Luteal phase symptoms: When it is, symptoms & how to manage

What is the luteal phase of the menstrual cycle?

The luteal phase is the latter part of your menstrual cycle. It usually lasts about two weeks, although this can vary person-to-person. In one study led by Natural Cycles, data from over 600,000 cycles logged in the app observed that the luteal phase lasted an average of 12 days per cycle in this group [1]. 

This phase is a time when hormone levels are fluctuating as your body prepares for an eventual pregnancy. These hormonal fluctuations cause some major changes in your body that can result in physical, mental, and emotional symptoms each cycle.

Other phases of the menstrual cycle

Let’s zoom out and do a quick overview of the full menstrual cycle, its phases, and the processes that happen during each one before diving deeper into the luteal phase. First off, cycles normally range from 21 to 35 days [2]. 

A 28 day cycle is typically used by the scientific community to break down cycle phases, but remember that most women don’t have cycles that last exactly 28 days. The study on Natural Cycles users mentioned above found that the average cycle length was actually 29.3 days [1]. The 28 day timeframe is just an estimate to give you an idea of how the cycle usually progresses.

Here’s what happens during each menstrual cycle phase [3, 4]:

• Menstruation (Day 1 to 7): Your cycle begins on the first day of your period, which typically lasts for up to 7 days per cycle [2].
• Follicular (Day 1 to 14): Technically, this phase includes the menstruation days since it’s defined as all cycle days before ovulation. During this time, the ovaries are working to develop follicles, aka the sacs filled with fluid and egg cells. Levels of the female sex hormone estrogen start to rise, allowing luteinizing hormone to rise as well.
• Ovulation (Day 14 to 15): The follicular phase ends when luteinizing hormone spikes, prompting the release of a fully developed egg cell, a process known as ovulation. This is the beginning of a brief 12 to 24 hour window when the egg cell travels from the ovary through the fallopian tubes to the uterus for potential fertilization by a sperm cell.
• Luteal (Day 15 to 28): This is the post-ovulation phase until the last day of your cycle, which is the day before you begin bleeding again.

What happens during the luteal phase?

After ovulation, luteinizing hormone levels fall, but estrogen remains present. The progesterone hormone also begins to rise, and peaks half-way through the luteal phase [9]. One of progesterone’s main functions is to continue preparing the body for a potential pregnancy if a fertilized egg implants into the uterine lining. It does this in two ways [4]:

1. Further prepares the lining of the uterus, filling it with nutrients for the potential embryo (estrogen helps with this, too)
2. Causes cervical mucus to thicken so that bacteria are less likely to enter the uterus

Progesterone also causes the basal body temperature (BBT) to rise and remain elevated during the luteal phase. If there is no embryo present in the uterine lining, estrogen and progesterone then start to decrease as the luteal phase nears the end, eventually leading to menstruation and the beginning of a new cycle [4, 5].

How long does the luteal phase last?

The luteal phase is one of the most consistent phases of the menstrual cycle with an average duration of 12-14 days for most people who menstruate. Cycle length variability usually comes from variations in the follicular phase, which can last anywhere from 10 to 22 days depending on the timing of ovulation [1]. If you’re using Natural Cycles, we can pinpoint the time of ovulation using BBT to predict your overall cycle length.

An irregular luteal phase, particularly a short luteal phase, is sometimes a sign of a larger diagnosis called luteal phase defect or luteal phase deficiency (LPD) [6]. Some studies have estimated that about a tenth of cycles have luteal phases shorter than 10 days, which is traditionally the indication of LPD. It’s a good idea to mention any cycle irregularities to your healthcare provider, especially if you’re trying to conceive.

How do I know if I am in the luteal phase?

The hormonal fluctuations that occur during the luteal phase can be observed indirectly, and you can look out for:

• A sustained increase in BBT [5]
• Thick vaginal discharge from the changes in cervical mucus
• Progesterone levels in your urine [7]

Using tools like daily body temperature measurement, or by speaking to your healthcare provider about additional testing, you can get a good estimate of where you are in your menstrual cycle timeline.

Luteal phase symptoms

Outside of these indications of the luteal phase, this time also tends to come with some noticeable uncomfortable physical, mental, and emotional symptoms like bloating, headaches, and mood changes. This phenomenon is commonly referred to as premenstrual syndrome (PMS), and unfortunately, scientists still aren’t sure exactly why or how the luteal phase causes PMS symptoms [8]. The leading theory is that it has to do with the drop in hormone levels during the latter part of the luteal phase if embryo implantation hasn’t occurred (i.e., you’re not pregnant!).

In the U.S., about 75% of women experience PMS symptoms, although the severity of the symptoms tends to vary, and it’s common not to experience all of the symptoms at once [8]. But for some, PMS is so severe that daily activities like work, school, or exercise are a struggle. It’s common for PMS symptoms to change over the course of your life, but women in their late 30s and 40s tend to experience worse PMS symptoms as they approach perimenopause. 

The good news is that these symptoms tend to subside within a few days after the start of your period, as  different hormone levels begin to rise again [8]. You can always track your menstrual symptoms with Natural Cycles to see if there are patterns over time.

