Why I Stopped Taking Prometrium

The end of the end came when I said something snarky on Twitter. Snarkiness is common for me. Also common is what happened next: someone took my playful jabs at Prometrium (and the inconsistency of unequivocally opposing the pill for hormonal therapy, while utilizing Prometrium) seriously. She started questioning my questioning, and I started questioning why on earth I was doing something so stupid.

I just heard a presentation by a nurse who argued that it is foolish to utilize the pill as treatment for conditions such as endometriosis, because it is an off-label use (rather than what the pill was designed for) and because it increases the likelihood of several types of cancer. Interestingly enough, this is also the case for Prometrium.

NFP-promoters tell me that I must ignore what doctors say about the pill and instead focus just on what the pill manufacturer says.  But somehow everyone expects me to listen to my doctor when my doctor tells me to ignore the warnings of the manufacturer of Prometrium.

In any case, it is all very mockable. So, after I took my little yellow pill I took to Twitter and mocked–mostly myself.

I was shocked by the childlike faith of my interlocutor. She believed that this drug was really different with a trust that was beautiful. I wish I had a doctor whom I could trust as perfectly as she trusts hers.

And then I realized the absurdity of the situation: I did not trust blindly, and I knew the distinct lack of evidence for the superiority of this drug, so why on earth was I taking Prometrium?

I was taking it because, short of going back on the pill, it was the only thing I had to take.

I ignored the fact that it showed no sign of helping. It never raised my BBT, changed my bleeding, or extended my luteal phase. Instead, it not only recreated my experience of being on the pill, it added in headaches and insomnia along with the expected subsequent increase in fatigue. In short, it took what would typically be my “good” 10 days of the month, and made them feel a whole lot more like the “bad” days.

I was motivated to take Prometrium by fear. Progesterone supplementation is presented by a certain group as something of a cure-all. Many say (without evidence) that you need to take it faithfully in order to see results, that if you don’t take it you will miscarry. They promise that if you take it you will not need to take the pill, and the implication is that if you fail to take the “good” medicine (Prometrium) then it is your own fault when you have to turn back to the “bad” (the pill).

Fear is powerful, but it is not conducive to making the wisest decisions. There is no evidence that Prometrium helps me, not even in something as simple as improving my hormone levels after a low-quality ovulatory event. Perhaps other forms of progesterone supplementation would help, but that is not what I was doing. And I knew that what I was doing was stupid.

So I stopped. And it was clearly the right choice for me. In each of the two cycles since then I have gotten over a week of happy days, days where I feel, and it feels good.

I am very thankful for the insights of people with whom I disagree online. So often they make me realize how stupid I am for behaving in a way which would only make sense if I  did agree with them!

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16 thoughts on “Why I Stopped Taking Prometrium

  1. waywardson23

    Yes, I remember K being given Prometrium years ago. Not quite sure why. Didn’t do anything except make her cycles even weirder.

    Actual problem? Vitamin D deficiency. Cleared everything up in one cycle.

    1. Rae Post author

      Prometrium vs. vitamin D deficiency? Is it okay that I find that hilarious? It feels like many doctors are just tossing anything at us. I was previously deficient in vitamin D (I’m scared of the skin cancer) but my most recent tests showed normal levels.

      1. waywardson23

        This wasn’t a doctor. It was more of a “Hey, you can buy a bottle of Vitamin D pills at Target for $10. Let’s see if it works.” To the surprise of everyone, it did.

        I started taking it too because I was probably deficient as well. (I work in a cave.) I seem to vaguely feel better. Or maybe it’s the placebo effect. I don’t care. It’s only $10 a bottle at Target. :-)

        1. Rae Post author

          I just meant the doctor prescribing Prometrium when it turned out to be vitamin D that helped.

          I am totally with you when it comes to the placebo effect and $10 treatments. Who cares as long as it works!

    2. k

      Your problem is most likely the additives and chemicals in prometrium – you can get prometrium – as compounded progesterone in olive oil capsules and the PMDD symptoms of depression etc…will subside if you actually have PMDD and not some other kind of psychiatric disorder.

  2. Michelle

    I agree that if Prometrium does not actually treat your problem, then there’s no reason to take it. I actually stopped taking it between baby #4 and baby #5. I don’t think I needed it then as I had regular cycles with good luteal phases. However, my dire need for progesterone supplementation reared its head with my baby #5 pregnancy and I was put all the way on injections. My body made it known to me after baby #5 that I needed the regular 10 days per cycle prometrium supplementation so back on it I went and had blissfully regular and reliable cycles all up until we conceived #6.

    But yes, if progesterone-deficiency is not your problem — or even if it is — Prometrium might not be the answer for you. Good for you paying attention to how you feel. Another thing I have noticed over the years is that no matter what, I can never rely on my body doing the same thing at say, age 38 as it did at say, age 32. And honestly, I could insert various ages in both parts of that statement and it would be true. Our bodies are amazing and they change all the time. In my experience, I have had to monitor what’s going on and adjust accordingly many different times.

    Glad you are feeling better (or are you?)

    1. Rae Post author

      I appreciate your wisdom! I think that progesterone supplementation is obviously fabulous for those who need it. Unfortunately I was part of the group that got the prescription due to lowish P+7 levels during *one* cycle, which may mean pretty much nothing. That doesn’t mean that I don’t understand that it can be essential for some women such as yourself (and I hope that your insurance covers it well, ouch!)

