Short luteal phase examples? How to identify?

[Kateeeeeeee]

Hello there!

I am about to start TTC and have done a long preparation of a preconception detox and cleaning up my lifestyle, taking lots of fertility boosting supplements etc for almost a year!!

I felt like this would give me a great start however I am only just discovering that I might potentially have a short luteal phase and it started worrying me so much due to the risk of miscarriages… I have NEVER been on the pill which I know can mess up cycles and always had regular cycles so this feels a bit shocking!

Basically in the last few years, I started having brown premenstrual spotting (sometimes) + my cycles have slightly shortened, from an average of 28 days to an average of 25 or so. Doctors said this is normal and had my progesterone tested which came back good and confirmed that I am ovulating. However they only test it at one point in time, and there is no way of knowing how soon the levels drop, therefore a luteal phase defect can’t be identified from this test. I have a suspicion that my progesterone drops quickly because I often get very bad PMS symptoms which suggest low progesterone. But the premenstrual spotting worries me the most because that is another big sign of it!

My question is: as what do I count the days of spotting? Are they a part of the luteal phase? Or do I count the luteal phase from ovulation until I get the spotting?

I have only just discovered cycle charting (where have I been?!) so don’t have a lot of data on the length of my luteal phases yet however can’t figure out how to count those spotting days and don’t see this information anywhere.

I am suuuuuch a worrier and am absolutely terrified of potential miscarriages now, I really hope that this spotting is not as bad as I make it out to be, especially since I look after myself so well 🥲 hope some of you can ease my mind a bit if you have been in a similar position to me and successfully conceived…

You need to start doing ovulation tests regularly and see what happens there. if your test is positive less than 9 days before your period i think that's classed as short luteal phase. the good news is if you have it then there's a very easy cure in the guise of progesterone pessaries (speaking from experience) so if you are finding this is the case i'd speak to the GP/Gyno before you start trying to try and prevent losses.

I think you count til your actual flow not just spotting but others may correct me

Yes, I've always been told to count from full flow, not just spotting.

Just curious @Bells3032 if you are in the UK? In my experience you have more chance of pigs flying than getting a progesterone prescription in the UK for short luteal phase. If you are than I'd love to know where you went for this so that maybe I can try my luck with them...

Thank you and @Bells3032 for your thoughts!

If I do count pre menstrual spotting into the luteal phase, then it would likely be a normal one of about 12 days or so. But if spotting is a sign of low progesterone, those 12 days would surely be a bit misleading…? Because if spotting occurs that probably means that progesterone has dropped a bit too low. That’s why I was wondering if those days shouldn’t be taken into the calculation. Do correct me if I am wrong, anyone!

@Kateeeeeeee do you know what your actual progesterone result/quantity was?

To reassure you, I have always had a short luteal phase (roughly 8/9 days including spotting days) and didn't have any trouble conceiving.

to be fair i was a bit cheeky and went to a private fertility clinic for it as i'm very impatient. cost me about £200 inc the meds but i had already had one loss and didn't want to risk another

Yes! It was normal at 12 nmol/L, and (I assume) that this was around 3 days after ovulation (solely based on charting CM, also I am new to charting so unsure if this was accurate).

Apparently that’s a pretty good result, but only 3-4 days after that test I suddenly got super strong low progesterone symptoms as I described in my original post, so I just assumed that it must have dropped at that time… and then another 4-5 days later spotting started. According to those calculations, would only be around 6 days of good progesterone levels, however this is obviously just guessing and perhaps I am being overly obsessed and dramatic…?

I actually just discovered that you can do a PdG test at home which measures the progesterone cycle over the whole luteal phase which I bought and planning to do on my next cycle. These might be useful for anyone else who would like to accurately measure if it drops too low too early!

This really is very reassuring, thank you so much for letting me know!

It is crazy how the information is so divided on this topic… some say that this raises the risk for MC so dramatically, and then others say that they haven’t had problems. It must really be quite individual. The human body truly is a fascinating, complex machine!!

I have had 2 progesterone blood tests (end of 2022 just before I conceived my second) and they should be done half way between you luteal phase (usually around 6/7dpo, 3-4 dpo is too early to confirm ovulation or progesterone levels are good or not. To confirm ovulation/progesterone levels they should be at least 30 nmol/l (from what nhs confirm) half way through luteal phase. Taking the bloods too early or too late won’t give an accurate result

You don’t count the spotting in your luteal phase it counts from day after ovulation (1dpo) until full flow. That full flow day doesn’t count though as that’s the first day of the new cycle. My luteal phase was 12 days (period started 13dpo) but I had 4-5 days spotting before full flow.

The spotting massively concerned me which is why I had tests and I couldn’t remember if I used to spot before my first born as was over 7 years previously and wasn’t planned so I never paid attention.

The wonderful news is that I did conceive within 4 cycles but had an early loss at 6 weeks on cycle 4 and again at 6 weeks on cycle 5 but I was assured that it wasn’t my spotting because my progesterone results were high (52nmol/l at 6dpo). I conceived again on cycle 6 and this baby stuck and is now 9 months old.

I hope it helps a bit to hear that spotting doesn’t always mean you can’t naturally conceive. I would get tests done at the right time in your LP and good luck 😊

Was it definitely 12 nmol/L rather than 12 ng/ml? Ovulation would be confirmed if the latter but definitely worth doing again if the former (and on the right day).

Which at home test have you gone for?

Oh, wow, this kind of made me realise that maybe I took the reference ranges they provided too seriously… yes it was definitely in nmol, but the normal ranges they provided were 3.8 - 50.6 during luteal phase, that’s why I assumed that my result looks good. But now I am confused. Do you know what are the correct reference ranges?

