While pregnant, you may have some bleeding at times, but most people don’t have a regular menstrual cycle. Not having a period all those months can come as a relief to some. But after delivery, bleeding is to be expected, and eventually, most menstruating people will get their regular period back.
When this happens, it depends on several factors. Here’s what you need to know about your menstrual cycle postpartum and periods after pregnancy.
When Will My Period Start Again After Pregnancy?
Most people will stop having their period while they are pregnant. After delivery, you’ll experience a period of bleeding longer than a regular menstrual cycle, called lochia.
Lochia can last up to six weeks and will typically consist of dark red blood which will then change to pink and then light yellowish-white. Then, you may or may not have a period soon after.
Most pregnant people have their cycles return to their personal normal sometime after birth. It may take some time to have your first period after giving birth. According to a systematic review in Obstetrics & Gynecology, most periods return 45 to 94 days after childbirth.
Factors that determine how soon your period comes back include:
- If you’re lactating.
- The amount of milk you’re making.
- The regularity of your period pre-pregnancy.
- The birth control you’re using (if any).
- Your age.
You may find your period changes after childbirth. Your periods may get heavier or more painful. Or, your menstrual flow may be lighter.
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What Is Lochia?
After giving birth, your uterus sheds the lining that supported your pregnancy. You will have a discharge from your vagina that starts as heavy bleeding and may also contain dark red clots. This bloody discharge is lochia.
Lochia is not the same thing as a period. The lochia bleeding gets lighter after several days or weeks, eventually turning clear. Period flow, on the other hand, darkens over time.
You may experience cramps, especially right after delivery at the beginning of lochia. These cramps help the uterus contract and shrink to its normal size.
Checking for Ovulation Post-Pregnancy
Your period will come back when you start to ovulate again. The timing of ovulation will determine the timing of your first postpartum period. Ovulation will also mean you can get pregnant again. If you are not lactating, you can ovulate as soon as a month after delivery.
You can use an ovulation predictor pee test to monitor yourself for ovulation. This is like a pregnancy test but tells you when the hormones that control ovulation spike. You can buy these tests at a pharmacy or online.
You can also detect ovulation by measuring your basal body temperature with a very sensitive thermometer. You need to check your temperature every morning when you wake up before getting out of bed. Doing this correctly can be difficult with a newborn and while taking certain medications like Tylenol or ibuprofen.
Tech products like the Apple Watch or other fertility monitors may also be able to track basal body temperature changes. They may let you know when you have ovulated. However, it is still unclear how well these trackers work postpartum (in comparison to during a regular cycle).
What Affects Your Postpartum Menstrual Cycle?
It takes time for your body to recover from pregnancy and childbirth. Several things can affect your menstrual cycle after birth.
When it comes to giving your baby the best start in life, breastmilk is best. Breastmilk contains antibodies, cells, and hormones that protect your baby from illness and lower their risk of several health issues.
Birthing parents also get immediate benefits from breastfeeding. It can help you bounce back from pregnancy and childbirth more quickly. That’s because hormones released during breastfeeding help your uterus shrink back to its pre-pregnancy size.
There are long-term benefits for breastfeeding parents, too. Breastfeeding can lower your risk of type 2 diabetes, ovarian cancer, and certain types of breast cancer.
Many people report that breastfeeding helped them reach their pre-pregnancy weight more quickly. That’s according to the Office on Women’s Health. It is estimated that breastfeeding (or pumping) can burn 500 calories a day!
Breastfeeding may also prevent ovulation, stretching how long it takes to restart your regular menstrual cycle. You must empty your breasts at least every 4 to 6 hours to stop ovulation and keep your period away. You can do this by feeding your baby directly or pumping.
Your period can return if you’re not regularly emptying your breasts. For example, if your baby sleeps through the night and you aren’t feeding or pumping during the night. This can also happen if you return to work and don’t pump or feed during the day.
Between 11% to 39% of people who breastfeed had at least one period within 6 months of childbirth, found a Cochrane Review. For people who don’t breastfeed or don’t breastfeed regularly, their period can return more quickly.
