When do periods return after childbirth, why can the first periods differ, and how does breastfeeding affect them? Balanced postnatal information.
The postnatal menstrual pattern describes the process of your menstrual cycle settling again during the postnatal period and breastfeeding. When your periods will return and what the first periods may be like vary from person to person, especially according to your breastfeeding situation.
When do periods return after birth?
When periods return depends largely on your breastfeeding situation. In people who are not breastfeeding, periods may generally return earlier; in people who breastfeed intensively and often, the return of periods may be delayed or irregular. This process varies from person to person and an exact time cannot be given beforehand.
How does breastfeeding affect the return of periods?
The hormonal state linked with breastfeeding can temporarily suppress ovulation and the return of periods. How often and how intensively you breastfeed is one of the factors that determine how long this effect lasts.
Can the first period(s) be different from normal?
Your first periods after birth may be irregular and may feel different in amount from the periods you are used to. This is generally an expected situation; your cycle tends to settle over time. However, do not count unusually heavy or long-lasting bleeding as a normal difference in a first period.
Can I become pregnant before my periods return?
Yes. Ovulation can happen before a period; for this reason not having had a period does not on its own mean you are protected from pregnancy. Which contraceptive method is suitable is determined with your doctor according to your breastfeeding situation and health history; it is advised that you talk about this early.
What is the difference between a period after birth and lochia (postnatal bleeding)?
Lochia is a process that starts straight after birth and lessens and lightens over time; the return of periods is a separate event that appears later and repeats cyclically. If you are unsure how to tell the two apart, share this with your health team.
When can you consult your doctor?
If you have not had a period for a long time, or if something about your menstrual pattern confuses you, you can consult your doctor at your postnatal check-up or by making an appointment. Sudden and heavy bleeding, severe pain or other urgent symptoms, however, should not be put off by thinking "this is an irregularity that can be seen in the first periods".
What can you ask your doctor?
- Given that I am breastfeeding, when can I expect my periods to return?
- If I want protection before my periods return, what options can I consider?
- When are irregularities in my first periods regarded as a cause for concern?
- Should I ask about my menstrual situation at my postnatal check-up?
Frequently Asked Questions
Does breastfeeding take the place of contraception before my periods return?
Breastfeeding suppresses fertility only in limited situations where certain conditions are all met; if these conditions are not met, or you are not sure, you may be unprotected. Whether breastfeeding takes the place of contraception is talked over with your doctor, together with your breastfeeding pattern and your menstrual situation.
If my first period after birth was very heavy, what should I tell my doctor?
If the bleeding does not have any of the urgent signs listed above, you can talk with your doctor or midwife at your postnatal check-up or at an appointment. Noting when the period started, how the bleeding differs from what you are used to and any accompanying symptoms makes the assessment easier.
Does continuing to breastfeed after my periods return protect me from pregnancy?
Your periods not having returned yet is one of the conditions in which breastfeeding can suppress fertility. If periods have returned, this condition is not met; breastfeeding should not be counted as a guarantee on its own, and which method is suitable for protection should be talked over with your doctor.
Is the same timescale true for everyone for the return of periods?
No. The time of return varies from person to person, especially according to breastfeeding status; an exact time cannot be given beforehand.
Can breastfeeding temporarily suppress ovulation?
Yes. The hormonal state linked with breastfeeding can temporarily suppress ovulation and the return of periods. Frequency and intensity are among the factors that determine this effect.
Can the first periods after birth be irregular?
Yes. The first periods can be irregular and different in amount from what you are used to. However, do not count unusually heavy or long bleeding as a normal difference.
If my periods have not returned, am I protected?
No. Ovulation can happen before a period. Not having had a period does not on its own show that you are protected from pregnancy.
Is lochia the same thing as a period?
No. Lochia starts straight after birth and lessens and lightens over time. The return of periods is a separate process that appears later and repeats cyclically.
What can I do if I cannot tell whether bleeding is lochia or a period?
If you are unsure, you can share the situation with your health team.
Can I ask about irregular periods at my postnatal check-up?
Yes. You can consult your doctor at your postnatal check-up or by making an appointment about not having a period for a long time or about questions on your menstrual pattern.
Can I wait if sudden heavy bleeding happens, treating it as irregularity in the first periods?
No. Sudden and heavy bleeding, severe pain or other urgent symptoms should not be put off by thinking of them as irregularity in the first periods.
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