Luteal insufficiency is a functional disorder of the corpus luteum and can be the reason for an unfulfilled desire to have a child. The corpus luteum forms during the menstrual cycle and produces the corpus luteum hormone progesterone.
Progesterone is especially important during pregnancy, as it prepares the body for the implantation of an embryo and is later also responsible for maintaining the pregnancy.
You can find out everything you need to know about luteal insufficiency here.
Table of contents
The Corpus Luteum And What It Has To Do With The Female Menstrual Cycle
The corpus luteum plays an important role not only in pregnancy, but for the female menstrual cycle in general. So to understand what luteal insufficiency or progesterone deficiency is all about, let’s first look at the phases of the menstrual cycle.
The main hormonal changes of the female cycle take place on the ovary in three phases.
Follicular Phase (1st Half Of The Cycle)
In this first phase of your cycle, follicles form in your ovaries. These follicles eventually mature into eggs, caused by follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
These hormones also stimulate estrogen production, which improves the quality of cervical mucus and makes it easier for sperm to reach the egg. Therefore, you are particularly fertile during this phase of your cycle.
Ovulation Phase (Middle Of The Cycle)
In the ovulation phase or ovulation phase, a mature egg is released into the fallopian tube. A few days before ovulation, your body releases large amounts of the hormone LH to initialize ovulation. The egg remains capable of fertilization for only a short time.
Corpus Luteum Phase (2nd Half Of The Cycle)
In the corpus luteum phase, also known as the luteal phase, the corpus luteum forms from the cells of the ruptured follicle. The corpus luteum produces the corpus luteum hormone progesterone, whose most important task is to prepare the uterine lining for the implantation of a fertilized egg.
Progesterone also causes the cervical mucus to become less permeable again, which is why this phase is also called the infertile phase. If fertilization of the egg fails to occur, the corpus luteum stops producing progesterone after 12-16 days and dies. As a result, the uterine lining is shed and bleeding begins. After that, the cycle starts again from the beginning.
Note: In case of successful fertilization, the menstrual cycle is interrupted. In this case, the corpus luteum does not regress but remains intact and produces large amounts of hormones during the first weeks and months to maintain pregnancy. After that, the placenta takes over this task.
What Happens In Luteal Insufficiency And How Does It Occur?
Luteal insufficiency inevitably leads to a lack of progesterone. Progesterone is a very important sex hormone, especially for women who want to have children. It is the dominant hormone in the second half of the female cycle.
It prepares the body for pregnancy and maintains it after successful fertilization. If the corpus luteum does not form properly during the luteal phase, it does not manage to produce enough progesterone and the fertilized egg cannot implant properly in the uterus. Pregnancy then does not occur at all or it ends in an early miscarriage. Doctors therefore speak of hormonally induced infertility.
But how does a luteal insufficiency occur in the first place? As a rule, the cause is insufficient maturation of the follicles. As you already know, the corpus luteum is formed from a follicle that has ruptured.
If this does not develop properly in the first half of the cycle, the corpus luteum cannot be formed properly and there is a lack of progesterone. The causes of insufficient maturation of the follicle can be manifold.
For example, diseases of the thyroid gland or diabetes can be behind it. A deficit of the hormones FSH and LH can also trigger luteal insufficiency or progesterone deficiency. These hormones are normally released in the first half of the cycle and stimulate the growth of the follicles.
If you have been using the contraceptive pill up to now, luteal insufficiency can also develop for a short time after you stop taking the pill. This has to do with the fact that the hormone balance first has to regulate itself again. In this case, the problem usually disappears by itself within a few months.
Note: In any case, it is important to get to the bottom of the individual causes of luteal insufficiency in order to be able to initiate adequate therapy.
Symptoms Of Luteal Insufficiency
If you have great difficulty getting pregnant, there is a possibility that you are suffering from luteal insufficiency. The main characteristic is a shortened second half of the cycle, which lasts only 12 days or even less instead of 14 days.
The reason for this is the dysfunction of the corpus luteum, which prevents it from producing enough progesterone. As a result, the corpus luteum quickly regresses and menstruation begins prematurely.
If the corpus luteum phase is too short, the fertilized egg cannot implant successfully in the uterus. Besides the irregular cycle, there are other possible symptoms that could indicate luteal insufficiency.
However, it should be said that they can be different for every woman. If some of the symptoms apply to you, this alone is therefore not an indication of luteal insufficiency. Your gynecologist will be the best judge of what is causing your infertility. Possible symptoms include.
- Water retention.
- Severe PMS symptoms.
- Bleeding between periods or spotting.
- Slow increase in basal body temperature.
- Early miscarriages.
- Ovarian cysts and fibroids.
How Do You Diagnose Luteal Insufficiency?
Your gynecologist can measure your progesterone level with a saliva or blood test. These hormone tests are performed in the second half of the cycle when the corpus luteum has already formed. Below-average values can indicate a weakness of the corpus luteum.
However, if your cycle is particularly long or irregular, it may be that you are still in the egg maturation phase, in which a low value is perfectly normal. Therefore, the diagnosis only works if you are absolutely sure that you are in the second half of the cycle.
To be on the safe side, you can regularly measure your basal body temperature and also check the quality of your cervical mucus. In addition to the progesterone level, other hormone values are often measured, especially estrogen, since a progesterone deficiency is usually accompanied by so-called estrogen dominance.
In addition to measuring hormone levels, your gynecologist will also check whether your adrenal gland is weakened and whether ovulation is occurring at all. Subsequently, it is useful to look for the causes of luteal insufficiency, if these are unknown.
Luteal Insufficiency – No More Children?
Having luteal insufficiency does not mean that you will never have children. In fact, once it is diagnosed, it can usually be treated well. Hormone therapy involves administering hormones – in the form of capsules, creams or patches – to help the follicles mature.
This is because if the follicles form well in the first half of the cycle, a high-quality corpus luteum will subsequently also form, which can produce enough progesterone to prepare the uterus for a potential pregnancy.
Usually, progesterone or similar hormones are prescribed to compensate for the lack of progesterone. However, hormonal medications such as clomiphene and utrogest may also be used. If conditions such as diabetes or thyroid disease are the trigger, they will be treated.
Your doctor will take care of an individual diagnosis and treatment tailored to you and your problems. To ensure that your desire to have a child is subsequently fulfilled, it is important to take the prescribed medication in the correct dosage and at the right time.
If you have already been diagnosed with luteal insufficiency, you should by no means abandon your hopes of having a baby. Luteal insufficiency is not a disease, but a hormonal dysfunction.
The progesterone deficiency can be treated very well with medication and as soon as your hormone balance is restored, nothing should stand in the way of your desire to have a child.