Luteal Phase Defect (LPD)

Understanding Luteal Phase Defect (LPD) and How It Affects Fertility

The luteal phase is the second half of the menstrual cycle that occurs after ovulation and before menstruation. This phase is when progesterone production is at its highest and when the uterine lining is preparing for embryonic implantation. The normal length of this phase is ideally 12 to 14 days. A LPD is a hormonal imbalance that affects ovulation and the uterine lining. It is said to occur when the luteal phase is less than 10 days, progesterone production is too low, the uterine lining is unresponsive, or there is poor follicle production.

In most cases, a woman’s Hypothalamus-Pituitary-Ovarian axis is out of balance which can cause an imbalance of hormone production. One such hormone is follice stimulating hormone (FSH) which directly affects the production of follicles each menstrual cycle. When a woman produces an abnormal level of FSH, or her ovaries do not respond strongly to the FSH, it results in poor follicle development. This inadequate follicle development then leads to poor corpus luteum development. (The corpus luteum is the lining around a follicle that remains in the ovary after ovulation and secretes oestrogens and progesterone, which are steroid hormones responsible for the thickening of the trium endometrium). When there is poor corpus luteum development, the production of progesterone is inadequate and fails to properly thicken the uterine lining for implantation of a fertilized egg. The result can be infertility.

In other cases, premature failure of the corpus luteum can occur even when the initial quality of the follicle/corpus luteum is adequate but it does not last as long as it should. Failure of the uterine lining to respond can also occur even in the presence of adequate follicle development and an adequate corpus luteum. For some reason the tissue does not respond to normal levels of progesterone. Common symptoms of LPD include:

• Shortened menstrual cycles
• Low basal body temperature
• Infertility
• Habitual miscarriage
• Bleeding between periods
• Intolerance to cold
• Fatigue
• Breast tenderness
• Feeling of internal heat
• Dry eyes
• Constipation
• Low back pain

How Chinese Medicine and Acupuncture Treat LPD

Chinese Medicine and Acupuncture views symptoms of LPD as a result of poor reproductive health rather than an inability to conceive. This is why women, who have previously been told they are too old, poor responders, and have no options due to LPD, can become pregnant after their bodies achieve a state of balance and their reproductive health is restored. In our clinic, we use acupuncture, Chinese herbs, reproductive organ massage, and nutritional guidelines to restore your reproductive health and balance your system, which will increase your chances of conceiving both naturally and through artificial reproductive technologies.

Acupuncture increases the blood flow to the ovaries to nourish the developing follicles and create better egg quality and stronger corpus luteums. It also normalizes the function of the Hypothalamus-Pituitary-Ovarian axis to regulate and improve the body’s natural hormonal production which in turn improves ovarian function and egg quality. With improved follicle and corpus luteum quality, progesterone levels can normalize to produce a thicker uterine lining for implantation. Acupuncture also relaxes the body and reduces stress levels (elevated stress can prohibit conception by blocking blood flow to the reproductive organs and causing an imbalance in hormonal production, thus resulting in irregular menstrual cycles, lack of ovulation, high FSH levels, poor ovarian production, and diminished egg quality).

Chinese herbs build strong, nutrient-rich blood for the ovaries which will better nourish the developing follicles and create better corpus luteums, stronger egg quality, and ultimately stronger embryos. Chinese herbs also normalize the function of the Hypothalamus-Pituitary-Ovarian axis to regulate and improve the body’s natural hormonal production which in turn improves ovarian function and egg quality. The herbs also nourish the spleen, liver, and kidney systems which are responsible for our reproductive health.

Reproductive organ massage is a highly specialized form of therapeutic massage that manipulates the fascia of the pelvic cavity to unblock any obstruction in the reproductive organs and improve the blood flow to these organs, resulting in a balance of hormonal production, improved ovarian production and ovulation, regular menstrual cycles, lower FSH levels, better egg quality, and stronger embryos.

Nutritional guidance is customized for each patient based on the health of her kidney, liver, and spleen functions, which control our reproductive health and underlie our metabolic processes.

How Western Medicine Treats LPD

The main treatments for luteal phase defect are the use of progesterone cream or suppositories, Clomid, human menopausal gonadotropin (hMG), and vitamin B6, all of which will try to stimulate follicle production and thicken the uterine lining for implantation.

Research and Related Articles on LPD

Preliminary report of the treatment of luteal phase defect by replenishing kidney. An analysis of 53 cases
Xijing Hospital, Fourth Military Medical University, Shaanxi
PMID: 1477503 [PubMed – indexed for MEDLINE]