Wednesday, September 8, 2010

Luteal Phase Defect (or something like it?)

Okay, everyone I need your help.

Have you ever heard of a luteal phase defect? Have you ever experienced it? What did you do? What did your doctor do? Was it treatable?

Does anyone have a success story for me?

I'd really like to hear it if you do.

Let me give you some (long winded) background. Last year, about a month before we started TTC I noticed that I started spotting a few days before I got my period. The first time it happened I thought "hum, that's weird...", but wasn't terribly concerned because you read in pretty much every woman's health book, website or magazine that 'some times your period can be a bit weird...but it's nothing to worry about'...etc. etc.

But I did start to worry. I'm just that type of person. Growing up with a chronic medical condition makes you pay particular attention to your health. I grew up analyzing every twinge. Now that I'm an adult and have a greater ability to think rationally (I was definitely a bit of a hypochondriac as a kid) combined with my nursing background (and a little help from Google Scholar), it makes me pretty accurate when it comes to knowing what's going on with my inner workings.

So when the spotting started 2-4 days before EVERY PERIOD in the months of May, June, July, August, September, October and November of last year, it made me anxious...really anxious. I knew something was wrong. I thought it was pretty rational to think that "hey, if something is wrong with my baby-making-parts and we are trying to have a baby then maybe I HAVE A PROBLEM!!!"

Like, no duh.

So, just to get a jump on things, I started ovulation charting around May or June of last year. And lo and behold I noticed that my 'luteal phase', the time between ovulation and my period (also known around these parts as the 'two week wait') was, for me, NOT TWO WEEKS. Usually I would start spotting at 8 days past ovulation and then get my period around 10 to 12 days past ovulation.

When I went into see my doctor about this she immediately said "oh, your progesterone is low". She ran a few blood tests (but did not check my progesterone for some reason) and the only one that came back abnormal was my prolactin levels. I think she figured my hormonal imbalance was causing the bleeding and she figured once my prolactin level stabilized with a drug she prescribed to treat it, my progesterone levels would normalized and I would be 'cured'. My prolactin levels did in fact normalize on the drug and as far as I know my prolactin levels were normal when I conceived Aidan.

But I never stopped having spotting before my periods. There was never any evidence that my progesterone levels returned to normal. In fact I had spotting a few days before I got my positive pregnancy test. I had spotting a few days afterwards. I had bleeding 12 days after I saw those two pink lines...and well, if you've been keeping up, you know that bleeding was a sadly common thing during my pregnancy.

You also know Dr. K. told me at my "what the hell happened to Aidan" visit, that abnormal hormone levels prior to becoming pregnant may have caused a 'bad' spot in my uterus and thus did not allow a 'healthy' endometrial lining to support a baby. Resulting in blood, more blood, loss of fluid and death. He was cheered when I said that as of June when I saw him the grand total of one period I had experienced up until that point was a 'normal' 26 day cycle with no spotting prior. I'm sure they weren't his exact words, but what I felt this visit amounted to was: Too bad. So sad. Oh well...try again...blah blah blah.

So, you can imagine my dismay when coming up to cycle #4 after Aidan, I woke up at the cottage and saw spotting.

Exactly like last year.

I must make an confession at this point. I have not been able to stick to my original plan of 'neither trying nor not trying to get pregnant for one year' like I promised sometime back in May.

In fact I've even spent money on one of those Clear Blue Fertility Monitors just so I can track my cycles more accurately. (I did get a really good deal on it, if that helps my case at all).

My lovely monitor cheerfully informed me that I ovulated the weekend of August 28th or 29th. So it depressed the hell out of me see spotting September 6th. And yes, even here in Canada that is only a grand total of EIGHT days in my two week wait.


I am right back where I started. It's like the beginning of my nightmare all over again.

As you can imagine I've been a bit down the last few days. Really down.

Thrown right back into the 'it's not fair's and the 'why-us's and the 'Holy Christ, I miss Aidan so much I think I might just keel over and die's. Seriously. I thought of phoning into work today claiming I was just too depressed to get out of bed.

