When does menstruation begin after childbirth?

A difficult ordeal is behind us - the birth of a baby. Finally, the long period of waiting for his birth has ended, and now you have united with him. A young mother is completely immersed in caring for her child, and for the first six months or a year of his life, she may not pay attention to her own health. She doesn’t even think about, for example, when the first one should arrive. menstruation after childbirth. She's just not up to it.

Meanwhile, you should definitely take care of yourself and consult a doctor if you suspect any illness. After all, the child, his well-being and development are directly dependent on the health of the mother. If you don’t have time to think about yourself, think about him.

One of the main indicators of women's health is regular menstruation with moderate blood loss. ? What will they be like? What to do if they are gone for a long time, and for what reasons could this happen?

• When should your first period start after childbirth?
• Time frame for the restoration of the menstrual cycle
  • Natural childbirth
  • C-section
• How to distinguish from bleeding
• Can the first menstruation occur 1-3 months after birth while breastfeeding?
• Changes in the nature of the menstrual cycle, discharge

First menstruation after childbirth

Among women there is the following opinion: those discharges that continue for a long time after the birth of a child are the first menstruation.

But that's not true. The first 1.5 months are accompanied by lochia. At first they are very abundant and require the use of special pads. By the 30th day they become scanty and may appear as just yellowish leucorrhoea. - These are bloody clots that are released by the contracting uterus. At this time, the uterus is one continuous bleeding wound, and it requires time to heal.

Then, normally, the lochia stops, and the woman does not feel the “delights” of menstrual bleeding for some time.

Restoring menstruation after childbirth depends on many factors. The main one is the presence or absence of breastfeeding.

Why are there no periods after childbirth? If a woman breastfeeds, the level of two hormones increases in her body:

• oxytocin;

The first one “supplies” milk, helping the baby suck it from the milk ducts. He is “responsible” for the mother’s attachment to the baby.

But the second one acts as an ovulation blocker. When there is a lot of this hormone, the production is suppressed:

• FSH (the hormone responsible for the maturation of the dominant follicle);
• LH (a hormone that regulates ovulation and “monitors”).

It's time to mature dominant follicle– and prolactin prevents this process from happening. This is the reason for the absence of menstruation: after all, menstruation occurs after ovulation, when the unnecessary egg is removed from the body.

Regular and painless periods are one of the indicators of a woman’s health. They serve as an indicator of the ability to give life to a person. Their absence during pregnancy and in most cases during breastfeeding makes it possible for a young mother to give her vitality to a baby who has only recently announced his presence in this world. The arrival of menstruation indicates that the woman is able to conceive and bear a child again.

What is the menstrual cycle

The menstrual cycle is a multifaceted biological process in the female body, affecting the functions of both the reproductive system and others (cardiovascular, nervous, endocrine and others). A cycle is the period of time between the first day of menstruation and the last day before the next period. Its duration should be regular (from 21 to 35 days), approximately the same each time. Each such cycle prepares a woman for pregnancy. It consists of the following phases:

1. Preparing for ovulation. The ovaries produce the hormone estrogen, which causes the inner layer of the uterus to swell and the follicle (the bladder containing the egg) to mature.
2. Ovulation. A mature follicle bursts and the egg leaves it into the abdominal cavity. Usually occurs in the middle of the cycle.
3. Readiness for fertilization. The egg begins to move through the fallopian tubes into the uterus. This process lasts on average three days. If fertilization does not occur during this time, the egg dies. The ovaries produce large quantities of the hormone progesterone, thanks to which the endometrium (the inner layer of the uterus) prepares to receive a fertilized egg. If pregnancy occurs, there are no periods.
4. Menstruation. If fertilization does not occur, the endometrium begins to be rejected, which occurs due to sharp decline progesterone production. Bleeding begins.

Restoring the menstrual cycle means the possibility of a new pregnancy for a woman

In many countries before, and in some even now, girls and women during their periods are treated differently. Some believe that a woman becomes unclean. Thus, some of our compatriots do not even go to church during menstrual periods. In some eastern countries Girls are forbidden to cook food, touch idols, perform homework so as not to desecrate anything.

