Hormones can feel like they’re all over the place during pregnancy, but what happens in postpartum? Take a closer look at your postpartum hormone timeline.
Having a baby is one of the most beautiful, selfless, and life-altering moments in your life. By this point, your body has gone through 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.
Part of the reason many women feel so good during pregnancy is that progesterone and estrogen – the two essential steroidal hormones – are also involved in creating dopamine and serotonin. Dopamine and serotonin are your mood-regulating hormones.
What happens to your hormones after pregnancy
Shortly after delivery, whether you had a vaginal or cesarean delivery, your estrogen and progesterone levels rapidly decrease. This drop in hormones – along with the physical and emotional stress of labor and delivery – can explain why most new moms feel as though they are in a complete haze over the first few days and even the first few months postpartum.
The sudden decrease in progesterone and estrogen may also explain why many women experience some form of “baby blues” or even postpartum depression. The CDC reported that 1 in 8 women will experience some form of postpartum depression. Unfortunately, many of those in the medical community believe that many more women experience postpartum depression but are never properly diagnosed or treated.
Many women often go undiagnosed with postpartum depression because the number of doctor visits goes from about 12-13 – on average – during pregnancy to only one during postpartum.
Recently, the American College of Obstetricians and Gynecologists (ACOG) recognized that although they had previously recommended most women to have only one postpartum checkup 4 to 6 weeks after giving birth, they now believe that postnatal care should be an ongoing process. Unfortunately, many women continue to struggle to have access to adequate care after six weeks of postpartum.
As a naturopathic doctor specializing in preconception and postpartum care, I feel as though the lack of adequate postpartum care is completely unacceptable and we must make a change in order to protect and support all mothers.
A closer look at your postpartum hormone timeline
Your postpartum hormones: week one
Immediately following delivery, whether that be a vaginal or cesarean delivery, progesterone and estrogen levels begin to decrease. At the same time, prolactin and oxytocin levels dramatically increase.
Prolactin, which is the hormone released by the anterior pituitary gland in your brain, is responsible for the stimulation of breast milk production.
Oxytocin, on the other, is released to stimulate contraction of the uterus during childbirth and postpartum. It also plays a vital role in bonding and attachment between mother and child.
Physical Changes During Week 1: Vaginal Delivery
- Uterine contractions and cramping
- Vaginal tenderness/pain
- Vaginal bleeding
- Urinary incontinence
Physical Changes During Week 1: Cesarean Delivery
- Pain at incision
- Difficulty walking/standing up straight
- Bladder catheter is removed if used.
Read next: Tips for Recovery After a Vaginal Birth
Your postpartum hormones: month three
Over the past three months, your hormones have continued to change to support different developmental stages of your baby. For example, your milk production and quantity varies significantly over the first three months postpartum. Typically between 2-3 months postpartum, estrogen and progesterone levels return to pre-baby levels.
This shift can also explain why many new moms experience postpartum hair loss around 2-3 months postpartum. Postpartum hair loss occurs because, during pregnancy, elevated levels of estrogen slows 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 your hair’s natural cycle of hair follicle shedding. This decrease in estrogen leads to what is known as postpartum hair loss. Postpartum hair loss is temporary but may last between three and six months for most women. There are some helpful things you can do to encourage your hair to regrow quickly and naturally.
Prolactin and oxytocin continue to be elevated while you breastfeed. During this time, we also notice sleep disturbances, which often leads to a decrease in melatonin and an elevation in cortisol. Cortisol is your body’s primary way of responding to stress. And, as many of you know, there are often many new stressors that develop when you have a young baby.
Your postpartum hormones: six months and beyond
At six months postpartum, many women will experience a decrease in prolactin production, which, in turn, leads to a reduction in breast milk. Even if you breastfeed past the six-month mark, your child’s demand for milk has significantly decreased as you begin to introduce solid foods and have passed significant early growth spurts. This decrease in prolactin also causes the composition of your breastmilk to change and is more suited for your growing baby.
Once your child has completely stopped breastfeeding, prolactin levels will go back to pre-baby levels. The decrease in prolactin will not only cause you to stop lactating, but it will also help stimulate your natural menstrual cycle. 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, if you are experiencing any new or persistent symptoms, make sure to contact your doctor.
Final thoughts on your postpartum hormone timeline
In general, whether you have any symptoms or not, I recommend continuing 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 a variety of conditions, including thyroid diseases, like Hashimoto’s Thyroiditis, which often develops postpartum, as well as diabetes, anemias, and nutrient deficiencies.
If you’re not breastfeeding, you can consider doing an at-home hormone test like this one to better assess your hormone levels at six months to a year postpartum. You can use the results to bring up any important concerns or questions with your doctor.
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