Luteal Phase Defect: What It Is, Symptoms And Treatment

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There are three phases of a menstrual cycle – the follicular, ovulatory, and luteal phases. The egg travels through the fallopian tubules during the three phases and attaches itself to the endometrial lining. Lack of fertilization leads to the shedding of the endometrial lining, which results in menstruation. Among the three phases, the third phase, or the luteal phase has an important role to play during conception. This is why learning about the physiological and hormonal changes that occur during this period may help you conceive. Keep reading to know more about the luteal phase.

What Is The Luteal Phase?

The period between ovulation and the onset of your next menstrual cycle is called the luteal phase.In this phase, the follicle (released during the follicularfollicular phaseⁱXThe phase of the menstrual cycle characterized by the maturation of the egg in the ovaries) converts into corpus luteum, a structure that produces the progesterone hormonein high amounts and some amounts of estrogen(1)(2).

How Long Is The Luteal Phase?

The normal menstrual cycle length is 21 to 35 days, of which the luteal phase lasts for about 14 days(3). The luteal phase is constant and fixed in most women. However, if your menstrual cycle is less than 25 days, then the luteal phase could be shorter.

The 14 days of the luteal phase is the time when the uterus in case of pregnancy prepares to house the fertilized egg.

How Are Luteal Phase And Pregnancy Related?

After ovulation, the corpus luteum triggers the production of progesterone, which facilitates the thickening of uterus lining (endometrial lining) for the implantation of the fertilized egg.

After fertilization , the fertilized egg moves down into the womb from the fallopian tube and gets itself attached to the endometrium in the uterus(4). This process takes place during the luteal phase.

If fertilization does not occur, shrinkage of the corpus luteum causes a drop in the progesterone secretion, and the uterine lining sheds, leading to menstrual bleeding. This results in your next menstrual cycle.

Knowing your luteal phase can help you track the ovulation period after a menstrual cycle. Ovulation is the time when you may have intercourse toget pregnant. Thus, calculating the ovulation date and three days before and after it can help you plan/ avoid pregnancy.

How Is Ovulation Calculated?

A hormone-specific blood test can help identify the ovulation and start of your luteal phase. Alternatively, you may track your cycle for around six months, and observe the pattern to calculate your luteal phase.

Another way is to useBBT charting.Your basal body temperature (BBT) increases during the time of ovulation and remains high until your next period starts. You can track your temperature from the beginning of the menstrual cycle and notice the rise in BBT. The elevation in the body temperature confirms ovulation(3).

Here is the formula forcalculating the ovulation time through the luteal phase.

• Day of ovulation = length of menstrual cycle – length of luteal phase

For example, let’s assume that for a 28-day cycle, the luteal phase lasts for 14 days. Putting the respective values in the formula gives you the day of ovulation:

28 (length of the cycle) -14 (length of the luteal phase) = 14. It means, the 14th day of your menstrual cycle is your ovulation day.

An ovulation predictioncalculatoror kit may also help you identify the ovulation day and thus the luteal phase.

Your body goes through some changes during the luteal phase.

What Are The Changes In Your Body During Luteal Phase?

The increase in the progesterone levels during this phase can lead to the following changes in your body:

• Tenderness of breasts and nipples
• Mood swings
• Bloating
• Fluid retention
• Anxiety
• Tiredness
• Stomach cramps, which can sometimes feel like menstrual cramps

These changes during the luteal phase are common and do not, in any way, affect your chances of getting pregnant.

What Is A Luteal Phase Defect?

The insufficient release ofprogesterone duringthe luteal phase is termed as luteal phase defect (LPD) or luteal insufficiency.This defect will prevent the thickening of the uterus lining resulting in inappropriate embryo implantation. It lowers the chances of sustaining a pregnancy(5). However, it is not clear if LPD is a reason for infertility(6).

The luteal phase defect can result of the following:

• Defective functioning of the corpus luteum resulting in the lower secretion of progesterone andestradiolⁱXA steroidal female sex hormone vital for maintaining the reproductive system.