In other regions, it is or was previously believed that women have special powers during menstruation. Thus, in the 16th century, the Korean general Gwak Cheu during the war wore red clothes dyed with the menstrual blood of virgins. The general believed that the dark feminine energy yin turned his clothes into armor inaccessible to enemy fire - the personification of male yang energy.

How to distinguish periods from lochia and postpartum bleeding

After childbirth, a woman experiences bleeding, abundant at first, and then increasingly scanty. This discharge has nothing to do with menstruation and is called lochia. Immediately after birth, lochia is very abundant. But after a few days they become similar to light periods, after which they gradually decline. After about a month and a half, they disappear without a trace.

Sometimes lochia stops faster, but the uterus does not have time to return to its original size (a noticeable tummy remains). This may indicate that the uterus is contracting poorly or the cervical canal is spasming. Such pathologies are diagnosed using ultrasound. Blood that is too dark in the form of clots may also indicate similar problems. Its color indicates that it was in the uterus for a long time and managed to oxidize.

If the uterus seems to have contracted, lochia has almost stopped, but suddenly appears copious discharge blood, and less than five weeks have passed since birth, which means bleeding has begun. In this case, you should immediately consult a doctor. The reason for this situation lies in a piece of placenta remaining in the uterus. Pathology is diagnosed using ultrasound and confirmed by hysteroscopy or curettage.

Video: doctor talks about discharge after childbirth

When to expect your period after childbirth

The monthly cycle of a young mother is restored gradually: for some, a month and a half after giving birth (but not earlier), and for others, after a year, which depends on many factors. But first of all, it depends on the woman’s hormonal background.

The level of hormones in the body is subject to changes, and the onset of menstruation depends on the quantity in which they are present in the body. If a woman is breastfeeding, her body produces large quantities of prolactin. It suppresses the work of the ovaries, thereby preventing the restoration of the menstrual cycle. This is how nature makes sure that feminine forces are directed towards the baby that has already been born, and not towards a new pregnancy. If for some reason the mother has completed breastfeeding, this is a sign for the body that the woman is free and can prepare for a new pregnancy. That is why, in most cases, mothers whose children are fully breastfeeding, no menstruation. The cycle is restored soon after the baby is transferred to artificial or mixed feeding or complementary foods are actively introduced.

Thus, most often the recovery time of the cycle depends on the nature of the baby’s diet:

• if a baby under one year old is completely breastfed, receives milk on demand at any time of the day, and complementary feeding is only a supplement to mother’s milk, menstruation should be expected when the baby turns one year old and “adult” food takes the main place in his diet;
• if the baby is actively fed from 5–6 months, gradually replacing breastfeeding with solid food, menstruation will appear when the baby is seven–eight months old;
• when the baby is on mixed feeding, discharge will most likely begin three to four months after birth;
• In mothers of bottle-fed babies, menstruation appears one and a half to two months after birth.

The hormone prolactin, produced in large quantities in the body of nursing mothers, inhibits the functioning of the ovaries and the resumption of menstruation.

U modern woman Over the course of her life, she has about 450 menstrual cycles. A few centuries ago this figure was lower - about 160 cycles. And in ancient times - about 50. This is due to the fact that they used to give birth to many children and breastfeed them for a long time.

What else affects the onset of menstruation?

Of course, other factors also influence the onset of menstruation, although to a much lesser extent than lactation:

