How Your Period Changes After Pregnancy

For one thing, your flow may be different.

Pregnancy brings about numerous transformative changes in a woman’s body, and one of the most notable changes is the alteration of the menstrual cycle. During pregnancy, the menstrual bleeding ceases for a significant duration, which can extend further depending on various factors, including breastfeeding habits.

The resumption of your menstrual cycle after pregnancy is a subject of curiosity and concern for many new mothers. Let’s delve into what you can expect in terms of ovulation and menstrual bleeding post-pregnancy, with a focus on the influence of breastfeeding.

The Return of Your Period After Pregnancy

The timing of the return of your menstrual periods following childbirth is contingent on whether or not you are breastfeeding. Understanding the dynamics of ovulation and menstrual bleeding after pregnancy is crucial for managing your reproductive health.

If You Are Breastfeeding:

When individuals give birth, their bodies produce the hormone prolactin, which plays a pivotal role in directing the milk glands to produce milk after delivery. Prolactin levels remain elevated as long as a person continues to breastfeed, and this hormone has the effect of suppressing ovulation. In essence, if you do not ovulate, you will not experience menstruation.

Dr. John Thoppil, an OB-GYN based in Austin, Texas, explains that prolactin “suppresses the pulse-like release in brain hormones that orchestrate ovulation.” Therefore, if you are exclusively breastfeeding, it is highly likely that your period will remain absent. On average, you can anticipate the return of your period between six and nine months postpartum.

Breastfeeding can serve as an effective method of birth control under specific conditions. This method, known as the lactation amenorrhea method (LAM), is considered reliable if you meet the following criteria:

• You are not experiencing any menstrual bleeding after giving birth.
• You are fully or nearly fully breastfeeding.
• You are less than six months postpartum.

It’s important to note that LAM carries a 2% risk of pregnancy, so it is not foolproof. Dr. Mary Jane Minkin, a clinical professor of obstetrics and gynecology at Yale University School of Medicine, suggests that some women may not resume their periods until six months after completely weaning their baby. If your period does not return within six months of weaning, it is advisable to consult a healthcare provider. While it is often normal to experience delayed periods under such circumstances, a healthcare provider can provide reassurance and guidance.

If You Are Not Breastfeeding:

In contrast to breastfeeding mothers, ovulation can occur as early as four weeks postpartum for those who are not breastfeeding. However, it is typically recommended to abstain from sexual intercourse during this initial postpartum period. Dr. Thoppil emphasizes that abstaining from sex during the weeks following childbirth allows ample time for the body to heal after delivery.

For non-breastfeeding individuals postpartum, ovulation can occur as early as 25 days postpartum. Nevertheless, fertile ovulation is less likely to occur until at least 42 days postpartum.

What Will Periods Look Like Postpartum?

The return of menstruation postpartum can bring about various changes in terms of flow, duration, and pain. These changes may differ from your pre-pregnancy menstrual experiences.

For some postpartum individuals, periods may become heavier, longer, or more painful than before. This change is often attributed to the expansion of the uterine cavity after childbirth, which results in more endometrial tissue to be shed. Dr. Thoppil explains that the uterus can enlarge post-pregnancy, leading to increased shedding of the uterine lining.

On the other hand, some individuals may experience lighter periods or even an absence of periods altogether. Two rare complications, Sheehan’s and Asherman’s syndrome, can lead to such outcomes. Sheehan’s syndrome occurs when severe blood loss or low blood pressure damages the pituitary gland, impacting hormone production. Asherman’s syndrome results from scar tissue forming in the uterine lining, potentially affecting the menstrual cycle.

It’s essential to recognize that pregnancy is not the sole factor that can influence changes in your menstrual cycle. Factors such as changes in birth control methods can also affect menstrual flow. For instance, if you switch to a different form of birth control, like an intrauterine device (IUD) or birth control pills, you may notice alterations in your menstrual cycle. Similarly, if you are not using a hormonal method, such as when your partner undergoes a vasectomy or you rely on condoms, your period may differ from when you were on hormonal birth control.

Moreover, menstrual changes can also be influenced by age. Dr. Thoppil notes that as individuals age, some may experience less severe menstrual cramps. Dr. Minkin adds that managing menstrual cramps may become a different challenge when you have a baby to care for.

Can I Get Pregnant Before My Period Resumes?

Yes, it is indeed possible to conceive before your regular menstrual bleeding resumes. Ovulation can occur before the first postpartum period, catching some women by surprise.

Dr. Minkin emphasizes that “some women can get pregnant immediately, even with exclusive breastfeeding.” This is because ovulation can take place before the return of the first postpartum period, rendering individuals fertile without them being aware of it. Some healthcare providers have encountered cases where parents visit their six-week postpartum checkup only to discover that they are already pregnant again.

To prevent unintended pregnancies with short gaps between children, it is advisable to discuss birth control options with an OB-GYN ideally before giving birth. Planning ahead and selecting a suitable birth control method can be a wise and proactive approach. Some birth control methods, such as progesterone injections, can be administered before leaving the hospital after childbirth. Dr. Minkin points out that progesterone injections are safe for breastfeeding and provide contraception for approximately three months.

A Quick Review

In summary, the return of your menstrual period post-pregnancy can vary widely, especially when breastfeeding is involved. While it may take up to nine months for menstruation to resume, the experience may differ significantly from your pre-pregnancy periods. Some individuals may find that their periods become more manageable, while others may experience changes in flow, duration, or pain.

It’s crucial to remember that factors beyond pregnancy, such as birth control methods, age, and underlying medical conditions, can also influence your menstrual cycle. Additionally, the possibility of conceiving before your period returns highlights the importance of discussing and implementing suitable birth control measures with a healthcare provider.

If you have any questions or concerns about how pregnancy and postpartum may affect your menstrual cycle, do not hesitate to reach out to a healthcare provider. Open communication with a healthcare professional can provide valuable insights and guidance to help you navigate this unique phase of your reproductive journey.