All About Sperm

These are some of the better links I've found about sperm generation and basic men's infertility.

MALE INFERTILITY

Male Infertility Overview ~ Assessment, Diagnosis, and Treatment

Male Reproductive Problems

Advanced Urology - FAQ's on Information pertaining to Male Infertility

Infertility in Men


SPERMATOGENESIS

Maturation of a sperm cell - diagram

Spermatogenesis Slides -- with details of various constituents involved in process

Spermatogenesis

MORPHOLOGY

Semen Characteristics: Advancement in Andrological Assessment - PDF
Indian Journal of Clinical Biochemistry, 2005, 20 (1)
173-183
R.S. Sharma** K.K.Gaur#, P.C.Pal*, Monika Manocha*, Deepak Tomar*, Arif Azam Khan*, Vinita Tripathi*, Vineeta
chattree* and A. Kriplani+

The Importance of Sperm Morphology in the Evaluation of Male Infertility

Poor Sperm Morphology

Sperm Abnormalities: Testicular Causes

Illustration showing nomal to abnomal sperm

More images showing sperm morphology (Google Image Search)

Differential production of reactive oxygen species by subsets of human spermatozoa at different stages of maturation

FOR MORE INFORMATION VISIT:

Vasectomy Reversal Information

Semen Analysis

Improving Your Semen Analysis

Interesting facts about estrogens

Estrogen, that is too much estrogen without enough progesterone to counterbalance it, is theorized to cause disease such as fibroids and endometriosis. Here's a complilation of information about estrogens.

"over 30 different forms of estrogen have been described; the most common forms tested are estrone [E1], estradiol [estradiol-17 beta,E2], and estriol [E3]"
http://www.labtestsonline.org/understanding/analytes/estrogen/glance.html

"The majority (over 90 percent) of the estrogen present in a pre-menopausal woman's body is made in the ovaries. A smaller additional quantity of estrogen is produced by the adrenal glands and peripheral tissues such as fat, liver, and kidneys by converting androgens to estrogens. Estrogen hormones are also formed in the placenta during pregnancy."
http://www.dhyansanjivani.org/Estrogen.asp

"Increasing FSH levels during the late luteal phase leads to an increase in the number of FSH receptors and ultimately to an increase in estradiol secretion by granulosa cells."
http://www.endotext.org/female/female3/female3.htm

"Estradiol-17b (E2), a steroid hormone, is the most active estrogen in the body. In circulation, E2 is primarily bound to sex hormone-binding globulin (SHBG)."
http://www.dpcweb.com/medical/reproductive_endocrinology/estradiol.html

"Estriol is produced predominantly in the liver as a metabolite of estrone and estradiol."
Is Estriol Safer Than Estradiol?

"For the first 4-6 weeks of pregnancy, estrone originates primarily from maternal sources such as the ovaries, adrenals, or peripheral conversion (57). Later, the placenta secretes increasing quantities of estrone from the conversion of circulating maternal and fetal DHEAS. The placenta continues to be the major source of circulating estrone for the remainder of the pregnancy (53). Estrone concentrations are less than 0.1 ng/mL during the follicular phase and may reach a maximum of 0.3 ng/mL during the luteal phase of a normal menstrual cycle. Following conception, estrone concentrations remain within the luteal phase range through weeks 6-10 of gestation(54). Subsequently there is a gradual increase to a wide range of 2-30 ng/ml at term (53,54,57) (Figures 6 and 8)."
http://www.endotext.org/female/female13/female13.htm

Estrogen Dominance Syndrome
by Ronald Hoffman, M.D.
Conscious Choice, September 1999

About Keloid Prevention Post Surgery

When I was facing surgery I was freaked by the prospect of having a
scar; I did cancel my surgery so I've not had to deal with that yet. My father who went to medical school told me that they use steroid shots in the scar, even a year or two later and it can help soften the scar and make it less noticible. It is mentioned in the first article link below as the oldest treatment but it does have some drawbacks.

