Progesterone for early pregnancy?

[EllieJai44]

After my 3rd miscarriage it was suggested I may need progesterone for ongoing pregnancies, just spoken to my GP who is confused as to why this would be prescribed and has said he needs to do some research into it....he said normally it comes from gynaecology but only if I am under them which I was waiting for a referral before all this coronavirus stuff and still haven't had it

Has anyone else had trouble getting GP to prescribe?

Hello,

Yep yep, I asked at least 3 doctors at my gp and the all flat out refused. The 4th (owner of surgery) agreed to send referral to the specialist handling my case at recurrent miscarriage unit and he also refused (doesn’t believe it makes a difference). I then had my 4th miscarriage in March and went in to a different hospital for a scan to confirm and there the doctor said there is small evidence progesterone call help after fourth miscarriage. I got my BFP again this week and have just picked up my progesterone from them.

My experience is NHS doesn’t want to subscribe it (there was a research recently which showed no difference when taking it). I however have heard otherwise and wanted to do whatever I could so I can at least say I give it my best shot.

If you can’t get it from the referral I would recommend going privately as they will definitely prescribe it.. but it will be expensive. Also, at my most desperate I almost bought it from eBay, not recommending it but you might see it advertised there.

Good luck and congratulations xxx

I was prescribed progesterone from the recurrent miscarriage clinic, haven't actually took any because haven't managed to get pregnant again yet but they said it can help if your miscarriages are early ones.

Thank you @PutOnAHappyFace @Hopingfor2021

I've just heard back from my GP again who's said that he isnt licensed to prescribe but he is going to speak to gynecology in the morning to see what they say, if I have no luck then I will contact the early pregnancy unit and beg them, I have to go there for early scans anyway so hopefully they can help if not! 🤞

I have my fingers crossed for you. I know myself after so many losses I'd try anything that could help.

Good luck

@PutOnAHappyFace thank you, I hope you get your BFP soon!

I was prescribed progesterone after my third miscarriage by a private clinic. My GP said they couldn't prescribe it.

Speak to your GP about the Prism Trial - www.miscarriageassociation.org.uk/research/the-prism-trial/

For women with 3 or more miscarriages it is proven to be of benefit.

I've had two MC's and I went private after the second as my GP dismissed me for any tests and wouldn't listen at all. You'll find miscarriage is still very much written off as 'one of those things' - unlike in many other situations where answers would be sought. Only organisations like Tommy's and Prof Quenby in Coventry amongst others are carrying our research and want to understand more behind why women miscarry. I'm

I did a lot of reading and research after my MC's so feel free to ask any questions.

When I fell pregnant again at the beginning of this year I went straight to my clinic and they put me on a whole cocktail of things - including progesterone pessaries and injections. My progesterone was also checked via blood tests to ensure medication could be adjusted if needed.

Arm yourself with information before speaking to GPs (and others) as this isn't an area of speciality for them they read much about I believe.

And just to add: progesterone pessaries such as Cyclogest are very inexpensive and don't cost much at all! Progesterone injections such as Lubion are expensive yes but more likely prescribed during IVF or other scenarios.

I still find it sad how little support is given to women who experience miscarriage. The physical side is awful enough, let alone the trauma it causes mentally. And when women then do seek answers, it felt (at least to me) that you wouldn't get any unless you went private and paid.

Seconded RE: the PRISM trial. www.tommys.org/our-organisation/about-us/charity-news/prism-trial-bleeding-early-pregnancy-and-miscarriage. It showed benefit for women with previous multiple miscarriages.

My consultant in the miscarriage clinic gave me a two week prescription before I even got pregnant. I've to take Cylogest until week 16 and my GP has since prescribed it for me twice after the first box ran out, but the consultant had sent them a letter asking them to do that, so I don't know if that's the difference?

This is my first time using it and I'm currently10+2 and this is the furthest I've ever gotten before miscarrying. Although we saw a heartbeat at 7 weeks, there's still no guarantees but I'll know more after my scan in Friday. Fingers crossed is all good.

Good luck @MariaDingbat

I'm 23 weeks now, also on progesterone thanks to the clinic, and so pleased to have made it this far this time.

Like you said, it is proven to help women with recurrent miscarriage.

And sometimes when they palm you off saying 'miscarriage is common' - not knowing the reasons why it doesn't happen doesn't equate to there being none.

Best of luck!

If this is of any interest - I’m a GP, who has been through fertility problems myself, and still I wouldn’t prescribe it without you being seen in fertility clinic first and them giving the go ahead. It’s outside the scope of primary care.

It’s nothing to do with us not being helpful or not knowing etc, it’s just there are guidelines and this falls into the remit if secondary care.

@vinoelle this is what my GP said, its beyond him but I've been waiting on a referral since beginning of February to a miscarriage clinic, so if it had happened I would be under their care, but atm I'm not, I'm in limbo, my midwives said to speak to my GP, hes going to ring Gynecology in the morning 🤷‍♀️

@LASandOtto Thank you, thats very informative! I will see what my GP says tomorrow if he speaks to gynecology!

@MariaDingbat congrats! And fingers crossed it works for you! 🤞

Thanks @LASandOtto. Congratulations on your bump!

