Luteal Phase Defect: What is it and How can it affect Fertility?

Luteal phase defect sounds like a strange phenomenon. It is one of my personal diagnosis that I dealt with, accompanying low progesterone. I stumbled across this on my own by learning how to track my cycles and paying attention to symptoms. I’ll admit though, for a while I became obsessed with it, but then again who isn’t while they are trying to have a baby? You grasp at anything you can find to be the cause for your troubles. Or anything that could indicate you actually got pregnant one month. 

When I first talked to my doctor about it, God love her, she didn’t think it was a part of my problem. Her reasoning though was because she did a blood test for progesterone levels and they were deemed as “normal” in the beginning. I kept pushing for more and telling her something just wasn’t adding up. I went to see another kind of provider who focused more on problems causing infertility and how to fix them versus just addressing symptoms of the problem. She did a more intense progesterone test and we learned that my levels were too low for the first part of my luteal phase and would then come back up around the time most doctors test for the level. My levels on that day were always on the lower end of the range for “normal” and occasionally would actually be under it. 

Now, getting an actual diagnosis is not the end-all-be-all to your problems. But it at least lets you know that you are not in fact crazy. It helped me put to rest some of the questions, what-ifs, and but what is wrong thoughts I had. The next step became figuring out how to fix it. I wish I had someone in my corner during that time with more natural solutions for these issues. I will say I did try to educate myself and learn what I could. It is so overwhelming to know what to do and what to look for, I know. 

Let’s get down to business and discuss the who’s, what’s, and now what’s of luteal phase defects. 

What is a Luteal Phase Defect?

The luteal phase is the part of your cycle after you have ovulated. It should be no less than 12 days and is the last phase before your period begins. During this time, the egg or the fertilized embryo will be making its way down the fallopian tubes and into the uterus. It should be getting nice and cozy in a spot to begin the next journey of developing into your baby. A phase of fewer than 12 days will not allow the uterus to properly thicken for implantation. This can cause a miscarriage if it is not where it needs to be. 

Signs and Symptoms of Luteal Phase Defect

• Low progesterone
• Spotting before your period begins
• Less than 12 days between ovulation and your period starting 
• Low basal body temperatures just after ovulation
• Low endometrial lining (tested by vaginal ultrasound between ovulation and before your next period begins) 
• Inability to get pregnant or having suffered from early miscarriages 
• Symptoms such as back pain, nose bleeds, tender breasts, exhaustion, skin problems 

Causes of Luteal Phase Defect

Progesterone has an important job during our cycles and can contribute to many problems if we don’t produce it properly. We produce it, or rather we should be, during the whole cycle and it will elevate after ovulation to support a thick endometrial lining and implantation of the fertilized egg. If levels drop too soon the body thinks it’s time to start over and will begin a new cycle. 

The pituitary gland is in charge of producing enough FSH hormone to trigger the follicle production. This can cause low progesterone and a thinned endometrial lining if too low. 

Luteinizing hormone (LH) is essential to trigger the actual release of the egg for ovulation. If this hormone is too low or the body is too stressed for it to raise appropriately, it will not trigger this response and cause low progesterone. 

Estrogen is responsible for actually thickening the endometrial lining. If the levels are too low after ovulation for this to occur, progesterone is not able to do its job to support the lining and a miscarriage can occur. 

Cholesterol is responsible for keeping hormones balanced and produced. If you do not consume enough healthy cholesterol in your diet, your hormones will be too low. This will cause low progesterone and luteal phase defect issues. 

Treatment for Luteal Phase Defect and Low Progesterone

Diet

A well balanced, whole-foods diet is essential to keeping your hormones balanced. Consuming foods high in Vitamin C, leafy green vegetables, essential fatty acids, and healthy cholesterol has shown to improve the production of these hormones. Chasteberry/Vitex supplements are believed to also improve progesterone levels. It is a small fruit tree in the Mediterranean that helps the body produce the luteinizing hormone to support ovulation and thus, higher levels of progesterone. B6 vitamin has been shown to lengthen the luteal phase and can be found in several foods, as well as supplements. Foods rich in antioxidants can have an impact on your overall fertility health and support a healthy luteal phase. 

Other Ways

Over the counter progesterone cream is generally a first reach for many women. However, it will only solve low progesterone and not affect any other contributing factors such as low LH levels. Make sure to follow the instructions carefully for any medications. Many doctors will often prescribe a medication to stimulate follicular growth at the beginning of your cycle or prescribe supplemental progesterone in the form of pills, injections, or vaginal suppositories. Supplemental hCG can also be prescribed to improve the secretion of progesterone by the corpus luteum. 

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