The menstrual cycle consists of several phases, including the ovulatory and luteal phases. A short luteal phase, lasting 10 days or less, can cause fertility problems. Causes include low thyroid hormone, high prolactin, and uterine myomas. Treatment includes addressing underlying conditions and using drugs like progesterone or Clomid.
The menstrual cycle is divided into several phases and there is disagreement about exactly how many of these phases exist. Most importantly, the cycle begins with menstruation and then transitions into ovulation or the ovulatory phase. This is followed by the luteal phase, which begins shortly after ovulation and is a buildup of the endometrial lining. This lining, which is produced monthly, is what supports implantation of a fetus, and a healthy lining that stays in place is necessary for both implantation and the maintenance of a pregnancy. When women have a short luteal phase or luteal phase dysfunction, fertility problems can definitely occur.
Typically, the luteal phase lasts about 14 days, but some women usually have a short luteal phase that lasts less time. When this stage is 10 days or less, infertility is a problem. Usually the only way women find out the length of a luteal phase on their own is by using things like ovulation monitors which can help them determine the length of time between ovulation and menstruation. Of course, if a woman has been trying to get pregnant for a while and hasn’t been successful, a short luteal phase could be one reason. Similarly, extremely short menstrual cycles could be indicative of luteal phase dysfunction, but this is not always the case. A more accurate measurement of the luteal phase can be done with a uterine biopsy, which is outpatient and usually done in a doctor’s office.
There can be a number of reasons why a person might have a short luteal phase. Sometimes conditions such as low thyroid hormone or having too much prolactin (hyperprolactinaemia) might cause the time between ovulation and menstruation to vary. Reduction in follicle stimulating hormone (FSH) may also affect the luteal phase and shorten its length. The presence of uterine myomas (fibroid tumors) could also create problems with the phases of menstruation.
Given the multiple causes of short luteal phase, treatment for the condition can be extremely varied. In many cases, a short phase may not need to be treated unless a woman is trying to get pregnant. However, conditions like low thyroid hormone or high prolactin definitely need to be addressed. These will simply not affect your menstrual cycle and can create problems with many systems in the body. Decreased FSH is quite common as women age, and again, should only be treated if pregnancy is a goal.
Common means of treating short luteal phase include first treating any underlying conditions. If these treatments aren’t enough, drugs like progesterone or clomiphene citrate (Clomid®) could help lengthen the luteal phase. Biopsy of the uterus about eight to ten weeks after starting treatment can help confirm whether the luteal phase dysfunction has been corrected.
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