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Last Updated:
Jan 3rd, 2010 - 00:09:53
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Question
I am 37 years old, with two children ages 6 and 3.5. I have been trying to conceive for one year using the fertility awareness method. I had a miscarriage (at 6 wks) in 12/08. Since spring, my cycles have been a regular 28 days, and according to ovulation predictors and my temps show, I am ovulating, however, I have very little cervical mucus, with no eggwhite at all.
I have tried using pre-seed, Robittusin, etc. and that did not work for me. Besides the CM problem, I also have extremely sore breasts 3 weeks of the month – usually after ovulation through to day 4 or 5 of my new cycle. I’ve been reading on the internet (e.g. dr. John Lee’s site) and think I might have some kind of hormonal imbalance.
I am also hypothyroid, and suffer from symptoms like dry skin, fatigue, low sex drive, and premature aging.
My question – could I be progesterone deficient? If I am, will natural progesterone supplementation help me get pregnant, e.g. help increase cervical mucus?
Any information would be so appreciated.
Thank you so much!
Katherine
Answer
Dear Katherine,
You ask if progesterone supplementation could help cervical mucus production. Progesterone can help in an indirect way, since progesterone supplementation helps the latter part of the cycle, after ovulation. The critical part of the cycle influencing mucus buildup is in the first half of the cycle. Supplementing progesterone in the latter half of the cycle will feed back on the pituitary gland, and MIGHT influence the next cycle's production of estrogen and mucus. Your breast soreness may indicate a progesterone deficiency.
But there are more direct ways to affect cervical mucus. First if all, making sure there is not a chronic vaginal or cervical infection of yeast or bacteria is important, as this can affect mucus. Second, evaluation of estrogen levels in the pre and postovulatory phases of the cycle is important, as well as checking progesterone levels after ovulation. If estrogen levels are low, supplementation with estrogen patches or pills can be helpful. Supplementation with B vitamins, particularly Vitamin B6 can help increase mucus in some instances. In addition to improving estrogen, progesterone, and nutrition, one of the most helpful therapies for improving mucus has been low dose Naltrexone therapy, which raises endorphin levels.
Since you have had a recent miscarriage, it would good to make sure you have ruled out treatable causes of pregnancy loss. A cervical culture for ureaplasma/mycoplasma is helpful. Even though you have 28 day cycles, the hormonal stimulation may not be adequate. Checking the thickness of your uterine lining after ovulation can give you a good idea about effect of progesterone and estrogen, in addition to checking levels of these hormones. The pregnancy hormone HCG can be injected to help estrogen and progesterone levels after ovulation, and does not have adverse side effects. Although post-ovulation therapy improving estrogen and progesteorne does not directly affect mucus, like progesterone supplementation, it can have a beneficial effect on the next cycle through a feedback mechanism.
Finally, your general health is important for mucus production. Adequate thyroid replacement, sometimes replacing T3 in addition to T4, may be needed.Two very important health considerations are adequate omega 3 fatty acids (found in fish oil) and good blood sugar control. Fatigue and low sex drive can indicate an adrenal problem. The best laboratory test to diagnose adrenal fatigue is by obtaining four saliva cortisol levels throughout the day. If you have adrenal "burnout" with low cortisol levels, you may have "cortisol steal", which will lowers your sex steroid hormones in order to prop up your body's production of cortisol. Evaluation for intestinal yeast and food allergies such as gluten can be helpful in dealing with fatigue and adrenal fatigue. A workup of cortisol levels, yeast, and food allergy may require using laboratories specialized in these areas.
Mary L. Davenport, M.D.
Dr. Mary Davenport is an obstetrician-gynecologist in private practice in El Sobrante, California.
She graduated from Tufts University School of Medicine and completed her residency at the University of California, San Diego.
Dr. Davenport is also a Fellow of the American College of Obstetrics and Gynecology.
She has an NFP-only medical practice and is a Medical Consultant in Natural Family Planning.
She is a board member for CANFP and the American Association of Pro-Life OBGyn's.
© Copyright 2005 by CANFP
The information on this page and web site is for informational purposes only,
and is not a substitute for medical diagnosis and treatment by a physician.
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