You probably are looking for anectodotal things that others have experienced but at the very least here are a few links for you to look at. You should talk to your doctor, and if your surgeon isn't interested in treating you then you might consider seeing a dermatologist or plastic surgeon instead. I don't know how that kind of post-op care works with the myo surgeon, plastic surgeons specialize in minimizing scarring though. Maybe others could offer more informed advice.

Keloid and Hypertrophic Scar

Keloids And Hypertrophic Scars - AOCD

Keloid

Treatment of Hypertrophic Scars and Keloids: A Multi-faceted Approach

Prevention of Hypertrophic Scars and Keloids by the Prophylactic Use of Topical Silicone Gel Sheets Following a Surgical Procedure in an Office Setting

A message to another woman with fibroids

I have low progesterone as well, I haven't had my DHEA tested though.

Low progesterone is linked to several things which can happen in any combination (and I'm sure there are more than I'm listing here):

* poor ovulation -- the follicle doesn't develop as well as it should and the remaining corpus luteum doesn't produce enough progesterone. also, progesterone is produced by the ovary prior to ovulation which helps to mature the follicle granulosa cells and helps set the stage for ovulation to occur. If you are low progesterone I suppose that this process can be somewhat compromised.

* annovulation -- your aren't ovulating and therefore aren't having the corpus luteum available to produce progesterone. The more cycles without ovulating the higher your estrogen to progesterone ratio rises furthering the imbalance. Polycystic ovaries can also cause annovulation I think.

* stress -- when you are under prolonged stress your adrenal glands go from producing adrenaline to producing cortisol. Cortisol is made in the body from progesterone and I've heard mention that this reduces the availabilty of progesterone in the body. Also, cortisol will bind to progesterone receptors in the body so that they aren't able to do their progesterone related actions.

Working too much, not eating regular meals, consuming too many simple carbohydrates and sugars -- basic the equivalent of running your body on empty (and we all know that feeling) -- creates additional stress in your body and stresses the adrenals and further promotes adrenal exhaustion and cortisol production. If you get tired easily then this might be a contributing factor.

This page/site is rather interesting in how it talks about symptoms of low progesterone/estrogen dominance, and other endocrinological imbalances:

http://www.digitalnaturopath.com/cond/C8769.html

Things to do:

* Eat regular meals
* Make sure you are getting enough nutrients from your diet and supplement when needed
* Cut back on caffeine (bad for adrenals) and simple sugars (don't give in to the sweets in the late afternoon -- eat something healthy like nuts if your energy starts to lag)
* get enough rest -- sleep deprivation is stressful on your body
* drink 6 glasses of water a day
* consider consulting with an herbalist, naturopath or chinese medicine practitioner for assistance with a customize herbal regime

Also, I used natural progesterone cream for a few cycles with some good results (even mood, less sore breasts among other things). This may be beneficial although treatment with progesterone has had mixed results in randomized medical trials and might for some women be linked to increased fibroid growth.

This actually goes back to my cake metaphor for hormones (I think I posted a couple months ago about it on the uterinefibroids list), a cake takes all of its ingredients in their proper measure, adding more salt won't make up for too little sugar -- it only makes it worse. Our hormones are a complicated, individual "symphony" (I think that is what Dr John Lee referred to it as). The more stories we hear from the list members and from the studies we read, etc. that while pregnancy can make fibroids grow, that for some other pregnant women they shrink. Fibroids are thought to be a condition of peri-menopausal women and yet we've seen young women of 19 and 20 show up with fibroids in our groups. Obviously there is a lot at play and the more we each learn the more we start to realize that our behavior and lifestyles have contributed to our hormonal imbalances which in turn has helped activate our genes to start developing fibroids.

Uterine Cramps and Pelvic Pain

Fibroids cause pelvic pain, here's what I know about uterine cramps and their physiology from a variety of sources...

From an RE...
Prostaglandins cause uterine contractions. Ibuprofen can be taken regularly to reduce prostaglandin formation but won't help if contractions and pain are present since the prostaglandins are already causing problems. If you are trying to conceive though you shouldn't be taking ibuprofen or other NSAIDs as they can impair ovulation and possibly implantation (there's no winning is there?).

