Postpartum symptoms: what to expect

Postpartum symptoms

In this article, we cover the main postpartum symptoms you may experience as well as the hormonal changes driving your symptoms. 

Postpartum symptoms can be confusing and overwhelming. Although the postpartum period is often filled with a lot of love and joy, it can also be a time of overwhelm, poor sleep, changing hormones and unexpected mood changes. So it’s good to be prepared and to know the key signs to look out.

What’s happening to my hormones in pregnancy?

To keep it simple, in pregnancy your estrogen and progesterone are extremely high, much higher than pre-pregnancy. In fact, a woman can produce more estrogen in her pregnancy than across the rest of her life (when she is not pregnant). 

In addition to rising estrogen and progesterone, your serotonin and GABA (hormones and neurotransmitters) are also high. This is because estrogen and serotonin are connected – estrogen helps to make serotonin – and so are GABA and progesterone. As one is high, the other increases too. Serotonin tends to make us feel calm, focused, happy, and emotionally stable and GABA has a calming effect on the brain, reducing anxiety and reducing feelings of stress. This helps us feel balanced and happy during pregnancy.

What’s happening to my hormones postpartum?

Immediately after delivery, estrogen and progesterone plummet. And so too does serotonin and GABA. Even though we lose the benefits of these hormones during this time, we also welcome in lots of oxytocin which promotes the feeling of love, comfort and connection. 

Regardless of whether or not you choose to breastfeed, we also get an increase in the hormone prolactin. When prolactin goes up, dopamine can go down. Dopamine is what is called the reward neurotransmitter, it helps with energy and motivation. 

Did you know? Dopamine is linked to feelings of attraction which is why many women do not feel attracted to their partner after birth and in the postpartum time. It is suggested this is biology’s way of ensuring the baby is the main focus!

 

These postpartum hormonal changes can lead to many emotions, increasing the risk of postpartum depression and anxiety. It is important to note here that many other factors can also contribute to mood, sleep and energy changes in the post-partum time. 

One of the big contributors is the dysregulation of the HPA axis. The hypothalamus- pituitary- adrenal axis is the communication pathway from the brain to the adrenal glands. The dysregulation of the HPA axis can lead to an increase in depression, poor sleep, and low energy. 

When will my cycle return postpartum?

This is different for everyone. 

For some women their cycles return quickly, even when breastfeeding. This can sometimes be due to high estrogen levels in the body (as prolactin usually suppresses estrogen and in turn suppresses ovulation). For others it can take longer as prolactin suppresses both estrogen and progesterone, which prevents cycles returning. 

If you are not breastfeeding then your period may return 6-8 weeks after birth. But again this can vary from person to person. 

Postpartum symptoms: warning signs

As we have explored it is a normal part of the postpartum experience to feel emotional changes. But if you’re experiencing symptoms that do not feel like they are temporary or changing, like extended low mood, anxiety that won’t go away, feeling isolated and alone, cannot sleep, very low energy or cannot stop crying, then it could be a good idea to test your hormones. Read on to find out when is the best time to test during postpartum.

What’s happening to my hormones post weaning?

Once you finish weaning and the prolactin levels decrease then this will signal to the brain that estrogen and progesterone can rise again. Therefore if you have not already, you will likely get your cycles back. 

As we welcome back estrogen, we also welcome back serotonin, and as we welcome back progesterone we welcome back GABA. Therefore 6-8 weeks after weening you will likely feel your mood rebalance again. 

If you are not feeling balanced and instead are noticing symptoms like painful periods, anxiety or changing moods then this may signal an underlying hormone imbalance and testing is highly recommend here. 

Please note that during weening (and the 6-8 weeks after) it is very common to feel weepy, anxious, and have trouble sleeping as well as other mood changes. It can be a really hard time as the oxytocin drops and it’s important to be kind and patient with yourself. 

Weaning symptoms: warning signs

If you are still experiencing mood changes or sings of imbalance a few months (12 weeks) after weaning, then it would be a good idea to test your hormones. In particular it would be important to look at the Advanced Hormone Test to assess the HPA axis (stress pathways), cortisol levels and also estrogen and progesterone to assess if they are contributing and driving the symptoms of imbalance for body and mood.

  • Comprehensive sex and adrenal hormone and hormone metabolites test
  • Expert-reviewed report with your results
  • Personalised protocol of supplements, diet and lifestyle recommendations

Hormone testing post-partum

Testing can be especially beneficial if you’re experiencing postpartum symptoms like low mood, anxiety, poor sleep, headaches, weepiness and low energy. 

Read on for commonly asked questions we hear from our clients.

Can I test my hormones if I am breastfeeding?

Yes, you can test your hormones when breastfeeding, especially if you have postpartum symptoms like poor sleep, low mood, headaches or migraines.

If you’re interested specifically in testing your reproductive hormones like estrogen and progesterone, then it might be better to wait until your cycle returns. This is because high prolactin levels lower your estrogen and progesterone levels. But if you have symptoms you can still test to discover what might be contributing. 

When breastfeeding you are more likely to benefit from the many other markers included in our Advanced Hormone Test, rather than looking at estrogen and progesterone. Our practitioners will be particularly interested to look at your adrenal function with markers like cortisol (stress can often be an issue postpartum) and also your nutrient and neurotransmitter balance as these could be contributing to symptoms such as low mood. 

Recommended test: The Advanced Hormone Test

Can I test my hormones when I am in the postpartum period?

Yes you can test during this time, as mentioned above, we often recommend waiting until your cycle returns (as high prolactin levels from breastfeeding can lower estrogen and progesterone) or if you have postpartum symptoms before this then it is advised you test. 

Again the Advanced Hormone Test can be very beneficial for understanding how your hormones might be contributing to low mood or postpartum depression. The Advanced test looks at your adrenal gland function and stress hormones which may be contributing to low mood here. If you are no longer breastfeeding, testing your hormones here can be beneficial as low estrogen and progesterone and high testosterone and cortisol can contribute to postpartum depression. 

Recommended test: The Advanced Hormone Test

How long after my period comes back should I wait to test?

It is best to wait for at least three cycles to return before testing your hormones postpartum. This is because it will ensure prolactin has lowered and is not interfering with your estrogen and progesterone levels so the test gives us clear results. 

3 ways to support your hormones post-partum

  1. Rest: The best thing you can do is to get as much rest as possible. Sleep when you can and for as long as you can. 
  2. Balance blood sugar levels: The next best thing you can do is ensure you eat three meals a day. Ensure you are eating meals that are focusing on protein and good fats to nourish your adrenal glands, promote healing and rebuild healthy hormones. This can be hard when you’re time poor – some easy nutrient dense meals include a protein smoothie, avocado on buckwheat crackers, eggs on toast. You can also ask friends and family to bring round a home cooked meal when they come to visit.
  3. Seek support: If you are struggling then it is advised to reach out for some personalised support. Our 1:1 consultations with our women’s health experts will provide you with a personalised health plan to support you during this post-partum time. 

References

Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol. 2005;106(5 Pt 1):1071–83. https://pubmed.ncbi.nlm.nih.gov/16260528/

Hendrick V, Altshuler LL, Suri R. Hormonal changes in the postpartum and implications for postpartum depression. Psychosomatics. 1998;39(2):93–101. https://pubmed.ncbi.nlm.nih.gov/9584534/

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