Effects of Spotting Before Period, Miscarriage & The Pill
Twelve years on the pill. My cycle is like 24 to 29 days, and I average 3 days’ spotting before my period arrives each month. Could what’s causing the spotting be affecting our ability to conceive again?
A: The answer is a resounding yes, particularly on the short cycles where you’re having a 24-day cycle. Generally speaking the way that the menstrual cycle works, we have two phases to the cycle and if you get pregnant you go into a third phase.
Essentially the two phases are the follicular phase, which is the first half of the cycle prior to ovulation, then you obviously have ovulation and then you have the luteal phase, which is the second half of the cycle.
The variation generally comes from the follicular phase and not the luteal phase. However, in instances where ‑ and this does happen ‑ where the luteal phase varies, generally speaking there will be miscarriage problems and sometimes even conception issues that arise as a result of that.
Generally, the luteal phase is shortened for a variety of reasons including a defective follicular phase. Having an egg that is not fully matured, it can also have another impact. Not having enough progesterone can certainly be an impact.
Just to go ahead and take progesterone is not necessarily going to address the issue. But also spotting prior to a cycle despite the fact that it can be any of those things that I have already said, it can also have a relationship to hypothyroidism. Sometimes it’s subclinical where it’s not necessarily diagnosed as a problem, but certainly, for you it might be enough for it to cause a problem.
The reason that you may be having the spotting and may also be having a fluctuation in the cycle may very well be the same. Of course, to be able to understand the exact cause of that is going to be absolutely essential, in order to address the problem, the ability to understand and really be very clear about what is happening in your particular regard is going to be essential.
You might want to go to your doctor and ask them to test your thyroid function. You certainly want to get your 7-day post-ovulation progesterone levels done, and I say 7-day post-ovulation because generally it’s a day 21 test but if you’ve ovulated earlier, it’s not going to be day 21 because you want to test it 7 days post ovulation.
Get your progesterone levels checked, get your thyroid function test. Ideally you want to be charting your cycles so that you know what’s happening in the first half and the second half of the cycle.
The reason for miscarriage can also be varied. It doesn’t necessarily have to be only because of recurrent miscarriage. I have done a Q & A session, where I discussed in great depth the seven category reasons for miscarriage, which I would highly recommend, understanding about the seven category reasons for miscarriage is useful to then understand what needs to be tested, what needs to be looked for, and certainly what some of the things that you can do about it.
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