Change in periods after pregnancy

First postpartum period: What to expect

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It is common for a woman’s period to change after having a baby. Some women experience heavier or more painful periods, while others find that their periods become easier.

In the months after giving birth, periods may be irregular but may return to normal over time. There is no way to predict how giving birth will affect a person’s period, but women who breastfeed typically go longer without having a period.

In this article, learn more about what to expect from the first postpartum period.

Having a baby is a major trauma for a woman’s body, and it takes time to recover. There is no such thing as a “standard” postpartum period, but it is common for the first few periods to be different from how they were before pregnancy.

There are many reasons why periods may change after childbirth, including:

the uterus taking time to return to its normal size
hormone levels shifting
breastfeeding affecting hormone levels

Some women notice that their periods are heavier after childbirth. Others find that the blood is a different color, that there are more clots than usual, or that cramps are more intense.

According to Cleveland Clinic doctor Diane Young, most women will notice their period returns to their personal “normal” over time, meaning however it was before pregnancy.

When will it arrive?

Among women who do not breastfeed or who breastfeed on an irregular schedule, menstruation tends to return more quickly.

A 2011 analysis of six previous studies found that most women got their first periods between 45 and 94 days after giving birth. One study in the review found that the average first period happened at 74 days postpartum.

The main factor affecting the timing of the first postpartum period is ovulation. Women who want to check whether they are ovulating can try using an ovulation predictor kit (OPK), which are available in pharmacies and online.

Measuring basal body temperature every day can also help detect ovulation.

Irregular postpartum periods

Especially in the months immediately after giving birth, it is common to have irregular periods. Women who are breastfeeding are more likely to notice irregular periods, as the hormones that support breastfeeding can cause the body to delay ovulation or ovulate infrequently.

Even in women who are not breastfeeding, periods may be irregular, as the body takes time to recover from pregnancy and childbirth.

Over time, menstruation will return to its usual pattern. However, some women may have had irregular periods before pregnancy, such as those with polycystic ovary syndrome (PCOS) or endometriosis.

If a woman is concerned about irregular postpartum periods, it is best that they speak to a doctor to find the underlying cause.

Lochia is the discharge from the vagina after giving birth. It begins as heavy bleeding and may be dark red and full of clots.

Over several days or weeks, the bleeding gets lighter, eventually turning pink, brown, and clear.

It is common for women to experience some cramps when passing lochia because the uterus is contracting as it returns to its usual size.

Lochia is not a period. It is a sign that the body is still recovering from giving birth, as the uterus sheds the lining that supported the pregnancy.

A 2012 review found that lochia bleeding lasted from 24 to 36 days. However, only one study followed participants until bleeding had stopped, meaning that postpartum bleeding continues for at least 3 to 5 weeks, but possibly longer.

It is possible to mistake lochia for a period or to think a period is lochia. While both lochia and menstruation begin with bright red blood, lochia tends to get lighter in color as the days pass, while the blood from a period darkens over time.

Women who are breastfeeding may not have a postpartum period for many months because breastfeeding often prevents ovulation and subsequent menstruation.

Some women treat breastfeeding as a birth control method. But a 2015 Cochrane Review of previous research found that 11.1 to 39.4 percent of women who were breastfeeding had at least one period within 6 months of giving birth.

It is safe to begin using some forms of birth control immediately after childbirth. Doctors usually recommend waiting several weeks or longer before starting combination pills, however.

Women who want to avoid hormonal birth control can consider condoms, diaphragms, the non-hormonal intrauterine devices (IUD), or fertility monitoring methods.

Hormonal birth controls may help regulate postpartum periods. These methods include pills containing estrogen and progestins, or only progestin, as well as the hormonal IUDs, injections, or implants.

Some birth control options can stop a woman’s period or cause less frequent periods. A doctor may recommend these options for women who experience very heavy or painful periods.

Women who are breastfeeding may worry about the effects of birth control on the baby or their ability to produce breast milk.

A 2012 study compared two different types of birth control — combined pills and progestin-only pills — and did not find significant differences in breastfeeding patterns or milk production.

While hormonal birth control is safe to use while breastfeeding, it is still essential for a woman to talk to a doctor about any new medication she may be about to begin.

After a woman has given birth, the doctor or midwife should offer advice about warning signs of a problem. Normal bleeding patterns vary, depending on the birthing method, a woman’s medical history, and other individual factors.

A person should see a doctor immediately for:

very heavy bleeding that soaks through more than a pad per hour for longer than 2 hours
bleeding that occurs with a fever
intense cramping
clots larger than a golf ball

A person should also arrange to see their doctor for unusual bleeding, very painful periods, or for questions about irregular periods.

