Many women dream of becoming moms. Therefore, it is important to monitor your health, including the regularity of the menstrual cycle, which is divided into several phases:
- menstrual (bleeding itself when a ripe follicle comes out),
- ovulatory (under the influence of estradiol, the dominant follicle continues to grow),
- luteal (follicle turns into a "yellow" body, which begins to produce progesterone in case of fertilization).
Luteal phase of the cycle: what is it?
The luteal phase (otherwise called progesterone, the corpus luteum phase) is the period of the menstrual cycle from ovulation to menstrual bleeding.
In the luteal phase, follicle ruptures. Cells begin to accumulate luteal pigment and lipids, which give the graph bubble a yellow tint.
The corpus luteum begins to secrete androgens, estrogen and “pregnancy hormone” - progesterone. Thus, the uterus begins preparing for a possible pregnancy. If fertilization has occurred, the corpus luteum assumes the production of progesterone until the placenta develops to the required level.
If fertilization does not happen, then the corpus luteum stops the production of hormones. There comes the next menstrual bleeding.
How to calculate the luteal phase?
Daily basal temperature can be measured in the rectum. When it gets above 37 degrees, it means that ovulation has occurred and the luteal phase has come.
In order to calculate the beginning of the luteal phase, it is worth remembering the first day of the menstrual cycle and counting 14 days from it. However, such calculations are not entirely accurate, since ovulation can shift and occur both on day 12 of the menstrual cycle (with a full cycle of 28 days) and on day 16, which is also the norm. Ultrasound diagnosis, measurement of basal temperature over several cycles can determine the average number of days for a woman before the onset of ovulation.
Luteal phase: what is it
The luteal phase of the cycle is also known as the corpus luteum. It comes in the 2nd part of the menstrual cycle, when the time of ovulation passes. The body of a woman is preparing for conception and subsequent childbirth. It produces hormones that contribute to these changes. The luteal phase, what is it and how to behave at this time, every woman who has reached reproductive age should know. During this period, the follicle is torn, freeing the corpus luteum. This is marked by the preparation of the body to bear the child. Pigment is produced to a large extent, which stains the body of the egg yellow.
In a woman's body, increased progesterone appears in the luteal phase. He, along with other hormones produced by the pituitary gland. During the process of fertilization, progesterone continues to be produced, otherwise all processes cease. Endometrial rejection occurs in the uterus and menstruation begins. The luteal phase of the cycle is expressed by swelling of the mammary glands, heaviness in the stomach, and changeable mood. Many women know the luteal phase that it is.
Calculation of the luteal phase
Due to certain changes in the female body, it is necessary to know how to calculate the luteal phase. There are several basic ways to do this. The most accessible is to measure the temperature in the anus. During the period of ovulation, it begins to gradually increase, and when it reaches 37 degrees, the most crucial phase begins.
There is another way how to calculate the luteal phase. It is necessary to clearly record the onset of menstruation. With the right cycle, the phase begins on the 14th day. The 12th and 16th days are also normal with different duration of the egg maturation period.
The length of the luteal phase and the time of its occurrence can be calculated by means of new technologies. If an ultrasound scan is performed within a few months, then it is possible to determine the timing of the period with greater accuracy. Increased progesterone in the luteal phase leads to general malaise and psychological instability, so you need to be ready for this. Knowing what is the luteal phase of the menstrual cycle, you can control the manifestations of the body.
The length of the luteal phase
If the question of what the luteal phase is in women is clarified, then its length is individual. If there are no interruptions in the menstrual cycle, and it is equal to a month, then the duration of the last period is 14 days. Inexperienced girls are interested in the luteal phase, what is it, what day of the cycle. To answer this question it is necessary to control all stages of menstruation. The length of the luteal phase, how to determine it using the female calendar. It is necessary to count the 12th, 14th and 16th day depending on the duration of the menstruation.
Normal luteal phase, what is it, what day of the cycle depends on the body functions, the level of excretion of necessary substances and the work of the relevant organs. The excessive duration of the luteal phase of the menstrual cycle depends on whether fertilization has passed or not, as well as the development of the disease.
What causes a luteal phase deficiency?
Lack of luteal phase most often leads to the inability to have children. There are certain reasons for the development of this disease.
- Stressful situations and injuries affecting the pituitary gland.
- Hyperandrogenism of the adrenal glands and ovaries.
- Excessive content in the body of prolactin.
- Inflammation of the appendages.
- Hypothyroidism and hyperteriosis.
For all of the above reasons, the luteal phase deficiency has no symptoms. It is asymptomatic. The only sign of the onset of the disease - a violation of menstruation. More global consequences is infertility. Luteal phase deficiency has its own methods of treatment. They are based on the use of hormones that contribute to the onset of ovulation. The lack of the luteal phase has no symptoms, so it is rather difficult to diagnose.
One of the important moments of the correct passage of the period important in the menstrual cycle is progesterone in the luteal phase, the rate of which is due to medical indications. This hormone is distinguished by its quantity at different stages of egg maturation.
