What is luteal phase defect / luteal phase dysfunction / luteal phase deficiency?
Luteal phase defect (LPD), which may sometimes also be referred to as luteal phase dysfunction, luteal phase deficiency, or even luteal insufficiency, is a condition characterized by a shorter-than-normal luteal phase of the menstrual cycle. In a normal menstrual cycle, the luteal phase is approximately 14 days long, and occurs after ovulation and before menstruation (so, the luteal phase is a woman’s second half of her cycle). However, in luteal phase defect, the luteal phase is shorter than normal, and ovulation often doesn’t occur at all.The absence of ovulation and a shortened luteal phase creates a few issues in terms of female fertility and general reproductive health. First of all, if a woman is having anovulatory cycles (meaning that her ovaries don’t release an egg during her cycles), she won’t be able to conceive since there won’t be an egg present at any time during the month to be fertilized by sperm. Second, a short luteal phase means that the woman’s body will produce lower levels of progesterone (and estrogen) during the second phase of her cycle, and that the endometrial lining will be significantly thinner than it should be. So, even if a woman with LPD does ovulate, she’s less likely to have success in conceiving because her hormone levels and the uterine environment are overall less favorable to embryo implantation and growth.
What causes luteal phase defect and how is iodine involved?
Luteal phase defect can be caused by a variety of factors. Some of the more conventionally accepted causes of luteal phase defect include:- Hyperthyroidism / Hypothyroidism (We talk in more depth about iodine supplementation for thyroid conditions here)
- Endometriosis
- Polycystic ovarian syndrome (PCOS) (Follow this link to read about iodine supplementation for PCOS)
- Obesity (Click here to learn about iodine as a treatment for obesity, unexplained weight gain, and unexplained weight loss)
- Stress
- Anorexia / not eating enough
- Extreme exercise regimens
- Hyperprolactinemia (Read about Lugol’s iodine solution as a hyperprolactinemia cure)
- Extreme/sudden weight loss OR weight gain
Out of this selection of potential causes of luteal phase defect, the one that stands out most to me is that of hyperthyroidism / hypothyroidism. Thyroid problems are nearly always a direct result of an iodine deficiency, especially in the modern world, and can be corrected with the use of iodine supplements and the appropriate supportive nutrients. And, in this case, iodine deficiency and thyroid issues are directly linked to many of the other potential causes for luteal phase defect that are on this list.
Thyroid health and reproductive organ health are both supported by the same nutrient: iodine. There are iodine receptor locations throughout the body, but the highest concentration of iodine receptors in the body are found in the thyroid and reproductive organs. These organs all absolutely require sufficient levels of iodine in order to function correctly, and studies have shown that certain reproductive conditions, such as anovulation, polymenorrhea, and menstrual cycle irregularities are all correlated with poor thyroid function.
More recent research has also shown that there are thyroid hormone receptor sites on the ovaries, which suggests that the production (or lack of production) of thyroid hormones may directly affect the ovaries and ovulation more than ever before realized. In these receptor sites, thyroid hormones may help encourage the production of progesterone by the corpus luteum, which is essential for the growth of the endometrial lining and the successful implantation and growth of an embryo should pregnancy occur. Since low levels of progesterone and thin endometrial lining characterizes luteal phase defect, this is a crucial link to consider for women with this particular health problem.
In regard to the list above, we’ve talked about iodine as a natural, effective treatment option for endometriosis, PCOS, and hyperprolactinemia, as well as for weight loss/weight gain and obesity. Follow the links above to learn about the details of how iodine supplementation can benefit women with these conditions.