From naturopathy...
Arachidonic acid is involved in the production of prostaglandins and is found in animal products. Reduce animal products consumption such as meat and dairy products, increase essential fatty acid consumption (such as flax seed oil). As ibuprofen interferes with the liver it is not advised.

From acupuncture...
My acupuncturist says that the weird crampy fullness in my belly is related to blood flow not going the right direction. Acupuncture can stimulate blood flow to go in the correct direction.

From my personal experience...
Ibuprofen won't stop cramps from fibroids. Hot water bottles do help with the pain and discomfort. Food and gas passing through your colon that is having to negotiate around the fibroid can also feel like cramps or cause uterine area discomfort -- as can a full bladder. Acupuncture can help with pain. I just had an amazing treatment this morning BTW, and I can't feel my fibroid at all right now and I feel really energized, almost lightheaded and lighthearted. My practitioner said that my blood was swirling around the fibroid and that instead of flowing in the right direction it was coming back around where it wasn't supposed to.

From the web...

There are links between progesterone and ararchidonic acid but I haven't totally made sense of them yet (I'll continue to research and see if I can make more sense of it for us).

I do know that progesterone stops contractions of smooth muscle (see: http://www.rnceus.com/hormone/progest.html and http://arbl.cvmbs.colostate.edu/hbooks/pathphys/reprod/placenta/endocr
ine.html)

Arachidonic acid is also linked to tumor formation as well (scary but here we all are with our tumors):

The Role of Essential Fatty Acids in Cancer
http://www.positivehealth.com/permit/Articles/Cancer/good6.htm

Skin carcinogenesis, inflammation, arachidonic acid metabolism, cancer prevention
Susan M. Fischer, Ph.D.
http://sciencepark.mdanderson.org/documents/sfischer/fischer.html
(note that they are interested in applying this research on skin tumors to prostate cancer)

This page has links to a bunch of studies that are available through Amazon.com about arachidonic acid:
http://www.health.xq23.com/arthritis/Arachidonic_acid.html

Abdominals not cut, Myo not panacea for fertility problems

ARE THE ABDOMINAL MUSCLES CUT DURING MYO?

I was worried about my abdominal muscles being damaged during myo (which have yet to undergo) and I asked the surgeon about it. She told me that they do not cut the abdominal muscles, instead they just push them to the sides, and I imagine they brace them there.

They do cut through some connective tissue and the abdominal fascia, a membrane that holds your internal organs together, but they stitch the fascia closed at the end of the procedure (I'm not sure if they reconnect the connective tissue -- I haven't seen mention of that anywhere) What Your Doctor May Not Tell You About Fibroids includes a detailed description of the procedure that you may with to refer to.

MYO TO IMPROVE FERTILITY

The ability of myomectomy to improve fertility is not definative at this point in time (this is confirmed in What Your Doctor May Not Tell You About Fibroids by Dr Michael Brody, an ob/gyn and former RAND medical researcher). There have been annectodal stories of success by patients and doctors but current research has had flaws that limit its usefulness in determining the appropriateness of this procedure to treat infertility, especially if other factors exist that may be contributing to the infertility (male factor, blocked tubes, endocrine issues, etc.) This is partly why I have been reluctant to undergo this procedure for my largely asymptomatic fibroid, we have a known male factor.

Gynecologic Myomectomy
"Myomectomy is also performed frequently in patients with infertility with the presence of fibroids (Vercillini, 1998). Studies supporting myomectomy as a fertility-enhancing procedure are uncontrolled and do not use life-table analysis; nonetheless, a number of authors recommend offering myomectomy to women who are infertile after other causes of infertility have been eliminated (Hutchins, 1995;
Nachtigal, 1989; Verkauf, 1996).

Several papers suggest that patients with fibroids who are undergoing assisted reproductive technology procedures may have lower success rates compared to patients without fibroids. Stovall et al (1998) noted decreased fertility rates in patients with any myomas undergoing in vitro fertilization or zygote intrafallopian transfer. Eldar-Geva and coworkers (1998) noted decreased success in patients with intramural and submucosal myomas but not in those with subserosal myomas. Ramzy et al (1998) noted no change in fertility, but this study specifically excluded anyone with large, submucous, or intramural myomas that distorted the endometrial cavity. Importantly, note that no randomized studies document that removal of these myomas
improves success rates."


