Chances are you may have heard of progesterone, particularly if you have had recurrent miscarriages. Progesterone is a hormone associated with pregnancy and the menstrual cycle.
Levels of progesterone rise every month after ovulation, preparing the lining of the uterus for pregnancy. In a non-pregnant menstrual cycle, progesterone levels rise after ovulation and fall just before a woman gets her menstrual period. When pregnancy occurs, the progesterone level should remain elevated. The ovaries produce the majority of progesterone through most of the first trimester, but eventually the placenta takes over production of the hormone by about the tenth week of pregnancy.
Because progesterone plays a role in maintaining the uterine lining, some researchers have theorized that having low progesterone before a miscarriage might actually play a role in causing the miscarriage. But whether supplementing progesterone actuallyprevents miscarriage is a matter of debate.
Right now, no medical organizations recommend supplementing progesterone in women with luteal phase issues or recurrent miscarriages, except in women using reproductive technologies such as IVF. (a.k.a bayi tabung)
No scientific studies have found definitive evidence that progesterone supplements prevent miscarriage in women who are not using artificial reproduction methods. Most studies find no difference in miscarriage rates when comparing women who took progesterone supplements to women who did not.
A few studies have found evidence that taking progesterone supplements might benefit women who have had recurrent miscarriages, but right now the numbers are too small to say whether or not the findings are significant. More research needs to be done before doctors will know whether or not the supplements are beneficial.
Low progesterone in pregnancy is definitely associated with miscarriage, but the reason why is controversial. On one hand, too-low levels could theoretically cause miscarriage if the uterus is not ready to support a pregnancy, perhaps because the ovaries have problems producing enough progesterone for some reason.
On the other hand, many doctors believe that low progesterone merely means that a miscarriage is impending for other reasons. With this line of thinking, the low levels are the first sign that the body is preparing to miscarry a pregnancy that has already failed for other reasons, such as chromosomal abnormalities in the developing baby, and progesterone supplementation is useless.
Right now, no one knows the correct answer, and the subject tends to be a matter of hearty debate.
Hormone production during pregnancy, especially in the early stages, is crucial to the development of the fetus and to the proper function of the organs of the mother. Normal production of hormones, including progesterone, is significantly increased during pregnancy, especially by the third trimester. This is why monitoring progesterone levels is so important in prenatal care. Without the sufficient presence of progesterone during pregnancy, uterine contractions can occur that may cause premature labor. Low levels of progesterone will also inhibit the growth of new blood vessels that provide nourishment to the fetus.
Progesterone is a steroid hormone that is vital to the reproduction process. Progesterone is regularly produced in the ovaries and the brain during the menstrual cycle by a chemical process that breaks down cholesterol molecules through double oxidation. Progesterone production begins on the first day of ovulation and continues for the next 12 to 15 days. During pregnancy, progesterone continues to be produced by the ovaries until the end of the first trimester, when the placenta takes over production. Progesterone becomes more and more crucial for development of the fetus and to maintain adequate blood circulation in the womb.
Spotting. The most common symptom of low levels of progesterone and the human chorionic gonadotropin hormone (hCG) is bleeding in the first few weeks of gestation. While there can be other causes of this, any spotting that occurs, especially if it is accompanied by cramping, could be an indication of low levels of progesterone. While the old standard for testing for low hormone levels called for special blood tests only after a third miscarriage, more obstetricians are recognizing the need for early detection of low progesterone levels.
Tenderness. Although blood spotting is the most common indication of possible progesterone deficiency during early pregnancy, women who have been found to be deficient in progesterone during pregnancy have reported increased tenderness in the breasts and lower back pain combined with spotting within the first trimester. These symptoms by themselves may not be indicative of low levels of progesterone, and may be due to other things that are taking place in the body, such as the growth of milk-producing cells and fibrocystic swelling. However, if spotting is happening and other symptoms occur, it could be a sign of low progesterone production.
Treatments. If insufficient progesterone production is suspected, blood tests can check for levels of progesterone and hCG. According to Dr. John Lee of DiagnoseMe.com, once progesterone deficiency has been determined, progesterone supplements can be prescribed. There are several types of supplements available, including vaginal suppositories, hormone injections and oral supplements. While there have been new developments in topical hormonal creams that have been reported to have some success, the opinion of some in the medical establishment indicates that topical creams may not have a significant effect on maintaining proper levels of hormones during early pregnancy.
Medical Advice. The advice of a reputable OB/GYN should always be sought by any woman who suspects she may be pregnant, especially if there are any symptoms of progesterone deficiency in the early stages. The chance for premature birth, ectopic pregnancy (a pregnancy outside the womb) and miscarriage can be greatly reduced by maintaining proper levels of progesterone. This will ensure healthy fetal growth, will protect the fetus from bacterial infection and will provide valuable information for a successful delivery.