I think I've got LPD - What should I ask the doctor about TTC?

[Bloomsbury]

Hi, for about 4 months I've noticed 5 - 7 days spotting before I get my period. I thought it was down to some gynae procedures I had done for abnormal smears (2 loops for CINIII/CGINIII) but the colposcopy clinic says that it shouldn't affect my periods. So I've done some looking on the internet and think that it might be down to low progesterone/Luteal phase defect. Does that sound right? I'm going to thte doctors this morning and wondered if anyone could advise me on what to ask and what treatment I should be pushing for if possible - I'm 34, turning 35 next month and am scared that this could really set me back ttc a second child. Thanks.

Firstly, you should be very careful about self diagnosing from the internet. While there are a lot of sources of good information out there, there is also a lot of information that can lead one to believe that something is wrong when it potentially isn't.

You should tell your GP the state of your periods, that you're having spotting beforehand etc, and he/she will most likely order a series of blood tests, a day 21 test to check if you're ovulating, and a day 3 test to check LH levels. They should also do a full blood count to check for anaemia/thyroid function etc.

Good luck

Thanks - GP has suggested day 3 blood test - FSH/LH and something on the form called SHBG (?) She's then said I should have a progesterone test 7 days prior to my period. My obvious concern with this is that I can only hazard a guess as to when this is (I'm a little irregular at the moment). What happens if I do it '7' days before my period (is due) and then get it early or later than presupposed. Will it mean the progesterone test is null and void?

Hi Bloomsbury

You say your periods are a "little irregular" at present. Irregular periods are often caused by homronal imbalances - a common one in this regard is a condition called polycystic ovaries or its related syndrome. Not suggesting you have this but it may be a possible reason why your periods are irregular.

Do ensure that your day 3 LH and FSH are COMPARED, not just looked at separately. You compare the two!!. Normally these two are about the same, if LH is higher than FSH this is one possible indicator of PCO.

If your periods are really all over the place I would use calendar days. As long as your progesterone is measured towards the end of the month it won't make much if any difference. In this regard a day 21 is a standard test. Ideally with this they like to see a level of 30 or above.

Sex Hormone Binding Globulin (SHBG). Increased androgen production often leads to lower SHBG.

Hope the above helps.

Would also suggest that if the above does determine a hormonal imbalance ensure you are referred to a gynae.

Thanks for putting my mind at rest re: the 21 day business - I can see from other people's posts that tests and referrals can take an age, so I don't want to muck this chance up. Re: the referral to a gynae - should it be a general practioner or should I ask for a referral to a specific reproduction specialist gynae?

Bloomsbury

Ask the GP to refer you to a subfertility unit particularly if any hormonal imbalances are detected.

Initially at least you are better off going under the NHS.

Hi,

I have exactly the same symptoms as you. I called NHS direct (before reading this) and after loads of questions the nurse suggested I go to see the doc tomorrow. She didn't really suggest what it could be but said I need to be checked out.
I also mentionned that intercourse was uncomfortable recently. This seemed to concern the nurse.

It will be interesting to see if the doc suggests these tests that you are having.
Good Luck.

Hi again,

My doctors sollution to this problem was to go on the pill!!!
Of course I said no.
His next suggestion was to do an internal once my current period has finished. So I have that to look forward to next week. A few people have suggested it may be fibroids as the spotting can be a sympton of that.
Have to wait and see.