Ask Our Experts: Irregular Periods Postpartum – What’s Normal?
Q: I got my period back at six months postpartum. It was regular to the day for three months and we decided to start trying for another baby in my next cycle. This month it just didn’t come! I’m not pregnant but have switched a breastfeed during the day to formula and baby started sleeping through the night without a breastfeed. When should I start to worry or seek medical advice about my cycle? I am mid 30s and, as I said, we want to start trying for another baby so would prefer to be proactive.
Chelsea: Menstruation can be irregular when lactating and it’s not uncommon to have missed or irregular periods as your hormones are finding balance postpartum. Hormonal fluctuations can last six months, or even longer in some cases, whilst your body is still trying to establish an equilibrium post-birth. It wouldn’t be a huge concern that you had a missed period at this stage. Also, sometimes a menstrual bleed and/or ovulation can be impacted by factors such as significant stress or being unwell, for example. Everyone’s threshold for when fertility returns postpartum is unique. The focus if you are trying to conceive would be on supporting ovulation each month. Progesterone is a key player for ovulation, so eating foods that support progesterone and doing activities that increase progesterone will be helpful. Restorative activities promote healthy progesterone levels as when our nervous systems are in parasympathetic activation (rest and digest mode) then progesterone is favoured over producing cortisol. If we are chronically stressed, our body will produce more cortisol and this will down-regulate the production of progesterone (needed for ovulation and conception). Focus on doing things that make you feel calm, meditation or yoga are great if these are your thing. Or just walking, being in nature, spending time with people who make you happy. Taking things off your plate and simplifying can be a nice way to keep your nervous system deactivated and relaxed.
Bringing an omega-3 fish oil or a vegan form of omega-3 supplement in can also support progesterone. Gamma Linolenic Acid (GLA) from evening primrose or borage seed oil can also support the production of progesterone (however, you may want to take it in your cycle before ovulation, as if you become pregnant you would cease taking it). Herbs are another avenue to support. A gentle herbal tea might be a nice place to start and you could consult with a herbalist or naturopath to find the right blend for you. Taking a preconception multi/prenatal or B vitamin (with folate) may be a good idea too, for progesterone and supplementing with folate 1-3 months before conceiving is beneficial to prevent neural tube defects. You could also consider acupuncture for hormonal and conception support.
If you try for 6-12 months with no luck, that’s when I would recommend seeking out medical advice. In the meantime, there may be small changes you can make to improve your chances of conception. If it will bring you peace of mind to seek medical advice sooner, that is completely your choice. You’ve got to do what’s right for you!