• the presence of diseases complicates recovery after childbirth, which means that menstruation is delayed;
• difficult pregnancy and complications of childbirth slow down the recovery process, so you will have to wait longer for the arrival of menstruation;
• the level of other hormones is interconnected with the production of prolactin, and therefore the onset of menstruation;
• correct balanced diet, the intake of sufficient quantities of necessary microelements and vitamins contributes to the full functioning of the body and the speedy restoration of the monthly cycle;
• adherence to sleep and rest patterns promotes recovery processes;
• presence of stress, depressed emotional condition have a negative impact on reproductive health and restoration of the menstrual cycle;
• the use of hormonal contraceptives can make adjustments to the functioning of the hormonal system: along with stimulation of progesterone production, their use reduces the amount of prolactin. Therefore, it is possible for menstruation to begin as quickly as possible, but at the same time, a decrease in the amount of milk produced;
• age and number of births affect the functioning of the reproductive system. A young, unworn body returns to normal faster;
• excess weight does not contribute to the timely onset of menstruation;
• The body of women who have given birth several times, as well as those who gave birth for the first time after 30 years, usually takes longer to recover after childbirth.

Recovery after caesarean section

Restoration of the menstrual cycle does not depend on whether the baby was born as a result natural birth or after surgery caesarean section. However, in some cases, recovery may be delayed due to complications in postoperative period: inflammatory processes in the uterine cavity, as well as in the suture area. Otherwise, the method of delivery does not matter.

Restoring the menstrual cycle after a cesarean section, if it passed without complications, is no different from recovery after a natural birth

Features of the menstrual cycle after childbirth

After childbirth, menstruation may have a completely different character than before childbirth, although this is not necessary. It happens that their frequency, duration, and nature of discharge, their intensity, change. They are often not as painful as they used to be.

Restoring the cycle takes some time. The first periods after childbirth do not immediately become regular, equal in duration, and do not always occur with the same frequency. The body needs time to adjust to new way. On average, this takes two to three months.

Table: what should menstruation be normally?

Often, before the onset of menstruation, a woman experiences premenstrual syndrome (PMS), even if it was uncharacteristic for her in the prenatal period. This condition is characterized by:

• mood swings;
• irritability;
• sleep disorders;
• absent-mindedness;
• swelling and mild soreness of the mammary glands;
• fluid retention in the body, edema;
• joint pain;
• allergic reactions.

Many women determine the approach of menstruation by changes in their well-being.

Soreness, heavy discharge and duration of menstruation are usually much longer in winter time than in the summer.

How to help the body recover

During pregnancy and after the birth of a baby, the load on all organs and systems (especially the nervous and endocrine) of a woman is very large. The following will help restore the cycle and ensure the proper functioning of the body:

• proper sleep and rest;
• peace of mind, tranquility;
• proper, balanced nutrition, taking vitamins;
• active lifestyle, full walks in the fresh air.

How does menstruation affect breast milk?

Mothers whose cycle has returned are often worried about how changes in their body will affect lactation. With menstrual flow, the amount of the hormone prolactin in the body sometimes decreases, which reduces milk production. At the same time, the quality, taste, and composition of milk remain the same. It is worth putting the baby to the breast more often so that he remains full and calm, and also drink more fluids.

Menstrual flow in a young mother does not affect the quality of her milk in any way, but can slightly reduce its quantity

Table: menstrual cycle disorders

Such violations are rare, but in order to prevent them in time, all women who have given birth are given an ultrasound examination and tests are prescribed, and are also recommended to regularly visit a gynecologist, especially in the first time after childbirth. By ignoring these recommendations, a young mother puts both her health and the health of her future children at risk.

Restoring the menstrual cycle after childbirth is one of the conditions for a woman’s physical well-being. Healthy image life, a positive attitude and timely consultation with a doctor in case of concern will help make the process easy and natural.

The menstrual cycle is one of the manifestations of a complex biological process in a woman’s body, which is characterized by cyclic changes in the function of not only the reproductive (reproductive) system, but also the cardiovascular, nervous, endocrine and other body systems.

More specifically, menstrual cycle- this is the period of time from the first day of one to the first day of the next menstruation. The length of the menstrual cycle varies among women, but on average ranges from 21 to 35 days. It is important that the duration of a woman’s menstrual cycle is always approximately the same - such a cycle is considered regular.

