Updated: Jan 11
Women’s period cycle is divided into two phases: follicular phases when follicles develop and mature. The time for eggs to mature and release may vary between different women and same woman in different period cycle. This is the reason why period cycles vary to a great extent. When one of the eggs becomes mature, it is released from the ovary. As soon as egg is released, luteal phase began. Dwon KA and Gibson M studied body basal temperatures (BBT) charts and the luteal phase defect from three menstrual cycles of 20 normal women and 20 women with luteal phase defect. They found that luteal phase length in the normal women was 13.4 days and that of the women with luteal phase defect was 11.8 days. 30% of the women with luteal phase defect had luteal phases with less than 11 days and 5 of these women had severely endometrial problems. None of the normal women had luteal phase less than 11 days. Luteal phase does not vary much with length of period. It is normally12-14 days. After ovulation, the remaining part of the follicle forms the corpus luteum which continues to grow and produces a hormone called progesterone. Progesterone is very important for making inner lining of womb suitable for fertilized egg to implant and supporting for early pregnancy. The inner lining of womb is like a comfortable bed for the egg. If the luteal phase is shorter than 12 days, the bed is not ready. This may be because the corpus luteum dies earlier than12 days, your body may not produce enough progestone to make a good bed for the embryo. Luteal phase defect affects 10% women with infertility and over 60% women with miscarriage. The symptoms of luteal phase defect include a short period cycle, spotting, low progesterone, disrupted BBT after ovulation, and other nonspecific symptoms such as low back pain, vagina dryness etc.
There are three causes that could lead to luteal phase defect. 1) Poor follicle production: After ovulation, remaining follicle becomes corpus luteum. If follicle development is poor, this would create poor quality of corpus luteum which does not produce enough progesterone, resulting in poor uterine inner lining. 2) Premature failure corpus luteum. Corpus luteum does not last as long as normal corpus luteum does. This can occur even if initial quality of follicle is good. Again this makes poor uterine lining. 3) Failed response from uterine lining. In this case, uterine inner lining does not respond well to normal progesterone level. As a result it is not well developed for implantation.
According to traditional Chinese medicine (TCM) theory, luteal phase defect is caused by kidney or spleen qi deficiency. Or it is caused by liver qi stagnation. Qi deficiency and stagnation cause blood stagnation and blockage of channels. As a result corpus luteum dies earlier. This is agreed with recent research. During corpus luteum formation, it becomes one of the most highly vascularised organs in the body. Blood flow in the corpus luteum is important for the development of the corpus luteum and maintenance of luteal function. It is important for progesterone synthesis and release. The corpus luteum blood flow in women with luteal phase defect is significantly lower than women with normal luteal function. Increasing corpus luteum blood flow improves its function. Acupuncture improves ovarian and corpus luteum blood flow. It is very effective to regulate period cycle and restore normal luteal phase. There was a report in Chinese Journals showing effectiveness of acupuncture on luteal phase defect with infertility. 50 patients were diagnosed luteal phase defect. Their age range is from 26 to 42 and average age 32. The history of difficulty to conceive is from 6 months to 4 years. Patients were received acupuncture. Pregnancy rate was calculated. Blood eostrogen and progesterone level was tested; egg development, ovulation and inner lining of womb were checked to measure the effectiveness of acupuncture. Result showed that 40% women achieved pregnancy during 3-6 months. In remaining 53% women, dominant matured egg size was increased, womb inner lining was thicker, blood oestrogen and progesterone level was increased comparing to those before the treatment. Follow up study with those pregnant showed that there was no miscarriage occurred. Another report from China was about effectiveness of acupuncture treatment on patient with recurrent miscarriage. There were 558 cases with recurrent miscarriage 4 times. 211 cases were treated with acupuncture between 1973-1976; success rate was 86%; 347 cases were treated with acupuncture between 1982-1984, success rate was 93.4%. References Takasaki A et al J Ovarian Res. (2009) 14:2:1 Hongwei Yang and Xueyan Huang Shanghai Journal of Acupuncture and Moxibustion (2010) 10:626-628 Downs KA and Gibson M Fertil (1983) 40:466-8