Luteal phase, progesterone, normal
The second half of the cycle is characterized by the highest concentration of this hormone. Progesterone in the luteal phase, the rate of which is 6.99-56.63 pmol / l, is very important for the normal functioning of the female body. The hormone in the critical period increases its quantity many times, but this is a normal manifestation. If this does not happen, then it is worth thinking about violations and the appearance of the disease.
The rate of progesterone in the luteal phase is determined by tests that must be carried out in medical conditions in a specialized clinic. A blood test shows accurate results, but the content of the hormone is different at different times. This study makes it possible to diagnose infertility, since the rate of progesterone in the luteal phase can be broken in one direction or another, and this is the main cause of the violation of the reproductive function of the female body.
What is the luteal phase, its features
The menstrual cycle consists of a series of processes occurring in the ovaries and uterus in the period from one menstruation to another.
The follicular phase begins on the first day of the month. It is the maturation of the egg, enclosed in a strong capsule (follicle). Normally, it ends in ovulation (rupture of the sheath of the follicle and the release of a mature egg from it).
Next begins the luteal phase. It continues from the moment of ovulation to the beginning of the next menstrual period.
How long is the luteal phase?
The average duration of the luteal phase is 14 days. In each individual case, the duration of the phase can be from 12 to 16 days. It depends on the time of functioning of the corpus luteum and the influence of female hormones on the work of the reproductive organs. The long luteal phase can be in the event of pregnancy or as a result of the presence of a corpus luteum cyst, which after a time can pass on its own.
Luteal phase deficiency
Luteal Phase Deficiency: Causes
Disruption of the luteal phase is a common cause of female infertility. If the phase is too short, it may be due to the following reasons:
- development of dysfunction of the hypothalamic-pituitary system due to stress, trauma, neuroinfections,
- a woman has signs of hyperandrogenism of adrenal, ovarian, mixed origin,
- high concentration of prolactin affects gonadotropic hormones,
- inflammatory processes in the uterine appendages,
- hyper and hypothyroidism.
Luteal phase of the cycle: symptoms
There is no external manifestation of a violation of the luteal phase, with the exception of the menstrual cycle.
Luteal Phase Deficiency: Treatment
To assess the duration of the luteal phase, ultrasound diagnosis is necessary to determine the time of onset of ovulation, and a blood test for progesterone. Carried out home graphs measure basal temperature is not informative.
The main treatment prescribed for a luteal phase deficiency is hormone therapy to stimulate the onset of ovulation (microfolin, urozhestan). As additional methods can be used:
- physiotherapy (intravaginal phonophoresis),
- Spa treatment.
Despite the seriousness of the violation of the luteal phase and the consequences of such disorders, hormone therapy in combination with alternative methods contributes to the successful occurrence of pregnancy in more than half of the cases.
Features of the functioning of the corpus luteum
In the follicular phase of the menstrual cycle, the dominant follicle matures. During this period, estrogens and follicle-stimulating hormone (FSH) play a crucial role. The latter, together with luteinizing (LH), is secreted by the adenohypophysis. Without FSH, LH effects cannot be realized. The follicle-stimulating hormone provokes the formation of receptors to luteinizing on the surface of granulosa cells in the follicle. Without them, LH will not be able to have an effect on the maturing follicle.
Biological effects of LH are as follows:
- stimulation of the synthesis of androgens as precursors of estrogen,
- activation of prostaglandins and proteolytic enzymes, which lead to rupture of the follicle,
- luteinization of granulosa cells that form the corpus luteum,
- stimulation of progesterone synthesis from luteinized cells, prolactin works in synergism with LH.
The time when the luteal phase begins, it is considered to be the end of ovulation. The standard menstrual cycle lasts from 21 to 35 days, but an average of 28 days. The duration of each phase of the cycle is variable, but on average, it takes 12-14 days from the first day of menstruation to ovulation. The duration of the luteal phase itself is also 12-14 days. After it ends, the cycle repeats again.
Follicle rupture occurs at the peak of luteinizing hormone secretion. The ovum enters the abdominal cavity and under the vibration of the fimbriae on the final part of the appendages it penetrates the fallopian tubes. Fertilization should take place there within 12-24 hours. More than this time, the viability of the egg is not maintained.
The lutealization process takes place in the bursting follicle. Cells of the granular membrane continue to multiply and grow, they accumulate a specific enzyme - lutein, which gives them a characteristic yellow color. This forms a temporary endocrine gland - the yellow body. The duration of its existence depends on the presence of pregnancy. If fertilization did not occur, then in 12-14 days the corpus luteum regresses.
The duration of the gland's existence increases with the onset of pregnancy. The embryo forms various cell types, one of which is the trophoblast layer. It is formed on 4-5 days after fertilization. Trophoblast cells begin to secrete the hormone chorionic gonadotropin (hCG), which supports the corpus luteum and stimulates the production of progesterone. This process lasts until the formation of the placenta, after which it assumes the function of the corpus luteum, and the gland is gradually absorbed.
Calculation of the period of the menstrual cycle
The duration of the luteal phase is normally 12-14 days. For women planning pregnancy, the day of ovulation and the state after it matters. Violation of the duration of this period can tell about the various pathologies that prevent the occurrence of pregnancy. Equally unpleasant consequences is the lengthening and shortening of the period of existence of the corpus luteum.
