I had a non-stop two-year-old son and a seven-month-old daughter who wasn’t sleeping through the night. I could not be pregnant again. The signs were all there though—breast tenderness, cramping, even a bit of what I thought was implantation spotting.
But a few weeks—and four pregnancy tests—later, I got my period.
I had recently weaned my daughter from breastfeeding and what I had experienced was just PMS. A very different PMS than I’d had before.
Was this normal? When I went online, I found other moms who’d had severe cramping and unpredictable periods after giving birth. Many others were also sure they were pregnant after experiencing irritability, headaches and nausea. Others described depression and anxiety when weaning their babies.
What causes these symptoms? Dr. Batya Grundland, a family physician at Women’s College Hospital in Toronto, says the return of menstruation is different for every woman, but it is common to have a heavier period and more cramping, due to the increasing estrogen in the body.
When breastfeeding, the hormone prolactin increases and estrogen decreases, which can suppress ovulation. When you wean, you return to a normal cycle (although some moms resume ovulation and menstruation while breastfeeding).
“Memory also has an effect. You get your period in your teens and then you often go on birth control and then you decide to have a child and get pregnant. So, many women haven’t had a normal menstrual cycle in 10 to 15 years.”
What about my emotions? As for depression and anxiety, Dr. Grundland said this could be due to stopping breastfeeding.
“It’s like grief, it’s a loss. Your baby is growing up. Breastfeeding is a very particular bond and it represents a change in the relationship,” she said.
Grundland suggests weaning slowly if possible and creating new special rituals with baby.
Robyn Berman, a doula in Halifax, says women may feel cramps more intensely because they remind them of labour pains. She said it may also be difficult coming to terms with menstruation resuming.
“It brings back feelings of womanhood and your sexuality. You may not be feeling all that sexual because of breastfeeding all day and all of the physical needs of motherhood. Your intimacy with your partner may or may not be back to what it was.”
Other effects women may notice are changes to the size and shape of the breasts and some moms feel the let-down sensation for many months after breastfeeding ends.
Why it’s a good idea to wean slowly Leslie Mills, a public health nurse in Vancouver, says weaning gradually helps, as suddenly stopping means a bigger shift for your hormones.
Prolactin and oxytocin, which are markedly increased during breastfeeding drop after weaning. Other hormones like estrogen, progesterone and FSH (follicle-stimulating hormone) increase.
“It’s another set of hormones starting to wake up and influence your body again. At the same time, you are aging too. So your periods never stay the same.”
On the upside, Grundland points out the increased estrogen could help rev up your libido, which may have taken a hit after delivery and while breastfeeding.
Help is out there If feelings of sadness or depression linger, Grundland says to be sure to seek professional help.
To ease cramps, try an anti-inflammatory, heating pad or a hot bath.
If periods are especially heavy, Grundland says to be aware of the risk of iron deficiency and get tested if experiencing symptoms, which include headaches and feeling weak or tired.
Berman says, above all, seek support from your doctor, friends, family or doula.
“Just talk about everything you are going through. It’s empowering.”
This article was originally published in September 2011.
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