Im Bleeding Because I Cut Again

Information technology is common to be prescribed progesterone or Provera (which is progestin, a synthetic form of progesterone), during the process of determining why you have no catamenia, in social club to see if you lot get a bleed. If you're given some random pills and told to take them to help with diagnosis, this is most certainly what the pills are. For the balance of this mail I will utilize "Provera" to mean either Provera or bioidentical progesterone because for these purposes the ii do the same thing.

Instead of coming up with a different mode of saying it, I'm going to copy the text from my book No Period. Now What? that describes the Provera claiming:

In addition to the blood tests and physical examination, some other common diagnostic
tool is the "Provera challenge." Your dr. will give y'all a prescription
for Provera … a synthetic version of progesterone. In a normal menstrual cycle, progesterone rises after ovulation to prepare the uterus for a fertilized egg. If no pregnancy occurs, progesterone drops and a period ensues.

Provera mimics this bike. You'll take it for anywhere from 5 to 10 days to run across if you bleed after you stop. The standard protocol is to wait ii weeks to see if there is whatever spotting or bleeding, although amid our survey respondents, all only ane person who got a withdrawal drain did then within eight days. Well-nigh 18% (48/256) responded to Provera the first time they tried it (i.e., they got a bleed). This indicates a less astringent degree of HA. No drain suggests a more than suppressed reproductive arrangement without adequate estrogen to build a uterine lining—in other words, full blown HA [hypothalamic amenorrhea].

The degree of HA is based on response to Provera and Clomid:

• HA degree 1 (least severe): You lot bleed afterwards taking Provera and Clomid.
• HA degree 2 (moderately severe): You bleed after taking Provera but
do not respond to Clomid.
• HA degree 3 (most astringent): Y'all don't go a withdrawal bleed later on
taking Provera.

Here is some additional data I didn't put in the book. 86 women responded with the corporeality of time information technology took  them to bleed after their Provera challenge:

• The median time to response was three days after the last pill (meaning half responded within three days, the other one-half three days or later)
• 95% bled by five days later on the final pill
• All but one responded by eight days after the last pill

Some women are told that if they respond to Provera they do not have HA, and must have PCOS instead. This is not valid. It is absolutely possible to have HA and reply to Provera, it only means your system is less suppressed. (Please encounter this mail service for more resources on HA vs. PCOS).

As I stated, information technology is common to do the Provera challenge as y'all work toward a diagnosis. If you do not bleed and have ruled out concrete issues preventing a drain, so this can solidify the diagnosis of HA. If you do bleed, this isn't peculiarly helpful for diagnosis, but probable means that if you do take HA, it's on the milder side. Interestingly, when I analyzed my data on Provera response, information technology did not predict recovery of natural periods. 46% of those who bled in response to the challenge restored natural cycles (the remainder moved on to fertility treatments), compared with 47% of those who did not bleed.

is repeating the provera claiming useful?

Some women volition try a 2nd Provera claiming as they work toward recovery. There isn't a particular do good to doing so, but nor is it going to fix you back. Information technology'due south really up to yous and how the result might make you experience.

If you drain, volition it help you to feel more than confident in what you're doing every bit you work toward recovery? (bloodwork might serve the same purpose?)

If you do not bleed, volition that set you back and go far harder to stay the course?

If you practice choose to do a second Provera challenge, I'd advise going into it with the expectation that you will not bleed; that way if you practise it's a bonus, if yous do non, well, that's kinda what you expected and y'all'll stick with what yous're doing anyway (if you need encouragement please bring together my facebook support group and check out the "recovery story" tag, which we started using May iv, 2018 – already 37 posts!) In the data from my survey, 26% (31/119) responded to a subsequent Provera claiming after not having responded the kickoff time.

Does provera provide a jumpstart?

What the Provera challenge can not and does not do is "jumpstart" a natural cycle. This is because in a normal menstrual wheel progesterone is a "downstream" hormone – the *result* of ovulation. It'southward non 1 of the hormones that *causes* ovulation. So fifty-fifty if you lot drain from the outside progesterone, it does nothing to alter your natural hormones that are low – it does non increment Follicle Stimulating hormone to really get a follicle growing and egg maturing.

Many doctors will prescribe progesterone, or even nativity control pills, telling patients this might jumpstart a natural cycle – this does not happen. More in my next post!

If you have whatsoever questions most the Provera or progesterone challenge, drop them in the comments!

-Nico

P.Southward. If y'all appreciated this post and would similar to support more of the same, please go a Patreon!

cannonbrince.blogspot.com

Source: https://www.noperiodnowwhat.com/research/progesterone-and-periods-part-1-provera-challenge

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