Each normal menstrual cycle prepares a woman’s body for pregnancy and consists of several phases:

During first phase The ovaries produce the hormone estrogen, which promotes swelling of the inner layer of the uterus, and the follicle (the vesicle in which the egg is located) matures in the ovaries. Then ovulation occurs - the mature follicle bursts and the egg is released into the abdominal cavity.

In second phase The egg begins to move through the fallopian tubes into the uterus, ready for fertilization. This process lasts on average three days; if fertilization does not occur during this time, the egg dies. In the second phase of the menstrual cycle, the ovaries predominantly produce the hormone progesterone, thanks to which the endometrium (the inner layer of the uterus) prepares to receive a fertilized egg.

If fertilization does not occur, the endometrium begins to be rejected, which occurs due to a sharp decrease in progesterone production. Bleeding begins - menstruation. Menstruation is bloody discharge from a woman's genital tract, the first day of which marks the beginning of a new menstrual cycle. Normal menstruation lasts 3-7 days and during this process 50-150 ml of blood is lost.

During pregnancy, the expectant mother's body undergoes changes associated with hormonal changes, which are aimed at maintaining pregnancy, which causes physiological amenorrhea (absence of menstruation).

The sequence of restoration of menstrual function

After the birth of a child, the work of all endocrine glands, as well as all other organs and systems, returns to its pre-pregnancy state. These important changes begin from the moment of expulsion of the placenta and last approximately 6-8 weeks. During this time, important physiological processes occur in a woman’s body: almost all changes that occur in connection with pregnancy and childbirth in the genitals, endocrine, nervous, cardiovascular and other systems undergo; the formation and flourishing of the function of the mammary glands occurs, which is necessary for breastfeeding.

The normal menstrual cycle is a coordinated mechanism of the ovaries and uterus, so the process of restoring the functioning of these organs is inseparable from each other. The process of involution (reverse development) of the uterus occurs quickly. As a result of contractile muscle activity, the size of the uterus decreases. During the first 10-12 days after birth, the fundus of the uterus drops daily by approximately 1 cm. By the end of the 6-8th week after birth, the size of the uterus corresponds to the size of a non-pregnant uterus (in nursing women it may be even smaller). Thus, by the end of the first week the weight of the uterus decreases by more than half (350-400 g), and by the end of the postpartum period it is 50-60 g. The internal os and the cervical canal also quickly form. By the 10th day after birth, the canal is completely formed, but the external pharynx is still passable for the tip of the finger. The closure of the external pharynx is completed completely in the 3rd week after birth, and it takes on a slit-like shape (before birth, the cervical canal has a cylindrical shape).

The speed of involution may depend on a number of reasons: general condition, the woman’s age, characteristics of pregnancy and childbirth, breastfeeding, etc. Involution can be slowed down in the following cases:

• in weakened women who have given birth many times,
• in primigravidas over 30 years of age,
• after pathological childbirth,
• in the wrong mode postpartum period.

After the separation of the placenta and the birth of the placenta, the uterine mucosa is a wound surface. Restoration of the inner surface of the uterus usually ends by 9-10 days, restoration of the uterine mucosa - at 6-7 weeks, and in the area of ​​the placental area - at 8 weeks after birth. During the healing process of the inner surface of the uterus, postpartum discharge - lochia - appears. Their character changes during the postpartum period. The nature of lochia during the postpartum period changes in accordance with the processes of cleansing and healing of the inner surface of the uterus:

• in the first days of lochia along with decaying particles inner shell the uterus contains a significant admixture of blood;
• from the 3-4th day, lochia acquires the character of a serous-sucrose fluid - pinkish-yellowish;
• by the 10th day, the lochia become light, liquid, without any admixture of blood, their number gradually decreases;
• from the 3rd week they become scanty (contain an admixture of mucus from the cervical canal);
• at 5-6 weeks, discharge from the uterus stops.

The total number of lochia in the first 8 days of the postpartum period reaches 500-1400 g, they have a specific smell of rotten leaves.

