From CANFP

Evaluation and Treatment
Pre-menstrual Spotting and Miscarriage Connection?
By Sheila St. John
Apr 28, 2008, 14:51

Question

I am 32 years old and have 3 children. My husband and I have practiced NFP since before our 1st child was born. Since the birth of our 2nd child, I have had premenstrual spotting. It seems to be getting worse. I have always had shorter luteal phases, from 9-12 days, but have also been
breastfeeding my kids during this time too.

I am currently nursing my 18 month-old 2-3 times/day. My period returned when she was 6 months old. The premenstrual spotting had always been brown, but the last cycle or two it has been reddish too. I should mention that about 5 months ago I miscarried when the baby was 7 wks. old.

My questions are, what is causing my premenstrual spotting? I've increased my intake of Vitamin B6 to 250mg/day, per Marilyn Shannon's book recommendations. Also, is the miscarriage connected to this premenstrual spotting?

Thank You!

Jenny

Answer

Dear Jenny,

The combination of symptoms you describe----pre-menstrual spotting, miscarriage, and short luteal phases---are indicators that you should have a hormonal evaluation, checking in particular your progesterone levels. There is such a strong association between these symptoms and low progesterone, that I would even suggest you obtain an evaluation prior to pursuing another pregnancy, to lower your miscarriage risk. Your knowledge of your cycle as an NFP user will permit a very precisely timed evaluation of levels, during the luteal phase of your cycle, and also will be the key to timing progesterone supplementation when needed and effective, also in the luteal phase.

If your doctor is not knowledgeable in this area, you may need to consult a physician who is. In California, those physicians are listed on our website at www.canfp.org.

Sheila St. John




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