From the Guidelines
Checking for late luteal (LL) phase is crucial in women with acute hepatic porphyrias (AHP) to identify and prevent cyclic attacks related to the menstrual cycle, which typically occur during the luteal phase when progesterone levels are highest. These cyclic attacks can be prevented by recognizing and removing exacerbating factors, using a gonadotropin-releasing-hormone (GnRH) analogue, switching to a low-dose hormonal contraceptive, or administering prophylactic hemin infusions 1. Measuring serum progesterone at the onset of symptoms is useful for identifying luteal phase and potentially progesterone-induced attacks. Some key points to consider when checking for late luteal phase include:
- Cyclic attacks in AHP are often related to the menstrual cycle, specifically the luteal phase
- Progesterone levels are typically highest during the luteal phase, which can trigger attacks
- GnRH analogues can be used to prevent ovulation and corpus luteum formation, thereby preventing cyclic attacks
- Low-dose hormonal contraceptives may also be effective in preventing cyclic attacks
- Prophylactic hemin infusions can be used to prevent recurrent attacks, including those related to the menstrual cycle 1. It is essential to individualize management and consider the patient's specific needs and circumstances when checking for late luteal phase and preventing cyclic attacks in AHP.
From the Research
Checking for Late Luteal (LL) Phase
There are no research papers provided to assist in answering this question, as the studies available are related to chronic kidney disease, diabetic nephropathy, and the role of angiotensin receptor blockers, but do not mention the late luteal phase.