      I so agree on age changing our bodies. I sometimes wonder how much my “conditions” have deteriorated my fertility, and how much of it is just the natural change from 21-27. But what American would ever admit that late 20s is biologically solidly on the downhill side of fertility? Let’s pretend it starts suddenly at 35. ;-)

      And I am feeling better *today*. Thank you. :-)

  3. Kathleen Basi

    I took prometrium for a while and then revolted because of the cost. “Can there REALLY be no cheaper alternative?” I said. They prescribed me “horse pills” instead–I guess the big thing about Prometrium is that it manages to compact a lot of progesterone into a small capsule. I said, “I can take a horse pill if it’ll cost me $15 instead of $75.” :)

    But I was taking it inside pregnancy.

  4. Napro Girl

    Is prometrium synthetic or natural progesterone? My prescription just says progesterone. I lost a pregnancy (possibly) due to luteal phase defect (it was a very early loss and occurred after many years of trying and a laparoscopy to remove endometriosis from my blocked tubes) and I have always had extremely short cycles. When they did cycle reviews with blood work several months in a row (I have a naprotechnology dr/surgeon) and I consistently had sub-optimal progesterone and estrogen, I was put on an HCG shot for a couple days post-peak ovulation day. The HCG was used to trick the ovaries into making more of their own progesterone and estrogen. Indeed, they did – but I was absolutely miserable with false pregnancy symptoms, it was cost prohibitive, and I had to wait a very long time to be sure I wasn’t actually pregnant because (obviously) every urine test would have said I was whether I was or not. I told the doctor these complaints and we switched to progesterone suppositories. First of all, gross. But also, they didn’t keep my levels high enough (more cycle reviews and blood work confirmed this) and I still had horrible PMS symptoms and a relatively short (though longer) cycle. Finally – Now I am on a natural progesterone pill (200 mg) that I take orally and my levels are way up where they belong (again, confirmed by blood work) and I have almost no PMS symptoms – no cravings (which had been rampant and uncontrollable for several days before bleeding) and only one day of anxiety the morning that I bleed (vs 5-7 days prior to bleed with panic and anxiety every morning). I am a new woman – the test will be whether it can actually help me to keep a pregnancy. I have not been pregnant again since our loss. I had a second laparoscopy last week to remove a little regrowth in tubes, one other little patch, and a large endometrioma from my right ovary. I’m praying for the best and very grateful for my oral progesterone! Many prayers for you and for all of us on this road.

  5. Mandi

    I know this is an old post but I just came across it. I’m taking Prometrium for the first time during this pregnancy and the side effects have been atrocious. I’ve taken progesterone shots previously and there were no side effects other than a sore bum. And an empty wallet since the shots weren’t covered by insurance, which is why I’m still doing the pills now. I’m already doing hCG shots which are around $500/mo. So an additional $200 for progesterone shots just doesn’t seem to be feasible. But I stop hCG next week, so I’ll probably switch to progesterone shots then. I’m honestly pretty suspect of whether progesterone actually causes miscarriages as much as some doctors claim and wish there was more research on it, but I’m not willing to take the risk that the doctors are right and stopping could harm the baby. So I totally get why there aren’t more double blind studies – who wants to take a chance at taking a placebo if the progesterone actually does makes the difference between life and death for a child? But I still can’t help feeling that I’m throwing away all this money and adding some nasty side effects for a medical myth… And as an interesting side note, Prometrium comes with a warning not to take during pregnancy.

    I’m glad you figured out what was best for you. I generally villianize HBC as birth control but I totally get that there are some legitimate reasons to use it for extreme cases. What pisses me off though is that doctors always reach for it as the first choice. I started taking it when I was 13 for heavy irregular periods. Neither my mom nor I were EVER warned about any of the side effects or risks. And I took various brands and versions of it for ten years. When I eventually went off of it, I had textbook 28 day cycles, barely any period pain, etc. In hindsight, I feel like I was horribly failed by my GYNs.

  6. Mary

    Here’s one huge difference to answer the inquiry: taking prometrium post peak works *with* your body’s own set cycle and you are taking it during the time when progesteronenis bormally being produced in greater amounts (after ovulation). The pill completely shuts down your cycles, and therefore, is bound to have more I’ll effects.

    Secondly, prometrium is identical to the kind of progesterone you produce yourself. The formnin the pill is “progestin”, and doesn’t “match” with your cells’ receptors as prometrium does. Pharmacologally, prometrium and the pill are two very different things.

    Also, promethium has not been linked to cancer. The pill is listed as a class one carcinogen .

    Surely prometrium is not for everyone, but if your progesterone takes a nose dive halfway through the post peak phase (like mine did and caused extreme PMS/PMDD), then prometrium tends to be very helpful for most. Again, it’s not for everyone if side effects occur, but it sure beats the pill as far as not direuptinf your body’s rhythm and even pheromone-sensing that is women use to find which men we are genitaccly different from.

  7. Tanya

    I know these are older posts, but just wanted to share my experience. I’m now in my mid forties, but was diagnosed with endometriosis in the late 90′s, went through three years of fertility treatment, and had 5 miscarriages (two after first trimester). I have 3 beautiful children now, and am certain it is because those 3 pregnancies (out of 8!) were the only pregnancies that I was taking progesterone. So for me progesterone was truly a life saver. Obviously everyone’s body is different, but I was/am obviously progesterone deficient.

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