Progesterone Pregnancy and IC

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I was having a conversation with someone today that is newly pregnant and thought I should post. Low progesterone can be a big problem with IC and, as many of you know, we don't advocate it's use or the use of hormones in general except in certain very specific situations. 

However, in the early stages of pregnancy if the progesterone dips, a miscarriage can happen as the progesterone dip signals the shedding of the uterine lining. It is often important to supplement with intravaginal progesterone. This will help keep the progesterone level constant so that the pregnancy may continue. Once the 12 week mark has been reached then often the progesterone may be discontinued. The upside is that this will help with holding the pregnancy.

The down side is that progesterone is very antagonistic to the symptoms of IC and inflammation in general. So, often when this is used symptoms will heighten significantly. There are things we can do to soften those effects, but, sometimes that too may be difficult while pregnant. This is very different in each case of course and each woman will react differently. Typically, a woman may not be aware of any of this until after she has had a miscarriage. But this is something we like to say in advance for those having or having had IC and planning on getting pregnant so that they are aware of this possibility and may head it off before it comes and avoid having to go through the painful process of a miscarriage.

So, if you are thinking of getting pregnant speak to your OBGYN before hand and discuss this issue with her or him so you may avoid losing the pregnancy. Of course, low progesterone may not be an issue for you , and in that case, supplementation may be irrelevant. But, it is good to know that this is a possibility and something to discuss prior to conception.

Dr. M