What is a Luteal Phase Defect or LPD?
Luteal Phase Defect
A luteal phase is the time in a woman’s cycle between ovulation and menstruation. In a pregnant woman, during the luteal phase the fertilized egg will travel from the fallopian tube and into the uterus for implantation. The luteal phase is normally 14 days long and on an average it can be anywhere from 10 to 17 days long. If your luteal phase lasts anything under 10 days it is considered a luteal phase defect. But some doctors believe that if the luteal phase falls under 12 days, then it is a problem. If you conceive and you have a luteal phase defect, you will have an early miscarriage.
A luteal phase defect cannot sustain a pregnancy because the uterine lining in these women begins to break down, bringing on the menstrual bleeding and causing an early miscarriage. There could be more than one reason for the luteal phase defect which can be found out after medical analysis. Going by statistics, the number one reason for a luteal phase defect is low progesterone levels. Your doctor can do a progesterone test on you 7 days past ovulation to determine exactly how deficient you are. Once you know that there are several ways of correcting this defect.
Causes of Luteal Phase Defect
The three main causes of luteal phase defect include poor follicle production, premature demise of the corpus luteum, and failure of the uterine lining to respond to normal levels of progesterone. These problems occur at different times during the cycle but can also be found in conjunction with each other.
- Poor follicle production occurs in the first half of the cycle. In this case, the woman may not produce a normal level of FSH, or her ovaries do not respond strongly to the FSH, leading to inadequate follicle development. Because the follicle ultimately becomes the corpus luteum, poor follicle formation leads to poor corpus luteum quality. In turn, a poor corpus luteum will produce inadequate progesterone, causing the uterine lining to be adequately prepared for the implantation of a fertilized embryo. Ultimately progesterone levels may drop early and menses will arrive sooner than expected resulting in luteal phase defect.
- Premature failure of the corpus luteum can occur even when the initial quality of the follicle/corpus luteum is adequate. In some women the corpus luteum sometimes does not persist as long as it should. Here, initial progesterone levels at five to seven days past ovulation may be low; even if they are adequate, the levels drop precipitously soon thereafter, again leading to early onset of menses and hence a luteal phase defect.
- Failure of the uterine lining to respond can occur even in the presence of adequate follicle development and a corpus luteum that persists for the appropriate length of time. In this condition, the uterine lining does not respond to normal levels of progesterone. Therefore, if an embryo arrives and tries to implant in the uterus, the uterine lining will not be adequately prepared, and the implantation will most likely fail.
Correction of Luteal Phase Defect
Fertility charting is an easy way of detecting whether you have luteal phase defect. If you do, don’t worry because luteal phase defect can be easily corrected. Immediately seek the advice of your physician first before starting any treatments to correct it. In most case, luteal phase defect can be corrected through over-the-counter remedies and/or with prescription drugs.
1. Over the counter remedies for luteal phase defect:
The two main over the counter remedies for luteal phase defect are vitamin B6 and progesterone cream. Vitamin B6 is generally regarded as safe and can be taken daily in dosages from 50 mg to 100mg. Taking vitamin B6 every day during the entire month will help to lengthen the luteal phase. Please note that taking mega doses of vitamin B6 can lead to serious medical issues. Be sure to check with your doctor before using vitamin B-6 to increase the length of your luteal phase to make sure it is the best option for you.
A progesterone cream is usually targeted for menopausal women; however this cream is also useful in lengthening the luteal phase. A cream with natural progesterone works best. Use about 1/4 to 1/2 a teaspoon of progesterone cream spread on the inner arm, inner thigh, neck, and chest – alternating places – twice a day from ovulation to menstruation or until the 10th week of pregnancy.
2. Prescription drugs for luteal phase defect:
The most common prescription drugs for luteal phase defect patients are Clomid or progesterone suppositories. Clomid is taken orally as prescribed by the doctor. The suppositories are taken through the vagina after ovulation has occurred and until either day 14 post ovulation or at some point weeks later during a pregnancy, if pregnancy occurred.