Started Progesterone Therapy and now my period is spotty

by S.N

Hello, I started PT last month. Prior to that my periods were pretty heavy and lasted about 5 days. Now I am experiencing spotty brown discharge and I'm not sure what this could be. I am using a saliva based test to check when I am ovulating and on the day I saw a bit of the fern pattern I started using progesterone. I stopped on the day before my expected period (which varies a little bit but I guessed) and it still hasn't come. I tested for pregnancy the day I was supposed to get my period but it's negative. Any suggestions?

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Dec 09, 2011
Started Progesterone Therapy and now my period is spotty
by: Wray

Hi SN Progesterone can upset the cycle when first using it, making it either early or late. Although I've found it's more often earlier. The brown discharge is old, oxidised blood, a good sign. I would have to know how much you are using, but it appears a very low level. I recommend 100-200mg/day, more if symptoms are severe. It appears you might be trying to fall pregnant? In which case please see our Pregnancy page. You live in Canada, the majority of people living there have very low vitamin D levels, see here, here, here and here. Vitamin D is critical for pregnancy and the growth of the foetus, see here, here, here, here and here. These are excellent videos to watch too, see here and here. For more info on levels, testing etc see the Vitamin D Council, GrassrootsHealth, Birmingham Hospital and Vitamin D Links websites. Blood levels should be 70-100ng/ml or 175-250nmol/L and not the 30ng/ml or 75nmol/L most labs and doctors regard as adequate. And the minimum daily dose should be 5000iu's per day, although the latest research indicates it should be 10,000iu's per day, see here. Take care Wray

Jan 13, 2012
Also Curious About Brown Discharge
by: Lily

Hi Wray,

Could you expand on why you believe the oxidized brown blood is a good sign?

I am 44, very regular, but progesterone deficient, per your questionnaire. The symptoms I suffered with most were severe, irrational anxiety (which wreaked havoc in my marriage), blowing up like a balloon with water retention mid-cycle, horrible night sweats about a week before my period (like I threw a bucket of water on the bed), and heavier than normal, clotting periods.

I have faithfully applied Natpro (200-300mgs daily) for the last 14 days of my last 3 cycles & also removed all known estrogenics I was unknowingly putting in and on my body. Thankfully, my symptoms of estrogen dominance almost completely cleared up, and rather quickly. Thank you, thank you, thank you! Were it not for your website, I would've continued suffering thru my symptoms, unaware there was anything I could proactively do about them.

But although my symptomology has improved, this month, instead of my period starting with red blood, it has begun with brown sediment, which I understand is aged, oxidized blood. I'm relieved to hear you believe this to be a good sign, but can you expand on the details of why? Thanks very much in advance and again, thank you for the website & cream!

Jan 17, 2012
Also Curious About Brown Discharge
by: Wray

Hi Lily Bless you for the kind words, and the good news too! I'm so delighted you used the high amount, I get very discouraged when all the time I get people complaining about progesterone, and I have to put them right. It's getting a bad name for no reason. It's always because they have been advised to use 20mg/day! That's the amount we make in a normal luteal phase, if it was sufficient, why then do we get adverse symptoms?! I seem to go round in circles, so it's such a pleasure to find someone who used a high amount. Each month we bleed, but not all the lining comes away. Some is absorbed back into the body, which is in fact how it works in most animals. We unfortunately bleed it out! But some remains in the uterus, it then oxidises, forms clots in some cases and stays there. I've found progesterone invariable 'cleans' out the uterus, which means no old blood is left behind. It normally only occurs once, but who knows, it could occur again! To put you in the picture of how it all works…….MMP's are enzymes that break down protein. They play a role in the breakdown of endometrial tissues at the end of the menstrual cycle, see here. Progesterone suppresses MMP's, see here. So it's only when the corpus luteum stops making progesterone at the end of the cycle, that levels plummet and the MMP's can begin breaking down the lining. In some instances they can cause a pathological reaction if excess oestrogen is present, as oestrogen stimulates their production. This can lead to inflammation, spotting and/or excessive bleeding in the uterus. If a low level of progesterone is present, and a high level of oestrogen, the lining will continue to grow. With a high level of MMP's the lining will also continue to break down. This of course leads to heavy continual bleeding. Using high amounts of progesterone, ie about 400mg/day, reverses this, and the bleeding stops. High oestrogen and high MMP's are also implicated in inflammatory diseases like arthritis. The MMP's degrade protein in the joints and cause inflammation. Take care Wray

Apr 06, 2012
Spotting on 400mg per day
by: KN

Good day,

Thank you a lot for the amazing work you are doing here, it has helped many of us.From charting the last 3 months, i realized that my luteal phase is only 9 to 10 days.

This month i began taking susten 200 twice a day (vaginal), morning and evening so 400mg per day. this i began on day 4 after +ve LH surge was detected with OPK. For 5 days (till 3rd April), i had no discharge just i assume the normal suppository withdrwal where some of the progesterone gets out.

