Progesterone Deficiency: Symptoms and Treatment Options

Insufficient progesterone?

Hello, Doctor.
My menstrual cycle has been quite regular.
I started my period on September 21 and it ended on September 26.
However, on the last day of my period, I began to experience breast tenderness.
About two weeks later, on October 6, I had some bleeding.
My app indicated that it was ovulation day, but the amount of bleeding was similar to my usual menstrual flow (which is not much), and there was no pain.
After three days, I visited a gynecologist.
The doctor performed a pregnancy test and a pelvic exam and concluded that I had a progesterone deficiency and elevated estrogen levels causing uterine bleeding.
I was given an injection of progesterone and prescribed progesterone medication for two weeks.
The doctor mentioned that I might be consuming too much soy milk, tofu, and seaweed, but I hardly eat those.
When I researched online, I found that high progesterone levels can also cause ovulation bleeding.
I would like to ask, can progesterone deficiency be diagnosed through a pelvic exam? Should I continue taking the medication? I am also taking isotretinoin for acne treatment and am concerned that continuing progesterone for two weeks might worsen oiliness on my face.
Thank you, Doctor.

Ddd, 20~29 year old female. Ask Date: 2023/10/10

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the factors that can affect the menstrual cycle or cause intermenstrual bleeding are numerous, including age, environment, lifestyle, stress, emotional instability, weight changes, medications, emergency contraceptive pills, diet, polycystic ovary syndrome, lesions of the uterus or cervix, infections, ovulation, pregnancy, and breastfeeding, among others.
It is recommended that if the bleeding symptoms persist or worsen after treatment, you should consult a gynecologist for further evaluation.
Thank you! Wishing you safety and health.
Dr.
Zhang

Reply Date: 2023/10/10

More Info

Understanding progesterone deficiency is crucial for managing menstrual irregularities and related symptoms. Progesterone is a vital hormone produced by the ovaries, particularly during the second half of the menstrual cycle, known as the luteal phase. It plays a significant role in preparing the uterine lining for a potential pregnancy and maintaining it if conception occurs. When progesterone levels are insufficient, it can lead to various symptoms and complications, including abnormal uterine bleeding, such as the mid-cycle bleeding you experienced.

In your case, the symptoms you described—breast tenderness following your menstrual period and subsequent mid-cycle bleeding—could indeed suggest a hormonal imbalance. The fact that your gynecologist diagnosed you with progesterone deficiency after a physical examination and pregnancy test indicates that they were assessing your hormonal status based on your symptoms and menstrual history. While a physical examination can provide some insights, definitive diagnosis of hormonal levels typically requires blood tests to measure hormone levels directly.

The treatment prescribed by your doctor, which includes an injection of progesterone and oral progesterone medication, is a common approach to address progesterone deficiency. This treatment aims to stabilize the uterine lining and prevent further abnormal bleeding. It's essential to follow your doctor's advice regarding the duration of the treatment, as stopping prematurely could lead to a recurrence of symptoms.

Regarding your concern about the potential side effects of progesterone, such as increased oiliness of the skin, especially since you are on isotretinoin (a medication for acne), it's important to communicate these concerns with your healthcare provider. While progesterone can sometimes lead to changes in skin oiliness, the extent varies among individuals. Your doctor can help you weigh the benefits of treating the hormonal imbalance against the potential for exacerbating your acne.

In summary, progesterone deficiency can be diagnosed through a combination of clinical evaluation and hormone level testing. Treatment typically involves hormone replacement therapy, which can effectively manage symptoms and prevent complications. However, it is crucial to maintain open communication with your healthcare provider regarding any concerns about side effects or interactions with other medications you are taking. They can provide personalized advice and adjustments to your treatment plan as needed. Always prioritize your health and well-being by discussing any changes or worries with your doctor.

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