TABLE 1 - ACOG CRITERIA FOR MYOMECTOMY IN INFERTILITY PATIENTS
Procedure:
Myomectomy* (68.29) (CPT Codes 56309 [laparoscopy with removal of leiomyomata], 58140 [abdominal approach], or 58145 [vaginal approach]

Indication:
Leiomyomata (218.0-218.9) in infertility patients (628.3), asa probable factor in failure to conceive or in recurrent pregnancy loss
(646.3)

Confirmation of Indication:
In the presence of failure to conceive or recurrent pregnancy loss:
1. Presence of leiomyomata of sufficient size or specific location to be a probable factor
2. No more likely explanation exists for failure to conceive or recurrent pregnancy loss

Actions Prior to Procedure:
1. Evaluate other causes of male and female infertility or recurrent pregnancy loss
2. Evaluate the endometrial cavity and fallopian tubes, e.g. hysterosalpingogram
3. Document discussion that complexity of disease process may require hysterectomy

Almost two years and facing Clomid/IUI

We've been trying for two years but we haven't used protection since 2000. We had the reversal before we were ready to try. It has all been an exercise in patience and faith.

I'm a bit scared of doing Clomid, we really don't want multiples. Couldn't they just do a trigger shot and IUI?

How does one find a fibroid specialist?

I agree, it is a difficult process. Most of the hospitals and clinics around here in the Seattle don't include very substantial information on their doctor profile pages about their expertise. Since OB/Gyn training and practice revolves around surgeries for multiple conditions I think they don't differentiate between procudures. But we as patients desiring uterus saving procedures know that there is a complexity here with the issues of blood loss, adhesions, retaining fertility, etc. that make us want someone who is passionate and fully vested in the outcome of our procedures.

I recently reread Sex, Lies and the Truth About Uterine Fibroids
and in it Carla mentions that some states have databases tracking medical procedures. Here is one of the examples mentioned in the book:

Center for Medical Consumers (NY)

Not all states track this information that it could even be published, that's another place where we need to weigh in and try to get our state legislators to help get us better information.

That said, it still seems like it is hard to find a doctor. There used to be a site that would allow patients to rate their doctors on a variety of criteria but I believe that was bought out by WebMD and it doesn't include that information anymore. Here are links to some directories that might be useful:

uterinefibroids Board Physician Database
Contains names of doctors that have been mentioned in the messages posted to this list with the number of the message to refer to -- inclusion in the database does not qualify as an endorsements of any of the practitioners however.

American College of Obstetrics and Gynecologists Physician Directory

WebMD Physician Directory

AMA Physician Select

You can also find out about licensed doctors in your state by visiting the state medical board web site; do a search to find the link.

The American Society of Reproductive Medicine has a page with links to a few other directories on it....

AMSR: Find a Doctor

MEDICAL RECORDS
Oh, and while we are on the subject, make sure that you request and keep copies of all of your records from the various doctors you see. You can then make copies to take with you if you confer with multiple care providers and it is helpful to be able to refer to them as well. Each State determines how much the clinic is allowed to charge for copies of the records but it seems to average around 75 cent to a dollar per page in my experience. To keep costs down just request the most relevant test results but you may want to have copies of all the chart notes as well. Each clinic will have a slightly different process for requesting records, sometimes a form or sometimes just a letter will do, and most of the ones I've been in contact with accept faxes.

The CDC -- hysterectomy info but no fibroid info

You all will like this one, the other day I was looking through the Center for Disease Control and Prevention (aka the CDC) website and I was surprised to find no mention of uterine fibroids. One would think that at the very least they would provide links to some of the other government heath websites (such as the ones listed in their response to me). There are other topics missing as well but my correspondence with them focused on fibroids. Read on...

My question submitted through their web form:

How is it possible that you have hysterectomy listed on the CDC website as a condition yet you don't have any listing for uterine fibroids? Since uterine fibroids are far more common than hysterectomy, and fibroids are also a disease while hysterectomy is a procedure, I would expect that the Center for Disease Control and Prevention to provide information for the former. Women need more
information about this condition -- prior to developing uterine fibroids.

