How To Survive Your Luteal Phase

You can't stop your luteal phase, but you can stop fighting it. I feel like the question we are all asking at the moment is: How Can I Make My Luteal Phase More Bearable? Whether it's eating more, changing your exercise routine, creating more boundaries or just understanding your cycle - there is a lot we can learn about this misunderstood phase. Dr Rachel is diving into the best evidence-based tips to not just survive, but thrive in your luteal phase.

What's Actually Happening In The Luteal Phase?

To understand why you might be feeling less like yourself, we need to understand the biology of the luteal phase. The luteal phase is the second half of your cycle, it is roughly 10-14 days in length and comes just before your period. It is known as the secretory phase as the lining of the womb secretes or releases many chemicals as it prepares for a potential implantation (a fertilised egg attaching itself to the womb lining).

The luteal phase is governed by the hormone progesterone, which you can learn more about in this article. Progesterone is responsible for skin, heart, breast and uterine health as well as mood, sleep and energy levels, its role here is to prepare the body for a potential pregnancy.

For naturally cycling women (i.e. those who are not on hormonal contraception and have not reached menopause yet), every month there is a rise and fall in progesterone during the luteal phase. This rising progesterone been found to be highly protective of our brain, spinal cord and nervous system, displaying the importance of our natural hormonal rhythms and our luteal phase. To learn about the phases of the cycle in more depth - check out our Menstrual Cycle: Unpacking The Four Phases article.

What To Expect Physically In The Luteal Phase

During the luteal phase, a lot of physical changes across the female body occur. Some changes are normal and are to be expected, as we know that there are around 200 proteins that change throughout the menstrual cycle. Our mood, hunger, energy levels, fear perception, gut motility, water retention, self-confidence and self-image are all  found to differ across the month, as well as many other metrics. 

Some common symptoms that are experienced during this phase:

• More introspective or reflective nature: wanting to be alone, less interested in social engagements, reflecting back on the last few weeks and analysing your relationship, friendships and how you've been feeling.
• Feeling more relaxed or sleepier: as progesterone rises, we feel its brain-boosting benefits. 
• Heightened emotional sensitivity: perhaps you feel less patient than usual, or you feel irritated by things which normally wouldn't bother you.
• Feeling hungrier: during the luteal phase, our metabolic rate increases and we actually need around 150 extra calories a day to feel satiated.
• The arrival of Premenstrual Syndrome (PMS): tender breasts, headaches, mood changes as described above, bloating or digestive issues etc. Over 90% of women will experience some form of PMS at some stage in their life, but it's important to note that PMS that disrupts your life is not normal and should be investigated. 

Why You're Not Thriving In The Luteal Phase

The most important thing to say is that in our current world, where we are overworked, stressed out and spending less and less time in nature, nobody is really thriving in the way we should be. Women have more freedom, knowledge and power around their own bodies now, yes, but as our world heats up and women take on more professional responsibilities whilst managing childcare and often caring for elderly parents - it is argued that our bodies are under more stress than ever before.

Through an evolutionary lens, the luteal phase is a time in which we prune our lives, check the status of our relationships and are more sensitive to threats around us; this is so that we ensure we are in the best social situation to support a pregnancy and then raise an infant. Our world has more threats in it now than ever before and the mental health of our global population is statistically worse, meaning that many women are struggling with existing anxiety or mental health problems which can worsen in the luteal phase (this is known as Premenstrual Exacerbation or PME, more on this below).

Some reasons you might not be feeling your best:

• You're not eating enough. During the luteal phase, your metabolic rate can rise between 7 and 11%, meaning you need to consume anywhere from 100 to 150 calories extra each day just to meet your energy needs. If you're hungry, this is likely to worsen your mood, drain your energy and make you feel less productive.
• You're not exercising enough. Social media tells us that we need to rest during our luteal phase, but this shouldn't be interpreted that we need to stop exercising. Exercise is a natural, brilliant source of dopamine - supporting your mood and energy levels. It helps you to maintain your routine and helps you to sleep better when progesterone drops at the end of the cycle.
• You're not addressing the stressors in your life. If your job, relationship, family members or friends are repeatedly violating your boundaries, making you feel stressed, unsafe or undervalued - this is likely to be contributing to your mood and this can come up during the luteal phase.
• Your diet is full of pro-inflammatory foods that irritate your gut. Your gut lining is one cell thick, meaning that any damage to it allows pathogens to pass into your bloodstream and wreak havoc in your body. This is known as leaky gut, which can cause high levels of inflammation in the body and worsen symptoms in the luteal phase.
• Your sleep hygiene isn't what it should be. If you're on your phone until 2am watching TikTok, if you wake up exhausted, if your bedroom doesn't feel like a place your nervous system can actually relax or if you're always going to bed and waking up at different times - your sleep is disrupted and this has a direct impact on how well you can cope with hormonal changes.*
• You might have PMDD. If you have PMDD, then research is beginning to show us that there are structural changes in your brain which mean you respond differently to the hormonal changes across your menstrual cycle. 1 in 20 women are suspected to have PMDD, so you aren't alone in this - scroll down for more info.
• Your hormonal contraception is making your moods worse. If you're taking hormones, it is worth considering that they are contributing to worsening mood.
• You aren't consuming enough Vitamin B6. One study found that consuming Vitamin B6 was the most efficient way of improving PMS symptoms! Vitamin B6 is found in beef, chicken, bananas, potatoes, avocados, tuna and eggs.
• You aren't consuming enough Magnesium. Women are likely to be deficient in magnesium than men. It supports so many of our functions (sleep, mood, nervous system regulation - all of which matter in our luteal phase management).

