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Last Updated:
Jan 3rd, 2010 - 00:09:53
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Question
I teach NFP and have a client who is married, with 2 children, using progesterone cream for the past 6 months for PMS. It seems to have dried up her mucus. Do you have any information on this?
Answer
The cervical mucus producing glands respond to progesterone by decreasing mucus output and by creating a thicker, viscous mucus that looks like a cobblestone wall under the microscope. This effect is produced whether from the corpus luteum (the remains of the follicle)or from oral, vaginal, or injectable sources.
Vaginal progesterone may produce an additional drying effect because of local contact. This is a treatment for those who have continuous background mucus and PMS. Some women may find the localized effect of the progesterone more of an irritation and furthermore may not absorb enough progesterone to be effective for PMS.
I am assuming that the mucus being dried is background mucus or a continuous mucus. I am also assuming that the client is using the progesterone cream in the post-peak phase only, such as days P+3 through P+12. If you mean that her fertile, estrogen type mucus has "dried up", I would wonder a couple of things. First, clarify that she is using the cream in the post-peak phase only. Secondly, does she really suffer from PMS or is she suffering from something else which gives symptoms like PMS. What was her chart like before the use of the progesterone, was any lab work done at appropriate times of the cycle, and is she getting relief of symptoms with the progesterone? Perhaps the loss of peak type mucus is a coincidence and further investigation is needed.
I have found that cooperative progesterone replacement therapy using oral rather than vaginal progesterone is much more effective for PMS. That is to say, using oral progesterone on Peak+3-Peak+12 where it occurs naturally in the cycle has a great benefit to the person suffering from PMS. There is much more flexibility with oral verses vaginal dosages of progestrone. Compounding pharmacists are very helpful in this area. Please keep in mind that
progesterone means naturally occuring, human progesterone, not a synthetic.
There are several ways to treat a continuous background mucus but it does not sound like your client is in such a situation. Perhaps she may suggest to her physician that she use oral progesterone, not a synthetic, during P+3-P+12. Dosage recommendation is 200mg daily, however this may be too strong. I have found adjusting the dosage down to 150mg or 125mg is effective as well. Additionally, I have used 200mg for the first 3 days, then a lower dose for the remaining 7 days. This is more similar to the natural physiologic progesterone curve.
Additional treatments for PMS exist but a discussion on that is far beyond your client's question at this time. Hopefully though, this information will be of help! Keep up the good work!
Dr. Gretchen Marsh
Dr. Marsh is a family practioner in Yuba City, CA where she lives with her husband and 5 boys.
She is a Creighton model certified Medical Consultant and a certified Fertility Care Practioner.
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