Mixed messages from the doctor’s office

June 23, 2009

divigelI am so confused.

When I saw Dr. B last month and learned about my ridonkulous progesterone levels, he prescribed an estrogen topical ointment for the second half of my cycle — an attempt to help balance out my crazy overachiever progesterone. He kindly gave me a few samples, which I used last month. I did not get pregnant, and I actually had what seemed like a slightly shorter luteal phase than usual. Bummer.

But I was hopeful that using it correctly last month might set me up for this month, my second month on the treatment. He also told me to get a P+7  blood draw in the second month to test how it was working.

This all sounded well and good until I came back to the blogosphere and could not find any of you with a similar treatment. To further confuse things, a friend of mine went to see a doctor (Dr. L.)  in the same practice and mentioned my treatment, and the doctor said, “We don’t do anything like that here.” What?

Anywhim, I love my (wonderful, Catholic) doctor and his practice, so I have tried to remain upbeat about it. I desperately want some anecdote of “I did the exact same thing and it worked for me!” But I just have to trust my doctor. I went to pick up the prescription today (day 14 — I usually ovulate around 17)… but now am even more frustrated and confused.

The first problem is not so much a *problem,* but an annoyance. The prescription was a bit expensive. My insurance company picked up a big fat $8. My “copay” was $60. (an aside: I will note that I am grateful to have insurance at all and probably should not complain … but I sure do pay a lot every month, and I wish they would help me out a little more.)

The second problem is a bigger deal: I don’t know when to take it.

Here’s how this came about: The box has a sticker on it that says not to take it when pregnant. I figured that probably only applies to people with normal progesterone levels, but thought I would call my doctor’s office just to make sure. Since, you know, the point of me taking the estradiol is to actually *get* pregnant (although I honestly have a very hard time believing it will happen). I know Dr. B told me to apply it from ovulation until menses … but what if — oh joy! — menses never arrives? when do I stop?

I left a message with the triage nurse, who called back shortly thereafter to say that the pregnancy thing should not be a problem, since Dr. B wants me to take it from DAY ONE until OVULATION. But I *know* that at my appointment he said *ovulation* until *menses.* My husband remembers this too, and I am pretty sure it is what he wrote on the prescription, which is now in nowhereland at the pharmacy.*

I told the nurse I thought it was from ovulation until menses, she said no.

Me: “Well, then have I been doing it wrong then? maybe next cycle.” Nurse: “sorry.”

I am so frustrated and confused! Which one is right? Should I call back *again* just to clarify? Am I going to be the crazy person who calls the doctors office twice in two days? Have we lost another two months due to miscommunication? Will I be in the country next month for the blood draw? How far will this put me behind in seeking surgery or the next round of diagnosis and testing? Argh!! Did Dr. B just tell me the wrong thing at first? This does not inspire confidence.

I will note that Dr. B is awesome. He is also the doctor for AYWH and several others in this circle, I think. I am a big fan. I just wish I could talk to him about this again — it’s so confusing! DR. B, ARE YOU OUT THERE READING OUR BLOGS? HELP! What do I do?!

*UPDATE: The Misfit gave me the brilliant idea to actually read the label on the box. It prints the doctor’s instructions as “take from ovulation until menses” …  not what the nurse told me to do. The intrigue continues!



  1. I don’t see why you can’t ask to have the *doctor* call you back. I know, at Tepeyac they always have the nurses call, but I have personally witnessed the ability of doctors to use phones. Also, I think whatever your doc wrote on the scrip should now be in that dot-matrix print on the prescription label – you might check just in case. I can see the logic of either pre- or post-ovulation, so who knows?

  2. Oh misfit, you are so clever. of course! I just looked at the label on the box, and it says “apply the contents of one packet as directed by your doctor from ovulation until menses.”

    ARGH! So confusing. I will call tomorrow. Mayhap Dr. B will call me back — it is my birthday tomorrow; perhaps they will have pity on me.

    I suppose the other “problem” is that I don’t really understand how this will help either way. sigh!

    I’ve also taken to drinking soy milk lattes, since I know soy also increases estrogen production. Of course, this is probably outweighed by the caffeine. OH, WELL.

  3. I would call and leave a message for him to call you back. He will! You don’t want to mess with medication and he knows that. If he knows that there is confusion and you are worried about it, he will want to clear it up for you. And don’t worry about being that patient who calls twice in two days, because I am that patient too! So at least you know you’re not alone!

  4. you ladies are the best. Thanks, K! How do I actually go about doing that? I think I just sent you an email asking the same thing — now I am an annoyingly persistent blogger/emailer AND will be an annoyingly persistent caller. Agh. But I know you understand. 🙂

  5. Ugh – so frustrating about this situation! If you remember, I am also a patient with Dr. L. I have wondered if this treatment might help me because my estrogen levels drop towards the end of my luteal phase. I will bring it up with her the next time I see her (next month.) Hopefully she has some information to share!

  6. Sorry, I didn’t get your email til now! What I would do is call and leave a message on the nurse triage line asking for him to call you back. I’m pretty sure they even say “To leave a message for a doctor…” And I’m pretty sure this is what the blogger GIMH did a few weeks ago (she also goes to him) and he called her back. Good luck!!

  7. […] first got the conflicting messages about the estradiol on a Tuesday. The prescription said I should take it from ovulation until […]

  8. I took prochieve 4% vaginal suppositories because my Dr said my progesterone was a little low and on the box it states not to use if pregnant but the Dr. said it was ok and then the next day I started to spot and called the Dr. and was told my cervix was irritated. Two days later I lost the baby. I has strange dreams, irritability, sick, weight gain, etc I will never use hormones like that again. Its just not natural and it states that some babies have been born with cleft palet, intestinal deformations, etc. I was also gave conflicting stories and the pharmist told me if I have questions to ask the Dr. because she did not know anything about this medicine and they had to special order it.

  9. Hello, I actually have to do the same thing… from ovulation (actually my trigger shot) until menses, so you aren’t that different. I have PCOS, and have also had 4 miscarriages. This last cycle, my lining was 7.6 mm, so they told me to do the Divigel. Maybe ask your doctor for some samples… I know my doctor has a CLOSET full! I would actually prefer a prescription, because we are very lucky that they are $3.00, which is better then having to go back every week for another 7-day sample pack! Good Luck!

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