Here are two awesome pictures that show what the Normal menstrual cycle should look like and what a women's hormones are supposed to do each month:
As for my suppression, first and second month were to go like this:
Starting April 1st Take 2mg Estradiol (Estrogen) twice a day everyday. On day 16-25 for ten days I was to add 100mg Prometrium (progesterone) once a day. Then on the 26th stop all medications, and I should get a period. Repeat this all over again May 1st. Then, after the second period in May or early June, I would count that first day Cycle Day 1 (CD1) and start Clomid on day 3 through 7!
(Clomid is the medication that [fingers crossed] is going to make me ovulate and allow us to get pregnant!! Clomid works by suppressing the natural occuring estrogen circulating and sort of tricks the pituitary into making MORE follicular stimulating hormone (FSH) and luteinizing hormone (LH). These are the hormones that stimulate the ovaries to RIPEN a follicle (which my body is not doing) and to release an ovum, or egg. However, most women who have taken this medication say it's 5 of the most miserable days of their lives with all the side effects which most commonly include severe night sweats, mood swings, headaches and weight gain...YAY!)
Unfortunately it didn't go EXACTLY as we'd hope. Aside from the progesterone making me fell drunk/dizzy/extremely tired ~10 minutes after taking it every night, on April 23rd I spotted. At the time I was so excited, being that I haven't had a period in years! I was hoping this spotting would soon turn to a full on, achey, PMSy, terrible period! But it never did. I spotted for one lousy day...and it was BEFORE the 26th.
After talking to my doctor about this, he was a little concerned that 1.) I only spotted, and 2.) it happened before the 26th. So the new plan would be this. . .if within the 10 days I take progesterone this second time around I were to spot or bleed again, I would add a THIRD estrogen pill to the mix. He also wanted me to change from taking progesterone once a day to twice and day. Lastly he suggested I change the progesterone from pill form to a suppository. Apparently some studies suggest progesterone is better absorbed vaginally than in a oral pill form. His reason for my body responding the way it did was due to having such low hormone levels to begin with and having very severe PCOS.
Clearly this was not the news I was hoping for, especially the day before Phil and I were flying to Colorado for a visit.
If you've never had to get progesterone suppositories before, then lucky you! The prescription was called in the day before we flew and the pharmacy told me they didn't have it in stock and would get it in a day or two. Since we were flying the next day, I called a Walgreens in Ft. Collins, Colorado to see if they could get it. They told me they would have it for me the next day when we arrived. Well long story short, it ended up needed to be compounded . . . microwaved and refrigerated. . . oh and my insurance didn't cover it! By the 19th they finally had it ready and it we kept it on ice until we checked into a different hotel with a refrigerator. I was taking the pills up until it was ready.
Aside from the obvious side effects of a suppository (TMI alert but the leaking is so uncomfortable), they were not that bad. No dizziness, drowsiness or drunk feeling!
On top of these changes we also discussed my workouts. I would truly workout 7 days a week if not for 12 hour exhausting shifts. Therefore I workout 4 days a week (the days I don't work). On those days I will usually run anywhere from 6-8 miles, mixing in weight lifting, Insanity, kickboxing and other HIIT workouts to the mix. I will admit in the past I did indeed work out too much. However, I truly thought my current workout routines are not over doing it. Nonetheless there are plenty of studies have shown that working out or running too much can cause fertility issues.
The effects of strenuous exercise on fertility could be related to (1) reduced progesterone production during the luteal phase of the menstrual cycle in ovulatory women (ie, luteal phase defect), (2) alterations in GnRH production, LH and FSH secretion, and estradiol production and metabolism, resulting in anovulation, or (3) changes in leptin levels. Other factors may include decreased body fat and changes in diet, such as an increase in fiber and a decrease in fat intake, in women who exercise strenuously.
WOW. . . talk about a wake up call. My doctor said he doesn't think my running/working out is causing my issues, and cutting back might not even help. However, it would be worth a shot to cut back and take it easy for a while. What a hard pill to swallow. From being obese, to losing +/-60 pounds 7 years ago and maintaing that weight loss all those years, to gaining +10 pounds since getting married last year and starting all these hormones (while still running +25 miles a week!). As much as I've been down on myself and upset with my weight gain and changes in my body since taking all these hormones, I want a baby so much more than a "nice body". I want a body that functions properly and actually ovulates! And while it's frustrating to see so many athletic, slim women getting pregnant without any issues and running up until delivering a perfect, 7lbs infant, I have to accept that my body just might now be able to do that. Slowly but surely I'm accepting this and moving on.
So combining all the changes in drug routes and dosages of these meds and decreasing my workouts here we are...and I'm happy to say I made it through all 10 days with NO BLEEDING!
With that the wait begins. I have no idea where we'll go if I don't get a period or spot at all now. But as I do about 90% of the time, I am remaining hopeful! Hopeful that I'll wake up in the next few days with horrible cramps, bloating, heavy bleeding and all the other lovely symptoms of having a period! It will be reassuring to know that things are finally working and doing what they should. Also depending on what happens in the next week or so, my doctor may want to suppress (do the whole estrogen/progesterone combo) again for another additional month before sparking things up with Clomid.
So yet another stretch of days and perhaps weeks of hurrying up and waiting. . .