Monday, October 10, 2005

Progesterone questions

If you're one of the hundreds of people who reach this entry because you're wondering whether the side effects that you're experiencing due to progesterone are normal, or o.k. - please note that this is *not* in any way shape or form medical advice. If you are concerned about potential interactions with the medication you've been given, please contact your health care provider.

I am just a lowly blogger who is dealing with infertility. I welcome you to read as much as my site as you would like, but remember - every situation is different and every woman can react a little differently to the medication depending on the form and manner it is administered.

Now - that disclaimer out of the way - and a big wave hello - let's get you to what you're really here for.

I for one, ended up taking 400 mg. of Prometrium (200 mg. 2x a day) orally. It has made me emotional and very tired thus far, along with incredibly sore breasts and deep headaches.

The R.E. told me that he will be prescribing Prometrium to be taken orally to help boost my progesterone levels after the IUI and through the first 12 weeks of pregnancy.

From most of the other blogs I've seen, you're either taking progesterone via suppositories/pessaries or via progesterone in oil intramuscular shots. Does anyone have any information as to whether a particular form of progesterone therapy is more effective?

If you're taking progesterone via a certain method, would you be so kind as to describe what level you were taking, how long you took it and your thoughts on it (side effects, practical problems with administering it, etc.).

I'm anxious that we are putting so much into this that I don't want to overlook something that may be a better source of treatment.

I know, I know. He's the doctor - but I like being a well informed patient, and I don't have time to get my minor in progesterone from Google U today.



At 3:24 PM, Anonymous Dooneybug said...

Hi dear...I haven't undergone an IUI or IVF, but my doctor did prescribe me 100 mg of Prometrium twice a day for 13 weeks. It's pill form so no messy suppositories or painful needles.

I haven't felt any unusal side effects....well, it's hard to say wether it's the pregnancy or the prometrium that causes the nausea. Oh, but the zits, those are killer.

At 3:36 PM, Blogger Nico said...

I got my doc to give me progesterone after my post IUI #1 LP was only ten days. So I'm on Prometrium also, 200mg, up my cooter once a day at bedtime. I do have to wear a pantyliner during the day, but that's really no big deal. I find that I don't mind it at all. I think that you feel much squishier down there if you're taking the suppositories 2x / day. Just before bed works really well.

At 6:23 PM, Anonymous Jenn said...

I haven't taken it orally, but on my MSN board many girls have. If you'd like an invite to the board, e-mail me and I'll ask a manager for one. I'm sure they would be happy to tell you all about it :)

At 8:13 PM, Blogger chris said...

I'm on prometrium, up the cooter, three times a day. It's less messy than the progesterone, definitely. Some of the IVF patients at my clinic were recently told that they had tried it and decided to go back to the progesterone supps, though. Not sure why.

At 8:23 PM, Anonymous mm said...

I'm on progesterone in oil (PIO). I've heard that it is the most effective way to take progesterone, but it can be a real PITA (ha!) to schedule the shots. (I put a numbing cream on the area for about a half an hour before the injection. It helps a bit.) I've been on it for 3 days and have already noticed two unforunate but common side effects... depression and constipation besides the obvious soreness that comes with having a needle jabbed into your muscle.

At 8:57 PM, Blogger Miss W said...

I tend to have a short LP (28-30 day cycles, but O around cd 19-21). After my 1st 2 miscarriages, I was put on oral prometrium, 100mg 2X/day. I don't know if it's helped me to keep this 4th pregnancy, but I was on it from O throughout the entire first trimester.

I've read that the PIO injections are the most effective while the oral supplements are the least. That being said, my levels were tested along with HCG every 2 days for WEEKS and were ALWAYS above 100 (sometimes 200 depending on the time of day I made it in for my blood draw; higher early in the day, lower in the afternoon and evening).

As for side effects, my skin was horrific for a while (dry in some spots, grease pit and zitful in others), extremely sore boobs, very tired. Thankfully no real nausea and never the first bit of morning sickness. Again, don't know if this is from the prometrium itself or if it was due to the actual pregnancy.