• The inability of the uterine lining to respond to the proper levels of progesterone and estradiol.

These defects or menstrual disorders could happen due to:

• Break down of the corpus luteum
• Defect in ovulated egg
• An unruptured follicle (this happens when the luteinizing hormone is not sufficient to rupture the follicle
• AnorexiaⁱXA psychological eating disorder that causes people to obsess about their weight and food
• Over-exercise
• EndometriosisⁱXA condition in which tissues similar to the uterine lining (endometrium) grow outside the uterus
• Obesity
• Polycystic ovary syndromeⁱXA condition where ovaries produce excess male hormones, leading to infertility, excess hair growth, and irregular periods
• Hyperprolactinemia (excess production of a hormone that makes breast milk)
• Thyroid disorders

女性经验LPD earlie时期r than the usual date. The LPD leads to a shorter menstrual cycle, where the luteal phase is less than nine days because of the lower production of progesterone. The defect manifests through other symptoms as well.

What Are The Symptoms Of Luteal Phase Defect?

Menstrual irregularities may indicate an abnormal luteal phase. The symptoms of luteal phase defect include:

• Getting menstrual cycles earlier than normal
• Spotting in between periods
• Miscarriages

LPD is not immediately recognized and requires a diagnosis to identify and treat the problem.

How Is Luteal Phase Defect Diagnosed?

LPD does not have any validated clinical diagnostic methods. However, the below tests are usually done for the purpose:

1. Blood tests to analyze:

Follicle-stimulating hormone (FSH), which regulates the ovarian function (this hormone is released by the pituitary gland)

Luteinizing hormone that triggers ovulation

Progesterone that stimulates thickening of uterine lining

2. Ultrasound:

It checks the thickness of the uterine lining. Anultrasound scancan help detect the functioning of each reproductive organ, i.e. ovaries, uterus, fallopian tube, and cervix.

2. Endometrial biopsy:

Although this method has failed to prove any correlation between luteal phase defect and fertility, it is still considered one of the best methods for LPD diagnosis. It is typically done one or two days before the onset of periods. During this test, a small sample of the endometrial lining is collected and examined under a microscope to check the thickness of the lining.

The doctor may use a combination of tests to confirm it is LPD, and then the treatment follows.

What Are The Treatment Options For LPD?

The treatment for LPD depends on the underlying cause. The doctor may suggest one of the below options(5):

• Clomiphene citrate (Clomid) or human menopausal gonadotropins (hMG) stimulate the ovaries to produce more follicles, which in turn release more eggs. The medicine is usually administered on the third to seventh, or fifth to ninth day of your menstrual cycle, depending on how long or short it is.

• Human chorionic gonadotropin (hCG) triggers ovulation. This is called the gonadotropin therapy in which the hCG is administered to trigger ovulation and extend the luteal phase(7).

• Progesterone supplements help in stimulating the growth of the uterus lining. These supplements are given after ovulation for ten days or until eight to ten weeks of gestation. The supplements can be in the form of injections, pills or suppositories.

The treatment focuses on increasing the progesterone hormone in the body so that the luteal phase is extended. You may complement the treatment with the right diet and routine.

How To Increase The Length Of Luteal Phase?

健康的生活方式可以帮助你避免一些gynecological problems, including LPD. It is necessary, especially if you are planning for pregnancy. Here is what you can do:

1. Have a balanced diet by including:

• Vitamin B6 rich foods such as banana and salmon
• Vitamin B complex
• Green leafy vegetables
• Vitamin C rich foods such as broccoli, papaya, Brussel sprouts, etc.

2. A potent herb called vitex(chasteberry) has been used since ages to treat luteal phase defects in women. You may take it in the form of capsules with a dosage of 30-45mg or 40 drops of liquid extract mixed with water. However, do not use it unless your doctor gives you the go-ahead.

3. Acupuncturehelps regulate the menstrual cycle, which in turn increases the luteal phase(7). Consult a qualified acupuncturist, who can help you with the treatment.

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