Four reliable methods are used that help both to calculate the luteal phase and to determine the general state of the menstrual cycle.
Basal Temperature Measurement
Body temperature is variable and can fluctuate throughout the day. The basal temperature reflects the temperature of the core of the body and is relatively constant. It is affected by hormones. Since the beginning of the menstrual cycle, it is relatively low, less than 37 ° C. On average, this indicator is 36-36,6 ° С. This continues until ovulation. On the day of the maturation of the follicle, there is a sharp jump in temperature to 37 ° C and higher. The temperature of 37.1-37.3 ° C persists for three days after ovulation.
During the second phase, it fluctuates around 37-37.5 ° C. And with the onset of menstruation, begins to gradually decline to the norm of the first period.
Read more about the basal temperature during ovulation, read our article.
Determine the luteal phase of the menstrual cycle can be on the calendar. But this method is only suitable for women with a clear duration of the entire cycle. If it lasts the classic 28 days, then from the first day of the last menstruation you need to count 14 days and take this date as ovulation. The next day begins the luteal period.
You can also notice how the selection changes. On the day of ovulation and the day before, they looked thick, rich and slimy. After the formation of the corpus luteum, they can decrease, vaginal dryness appears.
Determine what day the cycle is now, you can use ultrasound. Modern equipment allows you to see the follicle, the yellow body and determine their size. These parameters are strictly dependent on the day after ovulation.
The size of the follicle is on average 12-15 mm. After the rupture of its shell in the initial stage, the size of the yellow body is several millimeters smaller. In a week it reaches 18-22 mm. This indicates the readiness of the body to the onset of pregnancy. If fertilization has occurred, then stimulation of the corpus luteum with chorionic gonadotropin begins, it can increase to 30 mm. A size of more than 30 mm indicates a formed yellow body cyst, and not a progressive pregnancy.
To determine the onset of the luteal phase can be on the analysis of progesterone. To do this, you need to know the day of the cycle in order. Before ovulation, the rate of progesterone is 0.97-4.73 nmol / l. On the 15th day of the cycle, it begins to increase slightly and varies between 2.39 and 9.55 nmol / l. On the 21st day of the cycle, or on the 7th day after ovulation, progesterone peak is observed, it reaches 16.2-85.9 nmol / l.
But in the study should take into account the individual duration of the cycle. If a woman ovulation does not occur on the 14th day, but later, then the peak of progesterone will have a more delayed term: you should add 7 to the day of ovulation in order and get the date of the peak of the hormone.
Further progression of progesterone increase occurs at the onset of pregnancy and up to the moment before childbirth. But the large size of the yellow body (more than 30 mm) and high progesterone in the absence of the ovum will speak in favor of the cyst of the yellow body.
Changes in the luteal phase
The lutealization period may vary in the direction of increasing and decreasing the duration. Both options are not good and violate the reproductive function.
The maximum length of the luteal phase is 16 days. If the menstruation does not come on time, progesterone is maintained at a high level, or it is initially elevated, this can manifest itself as a lack of menstruation.
The behavior of hormones in different phases of the menstrual cycle
The short luteal phase ranges from 2 to 10 days. Such a duration is a sign of failure of the second period. This is usually associated with low levels of progesterone, which is not produced in the corpus luteum. Low progesterone in the luteal phase is not able to properly prepare the endometrium for implantation of the embryo. Soon after fertilization, a biochemical pregnancy will occur, which can be registered by blood tests for hormones.
If the fetus is able to attach, then signs of threatened abortion may appear. При этом женщина будет ощущать тянущие боли внизу живота, напоминающие таковые перед менструацией, появятся темно-красные выделения из половых путей. Если не предпринять срочные меры по сохранению, то беременность прервется в малом сроке.
Symptoms of luteal phase deficiency may appear in the following cases:
- hormone imbalance, which changes the ratio of LH and FSH,
- inflammatory diseases of the genital organs,
- systemic diseases (diabetes, hypothyroidism, hypothalamic tumors),
- psychogenic factor.
Long luteal phase and elevated progesterone lead to nonspecific symptoms:
- deterioration of the skin, increased greasiness and the appearance of acne,
- unwanted hair growth
- weight gain
- breast engorgement and tenderness,
- general fatigue, tendency to bad mood, depression,
- changes in blood pressure
- bloody spotting character.
At the same time, a high concentration of progesterone has a contraceptive effect, a woman cannot become pregnant, and the menstrual cycle fails.
How to reduce progesterone levels without harm to health? About this link.
The short luteal phase in most cases is a pathology of the corpus luteum. The extension of this period is associated with the pathological course of the follicular part of the cycle. At the same time, there are changes not only in the concentration of progesterone, but also of other hormones. Estradiol in the luteal phase will increase with the persistence of the follicle. In this state, the dominant follicle does not break in the ovaries, which means there is no ovulation. As a consequence, the corpus luteum is not formed, luteinization is also absent. An increase in the concentration of estradiol also occurs with an endometrioid ovarian cyst or its tumors. Reduced hormone is observed when:
- testicular feminization,
- drastically reduced weight
- heavy physical exertion.
