Wednesday, July 23, 2014

And Then There Was Progesterone

Well, three months have come and gone since our last NaPro follow-up, so we went for another one. I was pretty bummed that our last plan didn't work. Womp womp. But perhaps these new adjustments will do the trick?

Here are the deets:

Switch Clomid to Femara. Dr. G said that Clomid is most effective in its first 6 cycles of use, so since I've been using it longer than that, it's time to change things up.

Switch HCG injections to progesterone in pill form (Prometrium), but not taken orally (if you catch my drift). I'll take, or I guess insert, one pill each night for P+3 through P+13. He recommended switching it up because, like Clomid, I've been doing the HCG thing for more than 6 cycles now. I'm a little confused by the switch to progesterone because I don't have a post-peak progesterone issue. In fact, aside from a little dip in progesterone and estrogen on P+7, my progesterone and estrogen are both in the normal range post-peak, at least according to the one cycle of labs we did about a year ago. So, what exactly is this progesterone going to do for me? Is it another trick-your-body-into-thinking-it's-pregnant-just-long-enough-for-a-baby-to-implant kind of drug? 

(Yes, I know. I probably should have asked Dr. G all these questions. But I had already asked him a million questions at this point and I could tell I was holding him up. Oops.)

Dr. G also said I could stop the extended release B6 and the Robitussin (both taken for mucus production) since Femara typically doesn't cause mucus to dry up like Clomid does. I will NOT miss the taste of that Robitussin, thankyouverymuch.

We also have plans to repeat the seminal fluid analysis, but that's the last time I'll mention that since it's super awkward and such. More awkward, in fact, than putting progesterone pills in my girl parts, ifyouknowwhatImean.

And I'll be visiting Dr. G again next cycle to do a hysteroscopy, so he can really take a look at my uterine lining and that pesky infection that won't go away. I imagine he'll see a little infection monster just lounging on a beach chair, sipping a pina colada out of a coconut, saying to Dr. G, "Oh, you want me to leave? But it's so cozy and relaxing here." Infections are rude. And don't get social cues. 

So, that's it! I'm still on the Biaxin to treat the endometritis, which I take with a very strong probiotic, but everything else has been adjusted. 

Since I got tons of helpful advice when I mentioned starting Biaxin, I figured I'd throw this all out there to get some feedback again. And also just to keep all you curious folk in the loop about our NaPro treatment. 

Anything I should know about switching to Femara? Or taking progesterone? What crazy side effects should I anticipate? What do you think of these adjustments overall? 

Thanks for your help, friends!

30 comments:

  1. ahhh prometrium. I remember that. Out of all the crazy things to try it is not too bad. I have to tell you a funny story. I started to get it at my local CVS. Of course my dr wrote explicit directions on how to take it. The pharmacist argued with me that it could not be taken in that way. Then he got on the phone and started to use the V word outloud. I was so embarrassed. After that I had to order it online.

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    1. Hahaha! Yes! My doctor warned me about this! He said he was just going to put "take orally" on the prescription b/c otherwise the pharmacists try to switch it to a suppository or scream the V word while on the phone. Haha. Sorry you had to go through that. But glad to hear it's not too bad!

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  2. I don't recall any bad side effects with Femara other than a headache. Clomid is much much worse. And the progesterone - I only take it intramuscularly and I have heard prometrium side effects are worse. Even on the IM injections I get maaaaaad. Like ragefully mad for NO REASON. Hopefully you don't get that way too :)

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    1. All good to know! Thank you, Amanda! I think I was one of the very few who don't experience any side effects on Clomid. Actually, that's not true. It dried up my CM, but that was about it. Maybe Femara will be my evil drug, then? I hope not! And I hope progesterone doesn't make me mad!! STEPH ANGRRYYYY! I'll keep it in mind, so that if I end up yelling at the husband, I know a good excuse. :)

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  3. I've never tried Femara or Prometrium, but I'm praying you see good results with this switch up!

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    1. Thanks, girl! I cherish your prayers! And if you ever do end up using those drugs, let me know. By then I should know their side effects pretty well!

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  4. Femara was terrible for me, it took a healthier cycle and made it so there was no white stickers, I have been trying for nearly a year to recover :(

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    1. Oh no! So, Femara dried you up? Dang! I thought only Clomid did that. Good to know! Maybe I should stay on the Robitussin and B6. I guess I'll try out a cycle or two without it and then adjust from there. Thank you!

