Generality
In the "article dedicated to the relationship between pregnancy and menstruation, we have explored the biological significance of these small hemorrhages, explaining why the menstrual flow disappears during gestation, only to reappear a few weeks or months after delivery.
The onset of a new menstruation after a pregnancy is called the head of the ward, and should not be confused with the so-called lochiations, blood loss combined with pregnancy residues that occur during the puerperium. In fact, after delivery, the loss of blood will continue for a few more days, decreasing in quantity and becoming clearer and lighter, until it normally runs out within a couple of weeks.
While breastfeeding
Can the resumption of menstruation occur during breastfeeding?
In women who are breastfeeding, the resumption of menstruation may be delayed by even a few months, due to the hormonal antagonism, against estrogens, exerted by prolactin, the lactation hormone.
Breastfeeding increases both the probability of postponing the return to menstruation and the possibility of anovulatory head of the ward (in practice, the first menstruation appears without ovulation, therefore the possibility of getting pregnant again).
As a rule, in women who breastfeed regularly, the more anticipated the return of menstruation and the more numerous the anovulatory cycles.
On average, in women who are breastfeeding, menstruation reappears at the end of breastfeeding (5-6 months after birth). If, on the other hand, the woman is not breastfeeding, the blood loss of the head of the ward can occur after about 6-8 weeks from the birth of the baby.
During breastfeeding, ovulation continues to be suspended, as long as the lactation hormones are secreted on a regular basis, so that the newborn is exclusively breastfed, both day and night, at regular intervals and less than four hours. .
Get pregnant
Can I get pregnant from sexual intercourse during breastfeeding if my period hasn't come back yet?
After childbirth there is no way to predict with certainty when the woman will return to being fertile; for this reason, during breastfeeding it is not advisable to rely too much on this natural mechanism as a form of contraception; its effectiveness in this sense, although not excellent, is still good, but only if breastfeeding is regular and constant. Among other things, the resumption of ovulation and the consequent menstruation during breastfeeding breast does not necessarily mean a high probability that the woman will become pregnant; lactation hormones, in fact, can induce the development of deficient oocytes and an inadequate luteal phase, resulting in a low level of estrogen and progesterone, which translates into a natural obstacle to the establishment of a new pregnancy.
Given that - although difficult - it is possible to become pregnant even before the appearance of the head of the ward, during breastfeeding as a contraceptive method it is recommended to use a condom or diaphragm. If the birth took place vaginally, the spiral can be inserted as soon as the uterus returns to its original size, while in the case of a cesarean it is necessary to wait six months to avoid the device being trapped in the internal scar of the incision. Estrogen-progestogen oral contraceptives cannot be taken while breastfeeding, as estrogen may inhibit milk production, but it is possible to take the progestogen-only pill, which is harmless for the baby and quite effective.
Questions and answers
What is the normal extent of the first menstrual flow during breastfeeding?
The foreman may be a little more abundant than the usual menstrual flow.
The resumption of menstrual cycles after childbirth is rather irregular, is this normal?
Often, menstrual cycles can be irregular for a few months and as anticipated not all are ovulatory.
If the period after childbirth is late in coming, should I worry?
If the menstruation does not appear within six months from the date of birth, it is good to report it to your gynecologist or doctor. In some cases - fortunately very rare in industrialized countries - severe bleeding and shock associated with childbirth can damage the pituitary gland (Sheehan's syndrome).
If menstruation reappears during breastfeeding, can I continue breastfeeding?
The reappearance of menstruation during breastfeeding must NOT stop breastfeeding, although in this period the milk may take on a slightly different taste, which may not be appreciated by the baby; moreover, it is possible to observe a decrease in the quantity of milk, and very often an increase in gastro-intestinal disorders with variations in the consistency of the stool and evacuation. breastfeeding. In any case, during the first menstruation, breastfeeding should not be suspended, even when the baby feeds less willingly, is irritable and evacuates more often and less consistently.
