Luteal Phase: Understanding This Phase Of The Menstrual Cycle & How To Optimize It
A 36-year-old patient recently came to see me with PMS issues. She'd be rude to her kids in the ten days leading up to her period, feeling weary, bloated, and unable to multitask or do anything like she used to. She also revealed, through tears, that her marriage was in trouble. "I know I love my husband," she explained, "but I feel so angry with him right before my period that I don't want to have sex anymore."
Her cycle day-21 lab test revealed low progesterone levels, along with all the indications of a luteal phase malfunction. She isn't the only one who feels this way: Many women suffer from PMS, and up to 90% of women will experience it at some point in their lives—often due to a luteal phase malfunction.
It's nearly tough to notice when the luteal phase isn't working at baseline if you don't know what it is. So, let's take a closer look at this stage of the menstrual cycle: what it is, how long it lasts, how it affects mood, and so on.
What is the luteal phase, and what does it entail?
The luteal phase is the part of your menstrual cycle that begins after ovulation and ends when your period arrives.
Let's take a step back for a moment: Your ovaries create follicles during the early part of your cycle (the follicular phase). This is a stage of your cycle when estrogen is in the ascendant. Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) then cause ovulation (LH). This usually happens around day 12 or 13 of a 28-day cycle, but it all depends on the duration of your natural cycle, which is normally longer than 28 days. To put it another way, your chronology is unique to you.
We enter our luteal phase after ovulation. The Corpus Luteum is formed when the follicle that delivered the egg closes up. Its main purpose is to create progesterone and prepare the uterus for pregnancy and embryo implantation.
During the luteal phase, what happens?
Your progesterone levels are at their highest during the luteal phase, and your uterus is preparing for the implantation of an embryo and pregnancy.
I usually see the first half of your cycle as throwing clean sheets on the bed, and the second half as truly making the bed (because progesterone does that). You become slightly more insulin resistant during this time, which means you have a higher level of glucose in your blood and your body temperature rises. Track your basal body temperature first thing in the morning, before you even get out of bed, to see if you're in your luteal phase.
What is the duration of the luteal phase?
The luteal phase usually lasts between 12 and 16 days.
If you haven't been pregnant, your menstruation will begin. (The first day you begin bleeding is considered day one of your menstrual cycle, and it means the entire process will start over.)
A luteal phase deficit occurs when the luteal phase is less than 10 days following ovulation. If your progesterone levels don't reach their peak, you have anovulatory periods, or your body doesn't produce enough progesterone, this can happen.
Peak progesterone levels are measured in gynecology around day 20 to 22 of your menstrual cycle. If you ovulate between days 12 and 14, for example, measuring your peak progesterone levels seven to nine days after you ovulate is accurate. We recommend retesting if it's low [less than 10 ng/ml], as hormones are pulsatile and errors can occur.
How to find out what your hormone levels are.
Hormones can be measured by looking at their levels in your blood, or by measuring urinary progesterone levels or salivary progesterone levels during your cycle. If your progesterone levels are low, an ovarian reserve test, also known as an AMH (Anti-Mullerian Hormone) test, can be used to determine your ovarian reserves.
What are your feelings like throughout the luteal phase?
Your body temperature may feel warmer as a result of a natural increase in progesterone (remember to track your basal body temperature). Because your cells are slightly more insulin resistant during this time, generating an increase in circulating blood sugar, you may feel more energized.
To keep your blood sugar in check, wait until the last few days of your cycle—i.e., before your period—to consume any more glucose or carbohydrates. (For additional information on blood sugar levels and your menstrual cycle, click here.)
During the luteal phase, some women will experience PMS symptoms, especially if their progesterone levels are below optimum. Anxiety and despair, bloating, water retention, some brain fog, memory loss, mood swings, sleep disturbances, and a decrease in libido are all signs of premenstrual dysphoric disorder (PMDD).
During the luteal phase, libido usually peaks during ovulation and drops during the luteal phase. So, as I often tell my patients, if you only despise your partner two weeks a month, it's more than likely due to your hormones, not your relationship.
Is it possible to conceive during the luteal phase?
Fertility peaks at the time of ovulation, and sperm is viable for up to five days in the vaginal canal after 36 hours of intercourse. Within the luteal phase of the ovulation cycle, there is a five-day window during which you can become pregnant.
If you're using natural family planning and don't want to get pregnant, I recommend not having any sperm in your vaginal canal for six days before your period and six days after ovulation. This effectively initiates the luteal phase!
It's almost unfair because your desire is at its best when you ovulate because your estrogen and testosterone levels are at their highest. Be conscious that your physiology has an impact on your behavior, and it can either work in your favor or against you.
How can you make the luteal phase more effective?
Food, exercise, and other factors can all help to optimize the luteal phase. Here's what I suggest:
What should I eat?
During the luteal phase, your body is naturally preparing for pregnancy by having higher glucose levels and more desires. When possible, I advocate consuming high-quality, free-range, and organic proteins. To support the gut bacteria and hormone metabolism, I also prescribe healthy fats like olive oil and avocado, as well as plenty of dark leafy and microgreen vegetables. Protein, lipids, and fiber will keep you fuller for longer and may help you avoid undesirable cravings. (You can learn more about what to eat at each stage of your menstrual cycle by clicking here.)
What kind of workout should I do?
You could try high-intensity workouts during the luteal phase because you may have more energy (like this no-jumping HIIT workout, a 5-minute Pilates and HIIT routine, or this 15-minute HIIT cardio burn). Other high-intensity workouts, such as strength training, may also be beneficial at this time (here are a few for every part of the body: an eccentric full-body routine, an upper-body strength routine, and an at-home lower body workout).
However, because cortisol depletes progesterone, which might place a strain on this hormonal phase, you'll also want to include a stress-relieving activity like yoga.
What to stay away from.
You should avoid boosting your cortisol levels at any period, but especially during the luteal phase. I usually suggest adding a good contemplative practice, continuing to focus on what you're grateful for, taking a long walk, and arranging extra play and pleasure time to your schedule.
Because your blood glucose level will already be elevated, you'll want to avoid high-carbohydrate foods and simple sugars.
There are a few more things to consider.
While the menstrual cycle is natural, it should not be painful. If you're having trouble with the luteal phase, having trouble conceiving, or have already lost a pregnancy, talk to your doctor to obtain some answers and find healing.
The end result.
My 36-year-old patient was prescribed a healthy fat, protein, and greens diet, as well as additional luteal phase optimization strategies. She felt better after two months, less irritated with her spouse, and more confident. Her favorite part was when her smallest kid crawled into her lap and exclaimed, "Mommy, you're smiling again!"
When you understand how your hormones work during each phase of your cycle, the rest of your life will begin to feel more balanced as well.