With slow reverse development of the uterus, the release of lochia is delayed, and the admixture of blood lasts longer. When the internal pharynx is blocked by a blood clot or as a result of a bend in the uterus, an accumulation of lochia may occur in the uterine cavity - lochiometer. The blood accumulated in the uterus serves as a breeding ground for the development of microbes; this condition requires treatment - application medications, contracting the uterus or, at the same time, also washing the uterine cavity.

In the postpartum period, the ovaries also undergo significant changes. Reverse development ends corpus luteum- a gland that existed in the ovary during pregnancy in place of the egg that was released into the abdominal cavity and then fertilized in the tube. The hormonal function of the ovaries is restored completely, and the maturation of follicles - vesicles containing eggs - begins again, i.e. the normal menstrual cycle is restored.

Time frame for the restoration of the menstrual cycle

Most non-breastfeeding women begin menstruation 6-8 weeks after giving birth. Breastfeeding women generally do not menstruate for several months or throughout the entire period of breastfeeding, although in some of them menstrual function resumes soon after the end of the postpartum period, that is, 6-8 weeks after birth. Here you should not look for either a norm or a pathology, since the timing of the restoration of the menstrual cycle after childbirth is individual for each woman. This is usually associated with lactation. The fact is that after childbirth, a woman’s body produces the hormone prolactin, which stimulates milk production in the female body. At the same time, prolactin suppresses the formation of hormones in the ovaries, and, therefore, prevents the maturation of the egg and ovulation - the release of the egg from the ovary.

If the baby is entirely breastfed, that is, eats only breast milk, then his mother’s menstrual cycle is often restored after the start of complementary feeding. If the child is on mixed feeding, that is, in addition to breast milk If the baby's diet includes mixtures, the menstrual cycle is restored after 3-4 months. With artificial feeding, when the baby receives only formula, menstruation is restored, as a rule, by the second month after birth.

First menstruation after childbirth

The first menstruation after childbirth is often “anovulatory”: the follicle (the vesicle in which the egg is located) matures, but ovulation—the release of the egg from the ovary—does not occur. The follicle undergoes reverse development, and at this time the disintegration and rejection of the uterine mucosa begins - menstrual bleeding. Subsequently, the ovulation process resumes and menstrual function is completely restored. However, ovulation and pregnancy may occur during the first months after birth.

The restoration of menstrual function is influenced by many factors, such as:

• the course of pregnancy and complications of childbirth,
• woman’s age, proper and nutritious nutrition,
• adherence to sleep and rest patterns,
• presence of chronic diseases,
• neuropsychic state and many other factors.

Possible complications after childbirth

What problems do young mothers face when restoring menstrual function?

Regularity of the menstrual cycle: after childbirth, menstruation may immediately become regular, but it may take 4-6 months to establish itself, that is, during this period, the intervals between them may vary somewhat, differing from each other by more than 3 days. But, if 4-6 months after the first postpartum menstruation If your cycle remains irregular, then this is a reason to consult a doctor.

Duration of menstrual periodcycle may change after childbirth. So, if before childbirth the cycle was 21 or 31 days, then there is a high probability that after childbirth its duration will become average, for example 25 days.

Duration of menstruation that is, bleeding should last 3-5 days. Too short (1-2 days) and, especially, too long periods can be evidence of some pathology - uterine fibroids (benign tumor), endometriosis - a disease in which the inner layer of the uterus, the endometrium, grows in uncharacteristic places.

Volumemenstrualdischarge may be 50-150 ml, too small as well as too a large number of menstrual blood may also be evidence of gynecological diseases. Although there may be some deviations in the first few months after the first postpartum menstruation, they should still be within the normal range. physiological norm: So, on the heaviest days, one medium pad should be enough for 4-5 hours.

Long lasting spottingbloody issues at the beginning or end of menstruation are also a reason to consult a doctor, since most often they indicate the presence of endometriosis, inflammatory diseases- endometritis (inflammation of the inner lining of the uterus), etc.

