Symptoms of a Short Luteal Phase and why it's important when TTCing

Luteal Phase

Your luteal pahse is the time from ovulation to the start of your next menstrual period. This phase typically lasts 12-14 days but can be shorter or longer depending on your cycle length, and obviously when you ovulate during your cycle.

The length of the luteal phase is important because it determines how long the egg has to develop into an embryo after fertilization and successfully implant in the wall of your uterus. If the luteal phase is too short, there may not be enough time for this development and implantation to occur.

What is a Short Luteal Phase? What causes it?

A luteal phase that is 9 days long or less is considered to be a "Short Luteal Phase". You can measure this phase very accurately using a device like OvuSense.

A Short Luteal Phase can be caused by various factors, such as stress, obesity, being underweight and certain medications - all of which all can have an effect on your menstrual cycle. If you have other issues like an under or overactive thyroid, Polycystic Ovarian Syndrome or Endometriosis that can also cause a Short Luteal Phase.

Why is a Short Luteal Phase important when TTCing?

A Short Luteal Phase is one of a number of things to look out for which may be causing a "Luteal Phase Defect" or "Luteal Phase Insufficiency"

If you have this "Defect" or "Insufficiency", you potentially don't have sufficient time for a fertilized egg to develop and implant successfully in the lining of your uterus. Or your body doesn't release sufficient progesterone during the luteal phase for this to happen. This can result in a very early miscarriage, and it's often something you don't even realise until your next period starts.

What can I do about Short Luteal Phase, Luteal Phase Defect or Luteal Phase Insufficiency?

If you notice you have a Short Luteal Phase using a device like OvuSense, then you should talk to your doctor. OvuSense Pro can also be used by your doctor to screen for other common signs of Luteal Phase Insufficiency - such as falling progesterone after you ovulate. Your doctor can perform tests to confirm the diagnosis and recommend treatment options.

Treatment may include supplements, such as progesterone, or changes in lifestyle which will help to reduce stress.

Please always seek help from your healthcare professional if you are concerned.

The luteal phase is important when trying to conceive

As we explained above, the luteal phase is the time between the day on which you ovulate and the start of your next period. If your egg is successfully fertilized, it will go through several stages of development before implanting in the uterine wall.

It takes around a week from the day of fertilization for the fertilized egg to travel down the fallopian tube and reach the uterus for implantation. Once it implants progesterone should continue to rise, and the fertilized egg will develop into an embryo.

For this reason, your luteal phase needs to be at least 9 days long on average for you to successfully sustain a pregnancy, and your progesterone levels (as seen in the temperature measured by a device like OvuSense) need to remain high.

Measuring the length of your luteal phase and your menstrual cycle accurately is the essential starting point, but let's first talk about ways in which you can increase the length of your luteal phase naturally.

Follicular phase and follicle stimulating hormone

The follicular phase is from the start of the period until ovulation. Signals from the brain tell the ovaries to prepare an egg that will be released. During the period, the pituitary gland (a small area at the base of the brain that makes hormones) produces a hormone called follicle stimulating hormone (FSH).

During the first part of your cycle (the follicular phase), your ovaries produce follicles. This is a predominantly estrogen-dominant time of your cycle. Then, ovulation is triggered by follicle-stimulating hormone (FSH) and luteinizing hormone (LH). This typically occurs between day 12 or 13 of a 28-day cycle—but it really depends on your individual cycle pattern.

The menstrual cycle is typically described as a 28-day cycle with four phases. Each phase is triggered by different hormones, each of which comes with its own set of physical and emotional changes.

Here's how the phases break down in a typical 28-day cycle: Menstrual phase: Days 1–5; Follicular phase: Days 6–13; Ovulation: Days 14–16; Luteal phase: Days 16–28. Pre-Menstrual Syndrome is caused by changing hormone levels during the luteal phase which cause noticeable physical and emotional changes in some women.

What causes a Luteal Phase Defect or Luteal Phase Insufficiency?

Low progesterone levels are a common cause of Luteal Phase Defect or Luteal Phase Insufficiency. Progesterone is a vital hormone in the female body. When it’s out of balance, it can affect your health and menstrual cycle.

Good progesterone levels are crucial to support implantation, and that's why low levels or too little time for the levels to rise can be the cause of infertility or recurrent early miscarriage.

