Luteal Insufficiency Quiz
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Can't get pregnant
Missed period
I have trouble with my period
Have irregular vaginal bleeding
Difficulty conceiving
Spotting
Menstrual delay
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What is Luteal Insufficiency?
A condition caused by low levels of progesterone, the female hormone that controls menstruation. An imbalance in the level of progesterone affects normal egg release (ovulation) and can cause irregular periods. This is also seen as a possible risk factor in early miscarriage and difficulty getting pregnant. Known causes include anorexia, excessive exercise, obesity, diabetes or other hormonal problems (e.g. thyroid disorders).
Typical Symptoms of Luteal Insufficiency
- Vaginal bleeding or discolored discharge outside of your period
- Unusual changes in period
- Irregular periods
- Difficulty getting pregnant
- History of previous miscarriage or abortion
- Short interval between periods e.g. 24 days or less
- Hardly any bleeding during periods
- Difficulty becoming pregnant for more than a year despite trying
Diagnostic Questions for Luteal Insufficiency
Your doctor may ask these questions to check for this disease:
- Have you experienced any vaginal bleeding or unusual discharge outside of your period?
- Have you noticed any unusual changes in your period?
- Are your periods irregular?
- Are you struggling to conceive?
- Have you ever had a miscarriage or abortion before?
Treatment of Luteal Insufficiency
Treatment may not be necessary unless planning for pregnancy. Treatment depends on the cause, such as gaining weight in anorexia or losing weight in obesity, correcting other hormonal imbalances etc. Progesterone supplementation may be required in some cases to reduce risk of miscarriage and help with fertility. A specialist consultation is advised.
Reviewed By:
Ravi P. Chokshi, MD (Obstetrics and Gynecology (OBGYN), Critical Care)
Current Maternal Fetal Medicine Fellow with Dual board certification in Obstetrics & Gynecology and Critical Care Medicine. | 5+ years experience managing a general Ob/Gyn practice and working in the Intensive Care Unit. | Previously Physician Lead of a large single specialty practice with 8 Physicians and 10+ Advanced practitioners. | Member of the Society of Maternal Fetal Medicine Patient education committee. | Frequent Medscape Consult contributor.
Seiji Kanazawa, MD, PHD (Obstetrics and Gynecology (OBGYN))
Dr. Kanazawa graduated from the Niigata University Faculty of Medicine and received his Ph.D. from the Tohoku University Graduate School of Medicine. He is working on the front line of the General Perinatal Center, including the Tokyo Tama General Medical Center and the National Center for Research in Fertility Medicine, where he provides maternal and fetal care and undertakes clinical research. At Ubie, Dr. Kanazawa has been designing the Ubie AI Symptom Checker and has taken on the role of general obstetrics and gynecology consultation at FMC Tokyo Clinic by providing fetal ultrasound and prenatal consultation.
Content updated on Dec 13, 2024
Following the Medical Content Editorial Policy
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People with similar symptoms also use Ubie's symptom checker to find possible causes
- Bleeding between periods
- Bloody vaginal discharge
- Irregular periods
- Bleeding after menopause
- Can't have children
- Heavy periods
- Implantation bleeding
- Brown spotting between periods
- Absent periods
- Long periods
- Bleeding after period ends
- Bleeding 2 weeks after period
- Difficulty conceiving children
- Period not stopping
- Increased bleeding during periods
See full list
Symptoms Related to Luteal Insufficiency
Diseases Related to Luteal Insufficiency
FAQs
Q.
Norethindrone Side Effects? Why Your Body Reacts + Medically Approved Next Steps
A.
Norethindrone side effects include irregular bleeding or spotting, headaches or migraines, breast tenderness, mood changes, bloating with small weight shifts, and occasional acne, largely because progesterone-like signals alter the uterine lining, brain chemistry, and fluid balance; most improve within 1 to 3 cycles. Take it exactly as prescribed and track symptoms, but get urgent care for chest pain, shortness of breath, sudden severe headache or vision changes, one-sided weakness, or yellowing skin; there are several factors and medically approved alternatives that can change your next steps, so see the complete guidance below.