The amount of research being done into miscarriage is unfortunately woeful, a doctor can't even specilise in it the way they can for stillbirth or other neonatal conditions. There are always some cases where nothing can be done, but the PRISM trial shows the are other cases where there are potentially successful treatments.

I was randomly just lucky that my Trust is really proactive with miscarriages and happens to have a consultant who is a miscarriage specialist and very active researcher in the area. She was brilliant. I wish it wasn't such a lottery and everyone had access to the same support.

Thanks @EllieJai44, I hope your GP is able to help. Good luck!

Hi this is a timely discussion for me. I am 5+6 today and am using progesterone cream since a few days after ovulation and do believe it’s helped me get this far. This is because I have had 2 chemicals in Jan & Feb, as well as 2 before my little one.

As the cream isn’t licensed I spoke to my EPU doctor today to try and get progesterone pessaries and she said she wouldn’t give it to me unless I had had recurrent miscarriages further along. And had never heard of the cream but advised I stop.

So disappointing as I’ve read lots about how low progesterone can result in the very early losses.

Now I’m in a quandary as to carry on with the progesterone cream or to stop as it’s not licenced etc. Have read stories on here of others using it but would love to hear from anyone who has or is using it in a pregnancy?
Thanks

And congrats to those on here

@Pinkpaintlover congratulations on your pregnancy ❤️ I’m not really sure I can advice, probably depends a bit on what’s in the cream and the sort of reviews it has? I have always heard these progesterone creams aren’t strong enough so I never tried.

I have never really understood why it’s so difficult to get progesterone prescribed, it’s not like it’s harmful!! On the other hand, I know I could call my gp today and we prescribed very addictive anti depressants?! I understand GP are not specialised enough to prescribe it but this has been the attitude by a lot of the fertility specialists I have seen too. One of the doctors I had seen said he “guaranteed” I would have a baby by the end of 2020, my other miscarriages were just bad luck. Only for me to miscarry again in March this year. I have no idea if it’s because of the progesterone but this pregnancy is progressing much better than the others, as well as giving me confidence I am doing whatever I can to help it along.

Congratulations to everyone on here and hope your pregnancies go well xxx

@Pinkpaintlover I ended up using progesterone cream after 2MMC and 2 Early MC. I was desperate to try anything and although I can't say whether or not the cream definitely helped, I have a 15month old and am currently pregnant- both times whilst using the cream. I couldn't get it prescribed to me but did mention to the recurrent miscarriage consultant that i was using it and she said to carry on until 12weeks+.

@cujo101 that has made me feel much better. Thank you so much. And congrats to you. What cream do you use? I have Now progesterone from eBay. Says not to use in pregnancy but ignoring that. Going to carry on until 12 weeks. Thanks

Hey, hope you manage to sort things OP- suggest call your EPU if your GP doesn’t get anywhere?
Just thought I’d add my two cents though, the PRISM trial is a really important one but it actually doesn’t apply in your situation - that trial was about progesterone treatment in women who had bleeding in early pregnancy. It showed benefit of progesterone in women with a history recurrent miscarriage, who were bleeding. This is different from just having a history of recurrent miscarriage. There are a couple of trials about that, the most recent one I think is called the PROMISE trial which showed no benefit, but I believe there is other research that suggests maybe there is a benefit. It’s not particularly clear cut which is why you might be finding a bit of confusion. And definitely a specialist area - it sounds like your GP is doing a good job for you.
One other thing mentioned - that low progesterone is associated with early miscarriage - is true; but that is not at all the same as saying that adding progesterone supplements can fix it. It may be that the low progesterone levels are just an effect of the pregnancy already failing rather than the cause, if that makes sense.
Bottom line though - it’s definitely a safe thing to do, it may possibly help, and certainly if you feel it would help put your mind at ease it’s worth doing. Recurrent miscarriage is the pits (I’ve been there, but now 22 weeks) so I wish you all the best with this pregnancy - congratulations.

What creams are you all using that you can buy without a prescription and how do you use it

I've had multiple IVF cycles. It's fairly standard to have progesterone suppositories from early pregnancy in those senarios.

Professor Lesley Reagan who runs the recurrent MC clinic at St Mary's in London published a book which is an interesting read for anyone suffering with repeated or recurrent miscarriage.

I believe one of her findings is that women who are closely monitored during early pregnancy after previous losses have slightly better outcomes than those who aren't, as the additional care and support provides reassurance to women and it appears this level of care has a positive impact on the pregnancy outcome.

It is natural to seek answers when women have miscarriage after miscarriage. I for sure wanted to understand why this is happening. Putting it just down to chance and one of those things just doesn't compute if it occurs multiple times. Tests available on the NHS only find a reason in 50% of cases, the rest remains unexplained. Again, unexplained doesn't mean there is no reason it's just not been found so, where do women go from there?

In private care they're looking into more options including NK cells research which still requires to be investigated further.

The bottom line is, progesterone treatment will mentally support you in making you feel like you're doing 'something', it's inexpensive in pessary form, and some small studies done so far indicate some evidence it can help for recurrent MCs where bleeding was also present.

@2020wish I am using Now natural Progesterone cream. Bought on eBay for about £18