Hoping all goes well for you!

At 10:11 PM, Anonymous Leggy said...

PIO is technically most effective but not sure its really called for in IUI.

I have done them all- PIO, crinone suppositories, other progesterone suppositories, prometrium (orally 100 mg/4 times a day).

My body can't tolerate PIO in any form (major hives), so that's why I've used the suppositories and prometrium.

Side effects- basically sore boobs, major flare-up of hemmoroid that hasn't bothered me since I was pregnant with son (sorry to be gross, but true). I've also had weird, freako numbness/tingling symptoms in my legs that are magnified while on progesterone, but I wouldn't worry about it because apparently I am only person on earth with these symptoms (have been doing research on this and so far have found no one with similar issues).

At 6:13 AM, Blogger Blue said...

I am doing 100mg of Prometrium up the cooter 2X a day (my progesterone tends to be low normally). I get a bit of pink discharge in the undies and a bit of constipation during the LP but other than that no problems. T and I refer to it as "The Sticky Pill" since occasionally I find my bits glued together and I must stop and separate them. Ewww.

At 10:31 AM, Blogger Dee said...

I had to do prometrium suppositories in the lady bits once a day, at bedtime. I believe it was 100mg pill. It wasn't bad and I didn't have any symptoms from it. I had to wear a pantyliner as little bits of whitish ick would come out here and there the next day. I was on it for 12 weeks until the placenta took over progesterone production.

It's my understanding that the suppositories put the prog directly into the uterus, while with the injections it eventually gets there after circulating through your bloodstream first (since it's being injected into muscle or something like that). Also, with the injections, your progesterone blood tests will come back with higher levels than if you're just doing suppositories. Again, that's because the one gets into the bloodstream while the other is absorbed right into the uterus without circulating around the body first.

Hope that helps...good luck as things progress :-)

At 12:27 PM, Blogger Toni said...

With the IVF, I did shots. They HURT LIKE HELL. Try to avoid them if you can. I've heard of just about everything - I would have done pills if I could!

At 4:02 PM, Blogger Stephanie G said...

A bit late.... but here are my Prometrium thoughts: :-)
I suffered through 2 miscarriages before becoming pregnant with my daughter. With her... I was on Prometrium for 14 weeks. I think 12 is the standard... but I was so nervous about stopping Prom. that I begged for 2 more weeks - just to be sure! Bottom line - she's happy and healthy. But... prometrium did make me an insane woman! :-) I think it just compunded the exhaustion and crankiness! In the end... its worth it!
Good LucK!!!!!

At 12:36 PM, Anonymous Renee said...

I suffered 3 miscarriages and decided to go the IVF route. My doctor put me on Progesterone injections--at least until the preg test, and if that's pos. I need to keep taking it. Well, the downfall is that the after-effect of the shot is worse than the injection. I have Mount Everest on each cheek, with redness, soreness like the flu, and aches and pains. It is definitely not the easy route, but worth the effort if it works.

At 5:18 PM, Anonymous Anonymous said...

Progesterone in Oil Important Tips:

Been through IVF with PIO several times with disasterous consequence of barely being able to walk or sleep b/c of the pain. I have learned some great tips...

1. Make sure you are giving the shot in the hip and not your gluteal muscle. If giving the shot in your left hip....make an "L" with your left hand. Find you hip with the tips of your fingers and give the shot at the bottom of the "L".

2. Please ask your dr. for EMLA cream. Apply 1 hour + before injection and cover with saran wrap and tape or press n seal. This helps dramatically with the pain of the giant needle.

3. NEVER ice the injection site!! My IVF nurse suggested this and it was very painful after the fact.

4. Watson brand causes much less pain than generics from mail order pharmacy.

Good Luck Girls!

At 11:34 PM, Anonymous Anonymous said...

