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.
Many women feel so good during pregnancy because 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 the hormones progesterone and estrogen may also explain why many women experience baby blues or postpartum depression.Dr. Zenhausern
A closer look at hormones and 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 – on average – about 12-13 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 during postpartum.
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
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.
We’ve broken the postpartum timeline into three phases:
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: the hormone released by the anterior pituitary gland in your brain, is responsible for the stimulation of breast milk production.
Oxytocin: released to stimulate contraction of the uterus during childbirth and postpartum. Plays a vital role in bonding and attachment between mother and child.
Physical changes during week one: vaginal delivery
- Uterine contractions and cramping
- Vaginal tenderness/pain
- Vaginal bleeding
- Urinary incontinence
Physical changes during week one: 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 the different developmental stages of your baby.
For example, your milk production and quantity vary significantly over the first three months postpartum. Typically between 2-3 months postpartum, estrogen and progesterone levels return to pre-baby levels. Prolactin and oxytocin continue to be elevated if you breastfeed.
Common symptoms at three months postpartum
The shift in hormones mentioned above can also explain why many new moms experience postpartum hair loss around two to three months postpartum.
Dduring 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 your 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.
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 your breastmilk composition 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 cause you to stop lactating and 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, 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 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 various conditions, including thyroid diseases, like Hashimoto’s Thyroiditis, which often develops postpartum, as well as diabetes, anemias, and nutrient deficiencies.
Test your postpartum hormones at home
If you’re not breastfeeding, you can consider doing a simple at-home hormone test 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.
Explore more postpartum recovery resources
- Three Risk Factors for Developing a Perinatal Mood Disorder
- Steps for Accepting Your Postpartum Body
- A Closer Look at Pelvic Floor Issues in Postpartum