A luteal phase defect can impact anyone, whether or not you’re trying to conceive. Talk to your doctor about how to address your LPD and any other conditions it may be related to.
A luteal phase defect, or LPD for short, is a condition that affects the lining of your uterus and impacts your ability to get pregnant. Outside of pregnancy, LPD can also cause irregular menstrual cycles and spotting.
Understanding what a luteal phase defect is can help you figure out what’s happening in your body and how to address it. If you have a luteal phase defect, you and your doctor can determine the next steps to regulate your luteal phase, treat any underlying conditions, and manage the impact on your life.
What is the luteal phase?
First, it’s helpful to understand what the luteal phase actually is.
The luteal phase is a stage in your menstrual cycle, occurring after ovulation and before your period starts. The length of a typical luteal phase is 12 to 14 days, but may also range from 11 to 17 days.
Here’s how it works. Before the luteal phase, an egg is released from a follicle in the ovaries and travels down the fallopian tube – this is ovulation. During the luteal phase, the now-empty follicle becomes a structure called a corpus luteum. The corpus luteum releases progesterone and estrogen, hormones that tell the uterine lining to thicken in preparation for a potential pregnancy.
If the egg released during ovulation is fertilized by sperm, it becomes an embryo and implants in the thickened uterine lining. If the egg is not fertilized, the corpus luteum deteriorates, progesterone levels go down, and you shed the thickened lining as your period.
What is a luteal phase defect?
So, what is a luteal phase defect? Broadly speaking, it’s an abnormal luteal phase. If you have a luteal phase defect, the uterine lining doesn’t develop the way that it’s supposed to during the luteal phase.
Research suggests that LPD is caused by problems with the corpus luteum or with the uterine lining, also called the endometrium. If the corpus luteum doesn’t function correctly, it may prevent the endometrium from thickening. On the other hand, the corpus luteum may correctly secrete hormones, but the endometrium doesn’t respond to the hormonal changes.
Luteal phase defect can be clinically defined based on the duration of the luteal phase or on progesterone levels. Often, people can be diagnosed with LPD if their luteal phase lasts 10 days or less. Other clinical definitions use 9 days or less, or 11 days or less. In these cases, the shortened luteal phase means that progesterone levels are not elevated for enough time to allow the endometrium to fully develop.
People with luteal phases lasting the typical duration (generally 11 to 17 days) can also receive a diagnosis of LPD if they have low progesterone levels throughout the luteal phase. In these cases, the endometrium can’t fully develop because progesterone levels are not high enough. However, it can be difficult to diagnose luteal phase defect using measurements of luteal phase progesterone levels alone.
What can cause a luteal phase defect?
Certain conditions can alter your luteal phase, potentially causing you to develop a luteal phase defect. Some include:
- Eating disorders such as anorexia
- Excessive exercise
- Significant weight loss or gain
- Extreme stress
- Polycystic ovary syndrome (PCOS)
- Hormonal imbalances
- Hormonal issues like hypothalamic amenorrhea, hyperprolactinemia, or thyroid disorders
What are the symptoms of a luteal phase defect?
Like any condition, a luteal phase defect can look different for each individual. However, some common symptoms include:
- Spotting outside of your period
- Frequent or short periods, which can indicate a short luteal phase
- Recurrent miscarriages
Can you get pregnant if you have a luteal phase defect?
Proper corpus luteum function, elevated progesterone levels, and a thickened, developed uterine lining are essential parts of a healthy pregnancy. In people with luteal phase defect, one or a combination of these factors are disrupted. This makes it very difficult for an embryo to implant in the uterus and for pregnancy to occur.
In concrete terms, people with a luteal phase defect have a hard time getting pregnant and may experience multiple miscarriages.
LPD also affects people outside of pregnancy. A luteal phase defect can cause spotting, irregular menstrual cycles, and short menstrual cycles. LPD can also be a symptom of other underlying conditions, such as PCOS or hormonal disorders.
Addressing a luteal phase defect: treatment and diagnosis
If you’re experiencing possible signs of a luteal phase defect, you may want to consider talking to your doctor. They will run some tests to diagnose LPD, then determine treatment based on your unique situation.
Diagnosing a luteal phase defect
The first step is diagnosis. Currently, there isn’t one, standard test to diagnose LPD. Your doctor will likely recommend blood tests and pelvic ultrasounds.
Blood tests evaluate your hormone levels. In particular, your doctor will examine your progesterone levels. Pelvic ultrasounds check the thickness of your uterine lining. They will be conducted during your luteal phase to see if your endometrium is developing normally.
In the past, doctors also used endometrial biopsies. In this procedure, a piece of your endometrial lining (your uterine lining) is removed during your luteal phase in order to examine it more closely. However, this more invasive method has since been shown to be an inaccurate tool for diagnosing LPD, and it is generally no longer recommended.
How do you fix a luteal phase defect?
The type of treatment you undergo for a luteal phase defect depends on your overall health and your particular needs.
For people who aren’t trying to conceive
If you’re not trying to get pregnant, you may not need to treat your luteal phase defect specifically. However, if you have underlying health conditions that could be causing your LPD, such as PCOS or endometriosis, you and your doctor should discuss treatment plans for those conditions.
For people who are trying to conceive
If you’re trying to conceive, your doctor might suggest treatment to:
- Stimulate ovulation using medications such as clomiphene or injections of gonadotropin hormones like human chorionic gonadotropin (hCG)
- Increase progesterone levels using progesterone supplements, which can be injected or administered orally or vaginally (as a suppository or a gel)
If you’re dealing with infertility (generally defined as the inability to conceive after one year of unprotected sex, or six months if you’re over 35), LPD treatments alone are unlikely to fix the whole problem. While these treatments may help regulate your luteal phase, a luteal phase defect might not be the only factor contributing to your fertility issues. If this is the case, you’ll likely need other forms of treatment, as well.
Studies are currently inconclusive regarding how effective ovulation stimulation and progesterone regulation are at improving fertility. Additionally, studies have not shown that LPD treatments increase the chances of a successful pregnancy in unstimulated cycles – that is, in people who undergo LPD treatments but do not use assisted reproductive technologies (ART). Your doctor may therefore recommend combining your LPD treatment with ART methods such as intrauterine insemination (IUI) or in vitro fertilization (IVF).
The bottom line
If you suspect you may be dealing with a luteal phase defect, talk with your doctor to get tests done, determine your treatment goals, and figure out which methods of treatment are right for you.
If you’re trying to get pregnant, a luteal phase defect can make it hard to conceive and maintain a pregnancy. Combining LPD treatment with ART methods may increase your chances of having a successful pregnancy.
If you’re not trying to get pregnant, a luteal phase defect may still impact your day-to-day life, and could be a symptom of an underlying condition. While you may not need to treat your LPD specifically, you and your doctor should closely monitor your overall health and any potential conditions in order to treat the elements around your LPD.
- American Society for Reproductive Medicine. (2021). Diagnosis and treatment of luteal phase deficiency: a committee opinion.
- CDC. (2022). Infertility FAQs.
- Schliep K et al. (2014). Luteal Phase Deficiency in Regularly Menstruating Women: Prevalence and Overlap in Identification Based on Clinical and Biochemical Diagnostic Criteria.
Life With Oova
Join our community
Share your own stories with #MyFertilityTranslator