Implantation Bleeding? Am I in the 2WW?

Ok, so if any of you have read my previous long story post, I have hypogonadism and rarely get my period even with hormone replacement therapy. Recently I found out I have MTHFR defect hetero C677T, so I've switched vitamins and stopped eating fortified foods, and I'm trying to eat better (I am a chronic low-calorie gluten-free vegan). I finally got a period the end of March, which proceeded off and on through most of April - very classic dark red, clots, the works, just exceedingly long. I'm not one to get bad cramps or moody, sometimes just a light headche, I put in my Sckoon cup and I'm usually all good. The past couple of days my stomach has been achy, bloated, and crampy more painfully than during my period, and I'm having a light headache. I have had some painful twinges in my right ovary, so I thought maybe I'm about to ovulate. I've only ovulated once in my life a few years ago, and I remember it being painful and my breasts being hella tender. However I just returned from the bathroom with light pink discharge, no clots or that goopy-ness I associate with menstrual blood. Thoughts? Last BD was April 28. Because I don't get regular periods (I'm 33 and have had maybe a dozen in my life) and because I've never been pregnant, I really have no idea what I'm doing here! I'm supposed to start clomid as soon as I stop this cycle and clearly start a new one. Thank you!

That bleeding can come with ovulation too - I would not have you start Clomid that's for sure without more info (blood tests from doc) to tell you where you are in the cycle.

You can be pregnant even with what seems to be a normal period and since Clomid can cause problems for the baby if you take it when you're pregnant, we need to be EXTREMELY careful to be sure you aren't pg. If you can't get in for blood work, take a pregnancy test now and in 2 days. If you have heavier bleeding start, then take another pregnancy test 2 days after the bleeding begins and again the day you plan to start the Clomid (always take a pg test the day you plan to start Clomid)

If you were/have been bleeding on and off for a month I would guess that you are having breakthrough bleeding and not actual AF, despite the heaviness. Regardless, you shouldn't be bleeding for that long and should get checked out. A scan or blood work would be enough to tell you where you're at and clear you for Clomid.

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Originally Posted by atomic sagebrush

That bleeding can come with ovulation too - I would not have you start Clomid that's for sure without more info (blood tests from doc) to tell you where you are in the cycle.

You can be pregnant even with what seems to be a normal period and since Clomid can cause problems for the baby if you take it when you're pregnant, we need to be EXTREMELY careful to be sure you aren't pg. If you can't get in for blood work, take a pregnancy test now and in 2 days. If you have heavier bleeding start, then take another pregnancy test 2 days after the bleeding begins and again the day you plan to start the Clomid (always take a pg test the day you plan to start Clomid)

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Thanks for your input. I've been trying to wait it out, no return call from my doctor yet. Do you know if it's possible to have a progesterone surge without ovulation?

I'm definitely having progesterone surge symptoms like when I'm taking oral progesterone for a withdrawal bleed, but the last time I took any progesterone was March 1-5. My estrogen was reduced to 1mg daily about 2 weeks ago. I haven't had any bleeding since spotting for 2 days - pink on 5/4 and brown on 5/5. BD 4/8, 4/28 & 5/7. Period came and was normal 3/27-4/2, with spotting until 4/29 but it was red and period-like just light. It might be worth noting I started Tirosint about 6 months ago at 25mcg recently upped to 50mcg, and about a month ago I found out I'm heterozygous C667T for MTHFR so I've been off of synthetic vitamins since then and taking a methylated prenatal 1/8th dose.

Symptoms are mild cramping, bloating & gas, headaches, heartburn, dry skin, excessive thirst, skin blemishes, exhaustion/fatigue, cm has slowly been reducing (EWCM yesterday), moodiness, strong sense of smell, nausea with certain smells, super warm when I'm normally cold, runny nose, bouts of extreme hunger... sounds like a progesterone surge, right? But what could cause it if I didn't ovulate?

I'm really try to understand it all, I can't describe how difficult it is for me having hypogonadism and just never having any predictability :/

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Originally Posted by maidentomother

If you were/have been bleeding on and off for a month I would guess that you are having breakthrough bleeding and not actual AF, despite the heaviness. Regardless, you shouldn't be bleeding for that long and should get checked out. A scan or blood work would be enough to tell you where you're at and clear you for Clomid.

