Question

I have taken prometrium 200mg for about a year, and doing great on it. I am 43 and have struggled with thickening of the uterus, cysts, and very heavy periods. Now I'm doing great, but every month I have really bad cramping when I ovulate. Could it be the prometrium that causes this?

Cathy

Answer

The Prometrium, which is bioidentical progesterone, if taken correctly would not cause ovulatory pain. Things more likely to cause ovulatory pain would be impaired ovulation, inflammation, or a cyst. Do not take Advil or Aleve at this time because these non-steroidal anti-inflammatory medications can prevent a clean rupture of the ovarian follicle.

Take 2000 mg. fish oil daily. The Omega-3 fatty acids will help the follicle rupture in a clean way. Be careful about consuming sugar or refined carbohydrates. They may raise your insulin level, which can create inflammation and interfere with ovulation. Be sure you start the Prometrium AFTER you ovulate. In the protocol from Pope Paul VI, the Prometrium or other form of progesterone is begun three days after ovulation and taken for ten days. If taken too soon, the Prometrium/progesterone can adversely affect the rupture of the follicle.

If you are experiencing pain, obtain an ultrasound to ascertain if an ovarian cyst or other abnormality is present.

Hope this helps!

M. Davenport, MD

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