Luteal phase defect (LPD) is the inability to produce enough progesterone during the luteal phase, which disrupts the monthly menstrual cycle. The luteal phase is the two-week period between ovulation and menstruation. The ovaries release progesterone during this phase, aiding in the thickening of the uterus lining for pregnancy. Progesterone levels remain high in order to support the developing baby. A drop in progesterone levels will lead to a miscarriage.
The lining sheds during menstruation, if pregnancy does not occur. A woman with LPD experiences her menstrual cycle earlier than usual due to the low production or premature drop of progesterone.
LPD may occur if the ovaries do not produce enough progesterone or if the lining of the uterus does not respond to the progesterone.
Symptoms
- Frequent, short menstrual cycles
- Spotting between cycles
- Miscarriages
Diagnosis
Blood tests are used to check hormone levels, including the follicle-stimulating hormone, the luteinizing hormone and progesterone. If an endometrial biopsy is needed, it take place a day or two before the next menstrual cycle to observe the development of the lining of the uterus.
Medical Therapy
- Clomiphene citrate (Clomid) is used to stimulate ovulation and release more eggs.
- Human chorionic gonadotropin (hCG)is used to stimulate ovulation of mature eggs and produce more progesterone.
- Progesterone injections, pills, or suppositories assist with uterine lining growth.