Is My Premenstrual Spotting Related to My Miscarriages


I am 40 years old, with an almost-three-year-old daughter. My husband and I have been married for eight and a half years. We went through three years of “unexplained infertility” before conceiving our daughter naturally. Since then, we have lost three babies in pregnancy; one loss at 18 weeks (from an abdominal infection I developed) and the others in the first trimester (7 weeks and 4 weeks).
I normally have between five and eight days of spotting before my period starts. I chart my cycle, and my luteal phase is from 13 to 15 days. I’ve had my progesterone levels checked seven days after ovulation (and from my chart I knew when that was) and they have always been normal, even high. I asked about testing after that, thinking that perhaps my progesterone drops abnormally early, but my OB said there are no tests that would show what range “normal” is after CD21, so testing wouldn’t tell us anything. I’ve had an ultrasound that showed no cysts or polyps on my ovaries or anywhere else.

Are there other causes to my spotting that I am missing? Could this be linked to my miscarriages? The only thing the doctor offered was putting me on hormones that would suppress ovulation, but we would like to have another child, so that is not an option.

Thank you for any insight!



Last Updated: May 8, 2022
Dear Kristi,

Your two first trimester miscarriages and your premenstrual spotting suggest a luteal phase progesterone defect. While the peak plus seven progesterone level was reported as normal, you are correct, the rest of the progesterone curve could be abnormal. Premenstrual spotting can also be due to chronic, low grade infections of the endometrium (the uterine lining).

NaProTECHNOLOGY offers you a way to do a comprehensive hormone profile. This will give you your estradiol levels throughout your cycle as well as your progesterone levels on days peak plus 3, 5, 7, 9 and 11.

You can find a NaProTECHNOLOGY medical consultant by going to Click on the left column menu to find a consultant near you.

In health,

George Delgado, M.D.

Answered By:

George Delgado, M.D., F.A.A.F.P.
President and Founder of Steno Institute and Medical Director of Culture of Life Family Services (COLFS), San Diego, is a Professional Member / Supporter of CANFP. Board certified in both family medicine and hospice and palliative medicine, Dr. Delgado received his medical degree from the University of California, Davis, and completed his residency at Santa Monica Hospital/UCLA. Dr. Delgado is a Natural Family Planning Medical Consultant, trained in NaProTechnology.

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