The menstrual cycle is the main indicator of the health of the female body, so it is very important that periods after childbirth are restored at the right time and with the correct regularity.

Changes can only affect the nature of the discharge itself; in the very first menstrual cycle after childbirth, it will be scanty, more reminiscent of daub. They should last no more than 2-3 days. If the first menstruation is too heavy, and one pad is not enough even for 2 hours, the woman is most likely bleeding and should immediately consult a doctor.

At first, the menstrual cycle will range from 21 to 30 days. This will continue until ovarian function is completely restored. This will take several months; this period is individual for each woman.

Signs of pathological menstruation

In some cases, discharge after the birth of a child is pathological. If you see in yourself following signs, do not wait for the cycle to normalize, but urgently go to the gynecologist:

• if the discharge after childbirth “lochia” suddenly stops. This may indicate a bend of the uterus, endometritis, or stagnation of lochia inside the uterus;
• if there are very scanty menstrual flows for more than 3 cycles. This may be a sign of hormonal imbalance, endometritis or Sheehan syndrome;
• 6 months after its recovery. Breaks between menstruation of 3 months or more. This may be a sign of ovarian pathology;
• very heavy periods for 2 or more cycles in a row, especially after surgical intervention or termination of pregnancy. This may be caused by retained membranes on the inner walls of the uterus;
• and accompanied by general weakness and dizziness;
• if menstrual flow has an unpleasant, pungent odor, and the woman has a fever and eats severe pain in the stomach, this may mean the presence of infection or oncology;
• “smearing” before and after menstruation is a sign of endometriosis or inflammation;
• curdled discharge and itchy sensations in the vagina - a symptom of “thrush”;
• bloody, from 3 cycles in a row.

What changes may occur in the menstrual cycle?

Irregular monthly menstrual discharge may appear in a woman for several cycles after the birth of the baby. But this is not permanent. There shouldn't be any after 1-2 months. Menstruation should be the same as before pregnancy, only a slight change in its duration is allowed:

• 2-3 initial cycles may be observed, especially if the child is on mixed feeding;
• The first cycles after the birth of the baby for some mothers, on the contrary, occur with more abundant discharge. If after a couple of cycles the intensity of menstruation does not decrease, and pain also increases, you should definitely consult a specialist;
• the appearance of menstrual flow may be irregular;
• Painful periods may appear even in those who did not complain about it before pregnancy. painful sensations. Pain during menstruation after childbirth can be caused by intense contractions of the uterine walls or infection. Most often, after the birth of a baby, previously painful menstruation becomes normal due to a change in the position of the uterus;
• premenstrual syndrome or its precursors may appear: swelling, nausea, mood swings, dizziness.

Irregular periods

Critical days after childbirth may be irregular for several reasons:

• if irregularity is observed in the first few months after childbirth during the recovery period, then there is no reason to panic. Most often, this is normal behavior for them, since normalization of the cycle occurs individually for each woman. Irregular periods of menstruation are typical for breastfeeding mothers;
• In about 2 months, all systems and organs in the mother’s body return to normal. Here's normal functioning endocrine system occurs late, especially during lactation. For this reason, even with a good general condition of the body, a representative of beauty may not have her critical days;
• if regularity has not been established in 3 or more cycles, this may indicate inflammation, endometriosis or cancer in the organs of the genitourinary system.

To prevent development dangerous pathologies and prescribe treatment in a timely manner; at the first questionable symptoms, seek help from a gynecologist.

Delay

There are cases when, after childbirth, menstruation does not occur, although more than six months have already passed, the lactation period is over, or the child is just supplemented with mother’s milk. The most common cause of delay is a new pregnancy, but if you do, you should seek help from a doctor, because in this case the delay may be a harbinger of hormonal disorders, for example, Sheehan syndrome, which also causes weakness, dizziness, low blood pressure and lack of lactation. This is very dangerous disease, which can cause adrenal insufficiency and various infectious diseases.

In women over 40 years of age, the absence of menstruation may mean the onset of menopause, and in younger women, premature ovarian failure may occur. To determine the reason for the long absence of menstrual periods, you should definitely visit a gynecologist.

