Progesterone Deficiency: Causes, Symptoms, and Concerns

Luteal phase deficiency

Hello Doctor: I have been experiencing abnormal bleeding for two consecutive months, so I went to the hospital for an examination.
An abdominal ultrasound was performed, and after the examination, the doctor informed me that the cause of the bleeding is likely due to insufficient progesterone.
I was prescribed progesterone to take three times a day for a week to help regulate it.
In early August, a small tumor about 1 cm was detected, but it had not grown by the end of October.

1.
I have been taking progesterone for three days now, and while the bleeding is not heavy, I am still experiencing some bleeding.
Is this normal?
2.
Today, I suddenly had a noticeable bright red bleeding, followed by the passage of blood clots that feel very hard, resembling fleshy clots.
Is it normal to pass such clots suddenly?
3.
I am still very concerned.
Could this abnormal bleeding be related to cervical cancer or endometrial cancer? Thank you, Doctor, for taking the time to respond!

Niming, 20~29 year old female. Ask Date: 2017/11/03

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I experienced abnormal bleeding for two consecutive months, so I went to the hospital for an examination.
After an abdominal ultrasound, the doctor informed me that the cause of the bleeding was likely due to insufficient progesterone, and prescribed me a week's supply of progesterone to take three times a day for adjustment.
In early August, a small tumor approximately 1 cm was detected, but it had not grown by the end of October.

1.
I have been taking progesterone for three days now.
The bleeding is not heavy, but I am still experiencing it.
Is this normal?
Answer: Yes, it is normal.
2.
Today, I suddenly had a noticeable bright red bleeding, and I passed some blood clots that felt very hard, resembling fleshy blood clots.
Is it normal to pass these suddenly?
Answer: Yes, it is normal.
3.
I am still very worried.
Could this abnormal bleeding be related to cervical cancer or endometrial cancer?
Answer: If the situation does not improve, it is recommended to undergo a hysteroscopy.

Reply Date: 2017/11/03

More Info

Hello! Thank you for reaching out with your concerns regarding progesterone deficiency and the associated symptoms you are experiencing. It's important to address your questions thoroughly, as understanding the implications of hormonal imbalances can significantly impact your health and peace of mind.

1. Progesterone and Abnormal Bleeding: Progesterone plays a crucial role in regulating the menstrual cycle and preparing the uterus for potential pregnancy. When there is a deficiency in progesterone, it can lead to irregularities in the menstrual cycle, including abnormal bleeding. The fact that you have been prescribed progesterone to help regulate your cycle is a common approach. After starting progesterone therapy, it is not unusual to experience some bleeding as your body adjusts to the hormone. However, if the bleeding is persistent or significantly heavy, it is essential to communicate this with your healthcare provider. They may need to reassess your treatment plan or investigate further.

2. Sudden Bright Red Bleeding with Clots: The sudden appearance of bright red blood and the passage of clots can be concerning. While some women may experience clotting during their menstrual cycle, especially if they have a heavier flow, the nature of the clots and the timing of the bleeding are important factors to consider. Clots that feel firm and resemble tissue could indicate a more significant shedding of the uterine lining. This can happen during a heavy menstrual period or as a response to hormonal changes. However, since you have a history of abnormal bleeding and a small fibroid, it is advisable to seek medical attention promptly to rule out any complications or underlying issues.

3. Concerns About Cancer: Your worry about the potential link between abnormal bleeding and conditions such as cervical or endometrial cancer is understandable. While abnormal bleeding can be a symptom of these conditions, it is essential to remember that many benign conditions can also cause similar symptoms. Factors such as hormonal imbalances, fibroids, or polyps can lead to irregular bleeding without indicating cancer. However, given your symptoms and history, it is crucial to follow up with your healthcare provider for further evaluation. They may recommend additional tests, such as a Pap smear, endometrial biopsy, or imaging studies, to rule out any serious conditions.

In summary, while some bleeding after starting progesterone can be normal, any sudden changes in your bleeding pattern, especially the presence of clots, should be evaluated by a healthcare professional. It is essential to maintain open communication with your doctor about your symptoms and concerns. They can provide you with the best guidance tailored to your specific situation and ensure that any potential issues are addressed promptly. Remember, early intervention is key in managing any health concerns effectively. Take care, and I hope you find relief and clarity soon!

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