But for the second period of the ovarian cycle, other hormones are also important. In diagnostics, concentrations of the following substances are also investigated:
In some cases, the study complements cortisol and thyroid hormones.
Correction of hormonal background
Can I get pregnant in the luteal phase?
It depends on the previous, follicular phase and the state of hormonal background in the future.
Deficiency is a consequence of reduced function of the corpus luteum, in such cases support for the luteal phase is required. It is carried out with the help of progesterone drugs "Duphaston", "Utrozhestan". Most often they are prescribed from the 14th day of the cycle and 25. Each hormone does not affect fertilization. Correction of hormone levels only allows you to change the state of the endometrium and ensure the implantation of the ovum if conception has occurred.
But there are certain difficulties with the appointment of the drug:
- Selection of the dose. It must be assigned individually. Each woman has a progesterone level at a certain level, and it cannot be said for sure that with the same blood test results, the same dose of hormone will be required.
- Bleeding undo. After the end of progesterone intake, bleeding appears, which corresponds to the menstrual period. But if the woman was not protected during the treatment, then an embryo may be in the uterus. Bleeding will lead to detachment of the ovum and miscarriage. Pregnancy tests during this period are not effective. Therefore, those who are undergoing treatment should be protected from pregnancy.
But if the insufficiency of the corpus luteum is observed already with a diagnosed pregnancy, with existing signs of threatened termination, then the appointment of Duphaston or Utrogestan makes sense to save it. In this case, hormones are taken until the formation of the placenta, and in severe cases even up to 21 weeks of gestation.
Failure of the second period of the menstrual cycle can be observed periodically in perfectly healthy women. Therefore, the observation and diagnosis of only one month does not have such a value as two or three monthly studies. For example, it is necessary to independently measure the basal temperature and make its schedule.
In the absence of ovulation, it is impossible to talk about the insufficiency of the luteal phase, in this case the follicle does not mature, therefore the cyclical nature of the changes does not occur. Such forms of hormonal disorders require finding the cause and eliminating it, and not blindly assigning hormones.
What happens in the corpus luteum phase
After the follicle breaks and the egg leaves it, a yellow body forms in its place. This is a temporary gland that produces hormones that create the conditions for fixing a fertilized egg in the endometrium. Iron is formed from proteins and yellow pigment, which gives it color.
The processes in the follicular and luteal phases of the cycle occur under the influence of pituitary hormones. Follicle maturation is regulated by follicle-stimulating hormone (FSH). The onset of ovulation and the formation of the yellow body in the luteal phase occur due to a sharp increase in the level of LH (luteinizing hormone).
After the luteal phase begins and the corpus luteum appears, progesterone and a small amount of estradiol are produced in it. Estrogens affect the growth of the endometrium, increasing its thickness. Under the action of progesterone, the mucous membrane of the uterus becomes friable, which facilitates the implantation of the embryo. This hormone is produced in an overwhelming amount, so the luteal phase is called differently progesterone.
Due to the increased levels of progesterone, the following occurs:
- preservation of the embryo, its fixation in the uterus,
- the weakening of its contractions, contributing to the rejection of the ovum,
- increase in elasticity and stretchability of the uterine wall during pregnancy.
If fertilization of the egg occurs, the enhanced production of progesterone continues. For this reason, the maturation of new follicles is suspended. Progesterone strengthens the endometrium, prevents its detachment and the onset of menstruation. In the luteal phase of the cycle, the content of this hormone in the blood can be judged on whether it was conceived or not. In case of successful fertilization, its level remains high until the formation of the placenta.
If conception does not occur, the corpus luteum gradually dies off, the luteal phase ends, the production of progesterone is reduced to a minimum. At the same time, the endometrium begins to exfoliate, the next periods come.
Determination of basal temperature
Determine the time of onset of ovulation and the beginning of the luteal phase can be more accurately by scheduling basal temperature. It is measured every day at the same time for at least 3 months. It is recommended to do this in the morning without getting out of bed.
You may notice that by the beginning of the luteal phase, the temperature rises to 37 ° -37.2 °, and by the onset of menstruation, it again decreases by about 0.5 °. If pregnancy occurs, the temperature does not fall, it remains at the same level.
Violation of the duration of the progesterone phase
The luteal phase may be longer or shorter than usual.
If the periods do not arrive on time, knowing on what day this phase began, one can determine how much longer its normal duration is. Elongation of the yellow body phase indicates its increased activity. The reason may be either the onset of pregnancy or the formation of cysts.
The shortening of this phase is called its insufficiency.
Insufficiency of the corpus luteum phase
If the luteal phase is shorter than 10 days, there is a shortage of progesterone in the woman’s body. At the same time, full development of the endometrium becomes impossible. As a result, the fertilized egg can not be fixed in it, and the pregnancy "fails." In order for a woman to become pregnant, she needs to eliminate the cause of the failure and undergo a course of treatment to restore the hormonal background.