From 4th which was day 6 of taking susten and my would be first day of period, i had a spot of light red blood and wore a pad thinking my periods were here but then nothing else came. on 5th (yesterday, i began having a brown discharge and its still there today, i also tested for pregnancy and got a PFN. my questions are;

what do you think is causing the spoting?

My intention was to take the susten till day 14 after ovulation which is tomorrow the 7th april, then test and stop if i get a BFN. Is this what should be done?

my third question, if by any chance i get a BFP, should i still continue taking susten and what quantities of it?

Thanks a lot for the noble work you are doing and i am expectant of your responce.

Mother in waiting

Apr 07, 2012
Spotting on 400mg per day
by: Wray

Hi KN Thanks for the kind words! I'm puzzled why you started the susten on day 4 after the LH surge. And not from the beginning of ovulation, this takes place about 24-48hrs after the surge. The spotting is caused by the body adjusting to the progesterone, it does take time to settle down, in spite of the amount you were using. Most women experience bleeding either earlier or later than normal. You are correct in using the progesterone for 14 days, but it should be from ovulation, or within the 50 hour surge of progesterone which occurs prior to ovulation. There's more info about this on our Menstruation page. Home test kits for pregnancy are notoriously unreliable in the very early days. But if pregnancy is suspected, the progesterone should not be stopped. The amount you're using is very good, so stick to that if you do fall pregnant. We have more info on our Pregnancy page, and see this page here too. Take care Wray

Nov 08, 2021
When should progesterone be stopped if tying to conceive and period starts before 11 dpo?
by: Stacy

I started taking progesterone last cycle but wasn’t using it right, was using too little of it, then increased it towards the end of my cycle before my period started. Anyways, this cycle I started using 400mg/day (200mg twice a day) from when I got my LH surge because I’ve been trying to conceive my first child for nearly 6 years. I believe I have a luteal phase defect as I usually start spotting a few days before my actual period like day 8-10 dpo. This cycle I had what I assumed to be a yeast infection because I was very itchy and had some discharge, so I treated it with monistat 3 day treatment. I started spotting after the 2nd application on 6dpo. So I stopped it and didn’t continue the treatment. I spotted every day up until yesterday which was 11 dpo, when it turned into a lighter flow (no longer spotting) which now seems to be my period. My question is do I continue to take the progesterone cream until 14 dpo? Or do I stop it and start again next cycle? My plan is to continue until 14 dpo despite the bleeding, but not sure if that’s what I’m supposed to do.

Also, just a history…I started having issues after being on a 3 year vegan diet. I gained a bunch of weight, my hair stopped growing, lots of grey hair, brain fog, long periods with spotting in between periods just completely out of whack. Many of my symptoms healed once I changed my diet back to a regular diet. As a matter of fact I believe I got pregnant two months into my diet change but lost it immediately because my period came on time. I took a pregnancy test and it was negative (so I thought) chucked it under the cabinet because I didn’t want my husband to see it. That cycle I had a very symptomatic cycle which I never have. Forgot about it and one day was looking under there reorganizing and found it and it had a very obvious pink line. That is the only time ever in the 6 years of me trying that I have seen a positive pregnancy test. So needless to say I suspect estrogen dominance and low progesterone. I have not been seen by a doctor or gotten my levels checked. I’m just going based on symptoms. I also suspect I was pregnant about 6 months ago because I had another symptomatic cycle, lots of nausea, and was having headaches. My cycle was also the longest it’s ever been in the history of me tracking it. It was like 42-43 days long which has never happened to me. But I never got a positive test. The day I went to get a blood test I started bleeding.

Nov 08, 2021
When should progesterone be stopped if tying to conceive and period starts before 11 dpo?
by: Joy

Hi Stacy

Thanks for providing as much info as possible.  I'll start with your 'history'.  

Without offending any vegans of course, I do believe that we need to eat meat, organic of course.  It contains so many nutrients and amino acids, tryptophan being an important one.  A bit on tryptophan.  It's very low in all foods, specially veggies and grains. Highest in game, which not many of us eat! Interestingly the deficiency disease pellagra can occur from lack of tryp. Although it's regarded as a niacin (B3) deficiency, niacin is also made from tryp within the body. So people eating high levels of maize, which contains little tryp and niacin, are more prone to getting it. So if someone is eating large amounts of grains, especially maize, it would be a good idea to take additional tryp and/or niacin on a continual basis.  It's the precursor to serotonin, which is low in depression, insomnia, anxiety, OCD, a stomach in knots, aches and pains, hot flushes, a tight chest and more. It helps stabilise blood sugar as it's involved with appetite control. Often a sharp drop in blood sugar causes depression and anxiety. This drop can also cause a hot flush, studies have found tryptophan helps with these. Serotonin is the precursor to melatonin, our sleep hormone, supplementing with tryptophan helps with insomnia. 

You ate a lot of grains and pulses which are estrogenic, soy a BIG no, no.  It adds to Estrogen Dominance. You reverted back to a regular diet and things improved greatly. It's possible that you may have fallen pregnant at that time.  Who can tell without a check up.  Regarding your 42-43 day bleed, you don't state your age, but you could be in Peri-Menopause  when monthly periods become extremely erratic.  Progesterone levels drop sharply, estrogen remains the same.