Symptoms of Luteal Phase Defect
Some women may go years without ever knowing that they have a luteal phase defect, yet there are still some telltale signs that may suggest that a woman is struggling from anovulation and/or problems with the luteal phase of her cycle.The symptoms of luteal phase defect are listed below:
- Spotting in between periods
- Infertility
- Recurrent miscarriage
- Shorter-than-average menstrual cycles
- Bloating
- Headaches
- Weight gain
- Insomnia / disrupted sleep
- Mood swings
- Decrease or increase in libido
- Swollen, tender, or painful breasts
- Food cravings
Conventional Pharmaceutical Drugs for Luteal Phase Defect
In many cases, doctors prescribe one of three things to attempt to treat women with luteal phase defect:- Clomiphene citrate
- Human chorionic gonadotropin (HCG)
- Progesterone
Both progesterone and human chorionic gonadotropin (HCG) can be given to try and rebalance a woman’s progesterone levels during her menstrual cycle. Since low progesterone levels are associated with luteal phase defect, some physicians recommend that their patients receive at least one of these hormone treatments following ovulation.
The side effects of HCG supplementation include:
- Ovarian hyperstimulation syndrome (OHSS)
- Severe pelvic pain
- Swelling in the legs, hands, or abdomen
- Stomach pain
- Weight gain
- Diarrhea
- Nausea/vomiting
- Infrequent urination
- Shortness of breath
- Headache
- Restlessness
- Irritability
- Water weight gain / mild swelling
- Fatigue
- Breast tenderness and/or swelling
- Depression
The side effects of progesterone supplementation include:
- Headache
- Mood swings
- Irritability
- Gastrointestinal upset
- Cold symptoms (sneezing, cough, runny nose, etc.)
- Nausea/vomiting
- Diarrhea/constipation
- Pain the joints, muscles, or bones
- Vaginal discharge
- Trouble when urinating
- Vision changes
- Rapid heartbeat
- Abnormal vaginal bleeding
- Depression
- Skin rash
- Chest pain
- Difficulty with coordination and/or ability to speak
- Shortness of breath
- And more…
Clomiphene citrate (Clomid; Serophene) is a drug given to stimulate ovulation since it encourages the synthesis and release of follicle stimulating hormone (FSH) and luteinizing hormone (LH). Women with anovulation who also have luteal phase defect are more likely to receive a prescription for this particular drug. The side effects of clomiphene citrate include:
- Gastrointestinal upset
- Bloating
- Hot flashes
- Tender breasts
- Dizziness
- Headaches
- Abnormal vaginal bleeding
- Changes in mood or mental health
- Vision changes
- Edema in the chest, abdomen, or heart
- Rapid weight gain
- Diarrhea
- Decreased urination
- Shortness of breath
- Chest pain
- Fast or irregular heartbeat.
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Treatments for Luteal Phase Defect
The treatments for luteal phase defect are largely the same, regardless of why you’ve developed this particular problem. If you suffer from another health condition in addition to luteal phase defect, please consider the treatments below in addition to other treatments that may apply to your other health problem. Most people have to establish a cohesive healing protocol that combines a few different treatments before they see positive results.High Dose Vitamin C
When used correctly, vitamin C can do some pretty amazing things. Though lower doses of vitamin C, whether it be through food or a supplement, are normally sufficient, when it comes to treating health problems, higher doses of vitamin C are almost always necessary if a person intends to use this vitamin as a medicine.In women with luteal phase defect, some sources suggest that a minimum daily dose of 750mg of vitamin C may be able to increase/regulate progesterone levels and generally boost fertility. One study completed in 2003 demonstrated that supplementation with ascorbic acid (vitamin C) in women with luteal phase defect successfully increased the test participants’ progesterone levels and serum estradiol levels by significant amounts in comparison with the patients in the control group. In addition, the women in the test group had a higher chance of achieving pregnancy (these women also had a lower incidence of miscarriage in comparison with the women in the control group).
Vitamin C can be taken in significantly higher doses, though, with some people choosing to take a medicinal dose of 10-20 grams of vitamin C. Keep in mind, though, that vitamin C should be taken according to your tolerance level. Start on a day when you have some time to pay attention to your body, and begin your morning by taking 500mg of vitamin C. 30 minutes later, if you don’t notice any significant changes, take another 500mg. Continue increasing your dose in this way until you notice your stomach begin to gurgle, and then stop. Note down the dose you were able to take before this happened; this is your tolerable dose, and the dose you should aim to take while using vitamin C medicinally. Note that if you become pregnant, you can continue taking vitamin C.
