Luteal phase defect

The luteal phase is the second half of the menstrual cycle, which occurs between ovulation and menstruation. During this phase progesterone production is at its highest, and the uterine lining is preparing for embryonic implantation. The ideal length of the luteal phase is between 12 and 14 days. Luteal phase defect is a hormonal imbalance that affects a woman’s ability to conceive and carry a pregnancy, and is defined by a luteal phase shorter than 10 days.

Chinese medicine treatment for luteal phase defect

Chinese medicine offers treatments geared towards enhancing hormonal production, improving the functioning of all phases of the menstrual cycle and reducing the rate of miscarriage for patients with luteal phase defect:

Acupuncture is used to correct imbalances in the hypothalamic-pituitary-ovarian axis. Once signaling is regulated, the phases of the menstrual cycle can function optimally. Stress reduction acupuncture may also be useful for patients with luteal phase defect.

Herbal medication helps to increase the body’s endogenous progesterone production, reduces the chance of miscarriage once an implantation has been successful.

Reproductive organ massage in the follicular phase of the cycle is able to increase blood flow to the uterine lining, helping it to prepare for implantation.

Nutritional supplements and foods rich in vitamin B6 may be used to lengthen the luteal phase. Additional supplements may be prescribed depending on the underlying cause of the disorder.

Possible causes of luteal phase defect

The three main causes of luteal phase defect are poor follicle production, premature failure of the corpus luteum, and failure of the uterine lining to respond to normal levels of progesterone. One or all of these causes may be present in a woman with luteal phase defect:

Poor follicle production begins in the first half (follicular phase) of the menstrual cycle. This may be due to inadequate FSH (follicle-stimulating hormone) production, or poor ovarian response to FSH. Poor quality follicles lead to a deficient corpus luteum that is unable to produce adequate progesterone to allow for implantation in the uterine lining. Premature falling of progesterone levels causes early menstruation.

Premature failure of the corpus luteum can occur even if follicle quality is adequate. The corpus luteum dissolves early in some women, leading to low progesterone levels and luteal phase defect.

Failure of the uterine lining to respond can occur in the presence of adequate follicular development and a well-functioning corpus luteum. When the uterine lining does not respond to adequate levels of progesterone, implantation failure is likely to occur.

Symptoms of luteal phase defect

Common symptoms include:

  • Shortened menstrual cycles
  • Low basal body temperature
  • Infertility
  • Low back pain
  • Bleeding between periods
  • Intolerance to cold
  • Fatigue
  • Breast tenderness
  • Feeling of internal heat
  • Dry eyes
  • Constipation
  • Recurrent miscarriage

Western treatment for luteal phase defect

If poor follicular development is seen on ultrasound, fertility drugs (Clomid or human menopausal gonadotropin) are often prescribed to help the follicle to mature more appropriately. Premature failure of the corpus luteum is most commonly treated with progesterone suppositories or creams. Women who have uterine linings unresponsive to normal progesterone levels may be prescribed high-dose progesterone supplementation in an attempt to stimulate the conversion of the lining into one that can support implantation. Vitamin B6 supplements have been shown to lengthen the luteal phase, whatever the cause of the defect.