How the menstrual cycle changes after pregnancy

There is no reliable way to predict exactly when the first menstrual cycle will appear after pregnancy or how it will be in terms of quantity and rhythm, because the body of every woman is different.

In addition, it is normal to have blood bleeding and discharges immediately after childbirth, but this is not a cycle. These post-partum bleeding, called locks, usually last from 45 to 60 days.

The first menstrual cycle after the birth of the child is called head of the head and does not return to the same period to all women: it can reappear, in fact, about 40-60 days from childbirth if you do not breastfeed or, otherwise, even after several months . With exclusive breastfeeding then, it may also want more than a year, as prolactin can inhibit ovulation or in any case interfere with this delicate process. However, they are extremely approximate calculations, because The effects of breastfeeding on menstrual cycles vary widely. Some women who breastfeed exclusively 24 hours a day can start having menstruation a month after childbirth, while others who integrate with artificial milk may not have the cycle for several months.

We consider that broadly we can say that if the woman had a regular cycle before pregnancy, it can resume regular, but also to be totally irregular and must not arouse concern in the first year after childbirth

Will you ask me why? Consider that apart from breastfeeding, even the simple taking care of the new born can create imbalances in the regularity of the hours of night rest that can interfere with the normal and physiological pulse pulsatility pituitary pulsatility to which we were used to before. Furthermore, often during pregnancy and in the post Partum above all, the thyroid is affected by estrogen fluctuations, sometimes reacting in an abnormal way

We consider that the return of the menstrual cycle corresponds to the resumption of the regular ovarian activity of the woman. The first post-gravidation menstruation can be particularly abundant and last more than usual (even up to ten days). The subsequent cycles, on the other hand, tend to be more regular both as regards the frequency and quantity.

In addition, it may happen that above all women who used to have strong spasms have the opportunity to live an almost completely painless menstrual cycle, because after childbirth uterine contractility is significantly improved and, consequently, there is a lower production of prostaglandins, who have the task of promoting the contractions of the uterus at the time of the expulsion of menstrual blood and which cause pain

It is very important to emphasize that even if the head of the head has not yet appeared, it is possible that there are still miserable ovulations for which the woman can also be pregnant in breastfeeding or before the head of the chief appears, it is not at all rare as an event. So it is appropriate to take the right contraceptive precautions, as the WHO (World Health Organization) also recommend at least 18-24 months of interval between one pregnancy and another in women who currently live in western countries

It is therefore essential to program a gynecological evaluation with a transvaginal visit and ultrasound to control the post -partum physiological involution of the uterus, to evaluate how any scars have been repaired, both vulvovaginal and abdominals in case of childbirth completed by cesarean cut, and then it must be assessed In accordance with the woman, but I would say with the couple, the most appropriate contraceptive method, whether the woman breastfeeds and otherwise

It is always important to reassure neomamma that in addition to changes in the menstrual cycle, there may also be changes in the genital sensations to relationships, it is not strange and it is not pathological, but it is always necessary to evaluate with expert staff or trusted gynecologist or obstetrician, which everything falls in physiology

Dr Valeria Valentino

Spec surgeon. In obstetrics and gynecology

Pathophysiology of reproduction

Author of the first Italian essay on human fertility published Mondadori "La Via della Fertilita" "

Author of the Podcast Gyntalk

@drvalentinovaleria_ginecologa