No Period After Pregnancy: When To Worry?

Missing a period after giving birth can be concerning, especially when you're wondering if your menstrual cycle should have returned by now. Many new mothers expect their periods to come back fairly quickly after delivery, but this isn't always the case.

Your body goes through significant hormonal changes during and after pregnancy, and the recovery process affects when your menstrual cycle resumes. Understanding what's normal during this postpartum period can help ease concerns about when to expect your period to return.

Why haven't I got my period after giving birth?

It is very frequent not to get your period immediately after delivery, and in most of the cases it is completely normal. Postpartum menstruation depends a lot on hormones, mainly if the mother is lactating. Prolactin, the hormone responsible for milk secretion, is the one that suppresses ovulation and consequently delays the return of the period.

Every woman recovers at her own pace. The return of menstruation is influenced by the following factors:

• How the baby is fed

• The state of hormone level in your body

• The general condition of the body and the stage of postpartum recovery

Some women can have their periods back only after a few weeks, while others need to wait for several months. So, if you're not breastfeeding and your period hasn't returned, you should see a doctor.

What is happening in your body after pregnancy?

After childbirth, your body goes through major hormonal changes. Oestrogen and progesterone hormone levels fall quickly, while prolactin rises. This shift often suppresses ovulation, which can delay the return of your menstrual cycle.

At the same time, your uterus is healing, and your reproductive system is slowly adjusting back to its pre-pregnancy state. These changes are a normal part of recovery and can affect how soon your period returns. 

How soon after giving birth can you get your period?

If you’re not breastfeeding, your period may return as early as 6 to 8 weeks after delivery. But,if you’re exclusively breastfeeding, your period may be delayed for 6 months or longer. 

This is because the Lactational Amenorrhoea Method (LAM), the body’s natural response to frequent nursing, suppresses ovulation and can postpone menstruation. Although every woman’s timeline is different, both scenarios are considered normal.

How do you know when your period is coming back after pregnancy?

Your body often gives early signs that menstruation is returning. Common indicators include:

• Mild cramping similar to pre-period pains

• Noticeable changes in vaginal discharge

• An increase in cervical mucus

• Breast tenderness

• Mood swings or PMS-like symptoms

Factors that influence the post-pregnancy menstrual cycle

Several factors can affect the timing of your menstrual cycle's return after pregnancy:

• Breastfeeding:
  • When you breastfeed, your body produces prolactin. High levels of prolactin suppress ovulation, often delaying the return of your period. The effect is stronger with frequent nursing, especially at night.
  • As feedings decrease or weaning begins, prolactin levels drop, making it more likely for your cycle to resume.
• Hormonal changes:
  • After childbirth, your body goes through major hormonal shifts. These changes can affect the timing of your first period.
• Physical recovery:
  • Every woman’s healing process is unique. The pace of recovery can vary when your menstrual cycle normalises.
• Stress and lifestyle:
  • Adjusting to life with a newborn – lack of sleep, stress, or changes in routine – can also affect your hormones and delay menstruation.

For more personalised information about the postpartum period and to discuss your individual circumstances, consider consulting a fertility specialist. You can contact Thomson Medical to arrange a consultation and receive guidance tailored to your needs.

How to support your body during this time?

Taking care of your body during the postpartum phase can help with recovery and hormonal balance:

• Nutrition:

  • Focus on a balanced diet with iron, calcium, and protein to restore energy and support healing.

• Hydration:

  • Drink plenty of water, especially if you’re breastfeeding.

• Rest:

  • Sleep may be limited with a newborn, but prioritising rest whenever possible aids hormone regulation.

• Gentle movement:

  • Light activities like walking or postnatal yoga boost circulation and support recovery.

• Stress care:

  • Managing stress through relaxation and self-care is important, as emotional strain can affect ovulation and delay your period. 

When to worry about no period after pregnancy?

It's normal not to have a period after giving birth. But if you have any of these symptoms, consult with your doctor to ensure you're healthy after giving birth.

Signs that need medical attention

• If you have really bad or ongoing pain:

  • Postpartum cramping is normal, but severe pain may indicate a problem. These may include infections, problems with the womb, or other medical conditions that need to be checked out and treated straight away by a doctor.

• There are some unusual types of bleeding:

  • The discharge that occurs after childbirth, known as lochia, should decrease in volume over the course of several weeks.

  • If you have any signs of sudden heavy bleeding or large blood clots appearing months after giving birth, you should get urgent medical help. These symptoms could mean that there is some tissue left behind in your womb or that your womb has a problem.

• Longer absence:

  • Breastfeeding mothers often have delayed periods because of changes in the hormones in their body. However, periods usually return within six months for women who don't breastfeed.

  • If you are away from your usual routine for longer than this, you might need to see a doctor. They can check if you have hormonal imbalances, thyroid problems, or low oestrogen levels.

• Some more symptoms to watch out for:

  • Watch out for other signs of the disease, such as feeling very tired and losing hair for no reason, or feeling very happy or very sad for no reason. You should also watch out for feeling dizzy often.

  • These symptoms could be a sign of problems like postpartum thyroiditis (inflammation of the thyroid after pregnancy), anaemia, or other hormonal issues that need to be checked by a doctor.

FAQ

When to be concerned about no period postpartum?

If you’re not breastfeeding and your period hasn’t returned by 3 months postpartum, consult with your healthcare provider. For breastfeeding mothers, missing periods for up to 12 months can still be normal.

How long after not getting your period should you worry about being pregnant?

If your period is more than a week late and you are sexually active, especially without using contraception, it is wise to take a pregnancy test. Ovulation can occur before your first postpartum period, meaning you can become pregnant without having had a menstrual period.

What happens if my period does not come back after birth?

Can I get pregnant without a period after delivery?

Yes. Since ovulation happens before menstruation, you can conceive before your first period. Use birth control even before your cycle returns if you don't intend to become pregnant again. 

What is the maximum delay in periods if pregnant?

During pregnancy, your period stops until after birth. If you miss your period and it’s 7-10 days late, take a pregnancy test or consult your doctor. Some women may notice light spotting early in pregnancy, but not a true period.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.