Sometimes Menstruation is accompanied by pain. They can be caused by the general immaturity of the body, psychological characteristics, concomitant inflammatory processes that arise after childbirth, and strong muscle contractions of the walls of the uterus. If painful sensations are such that they bother a woman during menstruation, force her to repeatedly take painkillers, antispasmodics, disrupt the normal rhythm of life, this condition is called algomenorrhea and requires consultation with a doctor.

Although often after childbirth the opposite happens, that is, if before pregnancy menstruation was painful, then after childbirth they pass easily and without pain. This is due to the fact that pain can be caused by a certain position of the uterus - a backward bend of the uterus; after childbirth, the uterus acquires a normal position.

Often during menstruation chronic inflammatory diseases worsen- endometritis (inflammation of the uterus), salpingoophoritis (inflammation of the appendages). In this case, significant pain appears in the lower abdomen, the discharge can become very abundant, with an unpleasant, uncharacteristic odor. You should especially monitor the presence or absence of these symptoms if inflammatory complications were observed after childbirth.

Some women complain about the so-called premenstrual syndrome. This is a condition that manifests itself not just as irritability, bad mood or a tendency to cry, but a whole complex of symptoms. Among them: engorgement and tenderness of the breast, headache, fluid retention in the body and swelling, joint pain, allergic manifestations, distracted attention, insomnia.

There are many versions regarding the reasons for the development premenstrual syndrome, but there is no single cause underlying it, and therefore there is no specific drug that can cure it completely. If a woman is concerned about such symptoms, she should consult a doctor who will prescribe appropriate treatment.

After childbirth, especially complicated ones (bleeding, severe gestosis with severe edema, significant increase blood pressure, up to the development of convulsive syndrome, the so-called eclampsia), dysfunction of the ovaries may occur, which are associated with a violation of central regulation - regulation of the production of pituitary hormones (glands internal secretion located in the brain). In this case, the development of eggs in the ovaries is disrupted, hormonal changes occur and, as a result, menstruation is disrupted in the form of delays, which can be replaced by bleeding. With such manifestations, you should definitely seek the help of specialists.

It is important for a young mother to know that pregnancy can occur even in the absence of normal menstruation. This happens because ovulation begins on average two weeks earlier than your period. Therefore, in order not to be faced with the fact of an unplanned pregnancy, it is necessary to discuss contraception issues at the first appointment with a doctor after childbirth or consult about this before giving birth.

Restoring menstrual function after cesarean section

Complicated labor can also lead to various menstrual irregularities. In this regard, I would especially like to note the peculiarities of restoration of menstrual function in women after cesarean section. Their menstruation usually occurs at the same time as after normal childbirth. However, with complications in the postoperative period, menstrual function may not be restored for a long time due to a longer period of uterine involution due to the presence of a suture, as well as a longer process of normalization of ovarian function in infectious complications. Most likely, in this case, you will need to consult a gynecologist who will select the necessary therapy.

After the birth of a baby, a young mother’s load on the endocrine and nervous system increases. When breastfeeding, the need for vitamins, minerals and microelements increases, which a woman needs for the proper functioning of the ovaries and their production of hormones. If they are deficient, problems such as scanty or painful menstruation. Therefore, women after childbirth are recommended to take multivitamins with a complex of microelements for nursing mothers and a nutritious diet, including dairy products, meat, vegetables and fruits.

In addition, caring for a newborn takes a lot of effort and time from a young mother, and it must be remembered that the lack of a full night’s sleep and lack of sleep can lead to increased fatigue, weakness, and sometimes even depression, which also negatively affects the development of menstrual function; In this connection, it is necessary to create your own regime so that the young mother has time to rest during the day, and, if possible, save night time for proper rest.

As mentioned above, the presence of chronic diseases can also negatively affect the development of menstrual function, especially diseases of the endocrine system (thyroid gland, diabetes mellitus and etc.). Therefore, in the postpartum period, it is necessary to correct these diseases together with specialists, which will avoid menstrual irregularities.

In conclusion, I would like to note that restoration of normal menstrual function after childbirth is one of the main conditions for a woman’s future health. Therefore, any problems associated with its violations should be resolved together with a doctor.

