Pregnancy After Childbirth

Dear Dr Mary Davenport or other practitioner,
I read an “Ask the Expert” that Dr. Davenport wrote in response to a lady’s question about spotting just before her period. It sounded as if I should be detailed when I ask my own question and thus I will do so.

In my late teens and early twenties I had some infrequent asymptomatic spotting between my normal periods. No treatment was recommended by my doctor. At age 22, I began taking the pill for birth control purposes and the spotting resolved. Approximately 6 months later I noticed some mild dyspareunia which was managed with a lubricant. Overtime the dyspareunia worsened to a grade II as I began to have intercourse less frequently secondary to the burning vaginal pain even with a lubricant. I stopped the pill at age 27 and noticed some improvement in my natural lubrication and less painful intercourse. I was pregnant within 6 weeks. My dyspareunia was only mild during pregnancy. Following pregnancy I had grade III dyspareunia with vaginismus and a diagnosis of vulvar vestibulitis with symptoms only with attempted intercourse. I was unable to engage in penetration for one year but my symptoms are now 90 % resolved as long as I use a lubricant during intercourse (I do not need a lubricant however, when I am ovulating). We used the withdrawal method until my son was 16 months old and we pursued another pregnancy. I nursed him until 18 months old and quit due to advice it was hampering my pregnancy odds. For nine cycles since we have been attempting pregnancy, I also have bleeding prior to my normal menses at day 28. Initially I spotted 7 days but within a few months I was spotting 3-4 days before my normal menses.

I do have an LH surge on the ovulator predictor test with corresponding symptoms. I surge between days 12-13. I had a progesterone test taken at day 9 post ovulation, 4 months ago, with a level 12 (which my dr. said would be normal). My prolactin test showed a normal level. Even though it has been 7 months since I stopped nursing I still have milk in my breasts. (Is that normal?). I do avoid breast stimulation and have checked this infrequently.

I was told I might have a luteal phase defect even with the “normal” progesterone level. On my 10th cycle, I began taking 100 mg of progesterone BID sublingually beginning 3 days after ovulation. The first month I ovulated late, for the first time, at day 16 and my cycle was 6 days late with 2 days of spotting, pregnancy test negative. This last cycle I also began 50mg of Clomid, QD, (day 3-7 of my cycle) followed by the progesterone. My period was 4 days late with one day of spotting with a negative pregnancy test on day 29 of my cycle.

Some of my periods have been heavier with clotting and my last two cycles have been this way. Does this mean I may have a luteal phase defect that is improving since the two months I used progesterone because my cycles were 4 to 6 days late? Or is the late period just a normal side effect of taking progesterone. What does this sound like to you? I included my prior history of gynecological pain as I thought it may be related to a long history of hormonal imbalance. I sincerely thank you for any advice you could offer.