Postpartum Contraception and Menstrual Cycles on Birth Control

Contraception

1.
Breastfeeding can help prevent early pregnancy after childbirth due to the natural contraceptive effect known as lactational amenorrhea.
During breastfeeding, the body produces higher levels of prolactin, which suppresses ovulation.
This means that as long as a mother is exclusively breastfeeding and has not yet resumed her menstrual cycle, the likelihood of becoming pregnant is significantly reduced.
2.
The reason why menstruation can still occur while using contraceptive pills is that these medications often contain hormones that regulate the menstrual cycle.
While they are effective in preventing ovulation, some women may still experience withdrawal bleeding during the placebo week of the pill regimen, which mimics a menstrual period.
This bleeding is not a true menstrual cycle but rather a response to the hormonal changes induced by the contraceptive pills.

Kay, 20~29 year old female. Ask Date: 2000/10/02

Dr. Li Guanghan reply Obstetrics and Gynecology

Breastfeeding can suppress the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the pituitary gland due to elevated prolactin levels, which can lead to anovulation.
However, this does not guarantee absolute anovulation, so breastfeeding should not be relied upon as a method of contraception.
Contraceptive pills are also hormonal preparations that work by increasing hormone levels to inhibit ovulation, but menstruation can still occur.
Typically, the first 21 days of a contraceptive pill regimen contain hormonal agents, while the following 7 days often consist of iron or vitamin supplements, which means that menstruation can still occur in the absence of hormones during that time.

Reply Date: 2000/10/02

More Info

Understanding postpartum contraception and menstrual cycles while on birth control is crucial for new mothers. After giving birth, many women have questions about how breastfeeding can serve as a form of contraception and why they still experience menstruation while on birth control pills.

1. Breastfeeding as a Contraceptive Method: Breastfeeding can indeed help prevent early pregnancy, particularly in the first six months postpartum. This phenomenon is known as the Lactational Amenorrhea Method (LAM). When a mother exclusively breastfeeds, the body produces higher levels of the hormone prolactin. Prolactin inhibits ovulation, which means that the ovaries do not release eggs, thereby reducing the chances of conception. However, for LAM to be effective, certain conditions must be met: the baby must be less than six months old, the mother must be exclusively breastfeeding (no formula or solid foods), and the mother should not have had her menstrual period return. If these criteria are not met, the effectiveness of breastfeeding as a contraceptive diminishes significantly.

2. Menstruation While on Birth Control: Many women wonder why they still experience menstrual-like bleeding while taking birth control pills. This is primarily due to the way hormonal contraceptives work. Birth control pills typically contain synthetic versions of the hormones estrogen and progesterone. These hormones regulate the menstrual cycle by preventing ovulation, thickening cervical mucus to block sperm, and thinning the uterine lining to prevent implantation.
When a woman takes the pill, she usually follows a regimen that includes a week of placebo pills (or no pills) during which she experiences withdrawal bleeding. This bleeding mimics a menstrual period but is not a true menstrual cycle since ovulation does not occur. The bleeding is a result of the sudden drop in hormone levels when the active pills are stopped for a week.
It's important to note that while on hormonal birth control, some women may experience lighter periods or even skip their periods altogether, which is a common and generally safe occurrence. However, if a woman experiences unusual bleeding patterns or has concerns about her menstrual cycle while on birth control, she should consult her healthcare provider.

In summary, breastfeeding can serve as a natural contraceptive method in the early postpartum period due to hormonal changes that suppress ovulation. Meanwhile, the presence of menstrual-like bleeding while on birth control pills is a result of the hormonal regulation of the menstrual cycle, not an indication of ovulation or fertility. New mothers should discuss their contraceptive options with their healthcare providers to find the best method that suits their individual needs and circumstances.

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