Recurrent miscarriage is often due to insufficient levels of progesterone during the luteal phase (second half) of the menstrual cycle. Prior to implantation, the corpus luteum provides progesterone necessary to nourish the uterine lining, and this lining is incredibly important to the developing embryo.
Fertility Awareness Methods might seem new, but most of them have been on the scenes since the 1970s. The Creighton Model, developed by Dr. Thomas Hlgers and his team at St. Louis University School of Medicine is perhaps the most revolutionary of these Fertility Awareness Methods (FAMs).
Dr. Hilgers team didn't stop at developing the Creighton Model, in fact, this research team's revolutionized women's health with their development of NaProTECHNOLOGY, and it's their focus on women's health and reproduction that has helped bring about key insights into how dysregulated progesterone levels show up as luteal phase deficiencies (LPDs).
The Role of Progesterone in Healthy Pregnancy
Progesterone is often referred to as the "pregnancy hormone" because it is at its highest throughout pregnancy. Progesterone prepares the uterine lining for implantation and supports the early stages of pregnancy. This hormone shows up during the second half of the menstrual cycle (being produced by the corpus luteum, the leftover follicular shell that held this cycle's egg) to support the uterine lining before the placenta develops.
When that corpus luteum isn't well formed, progesterone isn't secreted as necessary to support the uterine lining until implantation occurs. NaPRO has well characterized four different types of luteal phase deficiencies (LPDs) and has identified a fifth type.
Any of these LPDs increases the risk of miscarriage and is most commonly suspected in cases of recurrent miscarriage.
Luteal Phase Deficiencies: A Closer Look
The luteal phase is the second half of the menstrual cycle, beginning after ovulation and ending with the start of menstruation. A deficiency in this phase can manifest in several ways, as identified through the NaProTECHNOLOGY and the Creighton Model:
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Insufficient Progesterone Production (Type 1 LPD): This type occurs when the corpus luteum, the temporary gland formed after ovulation, fails to produce enough progesterone. This can result in a luteal phase that is shorter than the optimal length of 12-14 days, leading to early miscarriage.
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Delayed Progesterone Rise (Type 2 LPD): In some cases, progesterone levels may rise to an adequate level but do so too slowly after ovulation. This delay can impair the proper preparation of the uterine lining for implantation.
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Premature Progesterone Drop (Type 3 LPD): A premature decline in progesterone levels before the end of the luteal phase can disrupt the support needed for the developing embryo, increasing the risk of miscarriage.
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Erratic Progesterone Levels (Type 4 LPD): Fluctuating progesterone levels throughout the luteal phase can create an unstable environment for pregnancy, contributing to recurrent miscarriages.
Addressing Luteal Phase Deficiencies
NaProTECHNOLOGY and the Creighton Model FertilityCare System offer a data-driven approach to identifying and treating luteal phase deficiencies. By charting menstrual cycles and monitoring biomarkers, women can work with NaPRO healthcare professionals to pinpoint the type of deficiency they may have and explore treatment options.
It is important to note that NaPRO practitioners aren't your standard run of the mill OBs. These are practitioners very educated in the ways of NaPRO. It's equally important to mention that this particular healthcare modality is strongly associated with Catholicism. Dr. Hilgers is a devout Catholic (and ultimately these convictions led him to develop the Creighton Model and NaPRO).
In my research, there is no secular equivalent to NaPRO. In my own opinion, seeking to resolve the underlying reason for any type of LPD is best done with a NaPRO practitioner, and because my approach is health first always, resolving an LPD regardless of your intention for pregnancy is worthwhile.
For many women who are interested in carrying a pregnancy to term (and not necessarily interested in resolving the LPD), prescribing progesterone is a common treatment method for women with a history of recurrent miscarriage.
Next steps to support healthy progesterone levels
If you have a history of recurrent miscarriage (or a known luteal phase deficiency), find more on NaPRO here.
If you're concerned your progesterone (or estrogen) levels may be off and want to take control of your menstrual cycle, I'm your girl! Reach out to me at hey@feelbetterthanfine.com for more about my program Reflected in Red.
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