Short-ish LP with lots of spotting, but progesterone levels "normal"

[lastboxoftampons]

I have an LP of about 10 days, which I know 'might' be an issue. I was pregnant once before, but miscarried at 11 weeks in March. Since the miscarriage, I have had lots of spotting during my LP. My GP did a blood test and progesterone levels came back 'normal' at 46. Just wondering if anyone else has the same issues and what can be done about it?

Spotting between periods should be checked out to ascertain the cause. Its often not serious but it should be checked.

What cycle day was the progesterone level tested?. Have they checked other hormone levels like LH and FSH? (these are usually tested earlier in the cycle, around day 3).

Yes, that's why I went to the GP - to find out why I've been spotting so much. She suggested the progesterone test. They didn't test for anything else at that point. The doctor said since I have a short LP the test was best done about 7 days before my period - it was done about 4dpo on CD24.

Also wanted to add, she checked my cervix and said everything looked normal - no signs of erosion or anything physical that might be causing me to spot.

Hi LBOT sorry to hear about your MC. Not sure what's causing it, but I've just had my first session of acupuncture to try to stop the 1-3 days of spotting I get before before my period arrives properly. It apparently can help regulate things...

LBOT - I dont have any answers but Ill be watching this thread with great interest as I have spotting for up to 4/5 days (usually 3/4) before my period. I have an LP of 11 days too so relatively short also.....

Thanks for your replies.

Interesting pinkmook - I've been doing a bit research and found that progesterone issues are really only one cause of a short LP. It could be down to poor follicular development - which is an FSH thing rather than progesterone. I spoke to my doctor this afternoon but she wants me to give it a couple of months before coming in again

Hi LBOT, can I join the unexplained spotting club?!

I have always spotted for the last 5-7 days of my cycle and had it checked out a few years ago (long before ttc) - and like you my internal scan looked fine, progesterone levels fine too.

Haven't had the day 3 LH/FSH tests done (GP wouldn't do them because she said the day 21 progesterone ones showed everything was ok).

I'm seeing the recurrent miscarriage specialist later this month, so will ask about the spotting, and presumably get it checked out (along with all the other poking and prodding they do) in case it is linked.

Have you got any links to your research? I'd be interested to check any info out as I've never found very much when I've looked.

Sorry - more questions than answers here!

Hi had to write as this thread could've been me this time last year. Had LP of 10 days too and would spot for 2 days before af arrived. I was convinced it was a short LP causing me secondary infertility (have ds 3) and went to see a gynae. He agreed that my LP was short (after follicle tracking with transvaginal scans for a couple of months) and he said he liked to see an LP of 12 days. He also recommended that I have a lap and dye and hysteroscopy to check my tubes and uterus were all ok. To my surprise I had adhesions on my left ovary and a little endometriosis as well as a twisted right fallopian tube. Whilst 'in there' my consultant untwisted the tube (sorry if tmi) and removed the endo and adhesions and said these had certainly been contributing to the infertility. My LP didn't lengthen on the cycle following surgery and I was told to come back the following month to start a cycle of fertility drugs. Before I had a chance to go back af was late and I got a bfp! I'm now 28 weeks pg. Sorry for all the rambling but I wanted to show that a 10 day LP is ok. My spotting was never explained. 46 is a good level for progesterone as it certainly shows that you are ovulating. As Attila says other tests need to be done early in your cycle. It might be worth asking for them to be done - as they are very easy and can give you more info. Hth.

Thanks for your responses.

trying have you had several miscarriages? I only had one - but it was a missed mc at 11 weeks (fetus measured 7). I've always thought my short LP was because of progesterone levels and always thought my mc might've been linked, but then found it strange that I mc'd "late" in the game for progesterone issues to be the cause and also that it was a missed mc (you'd think if progesterone wasn't sufficient, the fetus would abort immediately). I'm now wondering if it all had something to do with development during the follicular phase. I've found this article which I thought was interesting. Most everyone seems to think LPD = progesterone issues, but I guess it doesn't.

Buttercup Thanks for sharing your story. Wow, a twisted tube!??!? When I had my mc in March they did several scans and I had asked each time if there was anything that might prevent me from getting pregnant in the future. At the time they had said no, but I wonder if they would've picked up something if they didn't know what they were looking for? They did check out my uterus and ovaries and said all looked fine.

Hi LBOT,

Sorry to hear of your mc. 11 wks is tough.