The first postpartum period may be heavier and more painful than those before pregnancy, or it may be lighter and easier.

Some women have their first postpartum period shortly after lochia, while others may wait many months, especially if they are breastfeeding.

When changes in a woman’s period are painful or otherwise troubling, it is best to speak to a doctor, who can help relieve the symptoms.

Will my period change after pregnancy? | Your Pregnancy Matters

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Your Pregnancy Matters

October 12, 2021

Your Pregnancy Matters

Shivani Patel, M. D. Obstetrics and Gynecology

Childbirth changes most new moms’ menstrual cycles – but it varies for everyone.

Many new moms are surprised by how much they bleed after having a baby. For two to three weeks after a vaginal or cesarean section (C-section) delivery, they experience what looks like a heavy period. This is called lochia, a mix of blood and uterine tissue the body doesn’t need after pregnancy.

Like a period, it typically starts heavy and becomes lighter over time, eventually ending with some spotting. The color will transition from dark red to brownish-pink to off-white. However, you are not ovulating regularly yet – releasing eggs from your ovaries – so lochia isn’t a true menstrual period.

Cramping further blurs the line between lochia and menstrual bleeding. Your uterus expands several times its size to keep up with the growth of your baby; after birth, it shrinks back down. The muscle contractions from this process feel similar to period cramps.

Caring for a newborn will consume most of your attention, but be sure to monitor the amount of blood you’re losing during the first few weeks after delivery. Up to 5% of patients experience uncontrolled bleeding, or postpartum hemorrhage, a condition accompanied by symptoms such as low blood pressure, pale skin, and nausea.

If your blood loss seems excessive, see your provider right away. After lochia ends, the timing, flow, and duration of every woman’s period varies, but enough similarities exist to answer common questions about postpartum menstruation.

When should I expect my first period after pregnancy?

Your first period can come anytime between two and 12 weeks after delivery. For most women, it happens between six and 12 weeks.

If you exclusively breastfeed, your period will likely be delayed until you give your baby solid food and other forms of milk. As your levels of prolactin – the hormone that helps your body produce milk – increase, your levels of estrogen and progesterone decrease. These hormones help regulate your period; lower levels reduce the likelihood of ovulation and menstruation.

While you are experiencing lochia, your flow will act like a typical period: starting heavier, then gradually getting lighter. However, if the amount of blood increases after a few lighter days, consider slowing down your activity level for a few days so your body can rest and heal from childbirth.

Related reading: The ‘fourth trimester’: Why women need health care after delivery

Will my period look or feel different?

Most women can expect their first couple of periods after giving birth to be heavier than those they experienced before pregnancy. Menstrual blood should look like you expect: a bright red that fades into a darker, brownish red. You may see small clots the first time but should not see large clots (the size of a plum or golf ball). If you do, alert your provider.

Some research has shown that C-section scarring can increase period pain as well as flow. In general, postpartum period symptoms will be similar to pre-pregnancy symptoms, so if you used to have cramps, they likely will resume. However, some patients say their period pain improves after pregnancy.

Related reading: What’s going on with my uterus? 3 conditions related to pelvic pain and bleeding

How regular will my menstrual cycle be?

Your period can take up to a year to become regular, no matter how consistent it was before pregnancy. To develop, grow, and deliver a baby, your body experiences several hormonal changes, and it needs time to return to normal.

Breastfeeding moms are even more likely to have an irregular menstrual cycle. When you breastfeed, you have lower levels of estrogen in your body – a hormone that fluctuates with your period. Without normal estrogen fluctuation, you won’t have normal periods.

Whether or not you breastfeed, don’t be alarmed if your second period is late – unless you’ve recently had unprotected sex.

You may associate post-traumatic stress disorder with survivors of assault, war, or natural disasters. But as maternal-fetal specialist Dr. Shivani Patel will tell you, symptoms of PTSD can weigh heavy on moms who had complex pregnancies. She knows from personal experience.

Learn more

Preventing postpartum pregnancy

If you have sex without a reliable form of birth control, you can get pregnant – even in the first few weeks after giving birth. The majority of pregnancies that occur less than a year after a previous birth are unplanned.

You will start ovulating between delivery and your first period – up to six weeks after birth, which is typically the same amount of time we recommend you wait to have sex.

Related reading: Birth control after childbirth: Long-term options for new moms

Research-based recommendations suggest spacing pregnancies by at least 12 to 18 months. Postpartum pregnancy can prevent your body from fully healing from childbirth and put your baby at risk of premature birth and infant mortality. A CDC study also found that a shorter time period between births is linked to autism spectrum disorder.

