At a glance
- The luteal phase is the second half of your cycle, from ovulation to your period, usually lasting 10 to 16 days.
- Progesterone and estrogen both rise then fall during the luteal phase, and that drop is linked to PMS and PMDD symptoms.
- PMS symptoms ease once your period starts. PMDD needs five symptoms, including a mood one, confirmed over two cycles.
- SSRIs taken only in the luteal phase have helped in several placebo-controlled trials.
- PMDD comes from a different reaction to normal luteal-phase hormone changes, not from abnormal hormone levels.
What is the luteal phase?
The luteal phase is the second half of your menstrual cycle, starting right after ovulation and ending the day your period begins. It usually lasts 10 to 16 days, though it's shorter for some women. This stage is also called the secretory phase, because the lining of your uterus secretes nutrients to prepare for a possible pregnancy.
Here's what happens during the luteal phase:
- After an egg releases, the empty follicle becomes the corpus luteum, a temporary gland that makes progesterone and some estrogen.
- The corpus luteum supports the uterine lining in case you conceive.
- If you don't conceive, the corpus luteum breaks down about 10 to 14 days later, and progesterone and estrogen both fall.
- That drop triggers your period, and it's also what sets off PMS and PMDD symptoms in the days before bleeding starts.
Read more about the luteal phase and what's happening in your body and mood, or the gland itself in corpus luteum: what it means.
How does the luteal phase relate to PMS and PMDD?
Both PMS and PMDD happen in the luteal phase, in the one to two weeks before your period. The timing is the same. What differs is how many symptoms show up and how much they affect your life.
| Condition | Timing in the cycle | Core feature |
|---|---|---|
| PMS | Last 1 to 2 weeks of the luteal phase | Physical or emotional symptoms that ease once your period starts |
| PMDD | Last week of the luteal phase | At least five symptoms, including one mood symptom, confirmed over two cycles |
| Premenstrual exacerbation | All month, worse in the luteal phase | An existing condition, like depression, that flares before your period |
PMDD isn't caused by abnormal hormone levels. People with PMDD seem to react differently to the normal rise and fall of progesterone and estrogen in the luteal phase than people without it (Schmidt et al., 1998). For more on this, see what causes PMDD and PMDD, explained.
What does the research say about the luteal phase?
Researchers have measured several things that shift during the luteal phase, beyond progesterone and estrogen. A meta-analysis of 778 women found cortisol, the main stress hormone, runs lower in the luteal phase than in the follicular phase (Hedges' g = 0.13, p < 0.01) [1].
One trial tested dutasteride, a drug that blocks the luteal-phase rise in allopregnanolone, a calming brain chemical made from progesterone. At a high dose, it reduced irritability, sadness, and anxiety in women with PMDD, while a lower dose showed no measurable effect [2]. Read more in allopregnanolone: what it means.
Several randomized trials have tested SSRIs taken only during the luteal phase:
- Fluoxetine helped nine of ten women with luteal-phase symptoms respond, against two of ten on placebo [5].
- Sertraline showed a similar luteal-phase-only benefit in a separate trial [3].
- Citalopram showed a similar luteal-phase-only benefit in another trial [4].
Together, these trials point to the luteal phase as the window where treatment timing matters most.
Why does the luteal phase matter for treatment or coping?
Knowing you're in the luteal phase explains the timing of what you feel, not the intensity. Guidelines recommend a few options for PMDD, and a doctor decides what fits your history:
- SSRIs, sometimes taken only in the luteal phase.
- Certain hormonal contraceptives.
- CBT.
The luteal phase itself can't be lengthened or skipped, but understanding its rhythm can make the days before your period feel less random.
If this takes up a week of every month, or you have thoughts of hurting yourself, see a GP or gynecologist and bring two months of daily notes.
Niyora is a PMS and PMDD support app that gives you an estimated PMS window and helps you calm down, see a fight from another angle, and draft a reply before you send it.
To see how the whole cycle fits together, read menstrual cycle hormones, phase by phase.
Questions people ask
How long does the luteal phase last?+
The luteal phase usually lasts 10 to 16 days, running from ovulation to the start of your period. It's the half of your cycle where progesterone rises then falls if you don't conceive, and that fall is linked to PMS and PMDD symptoms in the days before bleeding.
Is the luteal phase the same as PMS?+
No. The luteal phase is a stage of your menstrual cycle, and PMS is a set of symptoms that can happen during it. PMS symptoms show up in the one to two weeks before your period and ease once bleeding starts, inside the luteal phase's second half.
What causes luteal phase symptoms?+
Luteal phase symptoms come from the fall in progesterone and estrogen after the corpus luteum breaks down, usually 10 to 14 days after ovulation. People with PMDD seem to react differently to this normal drop than people without it, not to having abnormal hormone levels (Schmidt et al., 1998).
Can you shorten the luteal phase?+
There's no way to shorten the luteal phase itself, but SSRIs taken only during it, some hormonal contraceptives, and CBT can ease PMDD symptoms within it, according to clinical guidelines. A doctor can help you decide which option fits your symptoms and history.
Sources
- 1.Higher Circulating Cortisol in the Follicular vs. Luteal Phase of the Menstrual Cycle: A Meta-Analysis, Frontiers in endocrinology, 2020
- 2.5α-Reductase Inhibition Prevents the Luteal Phase Increase in Plasma Allopregnanolone Levels and Mitigates Symptoms in Women with Premenstrual Dysphoric Disorder, Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 2016
- 3.Citalopram in premenstrual dysphoria: is intermittent treatment during luteal phases more effective than continuous medication throughout the menstrual cycle?, Journal of clinical psychopharmacology, 1998
- 4.Treatment of premenstrual dysphoric disorder with sertraline during the luteal phase: a randomized, double-blind, placebo-controlled crossover trial, The Journal of clinical psychiatry, 1998
- 5.Fluoxetine in the treatment of late luteal phase dysphoric disorder, The Journal of clinical psychiatry, 1991