Luteal Phase Dysfunction Treatment & Management

Updated: Dec 09, 2016
  • Author: Thomas L Alderson, DO; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Treatment

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.