*Progesterone is supportive of sleep, which is why in our luteal phase we can sometimes feel sleepier or we want to nap more. But when progesterone drops at the end of the luteal phase, it can disrupt our sleep and leave us feeling more tired in the days leading up to our period. 

Why Is My Anxiety Worse In The Luteal Phase?

Premenstrual exacerbation is the worsening, or intensifying, of symptoms of an existing condition such as depression, anxiety, OCD or bipolar, during the luteal phase. PME appears to be highly prevalent, affecting 50-60% of individuals with existing mood disorders. PME and PMDD can be difficult to tell apart.

What You Can Do To Support Yourself In The Luteal Phase

As well as addressing the issues above as a way of supporting your luteal phase, what I recommend is getting to know yourself, your menstrual health and your cycle. Yes, I'm telling you to track your cycle again (because it works!). This helps to explain what is happening to you at each point in the month and you can set some boundaries for yourself and others to support you through this.

Some practical tips for surviving your luteal phase:

• Herbal support. Calendula gently supports lymphatic movement and tissue healing, St John's Wort supports low mood and nervous system health, Lemon Balm calms anxiety levels and supports digestion and Rosehip is rich in Vitamin C and antioxidants.
• Journal prompts and brain dumps to get your thoughts out of your head and onto paper. Before you go to bed every night, write everything that's worrying you or that's in your mind onto a notebook page, close the book and put it away before you sleep.
• Breathwork. Learning 2-3 breathwork techniques can really support you in moments of overwhelm in the day and help to calm your nervous system before bed or when you wake up.
• Intentional movement that feels good FOR YOU. If you feel like running, power lifting, yoga, climbing - any exercise that's calling you during your luteal phase - do it. As long as you aren't pushing yourself too far or to exhaustion, moving your body supports somatic release of emotions and is a brilliant way to move through 
• Joining communities or attending a women's circle. If you've never sat in a women's circle, I highly highly recommend it. It's an opportunity to share what is troubling you, w
• Crafting! Using both of your hands means that you spend much less time on your phone. Knitting, drawing, collaging, crochet, woodwork, embroidery or just being immersed in something which means you spend less time in front of a screen and more time resetting your nervous system.
• Walking after meals, every single time. A 5-10 minute walk after your meals supports digestion and will help you sleep better and move more.
• Taking yourself on a date every month. Whether this is a coffee date, a solo hike, a new class or just going to the park and journalling - the most important relationship you will ever have is the one with yourself, so work hard on it.

What's Happening in Premenstrual Dysphoric Disorder?

PMDD is a complex condition that is only just beginning to gain the attention it deserves in medical practice and research. PMDD is characterised by debilitating emotional, cognitive and physical symptoms that appear 7 and 10 days before your period, during the luteal phase of your menstrual cycle, and disappear a few days after menstruation begins. 

PMDD can make you feel like a completely different person. To understand more about it, we recommend reading the following two articles on the Lena blog:

• Hormones: What They Do, How They Work and How To Harness Their Power. Scroll down to the section which discusses PMDD and progesterone.
• Understanding Premenstrual Dysphoric Disorder (PMDD).

I hope you've enjoyed this article and have taken away some practical tips. If you'd like to work with me one on one, I'd love to support you! Please get in touch via the link below, or find my page @rachskitchensync_ on Instagram. I want you to thrive, and I'll help you get there.

Written and edited by Dr Rachel Denham, a trained medic and Women's Health Practitioner, who has worked across the charity and humanitarian sector and now specialises in women's health. Rachel is the creator of Bloody Nora, a women's health and wellbeing zine that fuses storytelling, art and science.