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    2. It did :( ...and reading up on it, I am not the only one that this has happened to. I would look deeper into the Robitussin if you can... I heard that that particular brand is terrible for thyroid problems. If that is the case, I would not want any hormone messed with in the very fragile process of trying to get pregnant. Also, our nutritionist told us that people trying to get pregnant should be drinking a certain amount of good purified water everyday. As a woman around 120 pounds I should be drinking almost two liters... The thing is, he said it really needs to be good water if the body is having trouble (getting pregnant for example). ...I know, I know many people do everything wrong and get pregnant so easily, but I think every little bit helps.

      oh... and if you are a coffee lover like DM and I, then you might not want to hear this... but the doctor told us that a cup of coffee suppresses the adrenal system for 24 hours. Somehow everything in our body is connected and having a wonky thyroid/adrenal system could cause problems with ovulation and the like. I am not a doctor but those where the words in a simpler way.

      Hope I did not just complicate your life...

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    3. I think IF complicated my life, not you. Haha! There really is so much that goes into all of this. Lucky for us, coffee isn't really an issue. John drinks it a few times a week when he works, so maybe that's contributing, but I hardly ever drink it. I'm more of a tea girl myself. Phew!! I could definitely drink more water, though!! I'm going to have to work on that. Two liters?? Yikes! What do you mean by "good water"? Like, filtered? Or fancy bottled water?

      Annndddd, I can honestly say I'm happy you said Robitussin is BAD! My doc seems to like it more than Mucinex, for whatever reason, but now that you say that, I may switch to Mucinex, especially if I still need it with Femara.

      Thanks for all this advice! It's always good to have a few more pieces of the puzzle possibly figured out. :)

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  5. I don't have too much to offer, other than prayers. But I will say that I'm glad you're done with Clomid...almost everyone hates that stupid drug!!! And I have been on vag.inal Prometrium before, the only thing I can say is that it is a bit messy (TMI I know, but probably good to be prepared). It did not work well for me and never got my numbers where they needed to be...the only thing that did are the Progesterone sucrose lozenges that I'm on right now! Maybe that's worth suggesting if the Prometrium doesn't do the trick! Still, praying that Femara and Progesterone are the dynamic duo for you!!!

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    1. Thank you for your prayers!! :) They are so SO appreciated! I'm thinking I need to ask my doctor to do P+7 labs so that I can see if this stuff is actually working. He never did it while I was on HCG, so I have no idea if it actually helped with my hormones, but I think it's worth it now, even if that means inconvenient blood draws and shipping blood. At least I'll be able to know if it's really working or not. Also, thanks for the TMI. Seriously, I'm already starting to see how messy it is. Gross! But good to know it's normal. 'Scuse me while I go buy out Target of all their panty liners. :P

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  6. Hi Stephanie! I just typed out a response and it disappeared, so here goes again! Glad to hear you have some tweaks that might be the perfect "cocktail" for you. My husband and I go back to Dr. G for a post-surgery follow-up to see how things are going and make any necessary treatment changes. I currently take progesterone suppositories compounded by the pharmacy, so I'm not sure how alike it is to Prometrium. But, if it is like what I use and based on the post above, it is messy! Go ahead and get some panty liners. Also ask the pharmacy for a thing to insert the capsules (not sure what it's called but is kind of like a tampon - sorry if TMI!). I haven't experienced any bad side effects. If anything, I sleep like a rock when I take it. :) Hope this is helpful! Praying this is the magic solution for you! :)

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    1. Hi, S! Sleeping like a rock sounds like a fantastic side effect! Bring on more progesterone!! :P I kid. But thank you for all this great info. I think our progesterones are pretty similar, just in slightly different forms. I think I remember him saying he'd rather do the oral pills (that aren't taken orally) than the suppositories since the suppositories are a bit messier. Although, these are still pretty messy too. Panty liners, here I come! I'd love to hear how your follow-up goes! Hopefully he can tweak things just right for you guys!! I'll be praying for you!

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  7. I'm sorry 3 months has come and gone =( Those follow-up appts you wish didn't happen are tough.

    The only thing on your list I've done is a hysteroscopy - have you done that before? Sorry - can't remember! It wasn't bad at all - 2 days off work was plenty, and there's no incision so not much to heal.

    I hope the transition to these new meds goes smoothly!! Blessings!!

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    1. I think I did do a hysteroscopy before, but I went straight into work after having it done. Hrmmm. Is it the procedure where he looks inside your uterus with a little camera? I wonder if I should plan on taking a day or two off to recover. I just remember being kind of crampy after because of all the water he pumps in there to make it easier to look at, but that was all. I'll keep in mind that I may need to skip work that day, for sure. Thanks for the heads up! And thanks for hoping for us! :) Blessings to you too!

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  8. Wait - you're not doing monthly P+7 labs? Yikes! I've been on Femara and Clomid; while I had fewer side effects on Femara, it ruined my P+7 estrogen levels, which is why I'm back on Clomid. I don't know how we would be able to judge how effective treatment is without that blood work. I'm normally on HCG, but this month I'm on (actually oral) oral progesterone since my surgery date is so close.

