Luteal Phase Defect
What Is a Luteal Phase Defect?
The luteal phase is a period fixed between ovulation and menstruation during a normal menstrual cycle. During this phase, the corpus luteum – a transitory endocrine structure – discharges the hormone progesterone and prepares the endometrial lining for fertilization. Women that suffer from Luteal Phase Defect or LPD have the tendencies to produce insufficient progesterone in the process, especially when the endometrium does not cooperate well to stimulate progesterone production. As a result, the endometrial lining ends up not fully prepared for fertilization.
Causes of Luteal Phase Defect
- In some cases, medical conditions like hyperprolactenemia or thyroid issues bring this defect on women. By definition, hyperprolactenemia is the state when the body produces excessive prolactin – a hormone that stimulates production of breastmilk.
- During the first half of the menstrual cycle, some women may experience inadequate follicle production. When this happens, the woman is less likely to manufacture adequate levels of follicle-stimulating hormone or FSH because her ovaries do not react accordingly to FSH. The result of this phenomenon leads to insufficient follicle production, thus resulting to poor quality corpus luteum. Here, the corpus luteum will produce low levels of progesterone which makes the uterine lining promptly prepared for implantation. At the end of the day, the progesterone levels drop earlier; resulting to period arrival that comes way too early than normal.
- Another contributing factor to Luteal Phase Defect is early corpus luteum malfunction. Unfortunately, this can happen even when the follicle is initially in good condition. At rare cases, the corpus luteum does not last long as expected. In this process, the levels of progesterone may be low at first; but eventually drops soon which results to early menstrual flow arrival and LPD later on.
- When the uterine lining is unable to respond appropriately, LPD can also take place even if the follicle quality is sufficient and the corpus luteum works well for a long time. Here, progesterone production is inadequate; hence, the uterine lining will be incompletely prepared when an embryo is released and passes through the uterus, resulting to failed implantation.
- Hypocholesterolemia is the body substance that affects the preparation of steroid passageway. If the body fails to produce sufficient levels of this substance, the progesterone production may be become low or zero in worse cases.
Signs & Symptoms of Luteal Phase Defect
Most women do not notice the early signs of Luteal Phase Defect. In most instances, the symptoms start to appear when a woman tries to get pregnant – sooner if she is actively attempting to conceive. For most women with LPD but have regular cycles, menstrual flow will seem normal like before. In some cases, however, women go through frequent cycles in which the flow is lighter than usual.
Typically, a female with LPD reflects irregular basal body temperatures. Other obvious symptoms can be bleeding, lower back pain, and/or loose stools.
Luteal Phase Defect & Impact on Fertility
As we have discussed above, periods occur sooner in most cases during LPD. According to medical reports, most patients experience menstrual cycles as short as 26 days and the luteal phase as short as 11 days or less. However, these signs should not be the only bases for the diagnosis of LPD.
Physically, this condition is often associated with an assortment of abnormalities which include enlarged thyroid gland or hypothyroidism, excessive breastmilk discharge from the breasts or hyperprolactinemia, and enlarged and malformed uterus or uterine myoma.
Because progesterone plays an important role on embryo implantation and pregnancy preparation, the body needs adequate levels of this vital hormone. Otherwise, fertility will not be possible or spontaneous abortion might take place. Other independent studies suggest that LPD can lead to bone loss and decreased blood flow. These cases were commonly found among premenopausal women who suffer from either LPD or anovulation.
When to See a Doctor
If you think that you have LPD, charting your menstrual cycle and basal body temperature will help you determine whether you need a professional help or not. Once you observe that your luteal phase is shorter than 10 days and your body temperature is elevated at higher degrees than before, then it is best to seek the advice of your doctor. Most doctors recommend several tests to know if a patient has LPD. The most common and least invasive method being used is the 21-day progesterone test. However, some medical experts claim that endometrial biopsy is still the best method for LPD detection.
Medical Options For Luteal Phase Defect
In most cases, LPD can be treated by prescription medicines or over-the-counter medicines. Some popular names are shown in the list below.
Progesterone suppositories are the most common solution that doctors may recommend for LPD patients. Suppositories are administered vaginally after ovulation to 14 days after ovulation. They can also be administered for a few weeks after a woman confirms she is pregnant.
Clomid is also commonly used to treat LPD. Doctors will prescribe Clomid for 5 days during the follicular phase of the cycle. This medication can be started on Day 3 or Day 5 of the menstrual cycle. Clomid causes the ovary to release higher levels of progesterone during the luteal phase of the menstrual cycle.
- Vitamin B6
- Progesterone Cream (Topical)
- Chase Tree (Vitex)
- Royal Jelly Softgels
- Diindolylmethane (DIM) Supplements
- Omega 3 EFA
- Essential Fatty Acids (EFA)- EFAs play an important role in hormone production. Usually, these substances can be found in sardines, shrimp, walnuts, and salmon.
- Green Leafy Veggies- Leafy vegetables are packed with B vitamins which help in maintaining hormonal balance.
- Cholesterol From Organic Sources- Cholesterol is essential in hormone production as well. However, you have to make sure that you get it only from organic sources like eggs, grass-fed animals, milk, butter and other dairy products.
Luteal Phase Defect may seem like an overwhelming fertility issue; however, it can be easily corrected when treated with proper remedies. Before you take or use any of the treatment options presented above, always seek the advice of your doctor to make sure you are choosing the right alternative.
Hajishaiha M. Transvaginal sonographic evaluation at different menstrual cycle phases in diagnosis of uterine lesions. Int J Womens Health. 2011.
Trickey, R. Women’s Hormones & the Menstrual Cycle. Allen & Unwin. 2003.
Cooke ID. The corpus luteum. Hum Reprod. 1988.