Abnormal Bleeding After Progesterone Supplementation

Bleeding after progesterone supplementation?

I have a chocolate cyst and just finished treatment with Danazol last month.
I started trying to conceive after stopping the medication.
My period came three days after discontinuing Danazol, and it was previously very painful, with painkillers being ineffective.
However, this time it was much better, and I didn't have any issues with pain.
My period started on April 8, and on April 13, my doctor prescribed ovulation medication for five days.
On April 21, a vaginal ultrasound confirmed that I had ovulated an egg from my left ovary.
I was advised to have intercourse on April 24 and 25.
I started taking Duphaston on April 25, planning to take it for 12 days, one tablet in the morning and one in the evening.

On April 27 and 28, I experienced drowsiness and an increase in body temperature, and I noticed about a coin-sized amount of fresh blood (only visible when wiping with tissue).
On April 29, the bleeding increased, requiring a panty liner, and I passed blood clots from the vagina (gelatinous in texture), along with deep red and brown blood.
However, I did not experience abdominal pain, which is not typical for menstruation, but the amount of bleeding is concerning.
I am unsure if I should stop taking Duphaston.
The side effects mention abnormal vaginal bleeding, but how much bleeding is considered normal?

Ms. Ban, 30~39 year old female. Ask Date: 2022/04/30

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, please do not stop the medication.
Monitor the situation for now.
If there is still bleeding, it is advisable to see a gynecologist.
Wishing you good health.

Reply Date: 2022/04/30

More Info

Abnormal bleeding after progesterone supplementation, such as with medications like Duphaston (which contains dydrogesterone), can be concerning for many patients, especially those with a history of conditions like endometriosis or ovarian cysts. In your case, it seems you have recently undergone treatment for a chocolate cyst and are now trying to conceive. The bleeding you are experiencing could be attributed to several factors related to hormonal changes and the medications you are taking.

Firstly, it's important to understand that progesterone plays a crucial role in regulating the menstrual cycle and maintaining pregnancy. When you take progesterone supplements, they can cause changes in the endometrial lining, which may lead to irregular bleeding or spotting. This is particularly common in the initial stages of treatment or when there are fluctuations in hormone levels. The fresh blood and clots you describe, especially if they are not accompanied by significant pain, may indicate that your body is adjusting to the hormonal changes induced by the medication.

In your case, the timeline of events is significant. You started taking ovulation medication and then began progesterone supplementation shortly after. The bleeding you experienced on April 27 and 28, which increased in volume, could be a result of the progesterone affecting your endometrial lining. It's not uncommon for patients to experience breakthrough bleeding or spotting when starting or adjusting hormone therapies. However, the presence of clots and the change in blood color (deep red and brown) can be concerning and should not be ignored.

As for the question of how much bleeding is considered "normal," this can vary widely among individuals. Light spotting is often considered normal, but if you are soaking through pads or experiencing a significant increase in bleeding, it is advisable to consult your healthcare provider. They may want to perform an ultrasound or other diagnostic tests to rule out any complications, such as retained tissue or other issues related to your previous cyst treatment.

In terms of whether you should continue taking the progesterone, it is essential to follow your doctor's advice. If the bleeding is excessive or accompanied by other symptoms, such as severe pain or dizziness, you should seek medical attention promptly. Your healthcare provider may adjust your dosage or suggest alternative treatments based on your specific situation.

In summary, while some abnormal bleeding can be a side effect of progesterone supplementation, it is crucial to monitor the volume and nature of the bleeding. If it becomes heavy or is accompanied by other concerning symptoms, do not hesitate to reach out to your healthcare provider for further evaluation. They can provide personalized guidance based on your medical history and current treatment plan, ensuring the best possible outcome for your fertility journey.

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Understanding Abnormal Bleeding After Progesterone Supplementation

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, please do not stop the medication temporarily. If there is still bleeding, it is recommended to see a gynecologist. Wishing you good health.