Hi dear,
After my IUI, doctor prescribed me 100mg prometrium twice a day and 50mg progesterone suppository twice a day together. Anybody know taking pills and suppository is too much or not? I am really worry about this.


At 4:05 PM, Anonymous Varla said...

My RE says that PIO is definitely a much more effective delivery system than suppositories or oral so that is what we are doing.

I am doing my first round of IVF. Going into it I was very concerned about the PIO shots because I had read a lot about allergic reactions, pain, etc. I know a lot of people have experienced these things and I really feel bad for them, so please don't take this post as dminishing that in any way.

However, my experience has been that they really are not bad at all. I am doing PIO in sesame oil once a day. My hubby does the injection in the upper outer quadrant of the cheek and we alternate sides each night. I stand leaning over the sink with my weight on the side that is not getting the shot. We don't numb it first with anything. The only thing we do is warm the PIO for a few minutes beforehand (I put the vial in my bra to get it up to body temp). When hubby delivers the injection it is slow going in but I can't feel too much of it. I also haven't had any lumps or rashes and very very little residual pain. Considering what I had read up to this point, I am pleasantly surprised.

As for side effects: slightly sore boobs, minor constipation. Nothing a good bra and some high fiber snacks won't cure.

I only wanted to put this out there so people can see that although it is good to be prepared for the worst, it CAN actually be much better than you think.

Thanks for listening.


At 7:00 PM, Anonymous Anonymous said...

Has anyone ever heard of being on Prometrium 200 mg three times a day orally as well as Crinone 8% twice a day? It seems like a big dose, but that's what our doctor prescribed. The side effects have been absolutley terrible. What's even more strange is that this is a suspected male factor infertility.

At 1:13 AM, Anonymous Anonymous said...

Hi fellow soul sisters dealing with progesterone...

I have just gone through my first IVF attempt, and I was prescribed Progesterone in Peanut Oil. It sure seems unnatural to take a food that I have tried to generally avoid, and then shoot it into my butt. Aside from that, the shot initially caused significant pain for me the morning after I took it. I was giving myself the shot at night (I'm single), and i was waking up at 2 or 3 am in great pain. Here are the things that have worked for me to lessen this pain:
- Heat up the IM injection area with very hot washcloths for a solid 15 minutes before taking the shot.
- Heat up the shot of progesterone under hot tap water. I checked, and heating it up does not reduce the potency. Be careful not to make it too hot, I guess, but the heat makes it much runnier, which makes it a whole lot easier to inject.
- Lie down and relax, relax, relax... Make sure you don't have a single tight muscle in your rear end. Any tight muscle will make the soreness greater later on.
- Immediately after giving the shot, I take a very hot shower and aim the shower head at the injection site. I rub it vigorously. (Some people say "massage," which is good, but I would liken this more to tenderizing meat.) Think about it... the goal is to spread out that oil in muscle. It takes elbow grease.
- I then put a heating pad on it with moist heat. I leave that on for about an hour.
- I have a small butt, and the pharmacist said this could be why there is more pain. She suggested that I don't put the 1.5" needed in all the way. It definitely has to hit the muscle to be effective, so you don't want this to end up being a SC injection. However, putting it in 1 full inch is definitely hitting muscle, and this reduced my soreness a lot.
- If all else fails, take extra strength Tylenol.

I know this is long, but if I can help even one other woman out there who might be going through what I was going through, that's my goal.
Best of luck to all of you!

At 2:39 PM, Blogger Jessica said...

I have done my progesterone in oil shots. Have checked with many sources. It is the best choice, with the least potential for birth defects. The oil is a natural way to deliver the progesterone. So, I grin and bear the shots. I have been spoiled to have my mother who is a nurse give me the shots. The occasional itchiness is no big deal. And the upper buttocks feel no pain when you sit down. We alternate cheeks. I believe everyone should give this method a try. Suppositories are messy. I'm now 12 weeks pregnant with twins and will be weened off the shots this week.

At 4:49 PM, Anonymous Anonymous said...