A regular menstrual cycle is considered the main sign that the body of a woman who has given birth is recovering normally. Most of At first, women who give birth pay almost all their attention to the baby, but there comes a time when they begin to think about their health. At the same time, many new mothers are worried not because they returned critical days, but because from now on they can get pregnant again. In order to understand exactly what time a woman who has given birth begins menstruation, it is necessary to learn more about the characteristics of her body.

When does your period come after childbirth?

Almost all doctors say that the menstrual cycle returns to normal completely after breastfeeding stops. This is a completely natural process observed at a time when women breastfed their baby for 2 and even 3 years. At the same time, they fed the child only on demand. About 20 years ago, nursing mothers could completely forget about their periods for a long time.

Today, in most cases, things are like this:

• breastfeeding up to 6 or 12 months;
• there is a huge selection of food for babies;
• early initiation of complementary feeding is practiced.

Also that women's endocrine system begins to function “abnormally”, may be affected by medicated childbirth, hormonal contraceptives, as well as other factors that together can affect the moment of the onset of menstruation after childbirth, so it is almost impossible to say when this will happen with an accuracy of up to a week. In each case it is individual. However, if menstruation began 4 months or 2 years after childbirth, then in both cases this is considered normal.

How quickly the body of a woman who has given birth will recover is influenced by many factors, namely:

• how old is the woman;
• what is the state of her health;
• what are the features of lactation, and whether the woman is breastfeeding;
• how the period of bearing a child and the process of childbirth proceeded;
• Are there any concomitant diseases?

There are several reasons for the slowdown in the reverse development of the uterus (involution):

• the body is weakened;
• This is not the first birth;
• a mother over 30 years old gave birth for the first time;
• labor history is complicated;
• violation of the rules of the postpartum regimen;
• breast-feeding.

How do menstruation begin after childbirth?

For many women who have given birth, normalization of a regular menstrual cycle takes relatively little time. When in the first 2 months the onset of menstruation occurs earlier than expected or, on the contrary, there is a delay, this is considered the norm.

There is a lot of speculation regarding the menstrual cycle and the time it takes to recover. Many women are of the opinion that the way the process of normalizing the menstrual cycle proceeds is necessarily influenced by the way in which the baby was born. However, this is not the case. The onset of menstruation has no connection with whether a cesarean section took place or the birth was natural.

Menstruation occurring after childbirth causes less discomfort associated with pain than before the woman became pregnant. This happens because painful sensations during menstruation have a direct connection with the bending of the uterus, which causes disruption of the normal outflow of blood. Organs abdominal cavity Several change their position after the woman gives birth, and, most importantly, the bend is completely straightened. Therefore, pain during menstruation is practically not felt.

A large number of women mistake discharge such as lochia for menstruation. Lochia is mucus mixed with blood clots. Such discharge appears due to injury to the lining of the uterus. They are abundant and have a rich red color only in the first few days after birth. After 7 days, the discharge becomes significantly less and it changes its color to brownish. Every day the amount of lochia secreted decreases because the uterine mucosa is healing. As a rule, the release of lochia can last 1.5–2 months, after which they disappear.

A woman who has given birth and is breastfeeding a baby can become pregnant even in the absence of menstruation. This is because the mature egg begins to leave the ovaries approximately 14 days before bleeding occurs. Pregnancy can occur either a few days before or after ovulation.

The onset of menstruation in a woman who has given birth is not a signal that her body is ready for another pregnancy. It takes at least 2 years for it to fully recover. Experts advise planning the next pregnancy only after this amount of time. Therefore, contraception should be used even if postpartum menstruation has not yet begun.

How the menstrual cycle is restored

In a woman who has given birth, all systems and organs in her body gradually begin to function in the same way as before pregnancy. In the first 1.5–2 months, changes occur in many systems, for example, in the cardiovascular, reproductive, endocrine, nervous. And changes also occur in the mammary glands.