Now Google claims that luteal phase defects are often solved with added doses of progesterone and/or possibly Clomid. I'm all for that if it means the next baby (pleasepleaseplease) will have a better shot. But, as much as it cheers me that there might be an 'easy' solution to my problem, it also kind of kills me if it's true because:


I want to get in to see my doctor ASAP to figure out my next step. My appointment is booked for September 28th, an agonizing 3 weeks away. I'm hoping the time that I have to wait to see her might allow me to begin composing myself enough to enter her examining room with a rational way to explain my concerns, instead of dissolving into tears and stamping my feet and wailing "IT'S ALL YOUR FAULT!!!" I'm just wondering how aggressive I should be at this appointment? Should I play the 'dead baby card' and demand to see a specialist? What have other luteal phase defect mommies done? Have you seen an RE? Did a simple tablet of progesterone fix the problem? Did you need Clomid or other hormone modifying drugs? Did it work?

Also, if you live in Canada and you've been to see an RE did you self refer? Or did you need your family doctor to refer you?

So that is my life at this point. Feeling sad and depressed about my damn lady parts, just like last year, only this time I'm dragging around the knowledge that they not only failed me, but my poor baby son.

If you know nothing constructive about luteal phase defects, could I please just have some tea and sympathy from you. My poor sad heart would really appreciate it.


  1. sadly, i'm one of those people who "know nothing constructive about luteal phase defects." :( i'm sorry you have to go through it and i hope that your doctor's appointment would give you more info about the subject. *hands you some nice warm tea and some biscuits* i also hope that a rainbow will come your way soon. thinking of you and aidan. (((hugs)))

  2. Tea and sympathy from me. I'm sorry, I really hope that your doctor can help. xo

  3. Go see an RE. My OB/GYN referred me. It made all the difference in the world to go see an RE - who specializes in this sort of thing. While no one ever told me I had a luteal phase defect, I know I was not ovulating regularly. I could go for months without a period. With the help of clomid and progesterone, I was able to get pregnant more quickly than I ever thought possible.

    I guess I don't know much about luteal phase defects.... so I'll just say I wish we could sit down together and enjoy a cup of tea!

    Thinking of you often...

  4. I'm afraid I don't know anything about luteal phase defects, but I'm giving you lots of sympathy. I've never seen an RE, but I don't think it would hurt. As I'm sure you well know, you have to be your own advocate. If your doctor gives you a hard time about referring you, go to another doctor.

    I think of you and Aidan every day. I hope I'll be adding your rainbow baby to my thoughts soon too.

  5. Emily-I had some spotting last cycle too, and have been worried about this same thing. I too, google the crap out of everything and get myself all worried. I wasn't tracking my cycles or anything before (stevie wasn't planned), but if I am not pregnant this cycle (just O'd Monday), I will be making an appointment to get things checked out.

    Sorry, no success story here, but we may be in the same boat.

  6. I would suggest seeing an endocrinologist, who specializes in hormones or lack thereof and generally, yes, you do need a referral to see pretty well ANY doc nowadays, and esp. for specialists but your GP should be able to do that no problem. I hope things look up!

  7. Offering my tea and sympathies. :( <3 :hugs:

  8. Tea and sympathy my way!! I have a 10-11 day LP and have been told it's on the low side of normal. I'll have to watch the spotting closely and see if I spot at all prior to my period. I used to spot all the time but after Caleb was born it kind of went away. Let us know what you find out!

  9. ironic that you post this because i'd like to know the answer too. a friend told me vitamin b6 can help, but that's on the granola side of medicine. i only have a 10 day LP. told my OB my concerns and he told me under 8 is a problem.

    can you find me a new OB while you're at it ;)

  10. Not in Cananda, so can't speak to that question BUT I have always had the 2-3 days of spotting before my period. And I have LPD (untreated I average a 9 day LP).

    My midwife referred me to an RE after 10 months of TTC naturally with no positive baby in sight (at age 37). I also started getting acupuncture, which largely sorted the spotting issue as long as I kept up treatment. I was diagnosed by the RE with Luteal Phase Defect and prescribed Clomid/IUI which resulted in a positive (that unfortunately turned out to be a blighted ovum).

    Perhaps less helpful is the fact that I have not had any other success, unless you count consistent proper 14 day luteal phases. I'm still not getting pregnant.

    If you want to know more about my treatments, etc., you can check my blog or email me: mylazyovaries [at] gmail [dot] com

  11. I suffer from LPD (it's even worse after the loss of Bailey). My RE has put me on progesterone suppositories twice a day. I start using them 3-4 days post ovulation, and I continue them until I test on 14 dpo. If the test is -, I stop using them, and AF is there within a day or 2. If the test is +, I continue doing them (or something similar) until 12 weeks.

    I have also read that doing an infertility treatment such as Clomid or Femara can also help with LPD. I don't know how proven that has come to be, but it is something I have read over the years of all of this.