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Hi there, I'm hoping someone can offer some advice on my problem.

I am a 32 year old woman and for the past 17 years, I've suffered with intermenstrual bleeding. I have a BMI of 22, a relatively healthy lifestyle and am on no prescription medications.

The problem first began at age 15, roughly two years after my menstrual periods began. It started with a slight midcycle bleed that would last 2-3 days, but has become progressively worse over the years - at worst I can be bleeding for up to 18 days of my cycle (including menstruation).

Until just before I turned 30, I was at least guaranteed not to bleed during the week leading up to my period, but since this age, I often spot right up until my "proper" period begins (easy to determine when that is as my periods are very heavy and totally different to all the nuisance bleeding).

My periods generally last for 6-7 days and I also have a shorter than average cycle (usually between 24 and 27 days). I get very severe PMS too.

Since age 22, I've had the embarrassing problem of facial hair growth. Also, over the last 4 years or so, the hair on my head has been thinning on top and my sex drive is practically non-existant. It's all very upsetting.

I have had numerous tests done to try and figure out what the problem is, including smear tests, pelvic exams, a hysteroscopy (age25), and 2 ultrasound scans (one recently) - all were normal, so it's definitely NOT PCOS. I've never had a sexually transmitted infection and blood tests determined it isn't a thyroid problem either and my testosterone levels are "well within the normal range".

So far, I have been on the combined contraceptive pill (had to stop taking it as I had bad headaches), Norethisterone (didn't agree with me at all), Tranexamic Acid, and also had the Implanon and Mirena coil - both of these caused me to bleed every day, even though I tried them for over a year. I've also spent hundreds of pounds on various alternative therapies.

I'm at my wit's end with all of this. My doctor says he can't help me - all he has to offer is the pill. The problem is I have reached the stage in my life where I desperately want to have a child. A hormonal contraceptive is the last thing I want.

Frustrated with my doctor, I went to the well woman clinic. Through careful charting of my bleeding patterns and my use of ovulation predictor kits, we have discovered that it's "normal" for me to bleed around ovulation time, but that I also have a luteal phase defect (sometimes as short as 8 days). Blood tests have confirmed I am low in progesterone.

I am very upset, as I know that women with low progesterone levels/luteal phase defect can find it more difficult to conceive and are more likely to miscarry. The doctor at the well woman clinic suggested I could try Clomid - but I don't quite understand why as I am ovulating regularly, the problem is in the latter half of my cycle. Why do I need Clomid if I'm ovulating at the "right" time?

I've started taking a vitamin B complex and the herbal remedy Agnus Castus, as I've read they can help with LPD. I have also read online that women in my situation have had success lengthening their luteal phases using Cyclogest pessaries, and that they can also help with PMS symptoms. My doctor is reluctant to prescribe them as he says it won't help me, but I'd at least like to give them a try before Clomid. Can anyone relate or suggest a way forward here? I feel like I'm running out of options.

Thank you in advance.

Jacqui

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Since the lack of progesterone is behind luteal phase defect, besides vitamin B, other over-the-counter option that you can try before Clomid might be progesterone cream. A progesterone cream is usually targeted for menopausal women. A cream with natural progesterone should be the safest option and the crem is applied on the inner arm, inner thigh, neck, and chest – changing places – twice a day from ovulation to menstruation. And I’ve read that it’s a vitamin B6 that is most effective in this case from vitamin B complex. Maybe you can try with B6 only, because vitamin B6 is generally regarded as safe and can be taken daily in dosages from 50 mg to 100mg and taking B6 during the entire month should help to lengthen the luteal phase.
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Thanks so much for replying. I've been doing some research today and your suggestions are good ones. I have ordered B6 supplements and also natural progesterone cream. I'll give them a go for the next few cycles, hopefully it will make a difference.

Jacqui
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Hope it will work out!
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I have the exact same issues as you do with the same test results. Progest-E supplementation helps control the spotting but not eliminate it. I was put on synthetic progestin cream vaginally during my 2nd pregnancy after miscarrying my first. I carried to term and now have 3 healthy children from 3/4 pregnancies. The only problem is that my issues returned with a vengeance after pregnancies/breastfeeding and now I have prolactin levels that won't seem to go down (over 1 yr since stopping bfing). My progesterone levels are low, my estrogen levels are low. I'm suffering from mental cloudiness, panic attacks, anxiety, cyclical depression, etc which all seems to be related to the low hormone levels. It like going through menopause but with the constant spotting and heavy periods. Vitex made me suicidal and vitamin B, magnesium, oil supplements didn't balance me out over months. MACA ROOT has helped a great deal, but I still spot. I also did not react well to the birth control pills, in fact I had a "nervous breakdown" and was hospitalized from their use. It has been suggested to add more healthy fats to my diet since hormones require fat to be made. Hope this helps, you are not alone.

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I used to bleed constantly for 30 days or longer! Now understanding I have a lpd , I have been incorrectly takin my progesterone no pregnancy, stupid me! But it has helped me so much I'm now regular and don't not bleed like I'm dying anymore, I was 11 when I bled like that, got on ortha evra omg biggest mistake ever , I will never take bc ever again it ruined my body, plus it made my lpd worse! Good news is I ovulate twice a month now thx clomid:) but progesterone 200 mg by mouth for 20 days prior menstrual is how I was supposed to take it , well I'm going to pray I'm 24 now , fighting the depression and anxiety attacks ugh I just want to have a successful pregnancy! So I still have hope after 2mc, one of them was a chemical pregnancy, first pregnancy I made it to 4 months then bam! Miscarriage I was only 14, 9 years later pregnant again 2011 but couldn't hold it either , so I've been trying for over 9 years since my first mc I was hard headed and wanted a baby but it never happened, now that I'm mature and grown I understand my condition no thx to my first obgyn didn't try to help me understand anything nor did she explain to me my medicine when she changed the dosage ugh! I've been taking it 12 days prior menstrual, Smh but I am telling you progesterone is gold in a pill!

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