Hello Girls, I am 10 wks pregnant and the dr. put me on Prometrium, 100mg 3x day 3 days after i ovulated. After 1 wk I started bleeding and I thought it was my period so I stopped taking the pills. 5 days later I noticed my period wan't very heavy so I took a test and found that i was indeed pregnant. This is my first pregnancy and I am 37 years old. Never before have I had any miscarriages or any other child bearing issue of course. Had my visit with the dr. and she said that i needed to start taking the pills again so i did. 1 wk to 1 1/2 wks later I started to get the shakes and I was always tired. friends and family were telling me that it was the pregnancy. I then started to have shortness of breath, trouble talking, headaches, not beaing able to focus with my eyes,heart palpataions,nausea, stomach pains, dry mouth, chest & shoulder pain, increase in heart rate to 123 by just walking up my 13 steps at home. I've been to er twice and thay say nothing is wrong with me. I think I am going to stop taking these and call the dr. on monday. Dose anyone out there feel the same way? cause this is just too scary.

At 3:36 PM, Blogger GettingThere said...

Hi! I did, indeed, come to your blog because I was looking for information on side effects of Progesterone shots. I am awaiting the day of pregnancy test (first IVF). I am on both, PIO and prometrium. The shots are really not that bad for me (luckily, since I am TERRIFIED of needles)- I ice the site before and after the shot, never more than a few minutes (because if the cold reaches the muscle, PIO will hurt when it goes in because then it will become viscous) and don't feel a thing! Another thing that might be helping me is that i take the shots in the morning as opposed to night time. I guess the movement of the muscle throughout the day helps get rid of the soreness. Have a little soreness for a couple of hours later, but can't even tell where I got the shot the next day. BUT, I do have this numbness on the outside of my thigh, just on one side (i am taking the shots on both sides). I don't know why.

Good luck to you!

At 11:01 AM, Anonymous Anonymous said...

can constipation straining cause the embryos to fall out?

At 8:06 PM, Anonymous Anonymous said...

I am on the suppositories. I did 2 IUI 2 weeks ago back to back. I have had my test and it was negative. I am to stay on the prometruim another 3 days and take another test. Will I get a period while on it or how long after stopping the prometruim will I get one. This is so dishartening. Pretty sure pregnancy did not occur.

At 4:32 PM, Blogger me said...

I just wanted to let anonymous know that constipation straining can NOT cause the baby to fall out. Otherwise, our son would have never been born! I was constipated from day1! Even did enemas (sorry if tmi). Dr. told me to take a stool softner with my vitamin - and they even can prescribe vitamins with them IN the pill. Ask. Anyway, I'm going through what one of the others is: hemmoroids from hell!! Only side effect so far, but it's rough. Hopefully, it will all be worth it.

At 7:50 PM, Anonymous Anonymous said...

I'm undergoing IVF and have been on PIO for two weeks now. Waiting for the pregnancy blood test and then will hopefully move forward with suppositories. I'll share with you what has worked for me although it contradicts some of what was said by others.

The nurse helped us administer the first shot. Using a marker she drew a horizontal line right above the crack. Then she drew a vertical line running down the middle of each cheek. The upper right for the right cheek and upper left for the left cheek are the appropriate injection sites.

Everyday I numb the area with an ice pack (one that came in the package with all the meds) for at least 40 mins (as suggested by the nurse although she said I could reduce it - am not taking any chances). I alternate hips every day. The PIO bottle is stored at room temperature so I don't warm up the oil any further. I lie face down on the bed, blast music in my ears from my IPOD, and stuff my head between two pillows while my husband administers the shot. It takes all of 1 minute from the time he cleans the area and removes the needle. I don't feel a thing. I don't even feel the pad when he rubs it on the skin.

I then use a heating pad for about an hour to warm myself up. My husband then massages the area for 30 to 40 minutes at night and again the next morning. This is key - we didn't do this the first two days and I could barely walk. But since then there is some soreness but very very mangeable.

