Prometrium and Spotting in Early Pregnancy: What to Do?

Question
Hi,
My husband and I have been trying to conceive for almost 2 years and I finally had strong positive HPTs for the last week. Based on my calculations, I would be at 4w 3d today. Because I had a miscarriage in October and my ob/gyn and I were concerned about an eventual progesterone deficiency, she gave me a prescription for 100 mg of prometrium twice daily. Everything seemed to be going ok until about an hour ago, when I went to the washroom and noticed pink spotting on the toilet paper. I had used my prometrium vaginal suppository an hour before. Should I worry about a second miscarriage or is spotting normal on prometrium? Could it just be that my cervix is irritated and bleeding from the suppositories?

I'll call my ob/gyn to talk to her asap but I don't know exactly how long it's going to take.

Thanks for your help.

Answer
Dear Annick,

Well, I am hopeful that your OB has returned your call by now. Unfortunately, some who ask questions on this site are unaware that this is not an "immediate answer" site. I wish they would make that more clear for users so you wouldn't anxiously await a reply only to be disappointed! For future reference, experts on this site are encouraged to answer within three days time. Personally, I always try to answer within 48 hours unless I have a real issue going on here.

Now to your question... Breakthrough bleeding can be a side effect of progesterone suppositories. Other side effects can include insomnia, somnolence, rash, nausea, vomiting, diarrhea, breast tenderness, headache, and bloating.

The pink-tinged spotting, if it was an isolated incident, was probably nothing to be concerned about at all. It may have been related to the suppositories or to early pregnancy. Vaginal bleeding/spotting can occur frequently in the first trimester of pregnancy and may not be a sign of problems. Bleeding can be a sign of miscarriage but does not mean that miscarriage is imminent. Studies show that anywhere from 20-30% of women experience some degree of bleeding in early pregnancy. Approximately half of pregnant women who bleed do not have miscarriages.

Unless you begin to experience cramping (like strong menstrual cramps) and/or clots or tissue passing with heavier bleeding, I would not be overly concerned.

I hope this has helped you and answered your question. I wish you well and hope you will return with any questions in the future. Congratulations on your pregnancy!

Brenda