Causes of failure
It can appear both for natural reasons and as a result of pathologies in the body.
The deficiency of the luteal phase is sometimes manifested even in perfectly healthy women, if they are malnourished or specifically follow “hungry” diets. Such a state is promoted by too intense exercise. To eliminate it in such cases, it is often necessary only to normalize food and reduce physical exertion.
The causes of pathological insufficiency of the luteal phase can be:
- Disruption of the production of hormones FSH and LH. This is often due to the occurrence of hyperprolactinemia (increased prolactin production in the pituitary gland).
- Malfunction of the hypothalamic-pituitary system due to diseases and injuries of the brain, severe stress.
- Excessive production of male sex hormones (hyperandrogenism) as a result of dysfunction of the ovaries and adrenal glands. This leads to a decrease in progesterone levels in the luteal phase.
- Diseases of the thyroid gland and thyroid hormone production disorders that contribute to the production of sex hormones.
- Inflammatory, infectious and tumor diseases of the ovaries and uterus.
- Ovarian depletion.
Note: Failure of the progesterone phase also occurs in women who are breastfeeding. After the end of this period, the level of the hormone and the normal nature of the cycle are usually restored.
Forms of failure
There are 2 forms of luteal phase deficiency:
- The hypoprogesterone, when the corpus luteum is reduced in size, the production of progesterone is too small, and the thickness of the endometrium is less than 10 mm.
- Hyperestrogenic. Progesterone levels are lowered by exceeding the estrogen production rate. At the same time, the size of the yellow body is within the normal range.
Consequences and symptoms
For such a condition as a deficiency of the luteal phase, the appearance of menstrual disorders is characteristic. Due to its shortening, the duration of the entire cycle is reduced (to 20 days or less). There is menorrhagia (menstruation becomes very abundant, clots appear in them) or oligomenorrhea (short menstruating lung character).
The consequence of cycle violations is miscarriage (miscarriage in the early stages) and infertility.
Diagnosis and elimination of failure
One of the most important methods for diagnosing luteal insufficiency is a blood test for progesterone, as well as determining the level of LH in the urine.
Determine the ratio of levels of progesterone in phase 1 and 2 of the cycle. With luteal insufficiency, it is less than 10. Since the production of progesterone, even in a healthy woman, can differ significantly in different cycles, it is necessary to conduct tests for at least 3 cycles to diagnose an abnormal decrease.
To determine the cause of the luteal phase deficiency, tests for other hormones are also carried out.
The norm of hormones
The norm of hormones during the flow of phase 2 of the cycle
Changes in the level of the hormone in luteal insufficiency
The nature of the pathologies leading to a deficiency of the luteal phase
1. How to calculate correctly?
The duration of the luteal phase is relatively constant - 14 days (from 12 to 16). It does not depend on the total number of days of the cycle. If it is classic and lasts 28 days, then ovulation occurs on the 13-14 day of the cycle, after which the count begins the luteal phase.
If the cycle is stable, then determine the approximate date of ovulation and the beginning of the second phase can be, subtracting 14 days from its total length.
For example, with a 34-day cycle, the duration of the luteal phase can be calculated as follows: 34-14 = 20. That is, ovulation starts at about 20 days, after which the next stage begins.
You can check the accuracy of calculations with the help of special rapid tests for ovulation. They are sold in a pharmacy and act in the same way as pregnancy tests - according to the concentration of hormones in the urine, it is possible to judge about the early maturation of the egg.
They begin to carry out 3 days before the expected day of ovulation. A positive test means that before the release of the egg remains about 12 hours.
If the cycle is irregular, then the luteal phase can be determined using the basal temperature. It is measured daily in the morning in the rectum, without getting out of bed.
Normally, in the first phase of the cycle, it is slightly lower than in the second. The temperature jump to 37.1 ° C occurs before ovulation. Then it decreases by 0.1-0.2 degrees, but remains higher than in the follicular phase until the most menstrual.
Registration of basal temperature is a simple and affordable method that helps not only to calculate the phases, but also to identify the alleged causes of violations.
2. What happens in the body?
The menstrual cycle begins with the follicular phase. Without it, full-fledged ovulation and the formation of the yellow body are impossible.
During this period, granulosa cells actively grow in the follicle, and lutein begins to accumulate in them.
The rupture of the follicle membrane at the time of ovulation is a series of events:
- 1 At the top of the follicle, a part of the cells undergoes monetary changes.
- 2 Gradually collapsing layer collapses.
- 3 A surge of luteinizing hormone (LH) prior to ovulation stimulates the first peak of progesterone.
- 4 The elasticity of the follicle shell increases.
- 5 FSH, LH and progesterone simultaneously activate the enzymes necessary for protein dissolution.
- 6 Ovulation occurs.
- 7 After the release of the egg, the walls of the follicle collapse. In its center, hemorrhage occurs, stigma is formed - connective tissue scar.
For another three days, granulosa cells continue to increase in size. Between them, new vessels actively germinate, the blood flow increases. In 3-4 days it becomes the most intense in the body.
