Re: My doctor wants me on Progesterone and the too many periods hormone rollercoaster (long)
From: =?iso-8859-2?q?Zalányi Sámuel?= (anonymous@obgyn.net)
Mon, 2 Apr 2001 22:17:12 +0100 (MET DST)
Dear Becca,
I do not know, what pharmaceutical companies do write into the patient information leaflat, but if the product contains natural progesterone and progesterone only, then it is absolute nonsense to warn about birth defects. It means that every pregnant women should be warned of birth defects, because first their corpus luteum later the placenta produces huge amounts of progesterone and so this would cause birth defects. This is just rubbish.
As to the additional remarks to me: I have worked on the effect that progestogens (Provera and norethisterone) exert on the endometrium (I also published several papers on this problem) and for that matter natural progesterone (P) or its synthetic derivatives do not make a difference, it is absolutely false to prescribe P during a bleed. It would deplete the estrogen receptors of the endometrium and thus renders it irresponsive to estradiol, which is essential for the build up of endometrium after a bleeding episode. On the other hand if there is some estrogen effect exerted on the endometrium before P is added, than the natural course of events is mimicked, the secretory transformation of the endometrium occurs and after stopping P a menses-like bleeding follows. If the dr you visited fails to understand the mechanism of action of P (progestins) then it is difficult to discuss things. I keep wondering about medical practices over there... To stress my point I have treated several hundred women for irregular bleeding (both juvenile and premenopausal) this way with convincing results. As for side-effects, what was the dosage you have been taking?
I am looking forward to your (or the drs) reflections if he has any
Sam
P.S. later I found your next message. I wouldn't say that I am proud, that you found something to back me up. Simply I was sure that I am right and your dr is talking (and doing) nonsense. I really would like to know how he/she reacts to these informations.
Sam
> I suggest that people DO get pregnancy tests if there is ANY chance of a
> pregnancy before going on progesterone: I recently got two Rx for it,
> and there IS a chance of birth defects (genital malformations) while on
> it. Also, the note from the drug co. mentioned that in the past it has
> been given to prevent miscarriages during pregnancy, but that clinical
> tests have demonstrated that this treatment is not at all effective. THe
> manufacturers note was in addition to the normal paperwork that comes
> with the Rx, and I think it may be more recent.
>
> Sorry, Rebecca, if my last posting sounded abrasive. I was just worried
> because you sounded mad at Sam because of an easily understandable
> misunderstanding. :) We do have the same name...In high school there
> were several Beckys and Rebeccas, as well as a Beka, in my class with me
> (Becca). It's always confusing.
>
> Additionally, to Sam:
>
> An OB/GYN RNP, dr. and 2 pharmacists have all told me that after taking
> 5 days of progesterone during my period, it shouldn't come for at least
> 3 weeks. I also saw this regimen discussed on the internet as the
> treatment for polymenorrhea. I'm a little hesitant to try your
> idea...I'd have to go back to the dr to get estrogen (and mine is
> currently a normal level), plus the provera caused me extreme swelling
> and breast tenderness and I didn't feel so good. I'm hoping to go to
> the dr. in the next couple of weeks in any case. I went to see the
> infertility dept. on Fri. They are giving me an OGTT and several more
> blood tests ASAP and then scheduling my follow up, which will be with
> the "High-Risk and Complicated" OB/GYN. I will mention your comments to
> the dr., though. Thanks for your comments!
>
> Becca
>
> At Sun, 1 Apr 2001, =?iso-8859-2?q?Zalányi wrote:
> >
> >Hi Kirstin,
> >
> >You made a point: if you visited a doctor you should do what he has
> suggested. He checked your progegsterone: low. He ordered you to take
> progesterone to supplement your low levels and to bring on a period. What is
> the problem?
> > To your question: you have missed an ovulation and therefore your period
> is late.
> >
> >Sam (Ob/Gyn/RE)
> >
> >> At Sat, 31 Mar 2001, anonymous@obgyn.net wrote:
> >> >
> >> >Stress can make you late, cycle changes, more exercise then usual among
> >> other
> >> >things can make you late. You should wait a little while before taking
> >> >anything.
> >>
> >> The only thing I can think of that has changed is that I am walking more
> >> now that it's nicer outside, however, that has never affected me in the
> >> past (I used to run in the summer). I just find it odd that I'm late
> >> and hopeful that I'm pregnant, but also realize that I need to do what
> >> my doctor says.
> >>
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