Yeah had my 3rd mc a month ago. All have mc around 8-8.5 wks, but with fetal development to 6w, 6w and 8w respectively. So like you, I think they were perhaps too developed for progesterone to be the problem.

Thanks for the article - I'd never seen FSH and LP problems linked before. Will definitely ask for the Day 3 tests to be done.

Buttercup, thanks for your story and congrats on your pregnancy! Sounds like the tube, endo & adhesions were more of a prob than the luteal phase... really fortunate that your guy knew what he was doing and suggested the investigations.

Let me know how your Day 3 tests go, Trying. I'm curious to hear.

I'm going to try vitex this month while waiting to see my GP again. Told DH about my findings last night and he's said we can have the tests done privately if I'd like. But I just feel like I'm being impatient by not waiting for my GP to do the tests, and yet, in my gut I feel like something is wrong...

Would not suggest you self medicate with vitex/agnus castus as it can make some hormonal imbalances worse!.

If you really want to use this I would seek out the advice of a properly qualified medical herbalist beforehand.

Lastbox I got all my fertility stuff done privately - thankfully dh has bupa cover from work and they agreed to pay for everything upto diagnosis. It was very helpful as they paid for the op which fixed things (and would have cost us nearly 3k). Also I got to see the consultant quickly. Worth looking into but can be v expensive if you have to pay for it yourself.
I agree with attila again - not worth self medicating. I spent a few months downing excess amounts of vit b6 hoping to lengthen LP it didn't work (and also turns out lp wasn't the prob).
By the way I have a friend who had a 9/10 day LP and after 1 year of ttc she was given hcg injections by the same consultant I was seeing and it lengthened her Lp and she was pg within a couple of months. I believe hcg helps keep proj levels higher for longer.
My main bit of advice really is to try and see a fertility expert and get them to look into what is happening. I spent too long self diagnosing and should have just gone to see a specialist.
So sorry about your loss and hope that you get some good news soon.

Trying here's another bit that you might find interesting babymed.com/faq/Content.aspx?13391

Thanks for your info, Buttercup. How long were you TTC before you saw the gynecologist? We've technicaly only been trying for 4 cycles - got pregnant first try in January, mc in March, waited on cycle and TTC three cycles since - which is why my GP wants me to wait a few more. She thinks that things haven't settled down post-mc and that the best indicator of my fertility is my past experience - the fact that I've gotten pg and pg quickly means there's nothing wrong. But I just feel like my cycles are getting worse and it's frustrating that she hasn't referred me to a gyn.

We were trying for about 6 months when I first went to the GP. Like you I'd been carefully monitoring my cycle and discovered my LP was 10 days, with 2 days of spotting. It's very promising that you conceived so quickly in January. I have no experience of mc, is it possible that your cycle is taking time to return to normal? Did you spot before your mc? Maybe give it one more cycle and then really push for a referral. Ttc can be very frustrating but I'm sure things will work out for you soon.

Thanks for the new link. I had heard that Clomid was only ever appropriate if you were not ovulating at all, so that's a real eye opener. However, LBOT, I wouldn't have thought we could get as far as we did in our pregnancies if the follicle was 'inadequate' (from the article). So many questions for my appointment... It isn't until 29th July, but I'll report back.

buttercup the cycle directly after my mc was almost normal, but with lots of spotting, which I just attributed to the mc. After that I had one cycle that was more normal, but the two since then have been even less characteristic for me with lots of spotting before AF. I do think my hormones are out of whack from the mc, but they dont' seem to be reverting, they seem to be getting worse.

anniemac I was under the impression that 46 was perfectly normal and indicated a normal ovulation. What is 'high' meant to be?

Hey anniemac - how's things with you? Can they reduce your fhs level? My twisted tube and adhesions were caused by the c-section I had with ds. Apparently adhesions can be quite common after any abdominal surgery, and the tube my consultant thinks must have been moved during surgery and then ended up that way. Adhesions and tube issues can't show up on scans - they can only see it with a laparoscopy.
Lastbox I'm no expert but thought anything over 20 something indicated ovulation. I could be wrong though. It won't harm to have the early tests though and will probably give you peace of mind.

I have always thought that over 30 indicated ovulation but my friends was told at her fertility appointment that the clinic like to see 40 or above.

Worzsel, is your friend taking Clomid or similar? I think 30 indicates normal ovulation, but it should be a bit higher if assisted?