Here's what you need to know.
Why No Period After Pregnancy Is NormalImmediately after giving birth, your body is focused on producing milk for feeding your baby and recovering from the physical stress of childbirth. At this time, you will be bleeding, called lochia, which gradually tapers off. It typically lasts 6-8 weeks.
It is not recommended to use any internal menstrual devices during this (lochia) bleeding.
After lochia, though, any bleeding is typically put on hold if you can or choose to breastfeed. Periods are skipped while your body focuses on milk supply and physical recovery. This is referred to lactational amenorrhea and is a natural part of the months postpartum.
Lactational amenorrhea is most common in women who are breastfeeding exclusively. This is because suckling reduces luteinizing and follicle stimulating hormones which suppresses ovulation. Suckling also stimulates prolactin, the hormone responsible for milk production. However, it can also occur in those who are formula feeding.
For most, the menstrual cycle will return within six months after giving birth to a maximum of one year, although the timing can vary. Before 6 months, some people may experience anovulatory menses (menstruation that occurs without ovulation) but aren’t necessarily fertile again.
Signs of Returning Fertility While BreastfeedingSigns of fertility can be challenging to detect and it’s best to track more than one to confirm that fertility has returned.
Here are some signs that you’re fertile again:
- The return of a regular menstrual cycle is typically a sign that ovulation has resumed and that you’re fertile again. However, it is possible to ovulate without getting a period, so this is not always a reliable indicator.
- When a baby begins to nurse less frequently or for shorter periods of time, levels of the hormone, prolactin, can drop, allowing ovulation and fertility to return.
- Ovulation predictor kits can be used to detect the surge in luteinizing hormone (LH) that occurs just before ovulation.
- As ovulation approaches, you might notice cervical mucus become thinner, clearer, and more stretchy.
- If you're tracking basal body temperature, you may notice a rise after ovulation has occurred around mid-month.
If you are trying to conceive again, a doctor can help you determine if fertility has returned and provide support for becoming pregnant again. If you’re looking to prevent pregnancy and you are unsure whether you’re fertile again, make sure to use birth control when engaging in sexual activity.
No Period After Pregnancy: Here’s When to WorryWhile it is normal to have a temporary absence of periods after giving birth, there are some situations where eventually the lack of a menstrual cycle may be a cause for concern. These include:
1. Persistent Lactational Amenorrhea
If your periods do not return even after you have stopped breastfeeding, it may be a cause for concern. In some cases, persistent lactational amenorrhea can indicate that your body is not producing enough hormones to support ovulation and a regular menstrual cycle.
2. Abnormal Bleeding
If you experience abnormal bleeding (heavy bleeding, prolonged bleeding, or bleeding that occurs after lactational amenorrhea has ended and mid-cycle) after giving birth, it is important to seek medical attention. Abnormal bleeding can be a sign of a variety of issues, including hormonal imbalances, uterine fibroids, or even a retained placenta.
3. Hormonal Imbalance
Hormonal imbalances can cause a variety of symptoms, including a lack of periods. If you experience other symptoms such as hot flashes, mood swings, or changes in weight or sleep patterns, it may be a sign that your hormones are not in balance. Hormonal imbalances can also affect your overall health and ability to conceive, so it is important to address them as soon as possible.
4. Polycystic Ovary Syndrome (PCOS)
Polycystic Ovary Syndrome (PCOS) is a common condition that affects the ovaries and can cause irregular periods, fertility problems, abnormal hair growth, weight gain, among other symptoms. If you have a history of PCOS or are experiencing abnormal symptoms, talk to your doctor.
5. Other Medical Conditions
There are a variety of medical conditions that can affect your menstrual cycle, including thyroid problems, endometriosis, or even certain medications. If you have a history of medical problems or are taking medication that affects your hormones, it is important to talk to your doctor about how it may impact postpartum periods.
First Period After BabyYour body is still recovering, and things will be different. Do what you can to encourage recovery and support your new baby, as best you can. If you have any concern about the absence of your period after pregnancy, don’t hesitate to check in with your doctor for individualized care and support.
- Chao, S. “The Effect of Lactation on Ovulation and Fertility.” Clinics in Perinatology, vol. 14, no. 1, 1 Mar. 1987, pp. 39–50, pubmed.ncbi.nlm.nih.gov/3549114/.
- Chauhan, Gaurav, and Prasanna Tadi. “Physiology, Postpartum Changes.” PubMed, StatPearls Publishing, 2020, www.ncbi.nlm.nih.gov/books/NBK555904/.
- Cleveland Clinic. “Lochia (Postpartum Bleeding): How Long, Stages, Smell & Color.” Cleveland Clinic, 11 Mar. 2022, my.clevelandclinic.org/health/symptoms/22485-lochia.
- Rebar, Robert. “Evaluation of Amenorrhea, Anovulation, and Abnormal Bleeding.” PubMed, MDText.com, Inc., 2000, www.ncbi.nlm.nih.gov/books/NBK279144/?report=classic. Accessed 13 Feb. 2023.
- Vekemans, M. “Postpartum Contraception: The Lactational Amenorrhea Method.” The European Journal of Contraception & Reproductive Health Care, vol. 2, no. 2, Jan. 1997, pp. 105–111, https://doi.org/10.3109/13625189709167463. Accessed 22 Jan. 2020.