Response from the CDC:

Thank you for your inquiry regarding uterine fibroids.

The Division does not have information for consumers on this topic. However, the National Women's Health Information Center (NWHIC) may be able to provide this information to you.

There are two ways to obtain information from NWHIC. You may call their toll-free number to speak with an Information Specialist (800-994-9662 or 888-220-5446 for TDD services) from 9 am to 6 pm (Eastern Standard Time), Monday through Friday. At any time, you may view and search their website (http://www.4woman.gov ) at any time.

Two other Federal information services may be helpful if you have access to Internet services. The National Library of Medicine offers MedlinePlus (http://medlineplus.gov), which provides extensive health information for consumers, including dictionaries, health information in Spanish, extensive information on prescription and nonprescription drugs, health information from the media, and links to thousands of clinical trials. Another general information service is the Department of Health and Human Service's HealthFinder (http://www.healthfinder.gov), a searchable guide to general health information. Many public library systems provide Internet access to local residents needing assistance or access.

Please accept our apologies for not being able to fulfill your request.

Public Inquiries Group (knb)
Division of Reproductive Health
NCCDPHP/CDC

Information about the endometrial lining and menstruation.

There is a substance produced in the uterus which is supposed to help prevent clots from forming, it is called fibrinolysin. When the blood flows too quickly (profusely) the anti-clotting fibrinolysins can't keep up and clots form. Heavy bleeding is called menorrhagia.

"Blood clots or flooding are indications of heavy loss. Normally the blood lost from the vessels in the lining of the womb forms small clots and this tends to reduce the flow. The small blood clots within the uterus are broken down by chemicals called fibrinolysins and the normal menstrual loss should be a fluid. When the bleeding is heavy, the blood is extruded too quickly for it to clot within the uterus. In this situation, the blood clots in the vagina and the menstrual flow includes blood clots. Whilst menstruation is inevitably an inconvenience, it should not result in limitation of social activity."
http://askwaltstollmd.com/archives/menstruati/95779.html#95952
(This doctor had his licensed revoked but the information seems valid so I included it, you will see mention of it if you scroll down through the previous link so I thought I would link to this page FYI: (http://askwaltstollmd.com/faq.html)

Check out these two interesting pages with detailed descriptions and diagrams of how the endometrium forms each month, for your reference:

NORMAL MENSTRUATION

THE ENDOMETRIUM

For more information search with these key words in different
combinations (such as "endometrium anti-clotting"):

menorrhagia, endometrium, fibrinolysin, anti-clotting

Is it possible to not have problems when pregnant with fibroid/s?

From all the stories I've seen shared fibroids seem to be problematic during pregnancy, in example:

* they may grow
* they may outgrow their blood supply and cause pain
* they could restrict the baby's growth
* they (in rare cases) could cause deformity in the baby (pressure on developing bones)
* they could increase problems with bladder, kidneys
* they could outcompete the baby for the blood supply and cause miscarriage (or otherwise cause a miscarriage)

Surely there are people who have had other experiences such as fibroid reduction, no growth, no complications...and lived happily ever after. Anyone got a story to share?

Patient sharing info online and my mother's thyroid treatment when I was conceived

I know that doctors and the medical community are afraid of the information sharing that patients do online but I think it actually is to the benefit of the patient. Being able to meet other women in similar situations, and some not so similar, helps me keep things in perspective and not feel so alone. I like being able to ask tough questions of the doctors, I want the best medicine possible for myself.

I did meet a couple of women at a party recently who had fibroids during pregancy. One had no symptoms, the other one said that taking birth control pills afterwards (which she had never been on before) "melted" the fibroids away.

Here's a question my mother threw out to me last night. She was diagnosed as hypothyroid when she was trying to conceive back in the late 60s. They put her on thyroid medication, she said it was bovine source, and it was at really high doses. What might the affects of very high doses of thyroid hormone/s be on a developing fetus? I have only had the TSH test done with normal range results. Anyone care to speculate on whether this might have influenced some hormonal wackiness in me?