Read more about the benefits of vitamin C supplementation during pregnancy here.
A lot of people worry about taking too much of a vitamin or mineral. While there are indeed some cases where you should use some caution, vitamin C is not this way. If you take too much, your body will filter out the extra vitamin C in your urine. It’s very difficult to “overdose” on vitamin C (though you may end up with diarrhea if you increase your dosage too quickly or up to a dose that’s too high for you, which is, again, your body’s way of removing the extra vitamin C that it doesn’t need).
Lugol’s Iodine, 2%
Iodine deficiency is closely linked to a long list of women’s health problems, including (but by no means limited to) anovulation, luteal phase defect, menstrual irregularities, hormonal imbalances, PMS and PMDD, and much more. The reproductive organs in both women and men require larger amounts of iodine in order to function correctly, so when the body is deficient in iodine, these organs are generally among the first (besides the thyroid) to malfunction. For many women, supplementation with iodine at the appropriate dosage and in combination with the correct supportive nutrients is enough to significantly improve the symptoms of many reproductive organ-related problems, if not heal the condition entirely.We already discussed iodine and its role in healing luteal phase defect above, so here I’ll concentrate on dosing information.
Lugol’s iodine solution combines molecular iodine with potassium iodide; you need both of these forms of iodine in order to feed both the thyroid and reproductive organs. Other supplements, like Iodoral, also combine these two types of iodine. It’s important that you get an iodine supplement like Lugol’s or Iodoral that has both types of iodine, or else the supplement may not be as effective (or more unfortunately, may not work at all).
Start with a dose of 1 drop of Lugol’s iodine, 2% (only start taking the iodine after taking the supportive nutrients below for 2 weeks). You may take the iodine rubbed into your skin, or you can put it in a glass of clean, purified water to drink. The goal is to work up to a total of 20 drops of iodine per day (this is equivalent to a dose of 50mg), increasing your dose by 1 drop per day, but this will take you at least 20 days, if not longer than this, depending on the detox symptoms you experience. As you take iodine, another mineral known as bromine will leave your body. Bromine is a toxic mineral that can take up residence in iodine receptor sites in the body, thus making it somewhat more difficult to overcome an iodine deficiency unless you take high doses of iodine. In addition, the presence of bromine in the body can create bromine toxicity symptoms, which we talk about in more detail here.
As with most detoxifications, a person taking iodine supplements (especially if that person is located in the US or has taken pharmaceutical drugs containing bromine in the past) is likely to feel worse before getting better. There are exceptions to this rule, of course, but it’s smart to plan ahead for a detox reaction. On the days when you are feeling better, increase your dose by one drop. If you experience a detox, stop increasing your dose and remain at the dose you’ve reached until the symptoms pass.
The AlivenHealthy Iodine Bible - Everything you need to know to get started taking iodine and more!
Click here to learn more about iodine deficiency, bromine toxicity, and what to expect when you start taking iodine supplements. Print out the list of bromine detox symptoms and put them on your fridge to remind yourself of them. These symptoms generally go away between 1-2 months after beginning the Lugol’s iodine protocol.