In order for the menstrual cycle to normalize, it is necessary that the process of reverse development of the uterus (involution) be completed. Involution sequence:

• the first 10–12 days - lowering of the uterine fundus;
• within 1.5–2 months - reduction in the size of the uterus;
• first week - decrease in uterine weight from 400 to 50 grams;
• the first 1.5 weeks - formation of the internal os;
• within 3 weeks - this is how long it takes to close the external pharynx, while it changes its shape from cylindrical to slit-like;
• within 1.5–2 months - restoration of the endometrium.

The speed of the process of reverse development of the uterus depends on the woman’s health, on her age, on how the pregnancy proceeded and the birth itself, on the method of feeding the baby, etc. This process slows down when:

Start of menstruation after childbirth

The presence of various diseases, hormone levels, frequency of stress and several other reasons can affect the timing of the first postpartum menstruation. But the most important place here is how complete lactation is. For the first time, postpartum periods can approximately begin:

1. If breastfeeding is complete and additional complementary feeding is not used, then the first menstruation will begin after the lactation period ends. However, after the child turns 1 year old and continues to be breastfed, then the onset of menstruation may well occur.
2. If there is too little milk and the baby is supplemented with formula milk, then the first time menstruation may occur after 4-5 months, even if breastfeeding is not stopped. In this case, less prolactin is produced and its effect on the ovaries is much weaker.
3. Very often occurs completely artificial feeding. Some of the mothers themselves do not want to breastfeed, and some have certain health problems. In this case, the first postpartum menstruation occurs after 6–8 weeks.
4. If the baby was born as a result of a cesarean section, then the time of the first menstruation is directly dependent on breastfeeding, provided that the woman has no complications. The first postpartum menstruation will begin after breastfeeding is stopped or after the introduction of complementary foods.

Also, during the period of the first postpartum menstruation, other factors may influence. For example, is the regime followed correctly, the variety and usefulness of food products, diseases that have chronic form, age, psycho-emotional state. And no less important are the characteristics of the body of the woman who gave birth. In this regard, even a qualified specialist cannot say when exactly you should expect the first postpartum menstruation to appear.

How does artificial feeding and breastfeeding affect the cycle?

The body's ability to reproduce is completely restored when the menstrual cycle returns to normal. This means that the woman can now become pregnant again. The way your baby is fed has a direct impact on the cycle. Does breastfeeding occur on demand, or maybe according to a schedule? Or maybe formula milk is used to feed him? At what time does the first menstruation occur after childbirth when breastfeeding and formula feeding:

Possible complications

1. Lack of postpartum menstruation.

If breastfeeding has been stopped or the baby is bottle-fed but there is no menstruation, this may be a sign of health problems. This can be caused by a variety of diseases of the reproductive system, for example: endometriosis, postpartum pathologies, tumor, inflammation of the ovaries, etc. This may also be due to the fact that the woman became pregnant again. It should be remembered that a restored menstrual cycle is not a sign that the body is ready to conceive. A new pregnancy often causes exhaustion of the mother’s body, and the fetus may also suffer. All doctors recommend getting pregnant again only 2-3 years after the last birth. In this case, the body will have time to fully recover. The risk of conception can be reduced if you take care of protection in advance. Do not forget that breastfeeding is not a method of contraception.

1. Irregularity of menstruation after childbirth.

Restoration of the body occurs differently for each woman who has given birth. If the onset of menstruation is irregular, then this indicates hormonal changes. As a rule, everything returns to normal after 2 or 3 cycles. Irregularity of menstruation after the third cycle indicates the presence of the same diseases as in the complete absence of menstruation. This may also be due to hormonal imbalance. If there is a delay, this indicates a possible conception.

1. Heavy postpartum menstruation.

The amount of discharge varies from woman to woman. You can understand whether their abundance corresponds to the norm by comparing it with the volume of discharge that was before the woman became pregnant. Also, the presence of health problems can be indicated by the duration of menstruation for more than 1 week. If a woman experiences deep red bleeding for a week and a half, she may be hospitalized. The normal duration of menstruation is 3–7 days, and a woman should not lose more than 150 mg of blood.