Short Luteal Phase Defect: Treatment Options in Ottawa

There are 2 ways to determine if a Woman has a luteal phase defect, which is accompanied by low progesterone levels, one is with a blood test and the other more accurate method is through cycle tracking. A blood test in the middle of the luteal phase checking for progesterone levels helps determine if you are having low progesterone. However, according to research, a more accurate method of checking for a luteal phase defect is tracking the luteal phase. If the luteal phase (day 1 of the luteal phase starting from the first day you notice a positive ovulation predictor urine test) is 12 days or less, or if you notice significant spotting during the luteal phase, this is a strong sign of having an abnormally low level of progesterone. This will increase the risk of miscarriages and infertility, as a healthy fertilized embryo may be unable to implant on the uterine lining with low progesterone.

Common Factors Contributing to Luteal Phase Defects

1. Polycystic Ovarian Syndrome (PCOS): polycystic ovarian syndrome is well known for poor ovulation. When ovulation quality is low, the corpus luteum may not produce sufficient levels of progesterone in to the blood to support the uterine lining.

2. Ovulatory Dysfunction: poor ovulatory function can be a result of dietary issues as well as hormonal imbalances. For example, elevated prolactin or cortisol (stress hormone) levels may reduce ovulatory frequency and quality as well.

3. Medications: certain medications can reduce chances for ovulation and make it harder for the body to ovulate. For example, use of non-steroidal anti-inflammatory drugs (NSAIDs) can inhibit ovulation.

4. Suboptimal Thyroid Function: a hypo-functioning thyroid interferes with ovulation and fertility in general. It can also increase the risk for miscarriage and other complications during pregnancy.

5. Endometriosis: patients diagnosed with this chronic and painful disorder often have low levels of progesterone. Progesterone can help suppress endometriosis and reduces the harmful impact of chronically elevated estrogen (relative to the low levels of progesterone), as elevated estrogen if left unchecked can stimulate the continued growth and spread of endometriosis to nearby tissues. 

Treatment Options for a Short Luteal Phase Defect

1. Fertility Acupuncture: Fertility acupuncture supports healthy ovulation and hormone levels. It can increase ovulation rates in Women with polycystic ovarian syndrome (PCOS) as well as general poor quality ovulation.

2. Clinical Nutritional Supplements: Specific nutritional supplements can be used to help reduce levels of stress hormones, improve insulin sensitivity in PCOS, and support a healthy uterine lining.

3. Hormone Replacement: Bioidentical progesterone can help make up the insufficient levels in the body to help support a healthy uterine lining and a healthy pregnancy. The use of desiccated thyroid hormone helps to provide thyroid hormone in cases where there is hypothyroidism.

4. Botanical Medicine: Specific botanical remedies can be used to help stimulate and support healthy ovulation in patients with poor ovulation. They work by increasing production of luteinizing hormone (LH) from the pituitary gland and supporting ovulation. Additional remedies can be used to support healthy cortisol levels and reduce stress levels as well.

Benefits of Supporting a Healthier Luteal Phase for Fertility and Pregnancy 

 

Low progesterone levels may go unchecked often. This is because the blood levels of progesterone can change every couple of hours. So when a blood test is done to check for progesterone levels, it is just giving the value in that snapshot of time, and it may have been during a peak rather than a low in the constantly fluctuating blood levels of the hormone. For example, some patients may get pregnancy and have their progesterone levels checked to make sure their body is producing sufficient levels of this hormone to support pregnancy. And when checked after a period of time, the progesterone may be low and the patient may start spotting. In many cases, if the pregnancy is viable, the use of progesterone may help to reduce or stop spotting. 

 

One of the biggest applications for progesterone during pregnancy is its use to help prevent miscarriage, or help to reduce the risk of a miscarriage. There were two very large systematic reviews that compiled the data from various high-quality studies, and both of these research papers had come to the same conclusion: that the use of progesterone during the first trimester of pregnancy can help to significantly reduce the risk of a miscarriage. In general, the safety profile of supplementing this hormone is fairly good, but your Naturopathic Doctor will cover any risks based on your case, medications, and medical history. 

 

How is Progesterone Used?

 

Supplementing with progesterone can be possible in various forms. Commonly, progesterone is prescribed in the form of a cream, which can be applied once or multiple times a day. The cream is absorbed from the skin and distributed to the body through the blood in the circulatory system. If progesterone is needed to treat systemic symptoms of progesterone deficiency (i.e. premenstrual tension syndrome, nervousness, insomnia, etc) then the cream form is a good option. However, there is usually a higher risk for side effects as the progesterone is distributed to many organs, including the breasts, nervous system, liver, etc. The same is true for intramuscular injections of Progesterone hormone. When working with fertility or trying to reduce the risk of miscarriage, using a vaginal suppository can be great option as the majority of the hormone is absorbed locally in the reproductive organs. Research has shown that the concentration of progesterone in the uterus can be up to 30x higher when supplemented with a vaginal suppository instead of a cream or injectable form. There are also synthetic gels that may be prescribed by your physician or fertility clinic for vaginal application. 

This information is presented for educational and informative purposes only. This is not a replacement or substitute for medical advice from your fertility doctor or physician. If you have any questions or concerns regarding fertility drugs, please follow-up with your fertility

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