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I'm new to this, what is breakthrough bleeding vs a period? Would that be bleeding attributed to the estrogen and progesterone I'm taking?

I've been taking estrogen 2mg once daily since last fall, reduced to 1mg 2 weeks ago. I was prescribed progesterone once daily orally for the first 10 days of each month for a bleed, but it didn't work until March 1-5 my doctor had me take 2 pills daily for 5 days instead, and I began bleeding 3/27.

Even though I haven't taken progesterone since early March, I'm definitely having progesterone symptoms which is really confusing me. I don't believe it's possible I ovulated but what else could cause a random progesterone surge? Praying maybe my cycle will begin to regulate now that I'm on a good thyroid and MTHFR treatment plan! I just feel like a teenager trying to figure this stuff out for the first time :P

Something interesting that happens when progesterone rises, is that at the same time, estrogen DROPS. So I wonder if some of the symptoms you have previously attributed to higher prog, were actually a result of lower estrogen, and since they're appearing concurrent to having your estrogen dose lowered, that may be what is going on. That's my guess, anyway.

Breakthrough bleeding is caused by a drop in estrogen without ovulation, and it makes your lining slough off. Looks like a period but isn't one. I suspect that since you were given progesterone, that is what triggered the bleed beginning on March 27 and not really breakthrough bleeding per se but a medically induced bleed. I am assuming that the long time of bleeding is what caused them to reduce your estrogen from 2 to 1?? Supplemental estrogen can cause a heavy uterine lining to build up and so they may want to prevent that from happening in future???

Did they have any input into the long time of bleeding??

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Originally Posted by atomic sagebrush

Something interesting that happens when progesterone rises, is that at the same time, estrogen DROPS. So I wonder if some of the symptoms you have previously attributed to higher prog, were actually a result of lower estrogen, and since they're appearing concurrent to having your estrogen dose lowered, that may be what is going on. That's my guess, anyway.

Breakthrough bleeding is caused by a drop in estrogen without ovulation, and it makes your lining slough off. Looks like a period but isn't one. I suspect that since you were given progesterone, that is what triggered the bleed beginning on March 27 and not really breakthrough bleeding per se but a medically induced bleed. I am assuming that the long time of bleeding is what caused them to reduce your estrogen from 2 to 1?? Supplemental estrogen can cause a heavy uterine lining to build up and so they may want to prevent that from happening in future???

Did they have any input into the long time of bleeding??

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My doctor never really explains things. She dropped my estrogen because of the long bleeding, yes. I was on 2mg only because of an osteoporosis diagnosis last year. She's having me wait to take progesterone again in a few months after I haven't bled for a while. It's crazy how progesterone like these symptoms are! Hopefully the doctor will call me back today.

I didn't realise you were taking hormones. I wonder if going to a lower dose of estrogen prolonged your medically induced bleed (which is much more accurate than BB in your case)? Atomic is spot on about how low estrogen can feel like progesterone.

I personally think you could probably start Clomid at any time, since it is unlikely you have Oed on your own. If you want to be extra sure, you can wait until 2 weeks have passed since you last had unprotected sex and after a sensitive tests confirms you aren't pregnant. Or just see your dr for a scan/blood work to determine if you've Oed.

I'd be sorely tempted to do the Clomid as per Maiden's description - if you go 16 days without unprotected sex and KNOW you haven't ovulated then I'd be very tempted to go for it.

The risk is that if you were just about to O it may contribute to the formation of a cyst OR can delay ovulation. But those do resolve and aren't that likely anyway - additionally since your doctor is willing to prescribe another round of prog. for another bleed, you do have that in your back pocket if O is delayed, you'll be able to get things moving again. We sometimes have this terrible situation on here where women are prescribed Clomid, but their doctors will not give them progesterone or do any bloodwork, so they're left in limbo not knowing whether to take the Clomid or not, just waiting and waiting for a period that never arrives. Since you aren't in this situation it makes me feel good about you possibly starting it at a different point in time.