Hormones can feel all over the place during pregnancy, but what happens 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 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 – the two essential steroidal hormones – create dopamine and serotonin. Dopamine and serotonin are your mood-regulating hormones.
What happens to your hormones after pregnancy?
Shortly after delivery, your estrogen and progesterone levels rapidly decrease, whether you had a vaginal or cesarean delivery.
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.
A closer look at hormones and postpartum depression
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.
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 sudden decrease in the hormones progesterone and estrogen may also explain why many women experience baby blues or postpartum depression.
The American College of Obstetricians and Gynecologists (ACOG) recently recognized that one postpartum checkup six weeks after giving birth is not enough.
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 entirely unacceptable. We must make a change to protect and support all mothers.
Your postpartum hormone timeline
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.
Three phases of the postpartum hormone timeline:
Your postpartum hormones: week one
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 is responsible for stimulating 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.
Physical changes during week one: vaginal delivery
- Uterine contractions and cramping
- Vaginal tenderness/pain
- Vaginal bleeding
- Urinary incontinence
Read next: Tips for Recovery After a Vaginal Birth
Physical changes during week one: cesarean delivery
In addition to the above, you will also experience the following:
- Pain at incision
- Difficulty walking/standing up straight
- A bladder catheter is removed, if used
Your postpartum hormones: month three
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.
Common symptoms at three months postpartum
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.
We also notice sleep disturbances such as postpartum insomnia during this time, which often decreases melatonin and causes an elevation in cortisol. Cortisol is your body’s primary way of responding to stress.
Many of you know that many new stressors 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, 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.
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.
How to evaluate your postpartum hormone levels
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.
Test your postpartum hormones at home
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 any significant concerns or questions with your doctor.
Download now: Postpartum Hormone Handbook
A detailed guide on what you – and your hormones – can expect after birth written by a Naturopathic Doctor and Hormone Specialist.