Maximizing Fertility with a Healthy Luteal Phase
This great diagram shows the hormonal influences and activities over the course of a “normal” 28 day cycle. Now, many women do not necessarily have clockwork cycles, but they will likely still follow a similar rhythm. When determining causation for irregular cycles or sub-fertility it is important to evaluate both phases of the cycle to find where the hormone action may be out of balance.
The follicular phase is the time during a woman’s monthly cycle from the first day of menses to ovulation. It typically lasts two weeks. During this time estrogen is dominant. The luteal phase refers to the time in a woman’s cycle beginning at ovulation and ending when menses begin. The luteal phase typically lasts two weeks. The luteal phase culminates in the production of the corpus luteum that secretes progesterone. Progesterone helps to thicken the lining of the uterus in preparation for the possibility of pregnancy as well as helping to maintain pregnancy early on. Bottom line is that if women do not have enough progesterone, they have trouble getting pregnant and staying pregnant.
For progesterone to be produced, there are a variety of other hormonal factors involved. Sufficient cholesterol and pregnenolone must be present, as these two are the precursors for progesterone to be made. Proper thyroid and adrenal gland function are needed for a healthy luteal phase as well. Stress taxes the adrenal glands and turns pregnenolone into cortisol (to mitigate stress) instead of into progesterone. Here we see how high stress can directly effect a women’s menstrual cycle.
Lastly, adequate circulation to the pelvis is needed for a healthy luteal phase because the luteal cells have a particularly high metabolism and a high need for oxygen. The mitochondria (energy centers) of the luteal cells must also be functioning properly for progesterone to be produced.
A luteal phase defect refers to a disruption of the second half of the monthly cycle. If If the luteal phase is shorter than the normal two weeks, progesterone levels may be lower than optimal and healthy fertility can be compromised. Luckily with some simple natural therapies we can support the hormonal balance and increase progesterone levels, hence improving fertility.
Basal body temperature: the basal body temperature during the luteal phase should be high and steady.
Luteal phase bleeding or spotting: bleeding or spotting in the second two weeks of the cycle, or before the onset of menses may indicate inadequate luteal phase.
Short cycles (less than 28 days)
Progesterone: low serum (blood) or salivary progesterone (*best obtained seven days before the expected date of the next period) may indicate poor luteal cell function. This test is VERY important to run if you suspect low progesterone.
Other hormones to check: A full thyroid panel and adrenal/cortisol panel are indicated to assess the function of these glands.
Treatment varies for each individual. Here are some possibilities to discuss with your doctor:
Nutrition: prioritize a whole foods diet with high quality proteins (such as organic, free-range, grass-fed animal proteins and wild caught fish). Healthy fats such as avocados, nuts, seeds, and extra-virgin coconut oil provide precursors to some of the hormones needed for a healthy luteal phase.
Supplements which may be appropriate for you:
Supplements for the whole cycle:
Maritime Pine bark
Vitamin B 6
Vitamin B complex
Omega 3 fatty acids
Co Q 10 or ubiquinol
Supplements for the luteal phase only:
Chaste tree (Vitex Agnus )
Bio-identical progesterone supplementation
Evening primrose oil
Thyroid support in the form of L-tyrosine, selenium, iodine may be indicated if thyroid hormones are not optimal. Bio-identical hormones might be indicated as well.
Stress reduction and further adrenal support may be indicated. Acupuncture is excellent at balancing the adrenal glands as well as calming the nervous system. Other powerful tools are: yoga, slow deep breathing, meditation and anything which allows the brain to “turn off” and the breathing to slow.
Good ovarian blood circulation is needed for proper ovulation and progesterone production. Castor oil packs on the belly can help move blood to the reproductive organs. Just rub organic castor oil on lower belly before bed, cover with an old T-shirt(that can get oily) and cover with a heat pack. Also Mayan abdominal massage is a wonderful treatment for improving reproductive circulation.
Talk to your naturopathic physician or functional medical doctor to get a comprehensive plan unique for your body!