Is a short luteal phase caused by low progesterone infertility?

by | 6:00 am | Progesterone | 22 comments

Reader Question: I have been trying to get some information on bioidentical progesterone cream use for short luteal phase issues and can not find information anywhere.  I have been tracking my cycles for almost 10 years using the sympto-thermal method and after the birth of my second son, the length of my luteal phase has been VERY short…too short to sustain a pregnancy.  I know this is most likely caused by low progesterone infertility and was told that going the bioidentical progestone route can help me.  I am hesitant to do so.

Would you simply recommend Vitex and vitamin B6 to increase luteal phase length?

First, a primer on progesterone

An important part of conception, progesterone is also needed to carry a pregnancy to term. A woman’s body has to produce enough progesterone to support the pregnancy until the placenta is developed enough to take over (this happens at the end of the first trimester).

One of the reasons progesterone may be too low, is that there may be too much estrogen in the body and the first thing to look at is the weight of a woman {groan}. Our fat cells help to produce and carry estrogen in the body and when we are overweight, we’re more apt to have higher estrogen levels. Losing weight is neither fun nor easy, but even losing 10% of your body weight (should you need to lose any) can help balance out hormone production.

Another reason hormone levels can become unbalanced is if a woman is still nursing, as it’s a natural way our bodies “protect” themselves. Breastfeeding keeps our prolactin levels higher, thereby keeping the progesterone levels low. Weaning usually solves this problem within a few months, though the age of the baby should be taken into strong consideration as nursing until two years old is recommended. I have my own feelings on trying to conceive while breastfeeding, but vitex has been shown (in some women) to help lower the prolactin levels enough to boost progesterone.

Weak or no ovulation also causes low progesterone, so if you aren’t ovulating during your cycle there is no corpus luteum to signal progesterone production. (and no, you don’t always ovulate even if you have periods!)

Stress can also throw hormones out of whack. Lack of sleep and healthy foods (both hard to get when taking care of a baby) can cause stress to these organs. When these organs are not running at optimal levels, hormones become unbalanced. When our bodies are stressed the adrenals use the precursor hormone for progesterone (pregnenolone) to produce the “fight or flight” hormones instead.

A diet high in sugar and refined carbs also does a number on the balance between estrogen and progesterone! One main reason why is that our bodies are dependent on vitamin B6 to help process carbohydrates. So even if we think we’re getting enough vitamin B6 in our diets, our bodies may be using more than we’re consuming, essentially leaving us mal-nourished.

low progesterone infertility

photo credit, Alliance Images, via

My Answer:

I think that there are a lot of things you can do with whole foods to help a body heal, but it does take time. Make sure the diet is void of refined sugars and carbs, and full of healthy fats (butter, evoo, coconut oil), a variety of veggies and fruits, and good wholesome dairy.

Vitamin B6 is often linked to luteal phase problems and it’s a great place to start! But I also think nutrients are best utilized and absorbed when we find them in foods. So dietary changes are essential and should be looked at prior to, or along with, any supplementation. It’s also important to think about the B vitamins as a whole, whether you are supplementing or trying to boost intake through only foods. They all work together and should be consumed together.

When supplementing: Be sure to use a B-complex vitamin made from food sources and search out supplements that contain folate instead of folic acid

Vitex may be helpful for some women, but it definitely isn’t a one size fits all herb! From talking with other women, many of them have had good luck with vitex getting their cycles back on track, especially after a baby and while nursing. Not only does it seem to  help lower prolactin levels, it may also assist balancing out the estrogen:progesterone ratio as well.

On the other hand, some women find that vitex makes their symptoms worse, so it’s important to match a herb to all of your symptoms, not just the most annoying one at the time. I interviewed an acupunturist and fertility expert about vitex a while back, so please listen to her advice on the herb, or at least read through our summary – Vitex for fertility.

Many Vitex supplements contain other herbs as well, so before taking check to make sure that all of the herbs will be helpful for your situation.

Progesterone Creams – I think that if a woman who is having trouble lengthening the luteal phase or producing enough progesterone, that a progesterone cream is definitely an option. Especially if it’s been 3-6 months of adhering to a whole foods diet, lifestyle changes, and supplementation. I would personally seek the guidance of a health practitioner well versed in both natural alternatives to balancing hormones and the use of bio-identical progesterone creams. If a couple is actively trying to conceive (and not taking steps to avoid pregnancy while trying to balance the woman’s hormones) and the woman has a short luteal phase or known low progesterone levels, I’d almost be hesitant to not use a progesterone cream.

There are different creams, some more natural than others. Natural Progesterone creams all contain the same type of bio-identical progesterone. It’s produced in a lab by making changes to the chemical structure of a compound found in wild yams. The other ingredients though as varied and many contain parabens, synthetic fragrances, and preservatives I choose to stay away from. There are many good options for progesterone cream and many are even oil based (which means they don’t need a preservative like water based products do). One oil based product I’ve used before is from Beeyoutiful, though there are others.

From our Facebook community:

  • My understanding is that it can take up to 6 months for the luteal phase to get back to normal after the first post partum period. I would try to heal the body via whole foods and correcting imbalances first, because it is more than just progesterone that is probably out of whack, there is a whole series of hormones.


  • My reproductive endocrinologist & immunology specialist told me that treating a Luteal Phase Defect is treating a symptom, and the root cause of low progesterone in the luteal phase is insufficient estrogen in the ovulatory phase. Thus balancing hormones across your cycle would be best.


  • I have been fighting with this since my first miscarriage almost 4 years ago, and it’s not easy. It’s a slow process, depending upon how low your progesterone levels are to begin with, but there IS hope! In the last 6 months of working on it, I have had the best results with –
    • changing my diet (off of sugars and grains, unless they are soaked, adding lacto-fermented veggies and drinks [beet kvass is very high in B vitamins–good for progesterone!])
    • getting proper exercise (t-tapp has a workout designed specifically for balancing hormones and it works!)
    • supplements (Vit. B complex, C, D, E, Zinc, Selenium, Evening Primrose Oil, Vitex).


  • I have my youngest because I used progesterone. I have PCOS so my estrogen is very high and I needed to balance it with the progesterone. Once I conceived, I used everyday till 10wks (because I had miscarried the pregnancy before) when I allowed the midwife to try the heartbeat on a doptone. Then I weaned off it as the baby had implanted so my progesterone production was sufficient.

Have you ever dealt with a short luteal phase? What did you do to treat it?


*All information is given to inspire and encourage you to do your own research, learn from others experience, and learn to ask your doctor more questions. No answer given is from a medical professional and should not be taken as medical advice.

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