# Antibiotics and Progynova



## greatgazza (May 27, 2010)

Hi there

I am taking Progynova orally 3 x 2mg per day for my lining for DFET (been on it since cycle day 1, so 4 days as of today)

I am also taking Flucloxacillin 500mg 4 x a day for 10 days for a Staphylococus aureus infection.

I have just read on a thread on here that antibiotics can affect the effectiveness of Progynova and am concerned about it affecting my lining and therefore whether i can go ahead with tx.

I am under the FGA for immunes and with Reprofit for tx. I emailed Reprofit this evening and was told that as it is penicillin it won't have a major impact but to take 2 x 2mg orally and then at night 1 x 2mg vaginally (i believe that vaginally the antibiotics might not have such a detrimental effect on the absorption of the progynova?)

I'm a bit confused as I thought according to my results from FGA I am 'resistant' to penicillin but having had a quick google i believe Flucloxacillin, whilst in the 'penicillin' family is used when the infection is resistant to other penicillin meds. Is that right?



> HVS Culture +++ staphylococcus aureus
> 
> Staphylococcus sensitivity
> 
> ...


Also there is another lady on there who is quite distressed as she is also taking progynova whilst on doxycycline and is now worried about her lining/subsequent tx. Can you explain what the interaction is with those antibiotics and progynova and whether the progynova may be compromised?

Be great if you could reassure us both that the antibiotics we are both on won't compromise our linings and therefore our treatments and also whether you would advise to switching to taking the progynova vaginally to improve the situation.

Thanks very much

GG xx


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## Mistletoe (Holly) (Jan 1, 2007)

I think the worry in this case is that some of the oestrogen taken by mouth is recycled and reabsorbed into the body with help from the bacteria in the gut.

When you take antibiotics such as doxycycline or penicillins this can upset the natural flora of the gut and you do not get the extra help these bugs provide. The effect is probably quite small and no where near as bad as the antibiotics that induce the liver enzymes (e.g. rifampicin), which is quite a different story.

The evidence comes from the processing of the oral contraceptive pill and the possible lack of efficacy and possible unwanted pregnancy. Women wanting contraception are advised to use additional contraceptive measures.

The vaginal administration perhaps could have a local effect that does not require so much systemic absorption and recycling through the gut.

As these products are being used in infertility treatment unlicensed it is difficult to comment further as much higher doses are already being given compared to the licensed use in basic hormone replacement therapy for post menopausal women.

The intended blood levels required to grow the womb lining will vary woman to woman and the effect of the antibiotics will also vary.

I suppose you could try taking live yogurt or probiotic drinks whilst on the antibiotics to help replenish the gut flora (limited evidence) and of course discuss with the clinic and follow their advice on dosage.
As long as your lining reaches around 8mm you will be fine to go ahead.

Yes Flucloxacillin is a penicillin, but chemically enhanced to have activity against staphylococcus. The report does say that the bug is sensitive. Many people carry staph aureas as a normal flora in the vagina. Was it a particularly heavy growth/infection that they felt had to be treated?


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## greatgazza (May 27, 2010)

Hi Hopeful Hazel

thanks very much for that answer.

All i know about this infection is what they put on here:

HVS Culture                  +++ staphylococcus aureus

I have no idea of the strength of it.  Should I have been told that/do i need to find out?  I have no symptoms of any infection so had no idea i could have one.  Is that the case with staph aureus as with chlamydia etc i.e. you have no idea you have it?  I've done a bit of googling but really don't have much idea about it and/or it's impact on fertility.  Do you know much about it?  Could an infection like this have caused/been a factor with my most recent very early mc?  I don't usually have a problem with my lining but if this doesn't clear for some reason could it be causing me issues?

GG xx


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## Mistletoe (Holly) (Jan 1, 2007)

10-20% of women might be normally colonised with this bacteria and it is just part of the normal bacterial flora that we have on us. Although your risk of becoming systemically infected is increased if you are colonised with it and have invasive procedures because it is present when skin and mucus membrane defences are breeched, it is not routinely screened for in pregnancy or fertility treatment. 

I am not aware of anything about it causing miscarriage, but there may be some evidence out there which is why they are ruling it out this time. Take your doctor's advice on this.

+++ means a heavy growth, but the amount can vary over time, whether you have a period etc.

There is nothing to say that once you have had this course of antibiotic that you would not become recolonised with it and use of antibiotics just increases the risk of antibiotic resistance.

If you are a carrier, it is worth taking extra care if using tampons as staph aureus is associated with toxic shock syndrome which can by set off by wearing a tampon for too long or forgetting about it.


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## greatgazza (May 27, 2010)

Thanks for all your help and advice hopeful hazel.

GG xx


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