Some common PMS and luteal phase symptoms to watch for include:

Physical symptoms

• Backache
• Bloating or gas
• Cramping
• Clumsiness
• Headache
• Lower tolerance for noise or light
• Stomach issues like constipation or diarrhea
• Swollen or tender breasts [8]

Mental and emotional symptoms

• Appetite changes
• Cravings
• Depression or bouts of sadness
• Fatigue
• Irritability
• Low libido
• Mood swings
• Sleep problems like insomnia
• Trouble concentrating
• Tension or anxiety [8]

Some women experience a severe form of PMS called premenstrual dysphoric disorder (PMDD) during their luteal phase. In addition to an intense experience of many of the symptoms listed above, PMDD can come with a sense of hopelessness and overwhelm, frequent conflict, a loss of interest in activities you normally enjoy, and even suicidal thoughts [9]. If you’re struggling with these symptoms, help is always available. You can speak with someone at the National Suicide Prevention Hotline here and access resources on their website. 

What separates PMDD from major depressive disorders and other mental health diagnoses is that symptoms usually go away within a few days of starting your period, and then start back up again during the next luteal phase. With that in mind, both PMS and PMDD seem to follow predictable patterns associated with our hormonal cycles, but the exact link between the two is still being explored.

Tips for improving your luteal phase symptoms

While the causes of PMS and PMDD are not well understood, it's thought that certain lifestyle adjustments, supplements, and medications can help ease luteal phase symptoms [8]. We’ll go through some of the most commonly recommended solutions below, but it’s best to consult with your healthcare provider about your medical history and personal needs before making any major health changes.

Lifestyle adjustments

Exercise regularly: Moving your body consistently can help ease symptoms like mood struggles, fatigue, and difficulty concentrating. 

Maintain a healthy diet: Eating plenty of fruits, vegetables, protein, and whole grains can help with a host of health concerns, including some of the struggles associated with the luteal phase. You may want to avoid caffeine (try swapping this out with herbal teas), alcohol, salt, and sugar during the luteal phase if you can, but remember to consult with your healthcare provider about your unique dietary needs.

Get enough sleep: A lack of sleep is linked to mental health struggles, along with luteal phase symptoms like mood issues, headaches, and fatigue, so getting enough sleep can make a difference in those areas.

Avoid smoking: Women who smoke report more frequent and intense PMS symptoms than those who do not.

Explore healthy coping methods: Stress seems to be an underlying factor in how intense PMS symptoms tend to be, so finding ways to cope with stress, like journaling, meditation, yoga, massage, or talking with a trusted friend, can all help. [8, 9]

Vitamins and supplements

While not as regulated as pharmaceutical medications, some women find vitamins or supplements helpful in the management of luteal phase symptoms. Just be sure to consult with your healthcare provider first, as some of these may negatively interact with medications you’re already taking.

Calcium is a well-studied supplement for the reduction and management of PMS symptoms like fatigue, cravings, and mood struggles. It can be taken as a supplement, but it’s also found naturally in dairy products.

Vitamin B6 has been shown to improve PMS symptoms like irritability, bloating, difficulty concentrating, and mood struggles. It’s found in food such as fish, poultry, potatoes, and fruit, but you can also take it as a supplement.

Magnesium has shown mixed results for the treatment of luteal phase symptoms, but it may help relieve headaches. You can add it into your diet with more leafy greens, nuts, or whole grains or take a magnesium supplement.

Omegas (omega-3 and omega-6) have also been studied to help reduce cramping associated with PMS. They’re available as a supplement, or you can find them in nuts, fish, flaxseed, and leafy greens. [8]

Medications and treatments

For the cramping, headaches, and other body aches and pains associated with the luteal phase, you can try over-the-counter painkillers like ibuprofen to dull the pain [9]. Hot water bottles or heat packs can also be a source of pain relief.

Depending on the severity of your symptoms and your unique situation, your healthcare provider might also recommend certain medications in addition to, or instead of, the treatments listed above. They include:

• Hormonal birth control
• Antidepressants or anti-anxiety medicine
• Cognitive behavioral therapy with a specialist [8, 9]

Can you get pregnant if you have sex in the luteal phase of your menstrual cycle?

Yes, you can get pregnant during the luteal phase. Conception would happen right at the start of the luteal phase in the 24 hours after ovulation (technically the first day of the luteal phase) [10]. Conception occurs if the egg cell released during ovulation is fertilized by a sperm cell. The fertilised egg will then develop and eventually implant into the lining of the uterus. This usually happens around 8 to 10 days after ovulation. 

However, it’ll probably still take a few days to a few weeks for pregnancy tests to detect the pregnancy. It’s generally recommended to wait until the first day of your missed period (what would usually be cycle day 1) to take a pregnancy test.

So although conception happens on the first day of the luteal phase, the probability to conceive is highest when you have sex during the two days before ovulation [10]. If you have intercourse later in the luteal phase after ovulation it will likely not lead to pregnancy (less than 1% chance). It’s important to keep in mind that if you ovulate later than expected without realizing, you are at risk of pregnancy. 

Learn more about your menstrual cycle with Natural Cycles

We know that there is a ton of information out there about the luteal phase of your menstrual cycle. It can be tough to parse through and figure out what is most relevant to you, but we hope this guide to the luteal phase has given you some insight into what’s happening in your body and a few ways you can manage luteal phase symptoms. For more information and resources about your period, pregnancy, and beyond, find out how Natural Cycles can support you.