Mifepristone (RU-486)

In my research into progesterone over the past few weeks I did come across a couple interesting links which talked about how RU486 worked from a hormonal standpoint. These articles talk about it in relationship to endometriosis and depression, not really in the context of it an an emergency contraceptive. It's pretty interesting.


RU-486 may dramatically relieve psychotic depression


RU-486 Explained

Help Support Fibroid Research & Education

[please feel free to forward this to your friends and family, with whatever modifications you would like to make.]

I wanted to ask you to please contact your representatives to the House and Senate and ask them to support the Uterine Fibroid Research and Education Act of 2003 (House Bill H.R.2157, Senate Bill S.1087). These are both still in the Health subcommittees but it would be
great if more women would write in.

Uterine fibroids, non-cancerous tumors of the uterus, affect between 25% and 80% of women and can cause symptoms that may include: excessive bleeding leading to anemia, infertility, and put pressure on the bladder, urethra, intestines.

From the Senate testimony given last Spring by Maryland Senator Barbara Mikulski (with Senator Hillary Clinton of New York):

"Despite their prevalence, little is known about uterine fibroids, and few good treatment options are available to women who suffer from them. Right now, hysterectomy--the surgical removal of the uterus--is the most common treatment for uterine fibroids. More than 200,000 women undergo a hysterectomy each year to treat their uterine fibroids, which requires a six week recovery, has a 20 to 40 percent
risk of complications, and means a women can no longer bear children. Less invasive treatment options, like drug regimes or fibroid embolyzation, are promising, but many have not undergone the rigorous testing that women expect. In fact, the Agency for Healthcare Research and Quality at the Department of Health and Human Services
found 'a remarkable lack of high quality evidence supporting the effectiveness of most interventions for symptomatic fibroids.'

Women deserve better. That's why I am introducing the uterine Fibroid Research and Education Act--to find new and better ways to treat or even cure uterine fibroids.

This bill does three things. First, it expands research at the National Institutes of Health, NIH, by doubling funding for uterine fibroids every year for the next five years. Despite a budget of over $27 billion, NIH spent just $5 million on uterine fibroids research in 2002. This legislation authorizes $50 million over five years to provide the investment needed to jumpstart basic research and lay the
groundwork to find a cure.

This additional funding will help researchers find out why so many women get uterine fibroids, why African American women are disproportionately affected, what tests women can take to prevent uterine fibroids, and what are the best ways to treat them."

The research they might be able to do if this is approved could help other reproductive and gynecological conditions as well. At the very least it would help make sure women are given other options before hysterectomy.

Find your representatives here:

http://www.senate.gov/
http://www.house.gov/

To learn more about uterine fibroids, visit the National Uterine Fibroid Foundation website: http://www.nuff.org/health_statistics.htm

My Reasons for Not Wanting a Myo

Here are my reasons for not wanting a myomectomy:

1. major abdominal surgery
2. risk of adhesions
3. length of recovery period
4. fact that with multiple factors there isn't a documented increase
in fertility
5. they would require me to deliver by c-section if I did get pregnant post myo
6. that I'm largely asymptomatic except for slightly heavier periods and some pelvic pain for a few days prior to ovulation and at the start of my period

We don't even know if we want to do any assisted reproductive therapy anyway, we went to the reproductive endocrinologists (RE) to get their opinion on our situation (my partner had a vasectomy reversal and has an issue with sperm morphology -- morphology refers to shape of the sperm). It was just kind of intense having the head of reproductive endocrinology at a leading university tell you that he consulted with all of the other REs and they've decided they don't want to be my friend.

I've always wanted to go the natural way -- I was never on birth control pills, don't eat junk food really, stay fit. I don't like it when the medical establishment says (in its Terminator voice) "you are infertile. we will cut you open and remove that fibroid. take these drugs and we will harvest your eggs and MAKE you pregnant."

Now I don't know how the rest of you feel but I'm not feeling like I want to go out on a limb with any procedure since I would feel worse if I didn't feel like my care providers were on my side. I guess I will continue doing my watch and wait routine and in the meantime at least take advantage of the MRI order from the RE so I can learn more about what's inside of me. Maybe God or the Universe will intervene in the meantime.