Risks vary based on your age. So, if you want to get pregnant again soon after giving birth, work with your doctor to develop a safe plan that is specific to your situation.

Postpartum bleeding can be confusing. We’re here to provide clarity. To visit with an Ob/Gyn, call 214-645-8300 or request an appointment online.

About menstruation after childbirth | Clinic.kg

Menstruation after childbirth

30 June 2019

A healthy pregnancy and delivery of a healthy baby is a reason for a woman to be proud of herself and her health. An important topic that worries many women after childbirth is menstruation: when to expect it, why the cycle is irregular, is it possible to get pregnant while breastfeeding, and much more. We will analyze the main issues in our article.

Postpartum discharge

Postpartum profuse discharge in a woman has nothing to do with menstruation - these are lochia, which from bloody become sanious, and then transparent, completely disappearing. After about two months, the uterus and ovaries return to their physiological state and size, which means that the onset of menstrual cycles with the maturation of eggs and menstruation is quite possible. Thus, a woman can expect her first menstruation from the 2-3rd month after childbirth.

When should my period start after childbirth?

This period depends on the type of feeding of the child: natural or artificial. Breast milk is produced under the influence of the pituitary hormone prolactin. The level of estrogen does not increase, therefore, when breastfeeding, menstruation begins, on average, 2 months after childbirth, more often when feeding “by the hour”. But there are times when some nursing women do not have periods for a year, and for some, they can recover in a month and a half after childbirth. On average, the onset of menstruation with breastfeeding varies from 3 months to six months.

How long do periods last after childbirth?

Often the first menstruation is quite heavy. There may be strong discharge, menstruation with blood clots. If you have to change the pad every hour, you should seek help from a doctor: this may be a symptom of bleeding that has begun. Subsequent periods usually become normal. In other cases, in the first months, women have irregular spotting. This is typical for breastfeeding, when prolactin synthesis gradually decreases.

Reasons for the slow recovery of the regular cycle

Each woman has her own individual period for the restoration of the menstrual cycle. This is determined by the activity of the production of hormones of the sex glands, the pituitary gland, the state of the immune and reproductive systems as a whole. There are a number of reasons for this that affect the body in the postpartum period:

features of the individual hormonal background;
hereditary factors;
the nature of the birth process;
features of the restoration of the uterus.

What to do if the menstrual cycle has become irregular:

In the first months of the postpartum recovery period, do not panic. In most cases, this is the norm. For each woman, the normalization of the cycle occurs individually, usually during the first months of the resumption of menstrual bleeding. Irregularity is more common in nursing mothers.

It takes about 2 months to restore the normal function of all organs and systems. Balance in the endocrine system comes later, especially if breastfeeding is used. Therefore, a woman can feel completely healthy, but she will not have a period.

Notice the irregular cycle only after 3 cycles. This may be due to an inflammatory process, endometriosis or a tumor of the genital organs. A delay in the second period is not dangerous, unless it is associated with a second pregnancy.

Menstruation after caesarean section

Menstruation after caesarean section is restored in the same way as after normal delivery. During lactation, periods do not come for six months. Against the background of artificial feeding from the maternity hospital due to the lack of nipple stimulation (which activates the synthesis of oxytocin, which contracts the uterus), recovery may be somewhat slower, plus there is still a scar on the uterus. Therefore, the restoration of menstrual function may occur a little later, for several weeks.

Cycle after a pathological course of pregnancy or childbirth

After termination of a miscarriage or abortion, the first menstruation occurs within 45 days. If this does not happen, the woman should seek help from a gynecologist. To exclude such causes of amenorrhea as the remaining part of the fetal egg in the uterus or inflammation, 10 days after the termination of a frozen or normal pregnancy, an ultrasound scan is necessary.

Pathologies of menstruation, what to pay attention to and immediately contact a specialist:

Sudden cessation of postpartum discharge is a sign of a bending of the uterus or endometritis, accumulation of lochia in the uterine cavity - lochiometers.
Scanty periods for 3 or more cycles. Perhaps they are a symptom of hormonal disorders, Sheehan's syndrome or endometritis.
Irregularity of menstruation six months after its restoration, a break between bloody discharge for more than 3 months. Most often associated with ovarian pathology.
Excessive bleeding for 2 or more cycles, especially after a surgical delivery or abortion. They are often caused by the tissues of the membranes remaining on the walls of the uterus.
The duration of menstruation is more than a week, which is accompanied by weakness, dizziness.
Abdominal pain, fever, foul smell, discoloration of vaginal discharge - a sign of a tumor or infection.
Spotting before and after menstruation is a likely symptom of endometriosis or an inflammatory disease.
Itching in the vagina, an admixture of curdled discharge is a sign of thrush.
Bleeding twice a month for more than 3 cycles.

