Premenstrual Spotting, Short Luteal Phase, and Miscarriage

Question

I am 32 years old and have 3 children. My husband and I have practiced NFP since before our 1st child was born. Since the birth of our 2nd child, I have had premenstrual spotting. It seems to be getting worse. I have always had shorter luteal phases, from 9-12 days, but have also been breastfeeding my kids during this time too.
I am currently nursing my 18 month-old 2-3 times/day. My period returned when she was six months old. The premenstrual spotting had always been brown, but the last cycle or two it has been reddish too. I should mention that about five months ago I miscarried when the baby was seven wks. old.

My questions are, what is causing my premenstrual spotting? I’ve increased my intake of Vitamin B6 to 250mg/day, per Marilyn Shannon’s book recommendations. Also, is the miscarriage connected to this premenstrual spotting?

Thank You!

Jenny

Answer

Last Updated: August 15, 2023
Dear Jenny,

The combination of symptoms you describe—-pre-menstrual spotting, miscarriage, and short luteal phases—are indicators that you should have a hormonal evaluation, checking in particular your progesterone levels. There is such a strong association between these symptoms and low progesterone, that I would even suggest you obtain an evaluation prior to pursuing another pregnancy, to lower your miscarriage risk. Your knowledge of your cycle as an NFP user will permit a very precisely timed evaluation of levels, during the luteal phase of your cycle, and also will be the key to timing progesterone supplementation when needed and effective, also in the luteal phase.

If your doctor is not knowledgeable in this area, you may need to consult a physician who is. In California, those physicians are listed on our website at www.canfp.org.

Sheila St. John

Answered By:

Sheila St. John
Sheila St. John is the Executive Director of the California Association of Natural Family Planning, coordinating the non-profit’s education and advocacy efforts throughout the state. Initially attracted to NFP as a healthy, effective method for planning families, drug, device and surgery free, her passion for NFP has grown over the last 42 years as she has journeyed with the over 900 couples she has personally instructed in its use, and been privileged to witness its role in overcoming infertility, women’s health, and the transformation that occurs in lives of men, women, and families, when we embrace God’s design for love and life.

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