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    1. No, we're not doing P+7 labs. Sigh! I asked about doing them when we started the HCG, but my doc said that almost all of his patients see improved hormone levels on HCG, so he didn't feel the need to test. I didn't want to push him, but now I'm thinking I should. Especially hearing that Femara ruined your estrogen levels. How would I truly know if these drugs are working unless we do labs? It's time to put my foot down, I do believe.

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  9. Hope the new meds work! At least u dont have progesterone injections, they were tougher for me than HCG. Other than a sore rear i didnt notice in the way of side effects.

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    1. I have to be honest, I was a bit relieved when he said we were switching to a non-injected post-peak med. While it's not the worst thing I've ever had to do, it certainly wasn't pleasant. Sorry you had to endure all those injections!!

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  10. Femera gave me diarrhea....bad...every morning..which is not great when youvisitfamilieshomesforwork..kind of thing. :( Clomid gave me a ton of headaches...which wouldn't go away. So when the dr gave me a choice between diarrhea or 15 or more headaches a month...I chose to stop all meds. :) Good luck with this new medicine regimen. I had low progesterone post peak but the hcg worked better for me since progesterone (in all forms) gave me stomach issues and I had an allergic reaction to the prog. shots.

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    1. I think you made the right choice to stop all meds, especially with those side effects. Ugh! I'm so sorry they both did annoying things to you. And the progesterone too. Sounds like you and IF meds just don't get along. :( Sorry 'bout that! And thanks for the heads up! If I end up with diarrhea or stomach issues, I'll know exactly where it's coming from!

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  11. Hi Stephanie! Just wanted to touch base again because guess what? I'm going to be taking Femara, too! We saw Dr. G this past Friday for a follow-up and he wants me to try that next cycle for days 3-5. Is that what your regimen is? We will have to keep each other updated on the results with hopefully minimal to no side effects! Good luck to you! :)

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    1. Ahhh! Femara buddies! My regimen is exactly the same. CD 3-5. Let's definitely compare symptoms. Haha!! Thanks for letting me know!

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  12. You know the new protocol is femara on one day only.....I'm confused why no p7 on HCG. If I recall you had low E and no P7 on HCG? I've been out of the TTC for a long time so I'm rusty. But starting the femara/hcg protocol when I can man up! ha! I'm not looking forward to femara....I haven't heard good stories. :( Hence, my hesitation to start the hellmonal roller coaster.

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    1. I do have low pre-peak E, and post peak it's mostly normal, as well as the progesterone. It just dips a little on P+7 for whatever reason. And that was only seen the one time we did a hormone panel over the course of a cycle. I was pretty shocked when my doc didn't want to do P+7 draws. He said that almost all of his patients see improved numbers on HCG, so he didn't feel it necessary. I should have pushed a little harder because now I really want to know... was HCG really doing the trick for me? Obvi it didn't do *the* trick because I'm def not pregnant. But did it help normalize my hormones? The world may never know. And now that I've moved on to Progesterone instead, I'll really never know. And a word about Femara -- it's really not that bad!! Maybe a few sadder than normal days, but I think the post-peak progesterone is wayyyyy worse. Hope your ride on the hellmonal roller coaster is smooth as can be. :) Oh, what's this about Femara on one day only? Haven't heard anything about it yet...

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    2. I'm hearing horror stories from 1 day femara! Horror! Ha! I can't be on a rampage, well I can be but it's not pretty! ha! Interesting...HCG works for me post peak. My issues are post peak. Nothing happens. ha! P is flat lined..... Did he say why low pre peak E would affect anything if post peak hormones are decent? Post peak P compounded doesn't cause me issues. Yeah, it's interesting why no p7 was done on HCG. Thats a $$ medication to be on without a blood draw. LOL Oh well.....You feel any better on HCG?

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    3. I felt pretty good on HCG, but I'm not on it anymore. :( He switched it with post-peak P now. I think the hope with the HCG was that it would carry over to the beginning of my next cycle and help out the low E, making me have a better ovulation. I'm not sure though, kinda just guessing here. I'm obviously not great at asking questions. Ha! I typically just follow along and then months later think, "Now, why did I agree to that??" Haha. Also, I must have KILLER insurance because while I was told HCG would be about $85 a cycle, it only ended up costing $5!!!! Can you believe that?!?!? We had it shipped from somewhere in Arkansas. $5 is a steal!!! Maybe I've gotta start taking a compounded version of P because the vaginal stuff made me MISERABLE!!!!! Are you working with Dr. P at St. F Hosp now?

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  13. forgot to sign up for notifications since I'm rusty on blog reading! ha! Not that you will even comment back! ha!

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    1. BOOM. Commented back. And within 15 minutes. How's that? :)

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