Menstruation while Breastfeeding: Postnatal Physiology, Mechanism and Resumption

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Women feel troubled with menstruation before pregnancy. Even if it does not come after a while after childbirth, it may cause a little anxiety. Especially for mothers who are considering a second pregnancy, you may be concerned about the timing of the resumption of physiology.

Also, it is often said that “menstruation does not occur while breast-feeding”, but some have said that menstruation did come before breast-feeding which surprised them.

Therefore, we would like to talk about the mechanism of physiology after childbirth.

Women’s hormonal balance changes drastically with pregnancy or childbirth

Female hormones are greatly related to the menstrual cycle, pregnancy, and childbirth.

Prior to pregnancy, the hormones “estrogen” and “progesterone” are periodically secreted and controlled. During pregnancy, they become more actively secreted in making the placenta and preparing the uterus.

In addition, hormones called “prolactin” that make the mother’s milk will be secreted in the preparation of breast milk.

Since prolactin also has the effect of promoting the contraction of the uterus, the amount of secretion is suppressed by estrogen during pregnancy. When the amount of secretion of estrogen and progesterone sharply decreases after childbirth, the secretion of prolactin will become active, stimulated by the babies’ sucking.

When prolactin secretion becomes active, breast milk comes out. Prolactin also promotes the contraction of the uterus which speeds up the recovery of the postpartum body. Aside from these, because prolactin has a function to suppress ovulation, menstruation is delayed while it is being actively secreted. It is mainly due to the function of prolactin that menstruation does not come while breastfeeding.

Timing of Menstruation after Childbirth

In general, it is said that menstruation begins about 8 months after childbirth for around 70% of mothers. However, secretion of prolactin is said to return to pre-childbirth status about one month after stopping breastfeeding. If breastfeeding is extended, there is a possibility that menstruation will not come for 1 or 2 years after birth. Otherwise, it may resume in about 2 to 3 months after childbirth.

So why does menstruation come for some people even while breastfeeding? It is also related to the secretion of prolactin.

As we have already explained, prolactin secretion is stimulated when the baby sucks the breasts, but secretion decreases as stimulation decreases. When the number of breastfeeding sessions decreases or increases, the number of instances for stimulation is also affected. And that may promote ovulation and menstruation.

However, since hormone balance after childbirth takes time, the mother can easily be affected by unfamiliar tiredness, the stress of child-rearing, sleep deprivation, etc., Even if prolactin is secreted and menstruation ceases, when breastfeeding is stopped there are times when menstruation does not come for a while.

As the brain senses the secretion of prolactin, it intentionally works to make the physiological cycle irregular, so even if menstruation resumes, it seems that there are many cases where you suffer from irregular periods for a while.

Postpartum Menstruation, watch out for times like this

Postpartum physiology is said to be a barometer of uterine recovery. Although it may be easy for troubles to occur until complete recovery, caution is necessary in the following cases.

  • Menstruation does not come 1 year after childbirth or 3 months after breastfeeding
  • Menstruation does not come 2 years after childbirth
  •  Once the menstruation comes, it stopped immediately afterward
  • Pain when bleeding
  • The physiological cycle is disturbed

Because individual differences vary greatly, there is no need to worry more than necessary about the timing and cycle of resumption, but there is a possibility that the delay may also be a sign of hidden illness, so we recommend that you consult with the Obstetrics and Gynecology at once.

Remember that it depends on individuals when you have menstruation after childbirth.

In addition, because menstruation comes after ovulation, it may happen that you will pregnant again even before having your menstrual period again. We often hear the stories about women who thought that they were sick when they were actually pregnant.

So if you resume sexual activity while breastfeeding and do not want to get pregnant so soon, use contraception even before menstruation resumes. It is also recommended to maintain your basic temperature from birth soon after birth.


We need both physical and mental strength for child-rearing. Learn to live a life where you can get enough sleep and nutrition in order to avoid accumulating stress, hormone balance and return to a healthy body after childbirth as soon as possible.

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