Be sure to take the following supportive nutrients at least 2 weeks prior to starting iodine treatment, and then also to take them with your iodine supplements after you start using iodine:
- Selenium - 200-400mcg/day
- Vitamin K2+D3 - Take the recommended dose; make sure to get a product that contains the natural MK-7 form of vitamin K2
- Magnesium glycinate/citrate - 2000-5000mg/day
- Zinc + Copper - 15mg + 2mg (it’s important that you take a copper supplement with the zinc supplement, since long-term zinc supplementation has been known to cause copper deficiency; this way, you can get the benefits of zinc without having to worry)
- Vitamin B2 / Riboflavin - 400mg/day
- Vitamin B3 / Niacin - 500mg/day
- Amino acid supplement
- Sea water supplement - Add 1 teaspoon to every 8 ounce glass of water you drink
To hasten the process of bromine detoxification and to get rid of the symptoms of bromine detox, drink 1 teaspoon of sea salt in a glass of water whenever necessary. Drink this once every 30 minutes to 1 hour until you start to need to urinate more frequently, and then stop. The salt and the trace mineral in the salt will help bind with the bromine to remove it from the body more quickly and effectively.
Lunaception
Lunaception is a fertility management method for women in their reproductive years. It can be used not only as a natural contraceptive method (with surprising efficacy, when performed correctly), but also can be used to boost fertility and treat common women’s health complaints, especially those regarding the menstrual cycle or hormone balance/imbalance. This technique involve syncing one’s cycles with the moon in order to restore the menstrual cycle back to a normal length and pattern.Lunaception can help lengthen a woman’s luteal phase to a normal length, in addition to maintaining the whole cycle at a reasonable length as well. The technique is also known to restore hormone levels back to normal levels during different stages of the menstrual cycle, so it may help increase progesterone levels at the appropriate time of month, and also thus help encourage the development of a thicker endometrial lining.
Read more about the benefits of Lunaception and how to perform it here.
Vitex Berry / Chaste Berry (Vitex agnus-castus)
Vitex berry is probably one of the most important herbal supplements to have in your medicine cabinet if you’re a woman and still in your reproductive years. This one herb carries a whole host of health benefits for women, including for women with luteal phase defect. You can read more about vitex berry’s long list of women’s health benefits here, but in this section, we’ll focus specifically on how it can treat luteal phase defect.One of the ways in which vitex berry may benefit women with luteal phase defect is by supporting healthy progesterone levels. Multiple studies have shown that the use of vitex berry can not only increase progesterone levels, but that it can also lengthen/normalize the luteal phase of the menstrual cycle, increase basal body temperatures during the luteal phase, and significantly boost a woman’s chances of becoming pregnant, if she’s trying to conceive.
From the Traditional Chinese Medicine perspective, luteal phase defect is generally a condition characterized by Blood deficiency, Yin deficiency, Yang deficiency, and excess Heat, with organ imbalances in the Spleen, Liver, and Kidneys. Vitex berry is considered to be a Cold herb with special healing powers on the Liver meridian, with apparent action against Blood deficiency and Yin deficiency in the Liver. As such, the TCM model of medicine would also support the use of vitex berry in the treatment of luteal phase defect.
Note that women with luteal phase defect who also have issues with follicular development may not benefit from vitex berry in the same way, since this herb has been known to slightly lower follicle stimulating hormone (FSH) levels. If you become pregnant while taking vitex berry, it may be taken until the end of the first trimester to ensure that progesterone levels remain sufficiently high; use of vitex berry during the first trimester can help prevent miscarriage, especially in women with a history of miscarriage or who are at high risk of having a miscarriage.
Lifestyle Changes
Nobody likes to think about lifestyle changes, but when it comes to reproductive health, this is one of the first places to start. Many, many health problems related to infertility and hormonal imbalance can be traced back (at least partially) to poor diet or exposure to chemicals and environmental toxins. While it’s difficult to avoid all toxins, there are some important changes that a woman can make if she wants to minimize her exposure to disruptive food ingredients or chemicals. These changes not only can boost fertility and restore regularity to the menstrual cycle, but for women who are trying to conceive, these changes can also enhance her chances of having a healthy pregnancy and a healthy baby.Follow this link to read about simple and affordable alternatives to most cleaning and beauty products.
Click here to read about the basics of a healthy, toxin-free diet (dietary changes can be daunting, but there’s plenty of variety here; also note that although this particular article is geared toward men, that the same basic dietary principle apply to women, too).
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