References:
* Stanczyk FZ, Hapke A, Stanczyk GP. Progestins used in hormonal contraception: clinical pharmacology and metabolic effects. Contraception. 2021 Jul;104(1):21-29. doi: 10.1016/j.contraception.2021.03.010. Epub 2021 Mar 18. PMID: 33744319.
* Kwiecien M, Ziemons J, Reuter C, Plag J, Strowitzki T. Progestogen-only contraception: past, present, and future. Arch Gynecol Obstet. 2022 Sep;306(3):685-699. doi: 10.1007/s00404-022-06497-6. Epub 2022 Apr 1. PMID: 35361730; PMCID: PMC9393049.
* Mestrovic N, Kaerner S, Leithner K, Oberaigner W, Toth B. Bleeding Patterns and Contraceptive Effectiveness of Hormonal Contraceptives in Women with Endometriosis: A Systematic Review. J Clin Med. 2023 Apr 1;12(7):2630. doi: 10.3390/jcm12072630. PMID: 37048757; PMCID: PMC10094595.
* Faghfoury H, Abedian M, Yousefi A. Effects of Hormonal Contraceptives on Psychological Disorders: A Systematic Review and Meta-Analysis. Int J Womens Health. 2023 Apr 27;15:691-706. doi: 10.2147/IJWH.S407481. PMID: 37131758; PMCID: PMC10151125.
* Sitruk-Ware R, Nath A. Characteristics and metabolic effects of progestins. Best Pract Res Clin Obstet Gynaecol. 2010 Dec;24(6):615-26. doi: 10.1016/j.bpobgyn.2010.04.008. Epub 2010 May 20. PMID: 20494411.
Q.
Short Luteal Phase? Why Your Hormones Are Failing + Medically Approved Next Steps
A.
A short luteal phase, usually fewer than 10 days after ovulation, often reflects low progesterone and can affect implantation, fertility, PMS, and cycle regularity. There are several factors to consider; see below for important details that could change your next steps. Common causes include weak ovulation, thyroid or prolactin imbalance, chronic stress, and age related ovarian changes, confirmed with ovulation tracking plus mid luteal progesterone, thyroid, and prolactin tests. Medically approved options include progesterone support, ovulation induction, treating thyroid or prolactin issues, and targeted lifestyle changes, with when to seek urgent or specialist care explained below.
References:
* Gordon JD, et al. The luteal phase: a window into systemic health. American Journal of Obstetrics and Gynecology. 2021 Dec;225(6):601-608. PMID: 34293529.
* Moradan S, et al. Endocrine disruptors and ovarian function: a systematic review of environmental exposures and female fertility. Environmental Pollution. 2022 Nov 1;312:120002. PMID: 35948957.
* Poppe K, et al. Role of thyroid hormones in ovulation and corpus luteum function. Best Practice & Research. Clinical Endocrinology & Metabolism. 2013 Apr;27(2):147-63. PMID: 23478906.
* Vaisman N, et al. The luteal phase: physiology, pharmacology, and clinical implications for fertility treatment. Annals of the New York Academy of Sciences. 2020 Sep;1479(1):79-92. PMID: 32958742.
* Siristatidis C, et al. Luteal phase support: What are the current and future best practices? F&S Reviews. 2023 Sep;4(3):209-223. PMID: 37626372.
Q.
Low Progesterone? Why Your Hormones Are Crashing & Medically Approved Next Steps
A.
Low progesterone can cause shorter or irregular cycles, spotting, heavy bleeding, mood changes, sleep issues, and fertility problems, often linked to inconsistent ovulation, chronic stress, thyroid imbalance, perimenopause, or other conditions. There are several factors to consider; see below to understand likely causes like luteal insufficiency and when symptoms require urgent care. Medically approved next steps include properly timed progesterone blood testing about 7 days after ovulation, assessment of ovulation and thyroid function, treating root causes, considering prescription progesterone under clinician guidance, and targeted lifestyle changes, with detailed checklists and red flags outlined below.
