Postpartum Period

Nicole Wendler holds a PhD in biology in the field of oncology and immunology. As a medical editor, author and proofreader, she works for various publishers, for whom she presents complex and extensive medical issues in a simple, concise and logical manner.

More about the experts All content is checked by medical journalists.

It usually takes a while before the first period after the birth. The reason for this is the hormonal change. Depending on whether a woman is breastfeeding or not, the onset of the first menstruation is delayed for different lengths of time. Read here when you can expect your first period after giving birth, which hormones play a role and when you will be fertile again.

The hormones change

If the hormonal balance was set for pregnancy in the past nine months, the hormonal focus is on physical regression after the birth. This process begins immediately with the afterbirth. As the placenta gives birth, all blood and urine levels of the hormones it produces decrease. These include the steroid hormones estrogen and progesterone. When these hormones decrease, the regression and regression get going. The production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), on the other hand, picks up speed again, and follicle maturation in the ovary starts again.

The fact that the first period after the birth is still some time in coming is due to another hormone, prolactin. It is formed in the brain (more precisely: in the anterior pituitary gland) as soon as the estrogen drops. Prolactin ensures that the mother's breast produces milk in good time after the birth - as a rule, milk "spills" on the third to fifth day of the puerperium. As the baby sucks on the breast, the production of prolactin is further stimulated. In most breastfeeding mothers, prolactin prevents ovulation. The result is what is known as lactation menorrhea or breastfeeding menorrhea, i.e. the absence of menstrual bleeding during breastfeeding.

In women who are not breastfeeding, prolactin levels return to normal within two to three weeks. Then the first period usually comes soon after the birth.

When does the first period after birth come?

The onset of the first period after giving birth depends on how intensely the woman is breastfeeding. The more milk-forming prolactin is produced, the more effectively the maturation of the egg cells and ovulation are inhibited and the later menstruation starts again. Women are therefore less fertile, especially in the first six weeks after giving birth. Only after weaning does a normal cycle return to normal.

But even if fertility is reduced in the first six weeks after the birth and breastfeeding suppresses the maturation of the egg cells, it must be emphasized again and again: Breastfeeding is not a safe method of contraception! The first ovulation usually happens unnoticed before the onset of the first period after the birth. So you can get pregnant again before the onset of your first menstrual period!

Women who do not breastfeed can expect their cycle to start again as early as six to twelve weeks after giving birth. The first period after pregnancy and childbirth could therefore occur after about eight weeks. In addition to prolactin, the stage of regression also plays a role.

Weekly flow or period?

The weekly flow sometimes lasts up to six weeks. It is therefore possible that the weekly flow and the menstrual period follow one another directly. Since the weekly flow becomes light and rather white towards the end, the onset of the period with a new beginning bleeding can usually be clearly distinguished from the weekly flow. If you are still unsure, ask your gynecologist.

Does the period change after giving birth?

The first menstruation after giving birth is usually relatively heavy and painful. Sometimes it takes an unusually long time. The following cycles are mostly irregular and variable. The cycle usually leveled off again only after about half a year. But that does not necessarily mean that it is now the same as it was before pregnancy: For example, if the days used to be associated with strong cramps, they can now be quite mild.

Note: If the postpartum period is accompanied by unusually heavy bleeding and severe pain, you should contact your gynecologist.

First period after childbirth: tampons or sanitary towels?

If the first period after the birth starts within the first six weeks, the wound healing in the abdomen is not yet complete. Because of the increased risk of infection, you should therefore avoid tampons. Sanitary napkins are a better choice at this time. You can use tampons again later. When buying, however, you should be prepared for the fact that you may need one more size. Inserting a tampon during the first period after birth can also feel different or more difficult than usual, because the anatomy of the vagina has changed slightly during the birth. If you feel pain while doing this, ask your gynecologist for advice.

Tags:  tcm alternative medicine anatomy