This is my story of how progesterone cream made NFP tolerable, instead of intolerable.
The following post is purely in the interest of public service, and is not especially entertaining, amusing, or edifying (hence the Google-friendly title). I am not offering medical advice! I am just telling my story, in hopes that it will encourage other women to talk to their doctors, too. I wish I had done it a lot sooner, because now my cycles became intelligible, and NFP became endurable.
This post is all medical, and not for the squeamish. I will be using the words “cervix,” “mucus,” and “period.”
We use the Creighton Model of NFP. I do not seem to be able to take my (bizarrely low) temperature consistently, and I am too technophobic and mistrustful to try a monitor. Creighton was a good choice for us because you can use it while breastfeeding. But still, it was pretty awful for many years. If Creighton is “an authentic language of a women’s health and fertility,” then my charts were clearly saying, “Wha? Hasenpfeffer. I think! Potrzebie! Huh?” and occasionally, “Ow.” In other words, I never really knew what was going on, except that we did not have a lot of days available for sex. Some months, we had a grand total of one day (and I would be deep in the throes of PMS, so, super sexy with all the crying and screaming and paranoia). This was no good.
My Fertility Care Practitioner knew I was frustrated and kept on encouraging me to call this NFP-only doctor she knows, but I was sure it would just be a waste of time and money, because nothing will help, I’m doomed to suffer, etc.
The problem before progesterone cream
My main problem was continuous mucus.
- I never had dry days, even when my cycles were fully established and regular after night-weaning.
- There was just never a very strong distinction between peak-type (more fertile) and non-peak-type (less fertile) mucus, and that made charting almost useless, and a source of constant anxiety.
- To accommodate these ambiguities, I got yellow stamps, but the “is this essentially the same?” question hit me right in one of my weakest spots: I’m a compulsive second-guesser, especially when I’m tired, and the strain was enormous. We had so, so, so few available days, and I was never sure that they were actually okay to use. And saying “end of the day on alternate days when you’re — well, do you think you’re fertile? Trust yourself!” — well, that ain’t sexy talk.
Also, I could never do the seminal fluid elimination properly, no matter what ridiculous contortions I tried or how much water we both drank; so even once we were post-peak, there was always some uncertainty about what I was seeing.
So finally I went for a check-up. The doctor expected that I would have a cervical eversion from eight vaginal deliveries in 11 years, which can cause chronic irritation of the cervix, causing superfluous and confusing mucus. They can do simple treatment right in the office. But no, it turns out my cervix is (inexplicably) fine. So he gave me a prescription for progesterone cream, but I didn’t fill it for several months, because nothing will help, I’m doomed to suffer, etc.
So I finally filled the Rx, and within a month of starting to use a dab of cream for a week or so per month, I started having cycles like in the manual.
- The longer I used the cream, the more dry days I saw.
- The peak-type (more fertile) mucus is more abundant, and very distinct from non-peak-type.
- And most importantly, we now we have what seems like a luxuriously long post-peak phase. We can even have a fight post-peak, and still have time to make up and have sex again! It’s pretty sweet.
There are more available days pre-peak, too, but since most unexpected pregnancies seem to come from pre-peak conception, we are pretty conservative.
Seminal fluid is easy to eliminate, and even if I don’t do it, it’s very distinct from any cervical mucus.
I’ll say it again: my cycles now look like the ones in the manual.
- When I’m using the cream, my cycles shortened from a typical 29-30 days, to 26-27 days. My practitioner says that that is unrelated to the progesterone cream, but it sure is an amazing coincidence, because I never in my life had a cycle shorter than 28 days until I started using the cream; and now I rarely have a cycle longer than 26 days.
- My period is more “efficient,” which means it takes 5-6 days, but most of it happens over two extremely heavy flow days. They are no more painful than usual, but much more messy; but it is kind of nice to get it over with all at once, instead of having a gradual build-up and gradual wind-down that goes on and on.
- You can only use the progesterone cream if you are certain that you have already ovulated; otherwise, it may prevent ovulation. So if you suspect a double or split peak, you can end up waiting and waiting for the actual peak day to come, and then it turns out you just get your period anyway (and then your next cycle might not be as spiffy, because you haven’t had the benefit of the progesterone cream from the previous cycle). Obviously, that’s not a drawback of the progesterone cream itself, but could happen any time – - it’s just something that adds a slight layer of uncertainty, because you’re not just waiting to see what happens in the cycle, but also waiting to see if you should use the cream.
I rubbed the prescription cream into my inner wrist, inner elbow (is there a name for that part?) or abdomen once a day, starting on day P+3 and continuing until the end of the cycle. It hasn’t caused any type of rash or irritation, or dizziness or nausea.
In order to know exactly how much progesterone you’re getting, you need a prescription, and you need to get it at a compounding pharmacy. The only local one here does not accept insurance, and the cream costs $40 for two pre-filled syringes, which last me nearly three months.
However, after several months, I decided to try an over-the-counter version of progesterone cream called Emerita Pro-Gest, and it works exactly the same for me. It’s much cheaper and I just order it from Amazon. I use it in the same way at the same part of the cycle, but twice a day (morning and night).
However, I am probably going to go back to the prescription kind, because I want to make sure I’m getting the right dose if/when we go for another baby.
For goodness sake . . .
Please, please, please, do not try progesterone cream without talking to a doctor first! Strange cycles can be caused by any number of things, some of them quite serious. Progesterone cream is a hormone, and just because it’s sold OTC doesn’t mean it’s safe or appropriate for everyone!
Many people use progesterone cream to alleviate PMS symptoms. It hasn’t helped me with that at all. However, at least my cycles are intelligible enough that we can say, “Yep, it’s PMS” and we know I’ll be back in my right mind in 48 hours.
But you may not be doomed to suffer
If your cycle looks anything like mine did, maybe you should ask your doctor about progesterone cream. It couldn’t hoit! It does make some people feel terrible, and it doesn’t work for some people. Some people are allergic to it, and some people, as I said, have serious conditions that won’t be helped by progesterone, so talk to your doctor talk to your doctor talk to your doctor. You are much more likely to be taken seriously if you talk to a doctor who understands NFP. One More Soul has a directory of NFP-only practices.
I wish I had emphasized this more in my book: there are lots of kinds of NFP, and there are often things you can do to make your cycles more manageable. So don’t be a fatalist like I was! Look into your options, and make the investment of time, effort, and money to improve things, if you possibly can. Marriages are not meant to be sexless. NFP is hard, but sometimes it’s harder than it needs to be.
But for goodness sake, please, seriously, talk to your doctor.