Menstruation after pathological pregnancy or childbirth

The time of the first menstruation after childbirth depends both on the process of delivery itself and on the presence of any pathologies during pregnancy. Let's consider the features of critical days depending on the pathologies a woman has:

• . Menstruation is restored after a month only in a small percentage of patients; most often, the hormonal imbalance that caused the termination of pregnancy becomes the cause of an irregular cycle;
• abortion. will occur in 45 days, otherwise you need to go to the doctor;
• the remainder of the fertilized egg in the uterus or an inflammatory process. To avoid such a situation, you need to undergo an ultrasound scan 10 days after childbirth or termination of pregnancy;
• . The first menstruation should occur 25-40 days after its completion. If the critical days have come before this period, this is most likely uterine bleeding, requiring urgent appeal see a doctor. A delay longer than the specified period is also a reason for a visit to the gynecologist. Very often, an ectopic pregnancy is very stressful for a woman; in such cases, recovery can occur in at least 2 months;
• . In this case, the cycle is restored to the same as after a normal birth. At breastfeeding Menstruation comes no earlier than six months later. If the child is on artificial nutrition, the cycle should normalize within a maximum of 3 months. Very rarely does the recovery process drag on for a year; if there are no pathologies, then this is considered normal.

After suffering any of the above conditions, a woman is recommended to protect herself for at least 6 months from the onset of a new pregnancy, since the absence of menstruation does not mean that ovulation does not occur. This means that without critical days she can become pregnant, which is undesirable for a still fragile body.

Women in good health have no problems restoring their cycle after the birth of a baby. To avoid any failures, you should put some expert advice into practice:

• To quickly restore hormone production, you need to properly structure your diet. It should include more fruit, vegetable and cereal dishes, milk, and meat. You should follow a drinking regime, do regular exercises and take multivitamins for mothers prescribed by your doctor;
• no need to take oral contraceptives. They can affect hormonal levels, causing cycle irregularity. For sexually active ladies, it is better to temporarily give preference to condoms or other non-hormonal means of contraception;
• follow the regime. If your baby keeps you awake at night, get some sleep during the day. Don't refuse help from your loved ones. Nice holiday accelerates the recovery process;
• any chronic diseases may affect the duration of the recovery period, therefore, for diabetes, anemia, thyroid diseases, etc. It is imperative to consult with a specialized specialist and adjust the treatment.

There are cases when the first periods after childbirth passed normally, but the next ones after them were delayed.

This may indicate the presence of a hormonal imbalance. In this situation, it may be useful to take hormone tests and undergo other additional research. Such measures can prevent the development of various diseases, including oncology.

If these tips did not help and the cycle after childbirth did not recover in due time, you should definitely seek help from a gynecologist.

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 only to the baby who has recently declared 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 functions such as 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 along 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 a sharp decrease in progesterone production. Bleeding begins.

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

In many countries before, and in some even now, girls and women during their periods are treated in a special way. 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 prohibited from cooking food, touching idols, performing 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 yin energy turned his clothes into armor inaccessible to enemy fire - the personification of the male yang energy.

How to distinguish periods from lochia and postpartum bleeding

After childbirth, a woman experiences bloody discharge, 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 contracts poorly or is in spasm. cervical canal. Such pathologies are diagnosed using ultrasound. Too much may indicate similar problems. dark blood in the form of clots. 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 completed breastfeeding, this is a sign for the body that the woman is free and can prepare for a new pregnancy. This is why, in most cases, mothers whose children are fully breastfed do not menstruate. 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;
• mothers have babies artificial feeding 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.

A modern woman has about 450 menstrual cycles throughout her life. 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 interrelated with the production of prolactin, and therefore the onset of menstruation;
• proper balanced nutrition, intake of sufficient quantities of essential microelements and vitamins contribute to the full functioning of the body and the speedy restoration of the monthly cycle;
• adherence to sleep and rest patterns promotes recovery processes;
• the presence of stress and a depressed emotional state negatively affect reproductive health and restoration of the menstrual cycle;
• use hormonal contraceptives can make adjustments to the functioning of the hormonal system: along with stimulating the production of progesterone, 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 of natural childbirth or after surgery caesarean section. However, in some cases, recovery may be delayed due to complications in the 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 a 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.

Pain, heavy discharge and duration of menstruation are usually much greater in winter than in 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, sometimes the amount of the hormone prolactin in the body 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.

One of the signs of normal recovery of the female body after childbirth is the return of a regular menstrual cycle, which does not always happen smoothly. What happens to the base? reproductive function women after the birth of a child and what are the dangers of complications arising from this?

