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Recurrent miscarriages: why progesterone is worth investigating

Weekly pregnancy tip

 

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Miscarriages are incredibly common: it is estimated that 15% (1 in 7) of clinically recognized pregnancies end in miscarriage (i.e. those pregnancies that were confirmed with a positive pregnancy test).

When a woman has a first miscarriage, it is typically considered a one-off event – most likely due to genetic chance. Her risk of future miscarriages remains essentially unchanged. However, once a woman has had two or more miscarriages, her risk of future miscarriage increases dramatically.

Recurrent miscarriages are devastating – both emotionally and physically. There are no words to describe how challenging it is for women and their partners to experience the roller-coaster of repeated pregnancy and loss. Understandably they want answers and ways to prevent this from re-occurring.

While conventional medicine does not begin testing until three or more miscarriages, in my clinic I offer testing after the second miscarriage, to rule out a number of factors that can lead to miscarriages – including anatomical issues, immunological causes, and environmental factors. The issue that comes up again and again, however, is endocrine (hormonal) factors, which have been shown to account for between 15 and 60% of recurrent spontaneous abortions (miscarriages).

In my webinar and cheat sheet I talk about the important role thyroid function plays in maintaining a healthy pregnancy.

Another important endocrine factor is progesterone – the hormone that prepares the body for pregnancy and maintains the pregnancy in the first trimester before placental hormone production takes over. Not surprisingly, when progesterone levels are too low, the risk of miscarriage increases.

I cover this in-depth in the Preventing Miscarriage module of my online pregnancy coaching program, but in short progesterone deficiency can be assessed in two ways:

  • Assessing pre-pregnancy menstrual-cycle charts for what is called a “luteal phase defect” (when there are less than twelve days between the day you ovulate and the day your menstrual period starts)
  • Day-21 progesterone lab testing (a blood test on the 21st day of a pre-pregnancy menstrual cycle, when progesterone levels should be at their peak: levels below 10ng/mL suggest inadequate progesterone production)

If progesterone levels are insufficient, I generally treat this in one of two ways:

  • Oral progesterone (100mg per day through to the end of week 13 – this is given topically at a lower dose when trying to conceive, and then switched to oral once a positive pregnancy test is found)
  • Vitex agnus-castus (herbal medicine given at a dose of 250-500mg per day through to the end of week 13)

While neither of these treatment options have been assigned a formal safety rating, neither have any reports of adverse effects, and both have a demonstrated safety record.

If you have a history of recurrent miscarriage, I certainly hope you are able to explore potential hormonal imbalances and find the treatments you need to have a healthy pregnancy. I hope you have found this helpful, and do let me know if you have any questions!

If you are hungry for more evidence-based information in your pregnancy, sign up for my free webinar: 7 Pregnancy Myths Debunked – and get the information you need to have a healthy pregnancy and a thriving baby.

And if you are a care-provider looking for evidence-based resources for your pregnant patients, please get in touch with us at support@myhealthypregnancyplan.com.

In health,

Dr Jocelyn Land-Murphy, ND

Terra Life

Disclaimer: The information and content provided is for general educational and informational purposes only and is not professional medical advice, nor is it intended to be a substitute therefore. Please consult the Disclaimer and Terms of Use for full details.

References:

Hussain, M. et al. (2012). Progesterone supplementation in women with otherwise unexplained recurrent miscarriages. Journal of Human Reproductive Sciences, 5(3): 248-251.

Mayo Medical Laboratories. (n.d.). Progesterone, serum, clinical information. Mayo Clinic. Retrieved from http://www.mayomedicallaboratories.com/interpretive-guide/?alpha=P&unit_code=8141

Mesen, T. et al. (2015). Progesterone and the luteal phase: a requisite to reproduction. Obstetrics & Gynecology Clinics of North America, 42(1): 135-151.

Romm, A. (2009). Botanical Medicine for Women’s Health. St Louis: Churchill Livingstone.

Sctochie, J. & Fritz, M. (2006). Early pregnancy loss. Postgraduate Obstetrics and Gynecology, 26(9): 1-7.

Wang, X et al. (2003). Conception, early pregnancy loss, and time to clinical pregnancy: a population-based prospective study. Fertility and Sterility, 79(3): 577-584.

 

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