Sheesh!

So, I've been keeping you apprised of my situation. I just got off the phone with the RE (RE#2) and here's what he told me...

...that they won't do fertility treatments on me unless I have my fibroid treated

...that if I have the embolization they won't accept me as a fertility patient

...that they recommend myomectomy

...that he no longer authorized the MRI

They won't do fertility treatments if I have the embo because they are worried about the uterine wall being weak (weaker than a uterus that has had multiple fibroids removed -- aka. myomectomy!?) and the possibility of multiple births being so much higher with fertility treatments. They are also a little concerned about not the liability but their stats, that somehow I might compromise their success rates.

Heck, no one knows why I haven't been able to get pregnant, it could be any of the following that I've been able to deduce...

* sperm morphology
* low progesterone (I started using natural progesterone cream)
* anemia/low ferritin (being treated)
* fibroid (though I've never even been kinda sorta pregnant)

I don't even know what to think know. It seems like my options are a) leave it up to God, or b) do the embo and then leave it up to God, or c) do the embo and do fertility treatments if needed, elsewhere.

We're not interested in adoption.

Maybe I should just go save the dying children in 3rd world nations and give up on this mother thing.

Luteal Phase Dysfunction - Low Progesterone Info

I found this article which talks about low progesterone in the post-ovulatory (luteal phase) and saw that it does mention fibroids in the clinical section.

Luteal Phase Dysfunction

I know that not everyone has the same hormonal cause for their fibroids, and that they don't really know very precisely which they are and in which combination but for some of us progesterone supplementation might be helpful.

Anyone know the status of the fibroid research and education bills?

I wrote to my representatives last winter about the 2002 attempt to get this passed and wasn't paying attention when they were introduced again this past Spring.

Anyone know the status of Senate Bill 1087 and House Bill 2157 regarding funding for education and research of uterine fibroids? They were referred to commitee but I don't see anything on the committee web pages.

I thought this was a great line from the start of HB2157:

"The Agency for Healthcare Research and Quality found a 'remarkable lack of high quality evidence supporting the effectiveness of most interventions for symptomatic fibroids'."

Might we want to do a push where we write and call into our representatives? If I have time I might call the offices of some of the committee members to see what's up next week.

Here are some links:

House Bill 2157

Senate Bill 1087

About Menstrual Suppression

While researching the effects of progesterone on the endometrial lining today I came across some interesting site debating the efficacy of menstrual suppresssion (aka: extended contraception). I
can't say that I noted whether or not these sites mentioned it for use with uterine fibroids but take a look...

ASSOCIATION OF REPRODUCTIVE HEALTH PROFESSIONALS:
Choosing When to Menstruate: The Role of Extended Contraception


The Society for Menstrual Research
(click the link down the page for the statement on menstrual suppression)

CeMCOR - The Centre for Menstrual Cycle and Ovulation Research

Would you stop menstruating if you could?


More about menstruation:

Menstrual Cycles: What Really Happens in those 28 Days?!
(scroll down for more links)

The Menstrual Cycle: What your body is telling you

The Science of Menstruation

The Museum of Menstruation

Natural Progesterone Info

This site has a lot of information about progesterone but the navigation is a little weird -- you have to use the left navigation bar, roll-over HORMONES, the over SEX HORMONES, then over PROGESTERONE and you can click on the links that show up there. The directions they give are in contradiction with other information I've seen where you should only use it post ovulation (whenever ovulation occurs).

http://thecompounder.com/hormonesprogesteronefaq.html

I have this article bookmarked from this site linked which you might find helpful, it is by Dr John Lee and it talks about why transdermal dosing of progesterone is preferable. Note that it says too much progesterone can "[result] in rather high levels of allopregnanolone and the woman becomes rather anesthetized by it, a state that is sometimes confused with depression" -- so that would be a side effect if too much is taken.

LETTER TO A COMPOUNDING PHARMACIST
Delivery of steroid hormones.

You can learn more about progesterone by reading What Your Doctor May Not Tell You About Pre-Menopause(also by Dr Lee)