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Progesterone & the female reproductive cycle
I have polycystic ovaries and irregular periods and have been trying to concieve. I am using progesterone cream but I have heard that progesterone cream suppresses ovulation. Should I should use the cream from the 14th day of my period to the 28th day and thereby leave a window of opportunity for ovulation and conception?
The menstrual cycle
The menstrual cycle refers to the time it takes for the body to produce an ovum (egg), release it through ovulation and implantation of a fertilized egg when conception takes place.
The menstrual cycle is a complicated system that requires hormonal balance and optimal reproductive organ function. The health of all of the organs associated with this cycle is imperative and any hormonal secretions via the Pituitary and Hypothalamus (master hormonal regulating glands) affect changes and the cycle. Addressing hormonal balance, as well as nutritional status, and any functional or structural disturbances may help to increase fertility. A history of polycystic ovaries (PCO's) may also be a contributing factor regarding infertility complaints. PCO's are generally caused by an excessive amount of estrogen. It is therefore recommended to address this hormonal imbalance prior to trying to conceive.
The two female hormones estrogen and progesterone increase and decrease throughout a women’s cycle and initiate the production, growth and maturation of the egg and endometrial lining. Estrogen is involved throughout the whole cycle and especially to prepare the thickening of the endometrium and to kick off ovulation. Progesterone prepares the inner lining of the endometrium of the uterus and if fertilization occurs, it also maintains the uterus throughout the pregnancy and decreases the risk of miscarriage. Low progesterone levels can in some women cause a luteal phase defect which contributes to fertilization complications. Progesterone cream may help to address the progesterone deficiency/ estrogen dominance, a condition which we are gradually seeing more of these days due to diet, lifestyle and medication.
Progression of the menstrual cycle
Day 1-5 – Menstrual phase is the shedding of the endometrial lining, known as a period
Day 6-12 – Follicular phase of the ovaries requires domination of estrogen during the first week which builds the endometrium and the Graafian Follicules (mature follicle of the ovaries) are stimulated to begin the growth of an ovum. This event occurs due to the Hypothalamus (master hormonal gland in the brain) initiating this action. This is the phase of much activity of Luteinizing Hormone Releasing Hormone (LHRH) and Follicle Stimulating Hormone (FSH)
Day 13-14 – Ovulation phase (36 hours) occurs due to a surge of Luteinizing Hormone. After the Luteinizing Hormones and estradiol levels peak, a rise in progesterone levels increases the distensibility of the follicular wall. After there is release of an ovum the corpus luteum begins to produce estrogen, progesterone and androgens and becomes vascularised.
Day 14-28 – Luteal phase means an increase in the amount of progesterone production and the maturation of the uterus (thickening vascularisation) in anticipation of a fertilized ovum.
Progesterone and pregnancy
Once you fall pregnant, progesterone is the hormone which is of most benefit to ensure the growth of the fertilized egg and to reduce the risk of a miscarriage.
It is best to speak to your Healthcare professional regarding the amount of Progonol because only they have an understanding of your personal history and can alter the dose according to this. Let them knowany concerns you may have and enquire about having a week break from the cream when you are ovulating and therefore reducing your worries about fertility.
For further information see the Ask a Naturopath.com webpages concerning polycystic ovaries and fertility