I just converted 12 nmol to ng and it is 3.8 ng/ml.
On a quick google search, the information is quite mixed. Generally I think you are right that it should be higher to confirm ovulation but it is also advised to test it about 7 days before the period, and I had the test much earlier, so maybe that’s why the result was low…?

Doctors are crazy. I told my GP that the day she booked me in might potentially be too early, but the next date they had was a week after and I told her that this might be too late because I will then be very close to my period, so the choice was a lose-lose situation and we chose to test early…. Unbelievable how inaccurate these tests are.

Very interesting! Thank you for sharing your story! 😊
I am guessing that spotting can also have different causes so it might be hard to tell exactly if this is a progesterone issue or something else, I read that it could also be fibroids or what not… 🫣

@Kateeeeeeee Many GPs are entirely clueless about fertility tests. Probably did half a day as a student.

The usual level to confirm ovulation is over 30 nmol/L or 10 ng/ml. However I've seen that some NHS trusts have downgraded their threshold to 25 nmol/L and Bristol's says that over 12 nmol/L while having regular periods should still be considered evidence of normal ovulation.

https://www.nbt.nhs.uk/severn-pathology/requesting/test-information/progesterone

I expect that if you do the test again 6 or 7 days after ovulation you will have a higher level. If it's still on the low side you could could request further blood tests to check for hormone imbalance/ oestrogen dominance (which is also often the cause of fibroids).

Plenty of women manage to get pregnant with lower than standard progesterone and/ or spotting and/ or fibroids. You could ask your GP if they'd refer you for an ultrasound to investigate the latter but as above, many women have spotting without any resulting problems.

@Kateeeeeeee definitely could be one (or more) of many things, or nothing. I just wanted to show you not to panic quite yet. I would start with the progesterone tests at the right time in your cycle but would ask for full bloods to be done at the same time as lack of B12 (and other b vitamins) can cause spotting and some other things can make conceiving more difficult so worth getting them checked if you’re having bloods done anyway. My GP was happy for me to have all done because of the spotting so it’s worth an ask

If you’re in England it will be really difficult to get progesterone prescribed unless you go private or are already over 6 weeks pregnant after already having had losses and bleeding,

@Kateeeeeeee sounds just like me. My cycles dropped from 28 to 25 days once my periods came back after first born (about 1 year due to breast feeding), since then I always spot for 2 days from about 8 DPO then bleeding at 10DPO, I’ve always counted D1 as the day of the bleed not the spotting. Also get shocking PMS. I did a day 3 private blood test this cycle and my progesterone was actually higher than normal range for that part of cycle which really surprised me, as like you I felt I had an issue in this area (I used the randox test as really cheap). I had done some research into short luteal phase supplements and decided to start proceive max and had planned to do a repeat test at 7 DPO to see what was happening in my luteal phase. Sadly it fell on a Friday and so couldn’t test it…. On the Saturday I tested positive. I had to planned to add in some additional b6 and vitamin c to push the doses up higher but hadn’t gotten round to it prior to the positive test.
So I wouldn’t let the symptoms you describe discourage you, as they are pretty much identical to mine. I’d recommend the randox test for the price, and looking into trying some supplements. It starts with the egg is worth a read, really informative.

This is very helpful, thank you! 🙏
it sounds like you are very well informed on this topic, that’s amazing!
I guess I might just have to relax for now and start trying and see how it goes from there, while trying not to worry too much 😅

Good that they did all those tests!
I have actually been taking a b complex for years, apart from many other things, so very much doubt that I would have any deficiencies in this area…
so frustrating that it seems so difficult to get a progesterone prescription! I decided to just buy some low dose progesterone cream and see how this makes me feel, apparently there are many women who say it has worked wonders for them…

How interesting that you find yourself in a similar situation! It would make sense that this may have happened after you already had a child, but it worries me more since I have never even been pregnant before and always looked after myself so well…

Actually I read that book you recommended last year, it’s really good. I have a really good diet and I am also a supplement freak and have been taking lots of things for years already, including b6 and vitamin C that you mentioned and everything, so it feels quite disappointing to see that there might be issues in my cycle while taking such good care of myself 🥲

I have already ordered a PdG test to do on my next cycle so will see how that goes, but will keep in mind the randox one you did if need be!

Yes would definitely recommend the randox one as it’s £29 and has all the hormones on it and I just couldn’t get in for go bloods at the right times for love not money despite the fact gp had agreed to test med they were always booked by the time I knew what day I needed

Hi OP, I think you need to try and relax a bit. I wouldn't suggest any testing like PdG or doing any further Day 21 tests or trying to get progesterone, You aren't even trying yet! You don't know when you ovulate, so you cant know whether you have a short luteal phase. Maybe focus on tracking your ovulation and actually trying to get pregnant rather than worrying about what might be wrong, you'll probably have no issues conceiving if you're healthy.

Thank you so much for this grounding message. It kind of brings me back to earth, and makes me realise that I have become too obsessive about this and worry way too much in advance.
This is exactly what I needed to hear so appreciate you saying that.

Also TTC, also noticed short luteal phases (I’ve been off the pill for almost 5 months so I know that can affect it). I asked my dad who is a doctor, as well as an obstetrician friend of his about this. Both of them said that there is absolutely no scientific evidence to suggest that a shorter luteal phase causes more miscarriages or fertility problems.If you’re ovulating regularly (ie once a month) then you’re more than likely going to be fine, as most fertility issues in women are linked to ovulation rather than progesterone levels.

I have had shorter luteal phases (overall getting a bit longer) since coming off the pill, but trying not to get too bogged down by what’s on the internet. Plenty of women have short luteal phases and are able to conceive.