From CANFP
Premenstrual Spotting and Cramping
By Dr. Delgado
Jul 5, 2007, 14:26
Question
Hi, I went off birth control 2 months ago and for the past 2 cycles I have had light spotting and mild cramping about a week before my menstrual cycle. My menstrual cycle lasts for about 4-5 days. My husband and I are trying to conceive and my OB/GYN has prescribed PROVERA. She says that my progesterone level could be low and if I take it for 2 cycles that it will regulate me back to "normal", however, when I filled the prescription it says it cannot be taken during pregnancy and women who may become pregnant should not take PROVERA. My doctor never told me any of this info, but when I called and talked to the nurse they told me to follow what the warning says and use some form of contraception while I am taking the PROVERA. Are there any other options other than Provera that I could take and still continue trying to conceive?
Answer
Dear Angie,
Spotting and cramping a week before your menstrual cycle very well may be from low progesterone levels as your body recovers from the birth control pill. You really have three options: wait and let your body work through it, have a more thorough evaluation by a health care provider familiar with NaProTechnology or supplement with progesterone.
Provera (medroxyprogesterone acetate) is a progestin, a chemical that has some of the actions of progesterone. It also has male hormone effects which could be harmful in pregnancy.
When I want to supplement progesterone levels, I use the real stuff, micronized progesterone (a common brand name is Prometrium). The warning about use in pregnancy will still be there, only because problems have been detected with medroxyprogesterone acetate (Provera). According to the research of Thomas Hilgers, M.D. there have never been documented problems with using progesterone in pregnancy.
In health,
George Delgado, M.D., F.A.A.F.P.
Culture of Life Family Health Care
Voluntary Associate Clinical Professor
Department of Family and Preventive Medicine,
School of Medicine, University of California, San Diego
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