Menstrual cycle and its phases

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, the menstrual cycle is the period of time from the first day of one menstruation to the first day of the next. The length of the menstrual cycle varies among different 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 from it into 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, due to which the endometrium (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. Begin bleeding- 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 the placenta is expelled 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 approximately 1 cm daily. 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, the weight of the uterus by the end of the first week 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 acquires 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,
• with the wrong regimen in the 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 the 9-10th day, 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 appears. Their character changes during the postpartum period. The nature of lochia during the postpartum period changes in accordance with the ongoing processes of cleansing and healing of the inner surface of the uterus:

• in the first days, lochia, along with decaying particles of the inner lining of the uterus, contain a significant admixture of blood;
• from the 3rd to 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. The reverse development of the corpus luteum - a gland that existed in the ovary during pregnancy at the site of the egg released into the abdominal cavity and then fertilized in the tube - ends. 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 during 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 mixed-fed, that is, in addition to breast milk, the baby’s diet includes formula, then the menstrual cycle is restored after 3-4 months. With artificial feeding, when the baby receives only formula milk, 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 - menstruation 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, correct and good nutrition,
• adherence to sleep and rest patterns,
• availability chronic diseases,
• neuropsychic state and many other factors.

Possible complications

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 the cycle remains irregular, then this is a reason to consult a doctor.

Duration of the menstrual cycle 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 bloody discharge should be 3-5 days. Too short (1-2 days) and, especially, too long periods can be evidence of some pathology - the uterus (benign tumor), endometriosis - a disease in which the inner layer of the uterus, the endometrium, grows in uncharacteristic places.

Volume of menstrual flow may be 50-150 ml, too little, as well as too much menstrual blood can also be evidence 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 spotting and spotting at the beginning or end of menstruation are also a reason to consult a doctor, as they most often 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 general immaturity of the body, psychological characteristics, accompanying inflammatory processes, arising after childbirth, strong muscle contractions of the walls of the uterus. If the pain is such that it bothers a woman during menstruation, forces her to repeatedly take painkillers, antispasmodics, and disrupts 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), salpingo-oophoritis (). 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 is manifested not just by irritability, bad mood or a tendency to cry, but by a whole complex of symptoms. Among them: breast engorgement and tenderness, headache, fluid retention in the body and swelling, joint pain, allergic manifestations, absent-mindedness, .

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 swelling, significant increase blood pressure, up to the development of convulsive syndrome, the so-called eclampsia), ovarian dysfunction may occur, which is associated with a violation of central regulation - regulation of the production of pituitary hormones (endocrine glands located in the brain). In this case, the development of eggs in the ovaries is disrupted, and hormonal changes and, as a consequence, disruption of menstruation in the form of delays, which can be replaced by bleeding. With such manifestations, you should definitely seek the help of specialists.

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 restoring 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. 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 may occur. 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, it 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, lack of sleep can lead to increased fatigue, weakness, sometimes even depressive states, which also negatively affect 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 (, diabetes mellitus 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.

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, the menstrual cycle is the period of time from the first day of one menstruation to the first day of the next. 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 the placenta is expelled 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 approximately 1 cm daily. 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 is reduced 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 are also quickly formed. 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 acquires 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, 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,
• with the wrong regimen in the 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, lochia, along with decaying particles of the inner lining of the uterus, contain 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 - the use of medications that contract the uterus or, at the same time, washing the uterine cavity.

In the postpartum period, the ovaries also undergo significant changes. The reverse development of the corpus luteum - a gland that existed in the ovary during pregnancy at the site of the egg released into the abdominal cavity and then fertilized in the tube - ends. 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 mixed-fed, that is, in addition to breast milk, the baby’s diet includes formula, then the menstrual cycle is restored after 3-4 months. With artificial feeding, when the baby receives only formula milk, 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 the 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 much menstrual blood, can also be evidence of gynecological diseases. Although in the first few months after the first postpartum menstruation there may be some deviations, they should still correspond to the physiological norm: for example, on the heaviest days, one medium pad should be enough for 4-5 hours.

Long lasting spottingspotting 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 the pain is such that it bothers a woman during menstruation, forces her to repeatedly take painkillers, antispasmodics, and disrupts 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 is manifested not just by irritability, bad mood or a tendency to cry, but by 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 theories regarding the reasons for the development of premenstrual syndrome, but there is no single reason underlying it, and therefore there is no specific drug that would 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, a significant increase in blood pressure, up to the development of convulsive syndrome, so-called eclampsia), ovarian dysfunction may occur, which is associated with a violation of central regulation - regulation of the production of pituitary hormones (glands of the 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 may occur. 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, 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.

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 women's health– 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”).

The time has come for the dominant follicle to mature - and prolactin prevents this process from taking place. This is the reason for the absence of menstruation: after all, menstruation occurs after ovulation, when the unnecessary egg is removed from the body.