How JustAnswer Works:
  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.
Ask Dr. Pfeiffer Your Own Question
Dr. Pfeiffer
Dr. Pfeiffer, Doctor
Category: OB GYN
Satisfied Customers: 5987
Experience:  Ob/Gyn Doctor
Type Your OB GYN Question Here...
Dr. Pfeiffer is online now
A new question is answered every 9 seconds

I am experiencing horrible cramps for the last two das. I am

This answer was rated:

I am experiencing horrible cramps for the last two das. I am not menstrating yet but expected to. Ive been on 40 mg of natural progesterone cream 15 days and 20 mg the rest of the month. I have a normal tsh but hashismotos. Ive taken aleve and tylenol, applied hot packs and nothing is working, im insooo much pain

when was your last period?

when is your next period due?

are your thyroid levels normal at this point?

Any fever, nausea, vomiting?

any discharge?

Customer: replied 4 years ago.
Last period was 2/28/13, my period is expected today 3/27/13. Theres absoutely no way im pregnant, im a lesbian. My tsh is fine,spoe with my endo earlier. I do have auto immune disease (Hashismoos thyroiditis) been on natural progesterone for tht since last july. My thyroid is fine. No fever or vomitting but yes nausea. Had a headache sunday,monday and tuesdy, cramps started yesterday, and have been killing me. No flow yet


this may be an ovarian cyst...and perhaps a hemorrhagic cyst. These can be very painful and it may take several weeks for the blood in the pelvis to be reabsorbed.

If you feel as though you are in sufficient pain to require pain medication you should consider going to the ER for an exam and ultrasound.

A rare, but possible condition is an ovarian torsion where the ovary twists on itself...that would be the main concern. That could be what's going on...just very early. If progression you typically see nausea, vomiting, fever..etc.

I'd strongly consider going to the ER tonight for the US.


Dr. Pfeiffer

Customer: replied 4 years ago.
An ER visit last year for this same pain is wht made me get my thyroid checked. They said it looked like a cyst burst and i had small fibroids, thrn i found out i had hashismitos. When i started the cream it helped, then the pain came back, so she upped my cream for 20mg 14 after my period to 40mg, it helped then a few months ater the pain came back, she kept it at 40 mg 14 after my period and added 20 mg the rest of the month. That worked in Jan and has failed the last two months the principle is to try to shut down the ovaries to minimize the formation of order to do that the medication has to be strong enough to suppress ovulation.

We typically use a birth control pill to do that.

Sounds like this cream isn't working anymore...or there is something else going on.

The thyroid was simply a question as it can interrupt ovulation. I don't believe this pain is related to the Hashimotos outside of potentially being reason for not ovulating and hence a cyst.

Dr. Pfeiffer

Customer: replied 4 years ago.
i have an appt schedule with my doc on the 3rd, im going to deal her its not working. They gave me natural compund estrogen a few months ago bevause i was have no sex drive,hot flashes,insomnia,headches etc. she said my estradiol level was normal but on the low side of normal. I only applied it once and it had me sleepy during the day so i didnt take it agsin...
As far as the birth control, i see an alternative doctor and they try to first use natural before anything because birth control contain synthetic hormones which cuse unwanted side effects and i definitely wanted to stay away from that but this pain is debilitating and depressing, like clinically depressing. There arent any natural ways to stop ovulation without having surgery? I dont care for unnatural meds but i dont know now

unfortunately no...

those all require hormonal manipulation.

and any medication...hormone, natural or synthetic have potential side effects...

it's just a matter of how it's explained.

Dr. Pfeiffer

Customer: replied 4 years ago.
But progestin is the synthetic verion of progesterone. If she put me on a birth control pill that contains progestin, why would that work when the natural isnt working? Birth control pills stop you from ovulating,correct? So if i were to take both my natural progesterone and estrogen creams, wouldnt they do the same thing as birth control pills,since birth control pills contain both of them?

that gets into somewhat of an argument between profressions.

'natural' hormones are usually plant derivatives where the absorption and effectiveness are not well predicted.

synthetic hormones have been evaluated, studied and approved by the FDA and the affects are well know. Now, I'm not saying that some of the phytoestrogens haven't...just as a general rule that's the case.

Dr. Pfeiffer

Customer: replied 4 years ago.
Well thanks so much for you advice I appreciate it. It is very much confuding, if they have the same things,they both should work the same...truly shaking my head, maybe i should do the estrogen cream too and possibly have my i think cortisol,testogestrone and hormones check. Something got to. Give, im trying to make bc and a oartial hysterectomy my last choices. I havent had kids and according to studies ive read getting oregnant with a auto immune disease isnt adviced.

I understand where you're coming from...and you certainly are welcome.

It is terribly confusing.

Most of traditional Ob/Gyns do not treat levels....because 'low normal' might be fine for some women while others are not...and the same can be said for anywhere in the range. So we typically treat to symptoms.

And, if you're only talking about the hashimotos as the auto immune disease that can be fairly easily controlled in pregnancy. However, it's better after the hyperthyroidism passes and becomes hypothyroidism. It's safer to use the medications to replace the hormone than the medications used to prevent conversion.

Dr. Pfeiffer

Customer: replied 4 years ago.
Okay, so are you saying, being on the estrogen abd orogesterone cream right now, is better then being on a thyroid med? Like, i have auto immunebdisease but my thyroidisfine,so spparently the disease has damaged the thyroid yet correct? So the hormone replacement is to help the disease from causing hypo or hyper thyroididm? What hsppens whenthe hormone replacements doesnt help, like apparently the progesterone cream alone isnt helping the symptoms of ovuation and fibroids and cysts forming. So eould bothhormones combined taken sll month potentislly do better? Because currently i take progesterone creamallmonth and most sites say thats bad you shouldhave a break,especislly since impremenapausal,though i beg to differ, i think im very much peri right now but im no MD,just a research freak... the thyroid medication is more important than the hormones.

now, there are two phases of hashimotos...a hyper phase then a hypo phase. if you are taking thyroid supplementation you are in the hypo phase.

as far as the autoimmune problems go, it's usually antibodies generated against the thyroid gland. And while there might be other underlying auto immune's not for sure just because you have Hashimotos.

the hormones you are using and the reasons you are using them it's fine to take daily. Usually the break is so you can have a period.

Dr. Pfeiffer

Customer: replied 4 years ago.
The weird part is, dince ive been on the crwam,ive had a period each month, so etimes a few days sooner or later but it alwas comes and ive been on all month treatment with just the progesterone cream since december and i still have a period.
Im cramping horribly bad right now with no flow. I hate when this happens because, at least when you cramp when your bleedingit ast maybe 2 days,with this, i never know how long the cramping will last before i start bleeding. I was suppose to start today and still nothing but i still have the cramps aaarrgghhh
Ive never been on thyroid meds either, only progesterone cream since i was diagnosed with hashismotos. My endo just said today, your thyroid is fine. She told me to check with my doctors who put me on the cream because thy are the ones who discovered (tested my anibodies)
This crap sucks becuse i dont understand it at all, i just know im in pain now and im doing everything the ocs say with no letting up

I still think you need an ultrasound and probably pain medication.

Neither I can provide for you, which is the equally frustrating part of this type of format!

Customer: replied 4 years ago.
You be awesome, thanks so much, i have alot of questions for naturopathic md wednesdy lol...thnks

you bet...

I wish you the best and hope you feel better soon!

thanks and please take the time to rate my service...or it might say 'accept'


Dr. Pfeiffer

Dr. Pfeiffer and other OB GYN Specialists are ready to help you