After pregnancy, after giving birth and the baby is born, the body of a woman who no longer houses a child is slowly returning to its natural state. One of the parts that restart its functions is the reproductive system, and with it, ovulation, the preparation of the uterus for a new pregnancy and subsequent bleeding if it does not occur. That is, menstruation.
However, it is difficult to establish a specific moment in which to say that menstruation returns, because it depends on some factors that are different for each woman, the one that varies the equation the most the type of feeding the baby receives. To try to shed some light today we explain when menstruation comes back after pregnancy.
Women who breastfeed
When the baby is born and the placenta leaves the uterus the production of the hormone prolactin, responsible for the production of breast milk, skyrockets. It increases in concentration and this makes start producing milk (That is why it is false that it takes longer to raise the milk with the C-section, since what starts the production is not how the baby comes out, but the moment when there is no placenta). This increase in prolactin is linked to a decrease in estrogen and progesterone, responsible for the menstrual cycle, and consequently it is unlikely that ovulation will occur and therefore the rule will return.
When a mother is breastfeeding as recommended, that is, for six months exclusively, the frequency of the shots causes the prolactin to remain elevated and the other hormones decreased. Consequently, during the first months many women do not have the rule. But this is not an exact science, and there are babies who breastfeed more often than others, or who by the day suck a lot and less at night, and these differences can cause there are women with the rule when they are only breastfeeding.
From the sixth month onwards, when babies start with complementary feeding and the doses are not as frequent, prolactin levels go down, estrogen and progesterone levels increase and so comes a time when menstruation returns.
The first cycles, as if the thing were still green, they are irregular. So much that there can be a rule without ovulation, so much that it can last for several days or very few, there may be normal bleeding or minimal bleeding and so much that it can be very irregular cycles. This is normal because hormonal levels are not yet stable.
But when does menstruation come back?
As I say, in women who breastfeed, it is estimated that a low number of women (about 2%) have the rule even while breastfeeding exclusively. The vast majority of women will have it once the baby has started eating, between the sixth and eighth month (about 60% of women) and the rest will come in later months.
And when I say months later I also include those in which nobody explains how it is possible, those in which a baby is a year and a half, or two years old, and his mother, who continues to breastfeed, still does not have the rule. It is normal, usually happens, and it is usually recommended that a gynecological examination is done 12 months after delivery (recommended in all women) to see that, despite no menstruation, everything is going well. The question is whether the gynecologist will know that this is normal, because there are those who get on their nerves in the face of such a long amenorrhea, despite being normal.
Women who bottle feed
In women who do not breastfeed, who feed the baby with a bottle, the rule comes back much sooner. Prolactin does not remain elevated because milk is not being produced, estrogen and progesterone return to their usual concentrations soon and about the second month after delivery returns the rule for many of them. From that moment, and until four or five months, it will come to all of them.
