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Cycle confusion — I need your advice

August 3, 2009

My husband has been out of the hospital for a week and we’re adjusting to life on three legs (between the two of us). And I must say, it is quite an adjustment.

But he’s doing much better and can fend for himself in very basic ways. This has, of course, given me some time to go back to thinking about MYSELF, which must be my favorite pastime — sadly.

As if everything else weren’t frustrating enough, my cycle has been very confusing this month. I don’t know whether to blame it on the trauma or the estradiol. I’m on a new estradiol regime this cycle– after a lot of back-and-forth with my doctor’s office, I am taking it every day.

My immediate concern is that I am supposed to get blood drawn on P+7 to see how my estrogen-progesterone balance is doing.  However,  given the aforementioned husband-injury-trauma and my cycle confusion, I am not entirely clear on when P7 would be. But I don’t want to put off the blood draw another month; I *desperately* want to get  it done. I thought I was going to do it back in JUNE, but the whole when-to-take-the- estradiol debacle delayed things.

For various reasons, I am skeptical this estradiol thing is working, so I’d like to go ahead and get the blood draw so we can see what the levels are.  I don’t want to waste ANOTHER month and another $60 if it’s just messing me up.

The problem is I have no idea when my peak day was.  This is where I need your help. I must warn this will also involve more description of my cervical fluid than I thought I would ever post on the internet, but here we go …

I often ovulate around day 18. In the past I have had maybe 2 days of decent CM, but my doctor said the estradiol should help that (along with all the other garden-variety enhancers I’m using: mucinex, robitussin, antibiotic, etc.). I definitely saw a change this month, I noticed lots of CM on days 10-13. But I, err, dried up on day 14.

My husband’s bike crash and hospitalization was on my CD 12. I assume that could certainly have thrown my cycle off.

But, not to despair: the CM came back on day 17, and I had what I would consider good fertile-quality stuff on day 18. That was pretty much the end of it, except that I’ve noticed a very small (very small) amount of fluid on subsequent days . However, I am not sure it means anything —  when I took the estradiol post-ovulation in previous months, I noticed a similar resurgence of minimal mucus.

So… this all leads me to believe I ovulated on July 28, day 18 (as usual!) and therefore should get my P7 blood draw tomorrow (Tuesday) morning.

BUT, it’s not quite so clear as that.

Issue number one: I used some ovulation predictor sticks this month and never had a positive test. (I’ve been using them the past few months as back-up for what I already suspect with charting. It seemed like a waste of money, but some months my CM was so bad it was hard to tell about the ovulation, so the kits helped. And if I can never get that precious double-line on the pregnancy test, at least I can experience the joy of a positive ovulation test.)
I did have a light but not full line on the OPK on day 17. When I tested on day 18, I got nothing. But perhaps I tested too late? Or perhaps it was too diluted because I drank too much water? (It was a hot day.)
I continued testing on subsequent days, no  positives. Big waste of money on the OPKs this month.

Issue number two: No thermal shift. Actually, my temperature has gone DOWN even lower than normal the past two days.  Very strange.

I suspect this temperature suppression could be due to the estradiol, since progesterone is the heat-inducing hormone. Last month when my doctor’s office temporarily told me to take the estradiol post-ovulation, I started it a day or two after I had a positive test on an OPK. But my temperature never shifted. I was also travelling through three different U.S. timezones during that time, so I had another interfering factor. But I got fed up with the estrogen anyway, and after my doctor said I should really be doing it the whole cycle, not half,  I just stopped part-way through my luteal phase last month. It was after I stopped the estradiol that I finally saw a temperature shift (but I still think I ovulated back when I saw the positive test. Otherwise, I had a really short luteal phase).
Nota bene: This is also why I suspect the estradiol might not be the right tactic for me.

As you can see, this is all VERY CONFUSING.

My immediate question is this: Should I get my P7 blood test tomorrow, based on the fact that one week ago I had my day of most fertile CM?
Or should I wait, given that I never saw a temperature shift and have had glimpses of a tiny bit of CM since then?

I am inclined to go ahead and get the blood draw tomorrow, because I just want SOMETHING besides my neuroses and my half-hearted charts to guide me (and hopefully my doctor) in what to try next. If I have a CM resurgence and a “real” ovulation later on, I could get a new blood-draw prescription and try again later.

But then I think, “You’re really just making up this P7, you actually HAVE NO IDEA.”

So that is when I turn to you, internet. WHAT SHOULD I DO?

My longer-term question(s): Is the estradiol supplement screwing up my cycles or is stress? Or both? Or something else ALTOGETHER? And when should I try to see my doctor to talk about it? Back in May, he told me that if I’m not pregnant by September, I should make an appointment with a different doctor in his practice to talk about a lap, since we have not totally ruled out endo (I have no classic endo symptoms, other than infertility, but as we all know — plenty of people have endo without the cramps). Now we’ve changed the estradiol around a few times since then, so I assume they’d want me try it for longer. But I am not convinced it is helping, so I’d really like an appointment soon just to reassess this treatment plan. Can I just ask for one to talk about the estradiol? It’s so stinkin’ hard to get an appointment. I don’t know that they will even call me back about the blasted blood test.

Oh, sigh! Help.

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2 comments

  1. Not sure if you’re a Creighton charter, but was the mucus you saw after day 18 peak-type mucus (meaning clear, lubricative or stetchy)? Whatever your last day of peak-type mucus was would be your peak day, meaning even if it’s of “lesser” quality than what you saw on day 18, if it’s peak-type mucus then you chart your last day of it as your peak day (if you’re someone who tends to always have a lot of extra mucus post peak, though, then that might be a different story). Stress can also cause double peaks.. so if you end up seeing that, then obviously mention that as well since then your blood work will be off.

    If it were me, I’d just get my blood drawn on whatever day I thought was peak, rather than skip a month. When they call with the results, I would just mention you weren’t sure about the day and that it may be off (and if they don’t call, call them and ask to be called back).

    I also say make an appointment! Heck, if you called tomorrow you won’t get in until September anyways! (possibly not even until Oct. but I hope not!!). I know exactly how you feel.. I always leave appointments with a long term plan of waiting to see if I get pregnant and then to call in several months if I don’t. I’m always agreeable at the time, then later I’m like, ‘why am I not more aggressive when I’m there?’ Definitely do whatever works for you, but if you feel like you need to be more aggressive, there’s nothing wrong with that. I’m going to start to do that myself!


  2. Wow. Ok, I am no expert on any of this, but I would say double peaks = stress, and p = 18. But I don’t know what to make of the temps. Your estradiol theory is reasonable, but in a stressful month, you could skip ovulation completely. Why not get the blood drawn? Then you’ll know.



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