It is therefore important to consult your doctor if you suspect that this may be causing you a problem, as there may be other causes for progesterone deficiency such as thyroid disorders or Polycystic Ovarian Syndrome (PCOS).

Symptoms can include breast tenderness, loss of libido, headaches associated with your menstrual cycle, acne, anxiety, irritability, insomnia, weight gain, PMS, and irregular bleeding.

Low progesterone levels can be caused by things outside of the reproductive system, such as cholesterol levels and thyroid, pituitary, and adrenal gland issues. Once a medical professional determines what’s causing low progesterone, they can prescribe the appropriate treatment.

Your menstrual cycle can offer unique insights into your body, guiding you toward improved health and wellness and a better life.

How you can increase your progesterone naturally and help your luteal phase

Progesterone supplementation:

Progesterone creams — These medications need to be prescribed by a health care provider. It’s a gel that usually comes in dosed applicators to make it easy to use. It’s inserted into the vagina every other day for up to six doses unless your health care provider recommends otherwise.
Oral progesterone pills —These progesterone supplementation pills can be used for irregular menstrual cycles and uterine bleeding. The dose and duration of administration will be determined by your health care provider.
Vaginal suppositories — These are inserted once or twice a day over the course of your menstrual cycle.
Human chorionic gonadotropin (hCG) – hCG can help with ovulation and producing progesterone.

Talk with a healthcare professional. They can help you determine the best course of treatment for you and your body.

If you are concerned about your luteal phase length or luteal phase insufficiency, looking into your progesterone levels can help.

Tips on how to increase your luteal phase naturally and help your menstrual cycle:

1) Change your diet to help your luteal phase

Ensure an adequate supply of Vitamin C in your diet - research shows vitamin C improves hormone levels and increases fertility in some women with luteal phase defects.

Foods rich in vitamin C are papaya, bell peppers, broccoli, sprouts, strawberry, and oranges. Essential fatty acids are vital for balanced hormone production.

Many women have low omega 3. Some foods rich in essential fatty acids are walnuts, salmon, sardines, and scallops.

Green leafy vegetables - green vegetables are rich in vitamin B complex and are necessary for good hormonal balance.

2) Herbs

Vitex (Chasteberry): This herb has been used for centuries to treat women’s health problems including infertility. Research has shown that this herb effectively lengthens the luteal phase.

It also helps the body to increase its own production of luteinizing hormone (promoting ovulation to occur), which in turn boosts progesterone levels during the luteal phase of the cycle. Be careful with this supplement as it is very potent.

However, if you are not careful you can end up doing more damage than good, so always consult a qualified herbalist if you are considering this treatment.

3) Antioxidants

Studies have been found to show that women who had luteal phase defects have significantly lower levels of antioxidants than healthy women.

Around 40% of sperm damage is also thought to be caused by oxidizing free radicals.

Make antioxidants part of your everyday foods for the both of you by enjoying blackberries, blueberries, garlic, kale, strawberries, sprouts, plums, broccoli, and red peppers.

4) Alternative therapies

Although there is limited research into the benefits of acupuncture to support fertility, anecdotally women report positive changes to their menstrual cycle, and in particular, the luteal phase when using fertility acupuncture.

5) Medical treatment

There are medical treatments available to help with luteal phase defects and, if you are considering this option, take the opportunity to discuss the possible treatments with your doctor or healthcare professional.

Can your luteal phase be too long?

Long luteal phases (longer than 14 days) may be due to a hormone imbalance, such as seen in Polycystic Ovarian Syndrome (PCOS).

However, if you've ovulated more than 14 days ago and there is still no period, you could be pregnant. If you are concerned, it's best to get medical advice from your healthcare professional.

Advice from us

If you are trying to conceive through natural fertility and trying to determine your luteal phase length over your next menstrual cycle, we suggest tracking it with an accurate ovulation monitor to see if it is within the normal range.

To do this, you will need to chart your cycles for several months. You can use a fertility chart or an app on your smartphone to track your cycles.

We recommend OvuSense which has a vaginal sensor, or OvuFirst a skin-worn sensor, as they are the most accurate fertility monitors on the market in their category. Choose one that's best for you.

If you have had a repeated early miscarriage it's possible that you are having too short luteal phases. Please make an appointment with your doctor and discuss luteal phase deficiency fertility treatment options. They can work with you to improve pregnancy outcomes

As always, we wish you every luck and success on your fertility journey.

Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.