Your Postpartum Hormone Timeline: Here’s What Happens

Having a baby is one of your life’s most beautiful, selfless, and life-altering moments. Becoming a new parent comes with significant hormonal shifts, and by this point, your body has undergone extreme physical and chemical changes.

Not only does pregnancy cause an increase in progesterone, human chorionic gonadotropin (hCG) hormone, and estrogen, but you also often experience glowing skin, beautiful hair, and feeling fabulous. 

Many women feel so good during pregnancy because progesterone and estrogen – two essential steroidal hormones – create dopamine and serotonin. Dopamine and serotonin are your mood-regulating hormones. 

Shortly after delivery, your estrogen and progesterone levels rapidly decrease, whether you had a vaginal or cesarean delivery. 

This hormonal fluctuation creates a lot of changes in a short amount of time. It can be an extremely emotional experience.

This drop in hormones and the physical and emotional stress of labor and delivery can explain why most new moms feel in a complete haze over the first few days – and sometimes the first few months – postpartum.

Oh, and don’t forget about those mood swings!

The CDC reported that 1 in 8 women will experience postpartum depression. Unfortunately, many medical community members believe that many more women experience postpartum depression but are never properly diagnosed or treated.

It’s important to talk to your care provider to see if you’re experiencing lingering feelings of sadness or something more.

Many women often go undiagnosed with postpartum depression because the number of doctor visits goes from – on average – about 12-13 during pregnancy to only one during postpartum.

The American College of Obstetricians and Gynecologists (ACOG) recently recognized that one postpartum checkup six weeks after giving birth is insufficient. 

They now believe that postnatal care should be an ongoing process during postpartum. Unfortunately, many women struggle to access adequate care after six weeks postpartum. 

As a naturopathic doctor specializing in preconception and postpartum care, I feel that the lack of adequate postpartum care is unacceptable. We must make a change to protect and support all mothers.

Supporting women through postpartum is the best thing we can do to help families and communities thrive.

Hormones are a tricky thing, especially during the postpartum period.

The more you understand your postpartum hormone timeline and your accompanying signs of recovery, the better equipped you’ll be to physically and mentally support yourself.

1. Week one

2. Month three

3. Month six and beyond

Immediately following delivery – whether you had a vaginal or cesarean birth –progesterone and estrogen levels begin to decrease. At the same time, prolactin and oxytocin levels dramatically increase.

Prolactin is the hormone released by the anterior pituitary gland in your brain that stimulates breast milk production. 

Oxytocin is released to stimulate the contraction of the uterus during childbirth and postpartum. It plays a vital role in bonding between mother and child. 

You might also begin to experience postpartum night sweats around this time, with their intensity peaking around two weeks after birth. Thank you, hormone shifts.

1. Uterine contractions and cramping 

2. Vaginal tenderness/pain 

3. Vaginal bleeding 

4. Urinary incontinence 

In addition to the above, you will also experience the following:

1. Pain at incision 

2. Difficulty walking/standing up straight 

3. A bladder catheter is removed if used

Over the past three months, your hormones have continued to change to support the different developmental stages of your baby.

For example, milk production and quantity vary significantly over the first three months postpartum.

Between two and three months postpartum, estrogen and progesterone levels return to pre-baby levels. Prolactin and oxytocin continue to stay elevated if you breastfeed.

The hormone shift mentioned above can also explain why many new moms experience postpartum hair loss around two to three months postpartum.

During pregnancy, elevated estrogen levels slow down the natural cycle of hair follicle shedding. As a result, many women experience long, beautiful hair during pregnancy.

Unfortunately, during postpartum, women will experience a decrease in estrogen levels, leading to an increase in their hair’s natural cycle of hair follicle shedding.

This decrease in estrogen leads to what is known as postpartum hair loss, which is a common physical symptom.

Postpartum hair loss is temporary but may last three to six months for most women. There are some helpful things you can do to encourage postpartum hair regrowth.

We also notice sleep disturbances such as postpartum insomnia during this time, which often decreases melatonin and causes an elevation in cortisol (the stress hormone).

Cortisol is your body’s primary way of responding to stress. Sleep deprivation and an overall lack of sleep are also very common during this time.

Many of you know that many new stressors develop when you have a young baby. 

At six months postpartum, many women will experience a decrease in prolactin production, reducing breast milk production.

Even if you breastfeed past the six-month mark, your child’s demand for milk has significantly decreased as you introduce solid foods and have passed significant early growth spurts.

This decrease in prolactin also causes your breastmilk composition to change and is more suited for your growing baby. That’s good news!

Once your child stops breastfeeding, prolactin levels will return to pre-baby levels. The decrease in prolactin will cause you to stop lactating and help stimulate your natural menstrual cycle.

 →   Learn more in our Postpartum Hormone Handbook.

Most women report getting their period back within one to three months of discontinuing breastfeeding, although this is not the case for everyone.

You may also experience that your period may be irregular for the first few months. Although hormonal changes are “normal” postpartum, contact your doctor if you are experiencing any new or persistent symptoms. 

To better understand your postpartum hormones and recovery, I recommend regular visits with your OBGYN, PCP, or Naturopathic doctor at least every three months for the first two years postpartum.

Doing so will help your doctor monitor and evaluate your progress.

It will also allow your doctor to assess for various conditions, including thyroid diseases, like Hashimoto’s Thyroiditis, which often develops postpartum and diabetes, anemias, and nutrient deficiencies.

If you’re not breastfeeding, you can do a simple at-home hormone test to better assess your hormone levels at six months to a year postpartum (or beyond). You can use the results to discuss significant concerns or questions with your doctor.

If you are interested in learning more about your thyroid, diabetes, anemias, and more, you can purchase postpartum bloodwork through LabCorp directly and have more control over your well-being.

A detailed guide on what you – and your hormones – can expect after birth written by a Naturopathic Doctor. Get a copy now.

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DR. ALISSIA ZENHAUSERN  

Dr. Alissia Zenhausern, NMD (or Dr. Zen for short) is a licensed naturopathic doctor and the founder of NMD Wellness of Scottsdale. She believes in helping to educate, inspire, and empower women to better understand their hormones and fertility, so they can make decisions that are right for them. From preconception counseling, PCOS, fertility, and postpartum care, Dr. Zen helps women have a voice in their own health. She has been featured as a lead expert in wellness in Instyle Magazine, Shape, and Forbes and truly believes in empowering women to optimize their health naturally.