This coincides with the flowering of the corpus luteum. The maximum occurs at 8-9 days after ovulation.
Intense blood flow ensures normal progesterone synthesis. The hormone belongs to the steroid group, cholesterol and low density lipoproteins are necessary for its synthesis. Their ovaries can only be obtained from blood plasma.
Sometimes the ingrowth of blood vessels occurs so intensely that they develop ovarian bleeding and apoplexy.
In the yellow body there are two types of cells. At its center are large yellow cells that produce progesterone and some peptides, and on the periphery are small cells secreting androgens. About 25 mg of progesterone is synthesized per day.
The main hormone that supports the function of the corpus luteum is LH (luteinizing hormone). Its effect is short-lived, it quickly disintegrates.
A longer disintegration period (up to 12 hours) in hCG. It is a hormone that is produced by the germ trophoblast. It has a structure similar to LH, but at the expense of additional amino acids is more stable.
Therefore, after fertilization, it affects the corpus luteum. This process will last until the 16th week of pregnancy.
If fertilization was not, then the corpus luteum regresses. In the granulosa cells degenerative processes occur, they are reduced in size.
Connective tissue grows between the cells, which turns the yellow body into white. This means entering into the first phase of a new cycle.
3. Functions of progesterone
The main hormone of the luteal phase and pregnancy is progesterone, its action is multifaceted:
- 1 Blocks the maturation of new follicles.
- 2 Starts the endometrial secretion phase and prepares it for implantation of the ovum.
- 3 Reduces the threshold of excitability of the smooth muscles of the uterus.
- 4 Stimulates the growth of the breast.
- 5 Causes immunosuppression, necessary for carrying a child.
Progesterone also helps to reduce the concentration of prostaglandins. These are biologically active substances that are involved in the formation of pain in the premenstrual period. Their low level allows you to relive menstruation without serious consequences.
That is why women with luteal phase deficiency often have painful periods and symptoms of PMS.
The concentration of progesterone changes throughout the second phase of the cycle. From the moment of ovulation to 21 days, it fluctuates at a level of 2.39-9.55 nmol / l. On day 22-29 of the cycle, the concentration of progesterone reaches 16.2-85.9 nmol / l.
In women using combined oral contraceptives, progesterone fluctuations are less pronounced.
The hormone affects not only the reproductive function, but also the general condition of the body.
Many women know that the luteal phase accounts for the PMS period. One of the theories of the occurrence of premenstrual syndrome is associated with progesterone deficiency.
Sodium retention provokes swelling, engorgement and tenderness of the mammary glands. Lack of progesterone affects the mental state - the woman becomes irritable, aggressive, tearful.
The increase in the number of prostaglandins, the synthesis of which is not sufficiently blocked by progesterone, leads to the appearance of severe menstrual pain.
Oral contraceptives (COCs) allow to eliminate these symptoms.
What is the luteal phase in women?
Many can not give an accurate answer “Luteal phase - what is the cycle period? What is the phase of the menstrual cycle - the first or second? How long does the phase last? What changes occur in the endometrium of the uterus? What hormones prevail, depending on the phase of the menstrual cycle? ". Therefore, to understand - you need to understand how a woman’s monthly cycle is arranged, how many phases of the menstrual cycle.
Ежемесячно в женском организме происходят определенные немаловажные процессы, сопутствующие возможному благоприятному зачатию ребенка.
The physiological feature of each woman is the presence of the menstrual cycle, which normally should take place in three stages (1-follicular phase of the menstrual cycle, ovulation and 2-luteal phase of the menstrual cycle). The follicular, ovulatory and luteal phases are integral components of the physiological course of the menstrual cycle. The duration of the entire menstrual cycle is 21-36 d. In the normal state of affairs, monthly menstruation indicates the absence of a fertilized egg. That is, the conception of a child did not occur during ovulation and after its termination.
Against the background of these physiological phenomena, another (new) phase of the ovaries develops with a three-stage duration:
- Follicular phase of the cycle
- Luteal phase of the menstrual cycle.
The work of the ovaries is carried out directly under the control of the brain center - the pituitary gland. Usually the luteal phase develops approximately two weeks before the monthly discharge, in other words, it is the equator of the menstrual cycle.
The formed corpus luteum controls the process of preparing the eggs, therefore, according to its condition, it is possible to judge whether a woman is able to conceive.
What is the role of the luteal phase?
Upon completion of the monthly discharge, as a result of which the inner lining of the uterus is rejected, the follicle growth stage begins. At this time, the concentration of estrogen in the blood increases, and the endometrium gradually increases again. Before ovulation, follicles mature in the ovaries, after their rupture, the egg cell travels through the fallopian tubes into the uterine cavity.
At the end of ovulation, the female luteal phase of the cycle begins. Norm is the ripening of the corpus luteum. Perhaps many are interested, why it is yellow? In fact, the walls of the follicles contain fat and yellow lutein. The level of hormones that affect the possibility of conception is increasing, while in the second period of the menstrual cycle, a decrease in the concentration of FSH is observed.
