Postpartum Amenorrhea: When to Seek Medical Advice After Delivery

No menstruation after childbirth?

Hello Doctor: I gave birth on April 5th of this year and breastfed until the end of May (with low milk supply, not exclusively breastfeeding).
My lochia was completed around early May, and during my postpartum check-up, the doctor said my uterus had returned to its original position.
However, I have not yet had my period.
On July 4th, I had three drops of blood, but it stopped, and I have been experiencing very light yellow-brown discharge.
Is this considered abnormal? Additionally, how long should I wait without a period before seeking medical evaluation? Thank you.

Li, 30~39 year old female. Ask Date: 2016/07/14

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, postpartum menstruation typically returns in about 2 to 3 months.
If breastfeeding, it may be delayed, and the timing can vary.
Just ensure proper contraception is in place.
Wishing you good health!

Reply Date: 2016/07/14

More Info

Postpartum amenorrhea, or the absence of menstruation following childbirth, is a common experience for many women, particularly those who are breastfeeding. In your case, since you gave birth on April 5 and have been breastfeeding until the end of May, it is not unusual for your menstrual cycle to be delayed. Breastfeeding can significantly influence the return of menstruation due to the hormonal changes it induces in the body.

During breastfeeding, the hormone prolactin is elevated, which helps in milk production but also suppresses ovulation. This means that many women may not experience their first postpartum period until they have weaned their baby or significantly reduced breastfeeding frequency. The timing can vary widely among individuals; some may resume their menstrual cycles as early as six weeks postpartum, while others may take several months or even longer.

In your situation, since you mentioned that you had a few drops of blood on July 4, followed by very light brownish discharge, this could be a sign that your body is beginning to adjust and may be preparing for the return of your menstrual cycle. However, it is also important to note that postpartum bleeding (lochia) can continue for several weeks after delivery, and the nature of this discharge can change over time.

As for when to seek medical advice, it is generally recommended to consult with your healthcare provider if:
1. You have not had a menstrual period by six months postpartum: While breastfeeding can delay menstruation, if you are not breastfeeding and have not had a period by this time, it is advisable to seek evaluation.

2. You experience heavy bleeding: If you notice a sudden increase in bleeding or if you are soaking through pads in an hour, this could indicate a problem that needs medical attention.

3. You have other concerning symptoms: If you experience severe pain, fever, or any other unusual symptoms, it is important to reach out to your healthcare provider.

4. You have concerns about your overall health: If you feel that something is not right or if you have questions about your recovery, do not hesitate to seek advice.

In summary, while it is common for menstruation to be delayed postpartum, especially with breastfeeding, it is important to monitor your body’s signals. If you have concerns about your menstrual cycle or any other postpartum symptoms, it is always best to consult with your healthcare provider for personalized advice and reassurance. They can help determine if further evaluation or treatment is necessary based on your individual circumstances.

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