Are irregular periods after pregnancy normal?

While the happiness of having a baby is unparalleled, postpartum can be a tough time for a new mom. As she deals with sleepless nights and imbalanced hormones, irregular periods after pregnancy are also very common. They happen due to hormonal changes, breastfeeding or even the high-stress levels that a new mom goes through. However, while irregular periods after pregnancy can be natural. If they continue to be this way for a while, or are accompanied by severe pain and cramping, you need to head to the doctor. Here is all you need to know about the change in menstrual cycle after pregnancy and how to deal with them.

Are irregular periods after pregnancy common?

Yes, women undergo irregular periods after pregnancy as a result of hormonal changes while the body recovers from childbearing. A study, published in the journal Cureus, states that irregular periods can occur due to changes in the levels of the hormones progesterone and estrogen. If you are breastfeeding, prolactin, the hormone that stimulates milk production, may inhibit ovulation, causing skipped or irregular periods for a few months, explains gynaecologist Sandhya Rani.

Even if you’re not breastfeeding, it can take a few cycles before your menstrual cycle stabilises while your body gets used to it. Other reasons such as stress, sleeplessness, and deficiencies in diet can also lead to irregular periods. But if the irregularities are long-term or come with severe symptoms, it’s best to visit a gynaecologist for assessment.

Causes of irregular periods after pregnancy

There are many causes of irregular periods after pregnancy. Here is why you don’t get your period on time:

1. Hormonal imbalances

The body experiences tremendous hormonal changes during pregnancy, especially fluctuation in estrogen and progesterone. After giving birth, it may take some time for the hormones to settle down, causing menstrual cycles to be irregular. “When a woman is lactating, the hormone prolactin that helps in the production of milk can hamper ovulation. This can disrupt the menstrual cycle,” says the expert. Even in breastfeeding mothers, it takes a few months for the body to come back to normal hormonal levels, according to which the menstrual cycle length and flow will fluctuate.

2. Lactation and prolactin effect

Often breastfeeding is responsible for menstrual abnormalities. When the mother breastfeeds, her prolactin levels are high, suppressing the secretion of reproductive hormones such as estrogen and progesterone. The suppression may cause delayed ovulation or even total loss of menstruation (lactational amenorrhea). Women who breastfeed their children have a longer period of amenorrhea and infertility following delivery than women who do not breastfeed, states a study, published in the journal Clinics in Perinatology. This means that women who fully breastfeed may not receive their periods for a few months, whereas those who partially breastfeed might have irregular or unpredictable periods until their child undergoes weaning.

3. Physical and emotional stress

The postpartum time is physically and emotionally very stressful for the mother. Lack of sleep, adjusting to a new schedule, and healing her body after giving birth can all be sources of stress for her. Stress impacts the hypothalamus, which is the region of the brain that controls hormone secretion, and this, in turn, can interfere with ovulation and menstrual cycles. Elevated levels of cortisol from stress can disrupt the menstrual cycle as well, delaying it and changing the flow, states this study, published in the International Journal of Psychophysiology.

4. Uterine recovery and postpartum healing

Following delivery, the uterus contracts back to its pre-pregnancy size. Women have postpartum bleeding for weeks, which is not a period but the shedding of pregnancy uterine lining. The uterus and endometrial lining take time to get back to normal, thus delaying or disrupting menstrual cycles. In a few instances, conditions such as retained placental tissue or postpartum infection can also impact the predictability of periods.

5. Weight and nutritional deficiencies

Pregnancy and delivery drain the body’s stores of nutrients, which when combined with a poor appetite can impact menstrual health. Iron, calcium, vitamin D, and other key nutrients deficiencies can influence hormonal balance and ovulation, and lead to irregular periods after pregnancy. Also, extreme weight loss or gain following pregnancy can interfere with the cycles. Sudden weight loss can cause missed periods whereas weight gain can lead to hormonal imbalances, particularly if it is associated with conditions such as insulin resistance.

6. Other underlying medical conditions

Some medical conditions can also be a reason for irregular periods after pregnancy. These develop or become more severe following pregnancy, causing irregularities in menstrual cycles. Medical conditions such as polycystic ovary syndrome, thyroid conditions (hypothyroidism or hyperthyroidism) and diabetes all affect menstrual cycles. Complications of pregnancy, including postpartum thyroiditis (a reversible thyroid condition that may occur after giving birth), can also affect the body’s hormonal balance and cause irregular periods. If the intervals do not reduce over time, it is important to consult a gynaecologist to rule out any other underlying condition.

When to head to the doctor?

While irregular periods after pregnancy are natural, you need to be careful of a few things. You need to consult a doctor if your periods continue to be irregular for more than a few months after weaning, are very heavy, painful, or are accompanied by severe cramps, dizziness and abnormal discharge, says the expert. You should also consult a doctor if you suddenly stop getting periods, have symptoms of hormonal imbalance, or suspect an underlying condition such as PCOS or thyroid problems.

How to regularise periods after pregnancy?

The right way to deal with irregular periods after pregnancy is to concentrate on consuming a well-balanced diet full of iron, calcium, and essential vitamins to aid in balancing hormone levels. Stay hydrated and regularise a form of physical activity, e.g., walking or yoga, to enhance total health. Stress management through relaxation methods such as meditation or breathing can also stabilise hormone levels, and help with irregular periods after pregnancy.

Make sure you sleep well, even if it means adapting to your baby’s rhythm. If you are breastfeeding, keep in mind that cycles may take longer to come back, but gradual weaning can normalise cycles. However, make sure to consult your doctor if you have irregular periods after pregnancy for long.