The One With All the Lab Tests
This week’s post is brought to you by homemade cinnamon rolls, continually depressing news cycles, woolen socks, THE CROWN, and did you know how wobbly stale carrots get? Because Ted didn’t know until yesterday and anyway it’s been a fun week.
Hey friends! Update time! Much blood, many stabs; not enough hormones, as it turns out.
I'm a bucketful of problems, spoilers. In fact, I'm almost as problematic as this chart:
I’ve officially been diagnosed with ovarian dysfunction (SO FUN) and we all had a sinking, sneaking suspicion that I might have a luteal phase insufficiency, as well. And we thought HEY what better way to celebrate election season and days where it gets dark at like 3:30 and the prospect of subdued holidays than…to confirm those incredibly fun suspicions? NO BETTER WAY. We are party people and we are ready to do this thing, we said.
SO for the past week-ish, I’ve been trundling over to our friendly neighborhood lab every other day to get bloodwork done. (My arm looks lovely, and it isn’t sore at all.) We did this to paint a pretty good picture of my hormone levels over the course of my luteal phase.
Quick recap re: the Luteal Phase:
LUTEAL PHASE
- The part of the menstrual cycle after ovulation - so, like, after you’ve either poinged out your monthly egg, or you haven’t;
- The part of the menstrual cycle that’s actually the first lil bit of a real pregnancy, if you’ve managed to conceive;
- Therefore, a crazy important time for hormones that’ll allow your little nugget to burrow into your uterus.
TL;DR: If you don’t have the right hormones during this phase, it’s gonna be really hard to get pregnant. Foreshadowing?
SO! Let’s talk about the two main players during the cycle/the luteal phase: Estrogen, and progesterone. Here's a pretty portrait of their roller-coaster arcs:
Super brief reminder of what these two hormones do:
ESTROGEN
- Helps grow the uterine lining - so, the sleeping bag that your spawn’s gonna cuddle in for the next nine months aka the primary ingredient in your period if you don’t conceive
PROGESTERONE
- Helps get the uterus ready for pregnancy
- Specifically, helps get the lining ready for implantation, and so helps aid implantation
- Super fun fact! The building block hormone that results in progesterone is ALSO the SAME building block hormone that can be used for cortisol (the stress hormone). THIS IS WHY being stressed out isn’t great for fertility: If your body is making stress hormones, it’s legit stealing the material you’d need to make baby-fueling hormones. Which, evolutionarily, I get, but as a modern infertile woman who’s living through a pandemic, it’s like, you can only do so much yoga and meditation, and I gotta business to run, soooo…..?
SYMPTOMS OF ABNORMAL HORMONE LEVELS
Like, this is where I can provide a list, but also, hormonal imbalances present in every women in a million different ways?
For example, one of the classic symptoms of low progesterone is something that’s called ‘tail-end brown bleeding’. Information alert: This is where the last bit of your period veers more brown, or even black, as opposed to blood red.
The reason why I hesitate to go, oh yeah, this is definitely a sign that your hormones are weird is that brown bleeding is also an incredibly normal thing that happens? Blood changes color as it ages from bright red to brown (citation: scabs), so it’s very very normal for the last day or so of your period to have a duller hue.
Anyway. That aside, here are a few kinda symptoms that the Internet kinda sorta cites:
- Irregular cycles
- Infertility
- Mood changes
- Hot flashes
- Weight gain
- Mood changes
- Tail-end brown or black bleeding
I mean, these are all things we’ve seen before. My only real ‘symptom’ continues to be infertility………..FUN.
NUMBERS: WHERE MY HORMONES SHOULD BE
Okay, this is where we get a little bit more quantitative. Here’s a fun chart I found, courtesy of ResearchGate:
So, to keep in mind: Luteal progesterone numbers for a woman without hormonal imbalances tends to be circa 21, overall; the same levels from a woman with PCOS are circa 5. The other columns are for women on Clomid - an ovulation booster that should also increase progesterone, as well as Clomid+Metformin, a common PCOS med.
NUMBERS: WHERE WE’RE AT
Without further ado:
First draw was two days after estimated ovulation; draws continued every other day after that. I'm going in tomorrow for my last, but unless it rockets upwards, my picture seems relatively clear. If you compare my lackluster curve to the aforementioned 'roller coaster', you can already see a bit of an issue.
I'm on Metformin, which would suggest increased numbers based on the chart above...but, still:
My median’s right around 9. Which seems about right. In that it’s low, and fits with my ‘But mostly, PCOS’ diagnosis. Womp womp.
Glass half full: It seems my numbers are high for women with PCOS. This might indicate Metformin's influence or my lifestyle priorities or a number of things, tbh.
Glass half empty: According to research and what my doctor said, we'd rather have seen those numbers wayyyy closer to 20 for normal chances of conception.
(I also measured estrogen with each draw, but that was way less interesting; my estrogen seems pretty normal to me. If my doctor disagrees, we'll follow up with a What Up, Estrogen post.)