Side effects - some weight gain in the stomach and definitely in the boobs. I've gotten horrible back acne from the other fertility drugs - Menopur and Gonal F.

Hope this helps someone.

At 11:08 PM, Anonymous Anonymous said...

Glad to find your blog. I had two kids with no problems and then started to try for the 3rd and the problems began. I had a miscarriage and found out I had low progesterone. So I was on prometrium orally 200mg once a day and it didn't do a thing for me. My level didn't rise even a little. Apparently some people don't absorb it well or process it too quickly orally so I am now on the suppositories. I believe its 25mg but that sounds low.... I am really hoping this works. I have had some constipation but not much else. My boobs are always sore from ovulation on so that doesn't tell me anything. Anyone else had hte oral meds not work?

At 7:40 PM, Anonymous Anonymous said...

I was just placed on Prometrium 200 mg - oral- to boost my very low progesterone levels (1.4). I began taking 3rd day after ovulation. Does anyone know how long it takes for prometrium to increase progesterone? Is it too soon to hope for pregnancy this month since my levels were so low to begin with? This has become very frustrating as I am young and healthy otherwise but have tried for over a year to just find out that I am basically incapable on my own (w/ my husband's help, of course)!

At 6:27 PM, Blogger robotheart said...

ive taken various dosages of prometrium in hopes to avoid miscarriage. i can never tell if the side effects are from pregnancy or the pill. im looking for ONE that isnt caused by both. unfortunately that doesn't seem possible. ive had sore breasts/nipples, heartburn/reflux, nausea, extreme to moderate fatigue, moodiness, constipation, you name it. right now my dose is 100mg 3x a day. im taking one orally at the same time i take one as a suppository, and then another suppository at night...its difficult to now know if the prometrium is keeping the pregnancy...or just keeping you feeling pregnant...sigh.

At 5:53 PM, Anonymous Anonymous said...

I'm going through IVF now and have been taking Prometrium pills (100 mg 3x day) and suppositories (twice a day - don't remember the dosage but think it's 200mg) for about 11 days.

I've found that soluble fiber suplements help with the constipation. The nice thing about soluble fiber is it does not give you the runs. In fact soluble fiber helps with both constipation and the runs. Sounds strange, but apparently it makes a sort of gel that absorbs excess liquid (to help with runs) and also helps everything slide right out. Also it's natural.

I use acacia fiber - Fiber 35 to be specific (though any brand would do). I prefer to use the sprinkle on fiber since it is straight fiber with no sweetners. However lately I've gotten lazy and I just take one chewable tablet in the evening. That way I have a nice easy poop when I get up the next morning.

I've also been eating more beans and whole grains. These provide fiber and many nutrition benefits. I like to make a sort of pilaf with mung beans, adzuki beans, lentils, quinoa, millit, brown rice & wild rice. I often season it with cajun seasoning (I like Tony's), onion powder (or fresh onion), garlic (powder or fresh) and sometimes chicken broth. The seasoning isn't terribly important because I tend to serve it smothered in mixed vegetables cooked with herbs and sausage or chicken thighs. I make the veggie/meat concoction saucy with a can of diced tomatoes or sherry & cream to further season the grain mixture. It's a rather homey meal that my husband and I enjoy. Sometimes I melt cheese on top to make it even more comfort food feeling. This dish also makes good leftovers so I don't have to cook every night. I work full time and have been experiencing moderate to heavy fatigue, so not having to cook every night is important to me.

I hate to sound like a sales person (I get no commission or monetary reward for this btw), but for the zits, I love Paula's Choice Blemish Fighting Solution - it is great to prevent or get rid of zits whatever the cause. I actually use several of her skin care products and like them very much. She only sells online - google "Paula's Choice" if you're interested.

I too am experiencing tender boobs (they seem to be getting less tender lately though). They are also getting firmer and fuller - I like this side effect. :)

At 1:37 PM, Anonymous Becca said...

