Should I take progesterone?

[Handholdplease85]

I have two DCs already and had one MC in between. However the pregnancy was never properly established, the pregnancy test lines were never strong and I had bleeding right from the start and my HCG didn’t rise as it should have done in the first few days. Had scans and although they could see “pregnancy tissue” there was never a confirmed foetus or heartbeat.

i am now pregnant again and have been having on and off spotting for the past week (I’m now 7 weeks). I went to the EPU and had a scan which showed baby and heartbeat. However they have prescribed me progesterone because I have had a previous miscarriage.

Im struggling to understand the reasons for this. I thought that low progesterone was usually the cause of slightly later miscarriages, of “established” pregnancies, and therefore early MC like the one I had are not caused by low progesterone. I have also carried two babies to term without any issues. Therefore I don’t think there’s any reason to believe I have problems with low progesterone levels? I haven’t been offered a blood test, just given the progesterone pessaries.

Part of me thinks I should just take them anyway, but I’ve read that they can actually aggravate bleeding and I’m already on blood thinners for an underlying condition so this may actually make me bleed more. I can take them rectally instead but most people seem to say that they either give you the runs or make you constipated. I’ve got to take them morning and night and don’t particularly fancy going to work with a pessary up my bum which may or may not give me the shits?!

My consultant just says oh it won’t hurt to take them. But it would be for 6-8 weeks and it sounds really unpleasant. WWYD?

I meant to add that women are only advised to take progesterone once the pregnancy is confirmed by a foetal heartbeat which also implies that low progesterone isn’t the cause of very early MC?

It is part of NICE guidelines that women who have bleeding in first trimester with a confirmed viable pregnancy that have had a previous miscarriage, be prescribed 400mg progesterone pessaries twice a day. https://www.nice.org.uk/guidance/ng126/chapter/Recommendations#management-of-miscarriage point 1.5

This is off the back of researched evidence that it reduces the number of first trimester losses.

It does also reduce the risk of preterm birth/second trimester loss for some women at higher risk of this.

It is entirely your choice as to whether you take the pessaries but it certainly is standard practice to offer them to women in your situation.