MANAGING THESE HORMONES NATURALLY
We’ve talked a little bit about syncing up your hormones naturally in previous blogs. There are a lot of theories about ways to make sure you’re all in balance……….cycle syncing, super managing your stress response, going plant-based, ditching the caffeine, etc. I’ve been doing a lot of these things for most of this year…..and my hormones are still way not in a good place.
SO. If you’re in a place where you think your hormones are outta whack, there are definitely options you can pursue prior to medication. We've been doing that, and it's time to move on. For us. For now.
MANAGING THESE HORMONES…WHEN THAT WON’T WORK
While it wasn’t fun to learn that not only am I probably maybe not ovulating, at least not optimally/regularly, and I’m also not in a hormonal place to carry a kiddo……..we still haven’t learned anything, quite yet, that would de facto make it impossible for us to have a kid.
What we've learned makes our path forward harder, but not impossible.
Luckily enough, my two specific problems have two specific (potential) answers.
- PROBLEM: Rebecca isn’t ovulating.
Proposed solution: Get me ovulating. We’ve talked a bit about Clomid on the blog, but that can reduce your cervical fluid…something that I don’t have much of to begin with. We’ll likely go with Femara instead, a different drug that has the same net goal.
- PROBLEM: Rebecca doesn’t have enough progesterone.
Proposed solution: Get me progesterone.
Okay.
There are three basic ways to do this: Oral meds, self-administered injections, or … suppositories. (And with that, I have officially retired my ‘Infertility is Sexy and Fun’ t-shirt campaign.) There’s research to support each way, and each doctor tends to have a preferred method…so we’ll go with whatever our NaPro suggests.
Mini battle-plan-spoiler-alert, but our NaPro has suggested that it’d be a good idea to do one full cycle of hormone supplementation to get my body primed and ready to not be silly before we start ovulation meds. (Doing this can also help jumpstart better egg quality, which…man, I’d really rather not add bad-egg questions to our ongoing List of Problems, so, all in for that.)
Which means…we could be starting this real soon. Happy holidays to us!
ONE QUICK THING - FOR THOSE WHO READ OUR NAPRO 101 POST
Important note: I went back and looked over some of our older PWB posts, and remembered that our NaPro intro post was pretty down on the concept…yet, here we are. It’s not really what we expected.
I maintain my stance that NaPro needs RIDICULOUSLY better marketing.
It’s definitely doctor-to-doctor, as well; our doctor is a cool boi (he’s an Eagle Scout, which didn’t not help Ted (an Eagle Scout) be more inclined to trust him) (and, more importantly, he was personally recommended to us by like ten people I trust).
I’ve heard horror stories. I’ve also heard miraculous ones. We decided to give it a try, and, tbh, the fact that our NaPro was *the first doctor in my life* to actually give a lil’ listen to my “…but PCOS?” warblings went a long way in our book. We’ve liked working with our NaPro because it’s, thus far, been pretty to-the-point, quick-moving, science-and-data-based, and … sensible.
That could change, and I definitely get why others are skeptical - because that is ONE THOUSAND PERCENT not how it’s marketed.
I’m still doing acupuncture.
I’m still trying to eat well and exercise well.
However, it’s pretty clear to us at this point that I’ve got a few issues that might not be solvable by natural means on my own - or, at least, we don’t want to wait around for years to see if I can do it with lifestyle changes, particularly because I’ve already been doing them, and rn my progesterone levels … suck?
(Maybe for kid #2, or something? If we ever get there?)
Anyway. Just to recap, so far we’ve tried:
- Crossin’ our fingers and hopin’ for a few years that we weren’t infertile before realizing it was probably time to do something
- Startin’ smol with natural lifestyle-change-based solutions for infertility
- Takin’ a stab at acupuncture and TCM herbs (Which, update, my acupuncturist has officially diagnosed me as a highly sensitive person, which I didn’t know was a thing, but basically just means that my body has no capacity for stress or weird food or change or anything really SO GREAT)
- Talkin’ with my OBGYN
- Workin’ with a NaPro
Going into our Battle Plan, we’re gonna bring a mix of these approaches to see what we can get done. It’ll be fun!
We’re gonna try to get back a little bit into a posting rhythm, but, y’know, we’ll see. Coming right up, we have:
- Next week: CERVICAL FLUID: THE SCOOP ON THE GOOP
- Week after that: CLOMID vs. FEMARA: THE OVULATION THROWDOWN
Forgive me….coming up with terrible names for things is a joy I'm gonna indulge, especially since I can’t currently threaten that I’m going to name a kid Geonnifre or Tarmac or DEAR GOD DON’T ASK TED TO COME UP WITH A BAD KID’S NAME ON THE SPOT or he’ll look at you, baffled, finish chewing his apple, and then say, “…Flug…u…la?”
Moving on. We’re gonna release our official Battle Plan, along with what the New Year’s gonna look like for our lil family and this website and all kinds of great stuff DON’T MISS IT or do, whatever, we’ll be talking about it constantly, you’re prob fine to jump in and out whenever, duh.
Anyway. Time for more salt and vinegar chips, this week’s ep of the Mandalorian, and figuring out how to make a good Pinterest graphic.