfortable with cramping.
Day 9: Stayed at home. Saw my chiropractor for a regular appointment (treatment for a back injury) and asked him to do what he could to make sure nothing was contributing to the cramping pain. In the afternoon I had a massage and the massage therapist gave me an abdominal massage, not deep tissue or anything just helping go over the middle. I cried during that part. I ran a little way with my dog in the park and my breasts were killing. I realized when I got home that lactation had kicked in.
Day 10 (today): Stayed at home again. I was feeling very exhausted today. I had an acupuncture appointment this morning to help balance me out. He told me that my liver was out of balance and that it was throwing off my kidney and spleen as well. He said that the bleeding aggravated my anemia and that there was some blood stagnation. He helped get rid of a lot of the pain in my abdomen. I asked him what I could do for my liver since it seems to be the most out of whack and he suggested a small amount of red wine -- which I had already been taking each day and really did seem to be the only thing that helped.
I looked up in my medical endocrinological text today about the lactation thing. Evidently 3-4 days post delivery the levels of progesterone and estrogen drop and prolactin has the stage to itself, those other hormones no longer suppressing its action on the mammary glands. It is supposed to go away on its own, provided you don't add any stimulation, in about a week or so.
The only thing that I would do differently if I could turn back time would be to know about this process ahead of time so I would be more prepared than the fact sheet they gave me that said "you may experience some cramping and bleeding" and I do wish the doctor had given me a prescription for a strong pain killer ahead of time.
The other thing I think we should accept is that society doesn't expect women who have gone through labor to deliver babies to go back to work right away. I think we need to remember that if we who have miscarriages experience labor, that we give ourselves the same TLC that we would want as a new mother.
I'm really sorry for your loss but hopefully knowing more about the physical process will help you through it. It is an emotionally and physically draining experience but allow yourself time to grieve and recover. I think I'm going to wait a fully cycle to try again, but maybe not.
I found out on July 1 that we had a blighted ovum, so there wasn't a baby but just a gestational sac. I was deeply sad the first few days about not getting to be a mother. My doctor had us do a follow up u/s the next week which confirmed that no baby was present.
I was offered d&c or to miscarry naturally, I also looked into mifepristone (RU-486) but my doctor said since I have a large fibroid that he didn't think it was a good idea. My doctor was out of town the following week and I opted to have the d&c on July 19th. I figured I was giving my body a good chance to figure it out on its own by waiting.
Well, nothing changed while I waited and it just got kind of frustrating in a way that my body was spending so much energy on a pregnancy that wasn't going anywhere. I would see pg women on the bus or walking downtown and think "I'm pregnant too, but with nothing" and I hated having that in common with them. I also found that I couldn't talk to most people about what had happened, since it wasn't over yet. People heard about our failed pregnancy but didn't quite understand that I was still pregnant.
I had the d&c a week ago on Monday and it wasn't that bad. My doctor is an RE and did an u/s guided procedure to just remove the products of conception and not disturb the endometrium. The full on scrape out type of d&c can lead to scarring. [link=http://worthwhile.blogspot.com/2004/07/im-back-and-i-survived.html]You can read about my d&c here[/link].
The d&c is just helping move along the process of ending the pregnancy. The body has one way to recover from pregnancy and it uses it for miscarriage as well as normal delivery. I'm sure the resulting symptoms are stronger the longer one has been pregnant since the hormone levels only get higher.
[b]I'm someone who likes to know the details about what is going on so I'm sharing my experience with early pregnancy loss with you but skip if you don't want to know[/b]
There isn't a lot of information about what happens post d&c and I don't want to freak you out but in order to prepare you (and others) I will describe what I experienced (and other may have different experiences):
Day 1: (day of procedure) Feeling a little out of it and tired the rest of the day.
Day 2: I went back to work but couldn't really do anything. I felt kind of numb about the experience. Some cramps and very light spotting. A hot water bottle helped.
Day 3: Felt very tired in the afternoon. Still light spotting and occasional cramping. Fairly productive at work. In the afternoon I started feeling really sleepy. I felt sick in the evening which I think was a combination of a 24-hour virus coupled with a big hormonal shift. I got bloated and had a fever overnight (probably unique to my experience).
Day 4: Headache, neck and backache. Stayed home. Still had a fever for part of the day. Slept in the afternoon.
Day 5: Still felt a headache, stayed at home. Cramps all day long. Around 4pm they started getting worse. I tried laying down but they were overwhelming. I had really intense cramping which hurt from just below my ribcage to halfway down my thighs. I took ibuprofen but it didn't really help. Red wine and a hot water bottle offered the best relief. I started bleeding finally around 10pm. The labor like cramps went on until 2:30am at which time I guess they subsided or something because I fell into a deep sleep.
Day 6&7: More cramping, headache, backache and now sadness. Sadness and anger at having to go through this experience.
Day 8: Back to work. Very weepy. Still uncomfortable with cramping.
Day 9: Stayed at home. Saw my chiropractor for a regular appointment (treatment for a back injury) and asked him to do what he could to make sure nothing was contributing to the cramping pain. In the afternoon I had a massage and the massage therapist gave me an abdominal massage, not deep tissue or anything just helping go over the middle. I cried during that part. I ran a little way with my dog in the park and my breasts were killing. I realized when I got home that lactation had kicked in.
Day 10 (today): Stayed at home again. I was feeling very exhausted today. I had an acupuncture appointment this morning to help balance me out. He told me that my liver was out of balance and that it was throwing off my kidney and spleen as well. He said that the bleeding aggravated my anemia and that there was some blood stagnation. He helped get rid of a lot of the pain in my abdomen. I asked him what I could do for my liver since it seems to be the most out of whack and he suggested a small amount of red wine -- which I had already been taking each day and really did seem to be the only thing that helped.
I looked up in my medical endocrinological text today about the lactation thing. Evidently 3-4 days post delivery the levels of progesterone and estrogen drop and prolactin has the stage to itself, those other hormones no longer suppressing its action on the mammary glands. It is supposed to go away on its own, provided you don't add any stimulation, in about a week or so.
The only thing that I would do differently if I could turn back time would be to know about this process ahead of time so I would be more prepared than the fact sheet they gave me that said "you may experience some cramping and bleeding" and I do wish the doctor had given me a prescription for a strong pain killer ahead of time.
The other thing I think we should accept is that society doesn't expect women who have gone through labor to deliver babies to go back to work right away. I think we need to remember that if we who have miscarriages experience labor, that we give ourselves the same TLC that we would want as a new mother.
I'm really sorry for your loss but hopefully knowing more about the physical process will help you through it. It is an emotionally and physically draining experience but allow yourself time to grieve and recover. I think I'm going to wait a fully cycle to try again, but maybe not.
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