When a womens periods or menses come regularly, this is called the menstrual cycle. Having regular menstrual cycles is a sign that your body is working normally. The menstrual cycle provides important body chemicals, called hormones and it also helps prepare your body for pregnancy each month.
A cycle is counted from the first day of 1 period to the first day of
the next period. The average menstrual cycle is 28 days long. Cycles can range anywhere from 21 to 35 days
The rise and fall of levels of hormones during the month are what control the menstrual cycle
In the first half of the cycle, levels of estrogen will start to rise. Estrogen plays an important role in keeping you healthy and Estrogen also makes the lining of the uterus grow and thicken. This lining of the womb is a place that will nourish the embryo if a pregnancy occurs. At the same time the lining of the womb is growing, an egg, or ovum, in one of the ovaries starts to mature. At about day 14 of an average 28-day cycle, the egg leaves the ovary. This is called ovulation.
After the egg has left the ovary, it travels through the fallopian tube to the uterus. Hormone levels rise and help prepare the uterine lining for pregnancy. A woman is most likely to get pregnant during the 3 days before or on the day of ovulation. Keep in mind, women with cycles that are shorter or longer than average may ovulate before or after day 14.
Some cycles are every 32 days with ovulation being on or around day 18
A woman will become pregnant if the egg is fertilized by a man's sperm cell and attaches to the uterine wall. If the egg is not fertilized, it will break apart.
Then, hormone levels drop, and the thickened lining of the uterus is shed during the menstrual period.
What is the Luteal Phase
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.
A Luteal Phase Defect
A short luteal phase cannot sustain a pregnancy and this is called
a luteal phase defect or otherwise known as LPD.In women who have a
luteal phase defect the uterine lining begins to break down and brings
menses on early, because the time from ovulation to menses is short it
doesn't allow the egg enough time to implant and send out the hormone
human chorionic gonadotrophin (HCG) and so the uterine lining begins to
break down and causes a very early miscarridge.
One of the reasons for LPD is due to progesterone and a doctor can test for this by doing a 21 day blood test, Basically 7 days after you have ovulated blood will be drawn and tested to check your progesterone levels
Poor follicle production.
You may not producing a normal level of FSH, or your ovaries may
not respond strongly to the FSH, this will lead to inadequate follicle
development. When you have a 21 day blood test the doctor can test your
FSH AND LH levels.
Or you may have Premature failure of the corpus luteum which 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.
This was the case with me my 21 day bloods came back with a progesterone level of 8, a level over 5 indicates some form of ovulation, i was sure i was ovulating as i was getting a positive opk and ovulation pain but my doctor wanted my progesterone level to be over 10.
My luteal phase was very short after breastfeeding and
my first menses had a luteal phase of 4 days then 3 days the following month, i increased it's length with
vit b6 and progesterone cream to 10 days but in the end my doctor put
me on progesterone pesseries this resulted in finally getting a BFP
(positive pregnancy test).
Please note it is not unusual for breast feeding mums to experience a luteal phase defect when their periods return, this is due to the hormone prolactin which inhibits the production of progesterone.
Prolactin is needed to help the breasts to make milk as breastfeeding decreases so does prolactin and progesterone will slowly return to normal and your luteal phase will lengthen.
And the third reason may be due to failure of the uterine lining to respond
This can occur even in the presence of adequate follicle development and a corpus luteum, with 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.
What can i do to help correct a Luteal Phase DefectBy fertility charting you can easily determine whether you have luteal phase defect. If you do, don't worry because a luteal phase defect can be easily treated. You must seek the advice of your doctor first before starting any treatments to correct it. But in most case, luteal phase defect can be corrected through over-the-counter remedies and/or with prescription drugs.
The two main over the counter remedies for luteal phase defect are vitamin B6 and progesterone cream. Vitamin B6 is perfectly safe and can be taken daily in dosages from 50 mg to 200 mg.(take no more than 200mg, 200mg is the max you should take) Taking vitamin B6 every day during the entire month will help to lengthen the luteal phase.
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 1 or 2 pumps of
progesterone cream and rub on the inner arm and inner thigh,or on the neck, and
chest - alternating places - twice a day from ovulation to menstruation
or until the 10th week of pregnancy. (please see my page on progesterone
cream) Hopefully these two things will be enough especially if your
luteal phase is not as short as mine was to begin with however if it
does not lengthen your luteal phase enough then i recommended going to
your doctor, print off all your bbt charts if you chart online or take
in ones you do at home and show your doctor the most common
prescription drugs to treat luteal phase defect are Clomid or
Progesterone pesseries.
Progesterone pesseries are usually used 3 days after confirmed ovulation , they are inserted internally into the vagina daily up until day 12-14 where a pregnancy test will be preformed if the test is negative then the progesterone pesseries are stopped to allow menses to begin and give the body a break , if however the pregnancy test comes back positive then most doctors will prefer you continue to use them until 10-12 weeks of pregnancy when the placenta will begin to take over the production of progesterone.
Clomid is used when there are problems with ovulation
The most common dosage of Clomid is 50 mg, taken for five days, on days 3 through 7 of your cycle, or days 5 through 9 of your cycle.This is usually a doctors starting dose but he may increase it if he feels you will benefit from a stronger dose (With day one of your cycle being the first day of real menstrual bleeding, and not just spotting, it is thought a stronger ovulation with a better egg will help with higher progesterone levels during the luteal phase