Present time.  You are currently using 400mg progesterone per day.  For your information, this website advises on Natpro which is a 3.33% cream.  If using a different % please adjust accordingly or contact the maker of that cream.  Anovulation or a defective luteal phase results in low progesterone levels. A defective luteal phase can be one that's too short, or the corpus luteum is not producing sufficient progesterone. Thus making estrogen the dominant hormone, progesterone should be dominant in the luteal phase.  I suspect that you may have Candida.  Rubbing progesterone on the area and inserting it in the vagina at night will help, but look at your diet and eat as much fermented veg, kefir milk/water as possible. They are the best probiotics that you can get. Also progesterone will be aggravating estrogen receptors, it's probably the estrogen that is causing the yeast infection.  Many people think that progesterone is the culprit, it's not, estrogen is.  

Your body is definitely out of whack. I don't believe that you need to use as much progesterone. You weren't using 200mg for very long, you didn't give progesterone a chance to work.  It can take anything from 2-6 months before positive results are felt, longer if symptoms are severe.  There is of course nothing wrong with taking 400mg IF it is needed.  

I suggest you try this.  Use 200mg every day and be patient.  Progesterone therapy is not an overnight fix, it takes time and patience. Your body will go through all sorts of weird things as it adjusts. Whether you start to bleed or spot, ignore that.  Continue using until the body adjusts. If after a month there are no signs of improvement, then increase to say 300mg and see how that goes.  Forget about what day you think you may be ovulating, your body and hormones are all over the place now.  Give progesterone a chance to work and become dominant.  The moment a regular cycle returns, then and ONLY then can the cream be used by following your cycle  i.e.  luteal phase.  If using more than 200mg per day you can slowly reduce that amount to no less than 100mg per day.  Please read the How to use Progesterone Cream page.  You might also find the Pregnancy extremely helpful.

I do not know if your are taking Vitamin D3 if not, you should be, we all should be.  Please have a D3 test done, a lack of this reduces the benefits of progesterone, see here, here and here. It's vital for ovulation, conception, a successful pregnancy and breast feeding. There are some excellent videos on the pregnancy page about D3 and breast feeding, please have a look at them.   Nothing less than 5000iu's per day is needed, more if you are extremely deficient. Another nutrient you could consider taking when you are pregnant or not is taurine, vital for the developing foetus, and for the new born, see  here, here and here.

I hope that all this makes sense.  Please keep us posted.

Best wishes.

Nov 09, 2021
When should progesterone be stopped if tying to conceive and period starts before 11 dpo?
by: Stacy

Thank you for you’re response. I’m 35 years old. And I’d like to add that my period has been very regular. Before that long cycle it seemed like my luteal phase was longer about 12-14 days. After that they became consistently around 10-11 days with spotting for the first 4-5 days then 2 days of heavy period and few more days of spotting. My period always comes on time. And my ovulation day is pretty consistent at around 17-18 dpo. This cycle I ovulated later like CD 22.

I’d also like to add that I was never a fan of soy and always avoided soy even while vegan. Because I knew most soy is gmo. I’ve never had tofu. I was a Whole Foods vegan. I pretty much made most of my food at home. I was on a very restrictive "alkaline diet" (dr. Sebi diet). But I basically did have a lot of grains and nuts, and oils, and which are inflammatory and estrogenic. Prior to being vegan I was on an organic diet. Organic grass fed meats, raw butter, raw dairy. I’ve always been a healthy eater but was deceived into thinking veganism was the ideal diet. It completely screwed up my metabolism. When I came off I was eating a pro metabolic diet avoiding inflammatory foods, because my digestion was so bad. Thank God I’ve healed most of my issues. Oh and don’t know if I mentioned this but I suffered from chronic yeast infections and painful sex during veganism. Literally monthly infections. Once I changed my diet back to a regular diet after lots of healing I stopped having them and could finally enjoy sex.

Now as far as symptoms, this cycle I actually had a symptom free period. No headaches, no nausea, nothing really. That’s why I know the progesterone is working and helped me a lot. The only symptom really was the spotting before the period, and I guess the yeast infection. I am trying to conceive so I don’t want to use it consistently because I’m really not having any bothersome symptoms. Do you think I can still fix the spotting issue by taking progesterone during my luteal phase? I’m using onas 20% cream. I also have the 10% cream. Should I go back down to using 100mg twice a day? That’s what I was doing last cycle towards the end of it. Last cycle I had a few headaches that’s why I went up to 400 mg/day this cycle. But then again I started with a really low dose. I was taking progest-e oil, 3 drops 5 times a day. It’s 3mg per drop. Once I did more research I ordered onas 10% cream and started taking 100 mg twice a day, then got my period and stopped.

Do you think I still should take it consistently or would it be ok if I can take it during my luteal phase?

Nov 10, 2021
When should progesterone be stopped if tying to conceive and period starts before 11 dpo?
by: Justine

Hello Stacy,

Use it during your luteal phase.

Please read this whole page FAQ conception and pay particular attention to the part on 'Pregnancy'

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