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Luteal insufficiency: causes, symptoms and treatment

22 Jan, 2023

Luteal insufficiency: causes, symptoms and treatment

If women do not succeed in getting pregnant despite wanting to have children, this may be due to luteal insufficiency. This article tells you exactly what it is, what causes it and whether pregnancy is possible despite luteal insufficiency.

The most important facts about luteal insufficiency at a glance

  • The hormones progesterone and oestrogen are produced in the corpus luteum after ovulation.
  • If the corpus luteum is weak, not enough progesterone is produced and there is a deficiency.
  • The causes of luteal insufficiency include various diseases.
  • Typical symptoms of luteal insufficiency include a shortened menstrual cycle and severe PMS symptoms.
  • Since the lining of the uterus is not built up properly in affected women, pregnancy is much less likely.
  • Progesterone deficiency is usually treated with hormone preparations.

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What is the corpus luteum?

After ovulation, the corpus luteum forms from the remains of the ruptured follicle. In the second half of the menstrual cycle, the hormones progesterone and oestrogen are formed in the corpus luteum. The hormone progesterone is sometimes also called the corpus luteum hormone.

What role does progesterone play in pregnancy?

Progesterone is of crucial importance for pregnancy. The hormone is responsible for building up the lining of the uterus in preparation for the fertilised egg.

The formation of progesterone by the corpus luteum is maintained for three months after implantation of the egg. After that, the placenta is finally responsible for the production of the hormone.

What is meant by luteal insufficiency?

Luteal insufficiency is a disorder in the function of the ovaries. In affected women, the corpus luteum cannot produce enough progesterone. This means that the lining of the uterus is not built up after ovulation. As a result, a potentially fertilised egg cannot implant properly in the uterus.

For this reason, pregnancy is much less likely for women affected by luteal insufficiency. It is estimated that the unfulfilled desire to have a child is due to luteal insufficiency in up to 10 per cent of all women.

Causes: how does luteal insufficiency develop?

Luteal insufficiency can have various causes. For example, it can occur temporarily after stopping the contraceptive pill. This is because the body often needs a moment to get hormone levels back to normal. In this case, however, it usually only takes a few weeks or months for hormone production by the corpus luteum to return to normal.

In addition, luteal insufficiency can have the following causes, among others:

  • Endometriosis
  • PCO syndrome
  • Adrenal insufficiency
  • Damage to the ovaries
  • Diseases of the pancreas
  • Diseases of the thyroid gland
  • Diabetes
  • Taking certain medicines
  • Malnutrition

In some women, luteal insufficiency is also due to genetic factors. In addition, reduced production of progesterone by the corpus luteum is common in women going through the menopause.

What are the symptoms of luteal insufficiency?

An existing weakness of the corpus luteum is not easily recognised. In many cases, it is only diagnosed when women have been trying unsuccessfully to have a baby for a long period of time, or there has been a miscarriage very early in the pregnancy.

If this is not the case, the following symptoms may also indicate luteal insufficiency:

  • A noticeably heavy or long menstrual period can also indicate luteal insufficiency, among other causes.
  • A second half of the menstrual cycle that is clearly too short is a typical sign of luteal insufficiency.
  • Spotting or bleeding that occurs immediately after ovulation can also be a symptom of luteal insufficiency.
  • Uterine cysts are also one of the signs women should think about with regard to insufficient progesterone production.
  • Women with luteal insufficiency are often affected by particularly severe PMS symptoms.
  • A lack of desire for sex is also one of the possible symptoms of insufficient progesterone production in many affected women.
  • Acne and other skin problems can sometimes also indicate problems with hormone balance.
  • Because the fertilised egg cannot implant properly in the uterus due to the lack of progesterone, early miscarriages often occur.

How is luteal insufficiency diagnosed?

When possible symptoms of luteal insufficiency appear, a visit to the gynaecologist is strongly recommended. The gynaecologist will measure progesterone levels during the second half of the menstrual cycle.postpartum knickers

Keeping a cycle calendar and regularly taking your basal body temperature can be helpful in making a diagnosis. If you have records of your menstrual cycle and basal body temperature, you should always bring them with you to your appointment.

Is pregnancy possible despite luteal insufficiency?

In principle, it is possible to get pregnant despite luteal insufficiency. This is true at least if your menstrual cycle is normal, ovulation takes place and the amount of progesterone produced by the corpus luteum is sufficient.

If this is not the case, however, the chances are at least good that luteal insufficiency can be remedied with the right treatment measures.

How can luteal insufficiency be treated?

How to treat luteal insufficiency depends, of course, primarily on its cause. In most cases, however, the treatment is quite successful, so that the production of progesterone returns to normal with the help of the appropriate therapy.

Hormone therapy is usually the treatment of choice to correct the progesterone deficiency. For this purpose, the gynaecologist has a choice of different preparations that she can recommend to her patients.

In addition to eliminating the hormone deficiency, other measures may be necessary to treat the underlying disease responsible. What these are will be determined on the basis of the relevant examination results.

Why a cycle calendar can help with treatment

Because hormones do not have to be taken until after ovulation, it is helpful for women affected by luteal insufficiency to keep a cycle calendar.

This helps them to know when they are ovulating and makes it much more likely that they will get pregnant sooner with the help of hormone therapy.

What side effects does the treatment cause?

Hormone therapy can cause several side effects. These include nausea, tiredness and headaches. Some women also experience spotting when taking progesterone.

What is the prognosis for women with luteal insufficiency?

Depending on the cause, the progesterone deficiency can usually be corrected promptly by taking hormone preparations. The chances are therefore good that an existing desire to have a child can still be fulfilled despite the diagnosis of luteal insufficiency.