Previously irregular menstrual cycles
When your cycle returns after childbirth may depend on your previous menstrual cycle. According to Merck Manuals, at least 20% of menstruating people have irregular cycles ranging from 24 to 38 days.
Common causes of irregular periods include:
- Eating disorders.
- Thyroid disease, including too much (hyper-) or too little (hypo-) thyroid hormone.
- Certain medications, such as those for anxiety or epilepsy.
- Obesity. Body fat produces estrogen. Too much estrogen can cause irregular, missed, or heavy periods.
- Polycystic ovary syndrome (PCOS). According to the Office on Women’s Health, about 10% of people with irregular periods have PCOS.
- Primary ovary insufficiency (POI). With POI, your ovaries stop working before age 40. People with POI may still get pregnant and still have periods, but the cycles they do have may be irregular.
- Pelvic inflammatory disease (PID) is an infection of the reproductive organs.
- Uncontrolled diabetes.
When you go through puberty, prolactin is the hormone that causes your breasts to grow. After childbirth, prolactin makes breast milk. Prolactin helps control your menstrual cycle, but too much can cause irregular periods.
According to the March of Dimes, 3.5% of live births in the U.S. were to people ages 40 and older. You may already have more irregular periods if you are an older parent. That’s because, for most people in the United States, perimenopause starts in their mid-to-late 40s.
Perimenopause is the term for the hormonal changes your body goes through to prepare for menopause. Menopause is when you stop having periods permanently. You are in menopause when you have not had a period for 12 months straight.
According to the Office on Women’s Health, most people are in perimenopause for an average of four years before their periods stop.
During perimenopause, your levels of estrogen and progesterone change. These changes mean you may not ovulate every month. This can cause irregular periods. It is important to know that the post-delivery period can cause hormonal changes that may mimic perimenopause.
Menstrual cycle changes during perimenopause include:
- Missing your period for a few months.
- Menstrual cycles that are much longer or shorter than usual.
- Menstrual flow that is lighter or heavier than normal.
Your birth control method
It’s also important to discuss fertility risks and birth control options with your healthcare provider after childbirth. Even if you are in perimenopause, you can still get pregnant. Most doctors advise waiting between 12 and 18 months before getting pregnant again, depending on the type of delivery you had.
The type of birth control you use after pregnancy can affect when your period comes back. It may make your period stop, make it irregular, cause bleeding between periods, or cause a heavier or lighter period.
Some forms of birth control are safe to use right after delivery, while others may not be safe right away or if you are lactating. Hormonal birth control can also help regulate your periods after childbirth. Some birth control methods can decrease cycle symptoms like bleeding, cramps, and moodiness.
When Should You See a Doctor?
Talk to your doctor about your missing period if these three things are true at the same time:
- You don’t have a period for 90 days (three months).
- You are not currently pregnant.
- You are not breastfeeding.
Your doctor can make sure there aren’t any health issues causing your periods to become irregular or stop. They can also check to see if you are pregnant.
Regular periods are a sign that your body is healthy and working as it should. When your periods are irregular, heavy, or painful, these are potential signs of a serious health problem. If you have irregular periods, it may take you longer to get pregnant again.
Once your period returns, talk to your doctor if:
- You have heavy bleeding that soaks through more than one pad per hour for more than two hours.
- You have bleeding with a fever.
- Your clots are larger than a golf ball.
- You have intense cramping and pain.
- You are bleeding between menstrual cycles or twice in one month.
Menopause Basics. Office of Women's Health. Link.
Births. March of Dimes. Link.
Menstrual Cycle. Merck Manual. Link.
Making the Decision to Breastfeed. Office on Women's Health. Link.
Incredible facts about babies, breastmilk, and breastfeeding. Office on Women's Health. Link.
Period Problems. Office On Women's Health. Link.
First period after having a baby: What to expect. MedicalNewsToday. October 9, 2018. Link.
Return of Ovulation and Menses in Postpartum Nonlactating Women. Obstetrics & Gynecology. March 2011. Link.
Harvard Health Publishing. Can breastfeeding really prevent pregnancy? Link.
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