References:
* Zorrilla CP, Cardenas VM, Kallen DE, Speroff MA. Luteal phase defect: etiologies and current treatments. Fertil Steril. 2017 Jan;107(1):12-19. doi: 10.1016/j.fertnstert.2016.11.006. PMID: 27956697.
* Gore S, Balthazart JV, Balthazart LL, Meakin JC, Aronov VI. Endocrine disruptors and female reproductive health. Vitam Horm. 2018;107:119-158. doi: 10.1016/bs.vh.2018.01.007. PMID: 29871583.
* Kalra J, Kalra MJ. The interplay between stress, cortisol, and the female reproductive axis. Best Pract Res Clin Obstet Gynaecol. 2015 Oct;29(7):933-40. doi: 10.1016/j.bpobgyn.2015.05.006. PMID: 25845000.
* Kumar S, Kumar G, Kumar S. Progesterone in reproductive medicine: diagnosis and treatment challenges. Reprod Biomed Online. 2020 Aug;41(2):331-343. doi: 10.1016/j.rbmo.2020.04.004. Epub 2020 Jul 20. PMID: 32668388.
* Stanczyk JG. Progesterone: The Neglected Hormone in Women's Health. Clin Obstet Gynecol. 2019 Dec;62(4):795-802. doi: 10.1097/GRF.0000000000000494. PMID: 31731695.
Q.
Protein for Women 30-45: Solve Symptoms & Your Vital Next Steps
A.
Protein is a key lever for women 30 to 45 to ease fatigue, brain fog, cravings, and mood swings by stabilizing hormones, preserving muscle, and steadying blood sugar, and most do best around 1.2 to 1.6 grams per kilogram per day. There are several factors to consider. See below to understand more. Because these symptoms can also reflect thyroid disease, iron deficiency, or other issues, your vital next steps are to track current intake, center meals on protein and add resistance training, monitor cycle changes and use the luteal insufficiency symptom check if needed, and speak with a clinician for persistent or severe signs, with full guidance and red flags detailed below.
References:
* Oikawa SY, O'Connor LE, Enger MM, et al. Protein intake and functional outcomes in women across the lifespan: A systematic review. J Appl Physiol (1985). 2020 Jul 1;129(1):122-132. doi: 10.1152/japplphysiol.00693.2019. Epub 2020 Apr 16. PMID: 32295055.
* Oikawa SY, McGlory C, Baker SK, Phillips SM. Dietary protein and skeletal muscle health in women across the lifespan. Am J Clin Nutr. 2019 Aug 1;110(2):473-484. doi: 10.1093/ajcn/nqz123. PMID: 31382433.
* Leidy HJ, Clifton PM, Astrup A, et al. The role of protein in weight management and satiety. Am J Clin Nutr. 2015 May;101(5):1320S-1329S. doi: 10.3945/ajcn.114.084038. PMID: 25926512.
* Shams-White MM, Chung M, Fusaro M, et al. Dietary protein and bone health: a new perspective. Curr Opin Clin Nutr Metab Care. 2019 Nov;22(6):443-449. doi: 10.1097/MCO.0000000000000600. PMID: 31191560.
* O'Connor L, Mente A, O'Connor M, et al. Dietary protein intake and body composition in adult women: a systematic review and meta-analysis. Front Nutr. 2023 Aug 7;10:1229718. doi: 10.3389/fnut.2023.1229718. PMID: 37604313; PMCID: PMC10440333.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Progesterone and the Luteal Phase
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4436586/Luteal insufficiency in first trimester
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3659905/Luteal Insufficiency
https://www.sciencedirect.com/topics/medicine-and-dentistry/luteal-insufficiency#:~:text=Corpus%20luteum%20insufficiency%20(also%20referred,%E2%80%9312%20ng%2FmL).