Has anyone every used the progesterone cream? My DR says that the oral is hard on the liver and put me on the cream. 200mg twice daily. The only side affect i get with this is weight gain. i have had 15 miscarriages and want to avoid another. My baby is 3 and i have lost 8 after his birth.

a specialist told me to take the oral jell caps vaginaly at bed time. She says the side affects are much less. I get terribly dizzy with the oral. has anyone ever had good results with this?

At 2:40 AM, Anonymous Pollyanna said...

I also found your site while searching for PIO side effects.

The fist time we did IVF I was on PIO shots in sesame oil. They hurt like the dickens--I couldn't sit, walk or lie down without pain. I used a heating pad for the pain, but it really didn't help. I also ended up with a fever (102) and an eczema rash (have no idea if they are related, but I had to mention).

For the 2nd IVF, I took PIO shots again, but this time in ethyl oleate. WHAT A DIFFERENCE!! No pain, no problems and a successful pregnancy. I would highly recommend the ethyl oleate PIO for anyone who has to have the shots.

I did have crippling constipation both times.

Hope this helps someone.

At 6:14 PM, Anonymous Anonymous said...

I used progesterone ESOLUT OVULE 200MG per day at night after iui for 14 days...iui not worked for me and pg test neg.....Now i have stopped taking prog about 6 days before..but i have bad abdominal cramping from past 12 days and now from 3 days constant left side pain...i dont now how to explain this pain but i think it is in my overy.. i also fell thirsty and hungry always...please some one help me in this condition..........

At 2:58 PM, Anonymous Jette said...

I've been on large doses of oral progesterone in the last 2 years to treat hyperplasia. The natural progesterone just made me tired. The synthetics (Megace, etc.) were a nighmare - increased blood sugar, increased blood pressure, extreme fatigue, had to pee all the time, insomnia, calf pain, hungry all the time, swollen ankles and feet, etc. Luckily, my endometrium became healthy 8 months or so ago and I did my first embryo transfer. My doc prescribed PIO. By the time of the beta test (sadly negative) I had started developing hives at the injection sites. My doc thought I might have a mild allergy to the sesame oil it was in. This time round I went to a compounding pharmacy and got the progesterone in olive oil. I've only been on it for 2 days (my transfer is scheduled this Thursday - wish me luck). I forgot that the first couple times you do the injection the muscle is VERY sore the next day. It does get better as the muscle adjusts. I don't mind the actual injections. If you leave the muscle relaxed, once you get past the skin barrier it doesn't really hurt to me. A tight muscle equals a painful injection. It's the stiffness in the muscle that develops the next day that drives me bonkers. I don't get the stiffness if the injection is in my hip (but that takes another person to give the injection), only when it's in the thigh (since I often give myself the injection while at work, this is where I get it most often). Well, that and fatigue. I haven't tried the suppositories. Hope this helps for those of you new to progesterone.

At 11:57 PM, Blogger Mady's Mom said...

Hi all!
Doing second IVF cycle and am 6 weeks pregnant and terrified = daily shots of 1 cc of progesterone aren't a match for my fear of losing this baby. Lost last one on week 9. No heartbeat. Devastating.

I'm writing b/c my pants are tight! Is anyone else out there experiencing weight gain so early in their pregnancy? Maybe b/c this is our second baby? Pray for me people = I don't wanna go through this again. I hope the next weeks and months go smoothly. Amen!

At 10:35 PM, Anonymous Anonymous said...

I have a Luteal phase defect and was prescribed 200 mg Prometrium 3X a day orally 50 hours after LH Surge until AF arrives or longer if preg.. I had severe side effects, disorientation, extreme fatigue, sore stomach, cold sweats, tingling/numbness, etc.. I called my OB and he told me to take it vaginally instead to decrease the side effects and it works great! My side effects have practically disappeared the only problem is the inconvience of having to lie down for an hour after inserting my 2 pills.. Definitely way better than the alternative though! He wants me to start on the PIO injections after a positive test (have an irritable uterus and past pre-term labor with last pregnancy).


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