Even if conception occurred, the formation of the corpus luteum will still be after ovulation, and this is considered normal. Since this formation is responsible for the release of hormones, its presence during pregnancy is not considered a pathology. The production of hormones occurs until a certain point.
What is the luteal phase in women, what hormones are produced?
The luteal phase hormones should include:
Due to these hormones during pregnancy the probability of uterine contraction is reduced. They also influence the development of the mammary glands for feeding the baby. If the egg was not fertilized, then the corpus luteum produces much less hormones. As a result, necrosis and detachment of the endometrium occurs. At this time, the luteal phase of ovulation stops, and menstrual bleeding begins.
Is it possible to determine the days of the onset of the luteal phase?
In fact, it is not difficult to calculate the days of formation of the yellow body, if you know the characteristics of your monthly cycle. The luteal phase always occurs after ovulation. To accurately determine this period, you need to calculate the menstrual cycle. Based on its duration, the luteal phase is calculated. The norm in women without any abnormalities in the reproductive system - the second phase of the cycle.
The days of formation and functioning of the corpus luteum are determined taking into account the presence of certain features. It should be understood that, in accordance with age, deviations are possible.
The duration of the luteal phase
It is easy to understand what the luteal phase of the menstrual cycle is; it is more difficult to determine its length, since it is necessary to take into account the specific features of the organism. If the reproductive system works smoothly and without failures, then the duration of the luteal phase will be the last 14 days.
Days of formation of the yellow body can be determined using the ovulation calendar. Normally, this process should occur immediately after the release of the egg, follicular phase. Depending on the period of menstruation, it will be on the 12th, 14th or 16th day of the monthly cycle.
The luteal phase of a woman can be prolonged if fertilization of the egg has taken place, or if there are certain pathologies in the reproductive system.
What does the luteal phase mean - symptoms and signs
During this period, the woman does not experience pronounced symptoms, but you can track the onset of the secretory phase, paying attention to such manifestations:
- If the analysis is carried out, it will be seen that the level of progesterone increases significantly,
- The temperature of the luteal phase exceeds 37 degrees. It can be measured by the rectal method,
- Vaginal discharge are abundant. During the action of the corpus luteum, the secretory function increases,
- Under the action of hormones, the milk ducts in the breast expand, which causes an increase in the mammary glands.
What could be the consequences due to the insufficiency of the luteal phase?
Very often, against the background of this pathology, women cannot become pregnant. This condition may develop for the following reasons:
- Frequent stressful situations, as well as injuries affecting the pituitary gland,
- Ovarian and adrenal hyperandrogenism,
- High concentration of prolactin in the body,
- Hypothyriosis, hyperthyroidism,
- Inflammation of the appendages.
These causes of luteal phase deficiency do not cause any special symptoms in women. There is one single symptom of pathology that is not hard to notice, this is a failure of the monthly cycle. The most serious consequence is female infertility.
To normalize the luteal phase, the doctor prescribes hormonal drugs. Due to the absence of symptoms, it is difficult to diagnose this condition, so it is important to monitor the duration and peculiarity of your menstrual cycle.
Is the short luteal phase of the cycle a defect?
This pathology, as a deficiency of the luteal phase of the cycle, among women is quite common. This problem occurs against the background of violations of the internal organs of the reproductive system.
The insufficiency of the luteal phase of the menstrual cycle can be diagnosed not only in women suffering from infertility, but also in women who have undergone termination of pregnancy at an early stage of its development. The main reason for the development of this pathology is a sharp decrease in the concentration of progesterone, which is the main hormone for pregnancy. It is produced directly by the corpus luteum, formed during the luteal phase. Due to its insufficiency, the process of implantation of the embryo can be disrupted.
What are the phases of NLF?
Disruption of the luteal phase of the menstrual cycle can occur in two forms:
- When hypoprogesterone form appear such signs:
- The corpus luteum is not fully formed or less than normal volumes,
- The amount of progesterone hormone produced by the corpus luteum is reduced,
- The inner lining of the uterus in the second half of the monthly cycle has not reached the desired thickness, it may be less than one centimeter.
- Pathological hyperestrogenic appearance is accompanied by the following characteristics:
- The corpus luteum has a normal volume,
- The endometrium of the uterus is more than 12 mm thick by the 21st day of the menstrual cycle,
- High concentration of estrogen in the blood,
- The rate of progesterone in the blood is reduced to a small extent.
What is the short luteal phase?
In women suffering from miscarriage in the early stages of pregnancy, a low luteal phase can be diagnosed, with a low concentration of progesterone in the blood.
The luteal phase is considered abnormal if its period is less than 10 days. In such situations, it is better to consult a doctor for qualified assistance. To clarify the cause of this phenomenon is possible only after the diagnosis.
In order to establish an accurate diagnosis, the following therapeutic techniques are used:
- One week after ovulation, the woman is asked to donate blood for analysis to detect a progesterone index,
- If endometrial examination is required, then a biopsy cannot be done,
- Rectal measurement of basal temperature. In the luteal phase, it becomes more than 37 degrees. This information is necessary for the doctor to clarify the diagnosis,
- You need to know the exact dates of ovulation. To do this, you can conduct a special test or for several months to keep an ovulation calendar,
- On certain days of the menstrual cycle, a woman must undergo an ultrasound scan, only it is necessary to determine in advance the exact timing of the release of the egg from the ovary
- Assessment of vaginal discharge. During ovulation, the cervical mucus resembles raw egg white protein, it is transparent and elastic,
- Through a gynecological examination, you can inspect the condition of the cervix. Its level can be raised, also softness and friability are characteristic signs.
