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First Period After Pregnancy: What to Expect

Medically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT — By Chaunie Brusie on February 28, 2018

Overview

From glowing skin to a newfound appreciation for your body, there are many things to love about pregnancy. Another is that you’ll have at least nine months of freedom from your period. But after you deliver, you’re probably curious what will happen with your menstrual cycle.

When your period returns often depends on whether or not you breastfeed. And just like your life after baby, you might find your periods after pregnancy are somewhat different.

When will my period return?

Your period will typically return about six to eight weeks after you give birth, if you aren’t breastfeeding. If you do breastfeed, the timing for a period to return can vary. Those who practice exclusive breastfeeding might not have a period the entire time they breastfeed. “Exclusive breastfeeding” means that your baby is receiving only your breast milk. But for others, it might return after a couple of months, whether they’re breastfeeding or not.

If your period does return quickly after giving birth and you had a vaginal delivery, your doctor might recommend that you avoid using tampons during your first menstruation post-baby.

This is because your body is still healing, and tampons could potentially cause trauma. Ask your doctor if you can return to using tampons at your six-week postpartum checkup.

Why don’t breastfeeding women get their periods as quickly?

Typically, women who are breastfeeding don’t get their periods as quickly because of the body’s hormones. Prolactin, the hormone needed to produce breast milk, can suppress reproductive hormones. As a result, you don’t ovulate or release an egg for fertilization. Without this process, you most likely won’t menstruate.

Will my period affect my breast milk?

When your period does return, you may notice some changes in your milk supply or your baby’s reaction to breast milk. The hormonal changes that cause your body to have your period may also influence your breast milk.

For instance, you might notice a decrease in your milk supply or a change in how often your baby wants to nurse. The hormone changes might also affect your breast milk’s composition and how it tastes to your baby. These changes are usually very minor, however, and shouldn’t affect your ability to breastfeed your baby.

What about birth control?

Some use breastfeeding as a natural birth control method. According to the Association of Reproductive Health Professionals, fewer than 1 out of 100 women will get pregnant annually if they’re engaging in exclusive breastfeeding. Even though breastfeeding reduces your fertility, it’s not an absolute guarantee you won’t get pregnant again.

The key here is exclusive breastfeeding. Other than breast milk, no fluids or solids are given to the baby with exclusive breastfeeding. Even water. Supplements or vitamins don’t interfere and can be given to the baby. Breastfeeding that doesn’t fit this description might not protect against another pregnancy.

If you’re breastfeeding and your period does return, you’re no longer protected against getting pregnant. It’s also important to note that it can be difficult to predict the return of fertility. You will ovulate before your period starts, so it’s entirely possible to get pregnant again before your period returns.

Safe and effective birth control methods are available for those who are breastfeeding. Nonhormonal options such as the copper intrauterine device (IUD), condoms, and diaphragms are always safe for breastfeeding.

There are also some hormonal birth control options that are considered safe during breastfeeding. Your doctor can provide the latest updates on specific types of birth control. In general, low-dose combination pills that contain estrogen and progestin are considered safe after you’ve healed from birth. Progestin-only pills are also safe to use while breastfeeding.

How might my period be different postpartum?

When you do start your period again, chances are the first period after delivery won’t be like your periods before you got pregnant. Your body is once again adjusting to menstruation. You may experience some of the following differences:

• cramping that might be stronger or lighter than usual
• small blood clots
• heavier flow
• flow that seems to stop and start
• increased pain
• irregular cycle lengths

The first period after your pregnancy may be heavier than you’re used to. It might also be accompanied by more intense cramping, due to an increased amount of uterine lining that needs to be shed. As you continue your cycle, these changes will likely decrease. In rare cases, complications such as thyroid problems or adenomyosis can cause heavy bleeding after pregnancy. Adenomyosis is a thickening of the uterine wall.

Women who had endometriosis before pregnancy might actually have lighter periods after giving birth. Light periods can also be caused by two rare conditions, Asherman syndrome and Sheehan syndrome. Asherman syndrome leads to scar tissue in the uterus. Sheehan syndrome is caused by damage to your pituitary gland, which may be the result of severe blood loss.

What causes mildly painful postpartum periods?

Mildly painful postpartum periods can be caused by a combination of several factors. They include:

• increased intensity of uterine cramping
• the hormones of breastfeeding
• the uterine cavity becoming larger after pregnancy, which means there’s more uterine lining to be shed during menstruation

What should I expect from my first period postpartum?

Whether you delivered your baby vaginally or by cesarean delivery, you can expect some bleeding and vaginal discharge after giving birth. Your body continues to shed the blood and tissue that lined your uterus while you were pregnant.

In the first few weeks, blood might be heavier and appear in clots. As the weeks go by, this blood gives way to vaginal discharge known as lochia. Lochia is bodily fluid that can appear clear to creamy white to red in color.

This discharge can continue for about six weeks, which is about the time your period may return if you aren’t breastfeeding. If your discharge had the appearance of lochia, stopped for some time, and then you experienced a return of bleeding, this is likely your period. If you aren’t sure if the bleeding you’re experiencing is pregnancy-related or your period, there are a few ways to tell:

• Lochia isn’t usually bright red in color beyond the first week postpartum. It’s usually lighter and can be watery or white in appearance. Bright red bleeding that occurs six or more weeks after delivery is more likely to be your period.
• Pregnancy-related bleeding can increase with increased exertion or activity. If your discharge increases with exertion and decreases when you rest, it’s more likely to be lochia.
• Lochia also tends to have a distinct odor. Lochia may have a “sweet” smell to it, since it’s mixed with leftover tissue from the pregnancy. Report any foul order to your doctor.

It can also take some time for your cycle to regulate after birth. You might find that you have your first period, skip a cycle, and then have another period that comes sooner than expected.

During your first postpartum year, it can be normal for your periods to fluctuate in length, time between cycles, and intensity of bleeding. This is especially true if you’re breastfeeding.

According to the Cleveland Clinic, most postpartum women will have a “normal” menstrual cycle of 21 to 35 days with bleeding that lasts 2 to 7 days. Period cycles can change from what you experienced before pregnancy.

What postpartum symptoms should I watch out for?

It’s important that you call a doctor if you experience any of the following symptoms:

• soaking through more than one pad every hour
• bleeding that’s accompanied by sudden and severe pain
• a sudden fever
• bleeding continuously for more than seven days
• blood clots that are bigger than a softball
• foul-smelling discharge
• severe headache
• trouble breathing
• pain while urinating

Contact your doctor if you experience these symptoms or anything else that concerns you related to your period. Some of these symptoms may indicate an infection.

The takeaway

A return to your menstrual cycle is just one of the parts of recovery and returning to your prepregnancy body. In some, menstruation may be delayed due to the hormone increases associated with breastfeeding.

Breastfeeding as a form of contraception isn’t foolproof. Having a backup method, such as oral contraception or a condom, can help provide further protection. You can find a great selection of condoms here.

If anything seems out of the ordinary about your first period after pregnancy, contact your doctor. Excess bleeding or indications of infection are especially concerning for a new parent. Listen to your body and play it safe.

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.

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