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Luteal Phase Dysfunction Treatment & Management

  • Author: Thomas L Alderson, DO; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
 
Updated: Jun 14, 2013
 

Medical Care

See the list below:

  • Hyperprolactinemia and hypothyroidism cause luteal phase deficiency (LPD) through hypothalamic-pituitary dysfunction.
  • Bromocriptine and levothyroxine, respectively, are used to treat LPD in women with these conditions.
  • In women without hyperprolactinemia and hypothyroidism, vaginal progesterone is advocated to supplement endogenous progesterone production. The vaginal suppository or gel is preferred over both the oral and intramuscular forms because of superior endometrial progesterone concentrations. Vaginal suppositories are less expensive but are messier than the vaginal gel. Progesterone should be continued for 8-10 weeks to cover the time of the ovarian-placental shift.
  • A Cochrane review found that synthetic progesterone is preferred to micronized progesterone. The study also found that other substances, such as estrogen and human chorionic gonadotropin (hCG), did not improve outcomes. No specific route or duration was preferred.[6]
  • Clomiphene citrate corrects LPD by improving folliculogenesis and the resultant luteal phase following ovulation. Successful treatment with gonadotropins and HCGs probably results from superovulation rather than from a correction of LPD.
  • Following any of these treatments, the patient should have a repeat endometrial biopsy to determine that LPD has been corrected.
 
 
Contributor Information and Disclosures
Author

Thomas L Alderson, DO Program Director, Assistant Professor, Department of Obstetrics and Gynecology, Mount Clemens Regional Medical Center, Michigan State University College of Osteopathic Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

A David Barnes, MD, MPH, PhD, FACOG Consulting Staff, Department of Obstetrics and Gynecology, Mammoth Hospital (Mammoth Lakes, CA), Pioneer Valley Hospital (Salt Lake City, UT), Warren General Hospital (Warren, PA), and Mountain West Hospital (Tooele, UT)

A David Barnes, MD, MPH, PhD, FACOG is a member of the following medical societies: American College of Forensic Examiners Institute, American College of Obstetricians and Gynecologists, Association of Military Surgeons of the US, American Medical Association, Utah Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Richard Scott Lucidi, MD, FACOG Associate Professor of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Virginia Commonwealth University School of Medicine

Richard Scott Lucidi, MD, FACOG is a member of the following medical societies: American College of Obstetricians and Gynecologists, American Society for Reproductive Medicine

Disclosure: Nothing to disclose.

References
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