If the luteal phase is too long
Long maturation of the corpus luteum indicates a prolonged continuation of the menstrual cycle. If the increased luteal phase is higher than normal, this may indicate the occurrence of pregnancy. Usually, the corpus luteum functions after the estimated date of the menstrual flow.
The duration of this phase can also indicate the presence of a benign cyst of the corpus luteum. To eliminate this pathology, surgical or medical treatment is not required.
The role of progesterone and estradiol in the luteal phase
Due to these two hormones of pregnancy, the process of insulin release is regulated, which can be disturbed by glucose.
Insulin is secreted by the pancreas after eating. This process is controlled by progesterone and estradiol, which may differ in different perceptions of insulin.
The lack of the luteal phase may be in the increased progesterone concentration. For this reason, the perception of insulin is reduced, and the body can not independently cope with the normalization of glucose levels. This hormone actively affects the pancreas, causing a strong desire to eat sugary foods.
The level of this hormone increases in the blood, if a woman has diabetes. Also this phenomenon is considered frequent among pregnant women.
If the concentration of the hormone that affects the perception of insulin is growing, then most likely the woman will start to gain excess weight by eating a lot of sweet food. Together with kilograms, the indicator of cholesterol, the mark of blood pressure is growing. Often, women with this problem suffer from heart disease or thrombosis.
Doctors very often explain the fact of increasing progesterone overweight patient.
Insufficient luteal phase is considered an increase in estradiol in the blood. This hormone affects the increase in insulin susceptibility, which is why glucose levels are normalized. The desire to eat sugary food is significantly reduced, which is important for women with diabetes.
In order to normalize metabolic processes in the body, the level of hormones such as progesterone and estradiol should be within optimal limits in relation to each other.
Another problem is the lack of luteal phase in premenopausal. With this condition, the woman decreases the number of ovulations. The luteal phase of the menstrual cycle becomes shorter. An accurate diagnosis can be made only after passing the examination prescribed by the doctor. Analyzes are taken at different periods of the menstrual cycle, while specifying the exact dates of ovulation. Also not to do without instrumental and ultrasound examinations. Sometimes it is possible to solve the problem by taking hormonal drugs.
The deficiency of the luteal phase is a serious violation of the reproductive system of a woman, therefore, when suspicious symptoms are detected, you should seek qualified help.
What are the reasons for the short luteal phase?
Defect luteal phase can be caused by a number of reasons, which include:
- Disruption of the central mechanisms regulating the functions of the reproductive system. Such a condition can be diagnosed on the background of hyperandrogenism, hyperprolactinemia, diseases of the thyroid gland or adrenal glands,
- If the receptor apparatus of the inner layer of the uterus is changed for the worse, then a short luteal phase is possible. The reasons for this condition are explained by the presence of chronic pathologies in the genitals caused by infection or inflammation,
- Other causes, which include metabolic disorders, as well as insufficient blood supply to the corpus luteum and so on.
NLF treatment with medication
If, after testing, low progesterone is found in the luteal phase, treatment will be carried out with the help of hormonal preparations. In addition to hormones, it is necessary to regulate the follicular phase, which is important for the normal maturation of the egg and the growth of the inner layer of the uterus.
If a woman has a luteal phase deficiency, Duphaston treatment will be effective after consulting a doctor. With hyperprolactinemia or hyperandrogenism, Duphaston alone is not enough for treatment. In such cases, the use of drugs that regulate the concentration of prolactin and androgens.
Hormonal insufficiency in the first or second phase is often treated with oral contraceptives. If anovulation is observed, then reception of means for stimulation of work of ovaries is shown. If NLF is associated with impaired endometrial receptivity, the doctor prescribes the means to eliminate inflammatory reactions, as well as antibiotics and immunomodulators.
Physiotherapy and vitamins
Acupuncture, vitamin therapy, enzyme and metabolic therapy can be prescribed as physiotherapeutic methods.
If there is a diagnosis of luteal phase deficiency, duphaston can be taken along with folic acid, vitamin E, ascorbic acid and B vitamins.
If necessary, the doctor may prescribe the use of sedatives or special psychotherapeutic treatment.
Supporting the luteal phase - preventive methods
Support for the luteal phase is required if irregularities in the menstrual cycle are detected. Identify the problem as early as possible by using such methods:
- Regular management of menstruation. A woman can independently determine the presence of a problem, if the cycle time has become shorter or longer
- Visit the gynecologist twice a year.
To prevent the development of NLF, you need:
- Timely treatment of gynecological and chronic diseases, pathologies of internal organs and organs of the endocrine system,
- Maintain a balanced diet
- Do sport,
- Exclude psycho-emotional stress.