The ovulation cycle consists of two phases, namely, the follicular phase and the luteal phase. The follicular phase starts right after the last day of your period, in which one of the ovaries prepares itself for the release of an egg. As the egg is released, with time, the egg travels down the fallopian tube.
The second phase, also called the luteal phase starts after ovulation. During the luteal phase, the body prepares itself to receive sperm for a possible pregnancy and this phase lasts for about 11-17 days. As the egg is released from the follicle, the follicle changes into a corpus luteum. This corpus luteum is responsible for the release of progesterone, which thickens the uterus lining and the thickened lining of the uterus is basically for the implantation of the fertilized egg.
What’s important about the luteal phase is that in some women, the luteal phase may be short and is also referred as luteal phase defect (LPD), which makes it difficult for women to be pregnant. Let’s talk about its causes, symptoms and treatment options of the short luteal phase.
What are the Causes of the Short Luteal Phase?
A short luteal phase can last for about 8 days or less and for the implantation of the fertilized embryo and to achieve a successful pregnancy, the hormone progesterone is important. This short luteal phase can be a contributing factor to infertility.
Why infertility? Progesterone is important for the development of the uterus lining and due to the short luteal phase, there’s a lack of progesterone resulting in underdevelopment or failed development of the uterus lining. Thus, the fertilized egg is unable to embed itself in the lining.
In case, you do manage to conceive, you are more vulnerable to miscarriage. This is why the uterus lining should be thick enough for a healthy and safe pregnancy. The failure of a corpus luteum can also lead to a short luteal phase. Uterine lining can be shed before the fertilized egg gets a chance to embed itself due to the lack of secretion of progesterone from the corpus luteum. This can result in you having your period before the due date.
Other causes for short luteal phase are as follows:
- Polycystic ovaries (PCOS): the ovaries are enlarged consisting of cysts.
- Endometriosis: this is a condition in which the tissue that is usually found inside the uterus starts growing outside.
- Thyroid disorders: there could be an over-secretion or under-secretion of the thyroid, or there could be iodine deficiency.
- Excessive exercise
Comparison between Symptoms of a Normal Luteal Phase and a Short Luteal Phase:
As the luteal phase ends and you’re close to your periods, you may observe some signs and symptoms which are also referred as PMS (pre-menstrual syndrome). These signs and symptoms could be:
- Mood swings
- Tender breasts
- Appetite change
- Change in sex drive
- Spots and breakouts
In the case of a short luteal phase, you might not realize there’s a problem. Also, you might not suspect anything until you’re unable to find a reason as to why you can’t get pregnant. You can consult your doctor if you feel something is wrong or if you find it difficult to get pregnant and they could investigate your condition. Symptoms of LPD could be the following:
- Earlier menstrual cycles
- Inability to conceive
Diagnosis of a Short Luteal Phase:
If you can’t get pregnant, it’s more likely due to an underlying cause, and you should talk to a fertility specialist about it. The doctor could conduct different types of tests that would indicate a cause, whether it is due to a short luteal phase or some other condition. Blood tests might be conducted to check the presence of hormones. These are the following:
- FSH: FSH is the follicle-stimulating hormone that maintains the ovary function and is released by the pituitary gland.
- LH or the luteinizing hormone: the luteinizing hormone initiates ovulation.
- Progesterone: as mentioned previously it mainly functions in thickening the uterine lining for the fertilized egg to embed or implant itself.
Other than the detection of these hormones, endometrial biopsy can also be suggested. In this procedure, a sample of the uterine lining is taken for examination under the microscope. The thickness of the uterine lining may be checked.
Another test recommended would be the pelvic ultrasound for examination. This is carried out to determine the uterine lining thickness. The ultrasound generates pictures of organs by sending sound waves. The organs included in the pelvic region are:
- Fallopian tubes
Treatment Methods for Short Luteal Phase:
Pregnancy can be possible depending upon the underlying cause of your LPD. To improve fertility and increase the chances of a pregnancy, the treatment of the underlying cause is the first priority. For example, as given in the causes, the cause for your LPD is excessive exercise. The first step would be to decrease your daily physical activity to bring up the luteal phase back to normal.
The underlying cause could also be extreme stress and to cope with that, you would be suggested stress management. Stress levels can be improved by the following techniques:
- Moderate exercise
- Deep breathing exercise
The doctor could recommend hCG which is a pregnancy hormone produced when you’re pregnant and is produced by the placenta. If you take hCG, supplements, it can increase the production of the progesterone hormone. Progesterone supplements can also be prescribed which should be taken after ovulation. The supplement would play its usual role of thickening the uterine lining for the implantation purposes of the fertilized egg.
To increase the chances of pregnancy, medications can be prescribed to induce the production and release of more follicles and eggs. Since everybody is different, every woman and every pregnancy are different, the prescribed medication and the dosage is also different and hence, professional help is suggested. Talk to your doctor and discuss your condition with them.
Controversies regarding the Short Luteal Phase:
There are some controversies over the short luteal phase regarding its role in infertility and that if it even exists or not. Some of these controversies are:
- No consensus over the diagnosis of LPD: although used as a diagnostic tool, some studies direct towards the poor correlation between endometrial biopsy results and infertility. Other diagnostic tools are BBT monitoring (basal body temperature) and progesterone level measurement.
- No clear evidence: some studies also show that having a short luteal phase is quite common and can affect a person short term but not really long term. Research also shows that the birth rate was equal among women with short luteal phase and long luteal phase who underwent IVF.
- Limited efficacy of treatments: In 2012 there were treatments that did not really bring about any change but the current hCG supplementation did show improvement as compared to no treatments or placebos.
The time period where you’re trying to conceive but are unable to can be frustrating and emotionally exhausting and in such cases, rather than making assumptions, you should consult your doctor and let him know of your current situation, the signs and symptoms you’re observing, and other linked problems.
The doctor would give the best advice for your body and condition. There could be an underlying cause that needs to be detected or other reasons. Keep yourself physically and mentally healthy to reduce any chances of problems or possible complications.