Is it possible to get pregnant?

The most common myth is that a woman cannot get pregnant if she is breastfeeding a baby. The fact is that the process of ovulation, the first after childbirth, is formed before the onset of the first spotting, and it is she who, with unprotected intercourse, can lead to an unplanned pregnancy, and a woman will give birth to the weather. If a woman does not feed, it is necessary to think about protection after childbirth immediately, from the very first sexual contact, since the dynamics of the restoration of reproductive functions is different for everyone, after 6-8 weeks from the moment of birth, the first ovulation is already possible.

Remember that a long delay in menstruation after childbirth or a cycle failure are not always symptoms of dangerous disorders, but in any case it is undesirable to self-medicate. For any questions and problems that arise with the reproductive system, please contact our specialists for advice.

The first menstruation after childbirth - the timing of the cycle recovery

Urgently in the room: she is back!

So. .. A lot of time has passed. After a short break (while the uterus was a little busy carrying a person), menstruation is finally back! But when exactly after childbirth does the cycle return to normal and what will it look like? Below we cover everything you need to know about your first period after pregnancy.

When does the first period start after childbirth?

Waiting for your period after pregnancy can be like waiting to reunite with an old friend… or meeting an annoying acquaintance you never missed! No matter how you feel about it, your period will return in due time, and there is no reliable way to predict exactly when.

If you are bottle feeding or combining formula and breastfeeding, your period may start as early as 5-6 weeks after birth, but exclusive breastfeeding may delay its return [1]. If you are breastfeeding, the hormones responsible for milk production keep progesterone and estrogen, the hormones that cause ovulation and menstruation, low.

When your period returns, it may take some time to regulate your cycle, or even longer if you are breastfeeding. Let's talk about what the first period after childbirth can look like, so you know what to expect.

What does the first menstruation after childbirth look like?

While your body in general and your V-zone in particular are getting back in shape, your menstrual cycle after giving birth may be different from what you were used to before pregnancy. At first, periods may be irregular or more abundant, and small clots may be released. Any symptoms of PMS, such as menstrual cramps, may also feel different from what you're used to. Try not to pay attention to any changes: this is how your body enters a new natural rhythm.

Attention: do not confuse the first menstruation after pregnancy with lochia - discharge that occurs immediately after childbirth, often quite abundant, especially in the first days of the postpartum period. While this discharge may seem intimidating, remember that this is how your body naturally regenerates after childbirth and is usually nothing to worry about. To learn more, you can read our postpartum discharge article.

Can tampons be used after childbirth?

When your menstrual cycle stabilizes, you can go back to using tampons if that's what you're used to. It is important to wait at least six weeks before using a tampon or menstrual cup, otherwise there is a risk of infection [2]. During your postpartum check-up, about six weeks after giving birth, check with your doctor if you can use your usual remedies again after your period returns.

If you had a vaginal birth, you may find that you now need a larger tampon. This is due to the fact that the vagina has become looser, at least for the next few months, and it is now difficult for you to keep the tampon inside. It may seem strange that your body is not the way you remember it. Such changes are very common, and all because your body has done a great job, carrying and giving birth to a new little man. So try using tampons one size larger. Keep looking for the right tampon size and absorbency for you. Remember: Ideally, you should change your tampon about every four hours.

If you normally use the largest sized tampons and find that they don't stay in, you may have to wait until your pelvic floor has strengthened enough to allow you to use your usual hygiene product again. Ask your doctor about pelvic floor exercises to tighten your vaginal muscles. It only takes a few minutes to train your pelvic floor muscles, and you can do it while standing in line at the supermarket or watching your favorite TV show. You can change things for the better very quickly!

When you start using tampons after giving birth, you may find that you need extra protection at some point. Thick or thin pads can come to the rescue, which will protect clothes from any surprises. Yes, surprises can still arise while you are choosing products with the right absorbency for your cycle, but all this is part of the joys and sorrows of life with menstruation.

How soon after giving birth can you get pregnant again?

You can get pregnant as early as 3 weeks after giving birth, even if you haven't started your period yet! If you don't want to, it's important to use contraceptives when you finally get back to a regular sex life after giving birth (which will happen in due time - just talk to your partner when you feel ready). You can discuss with a specialist which contraceptives are best for you.

If you have become pregnant with IVF or have been told that you may need fertility treatment in the future, but would like to try another child, you can see a fertility doctor soon after giving birth.

If you want to know more about what can happen after childbirth, read our articles on postpartum discharge and how the vagina changes after pregnancy.