Hormonal changes to expect after having a baby (and which hormone tests you may need)

As if you didn’t just experience enough change over the past nine (really 10) months of pregnancy, you now have to deal with all the changes that happen to your body and mind after birth. There are many hormonal fluctuations that happen in the coming months postpartum. Knowing what to expect can help you adjust and thrive as a new parent.  

After birth, there’s a whole hormonal cascade that happens---after delivering the placenta, progesterone and estrogen take a rather sudden dive from their high levels during pregnancy.

Levels of prolactin, a “breastfeeding hormone,” are also high right after birth, which is necessary to stimulate milk production that lets you nurse if you choose to. (If you opt to formula feed---fed is best!---then prolactin will decrease in the absence of nipple stimulation.)  

Also, you might have felt a “high” right after birth. It’s not just because of the triumph of physically having your baby---a release of endorphins and the “love hormone” oxytocin bond you and baby during the first days. Many parents find that these good vibes don’t last long, though.

Thanks to these drastic hormonal shifts that happen right after birth, you may start to feel blue---aka the baby blues---a few days after delivery. The baby blues are tough to get through, and there are so many changes happening at once (sleep deprivation, no time to eat, conflicts with your partner as you adjust to the new normal), it’s completely understandable to feel down and sad right now.

If the baby blues last longer than two weeks and into the next month, then you may be experiencing postpartum depression, something that affects one in nine people who have had a baby, according to the Office on Women’s Health. Postpartum anxiety is also common, which can make you feel as if you’re on edge constantly. 

Some people rave about pregnancy hair---the thick and long locks they’re able to grow. Unfortunately, the thicker ponytail doesn’t last forever.  

Birth, as joyous as it can be, is also an incredible shock to your body. Times of extreme stress can trigger telogen effluvium, which prompts a portion of hair follicles that are actively growing hair into the “resting” phase, where it falls out. That means more of your hair will actively shed, and you’ll see the result on your hairbrush, in your shower drain, or simply collecting on your floor at home.

Hair loss tends to happen two to four months after birth, according to a review in Clinical, Cosmetic and Investigational Dermatology, so be prepared for thinning strands to really hit their stride now. Deep breath: This is not permanent---they will grow back, usually within a year, but are nonetheless distressing.  

Another change? A small number of women experience a condition called postpartum thyroiditis, where the thyroid gland becomes inflamed after having a baby, notes Johns Hopkins Medicine. At first, your thyroid goes into overdrive, but then slows down, leaving you with an underactive thyroid. It’s not until one to four months after birth when you may start to notice symptoms of a thyroid disorder, such as temperature intolerance, muscle weakness, anxiety, fatigue, and constipation, many of which can easily be brushed aside as your body continues to recover from birth.

Finally, low estrogen levels during breastfeeding can contribute to vaginal dryness, making intercourse uncomfortable and affecting your libido.

Where’s your period? If you did not breastfeed, then your menstrual cycle, including ovulation, may begin to return a couple of months after birth.

However, if you have been breastfeeding, you’ll probably go longer without a period. Prolactin, needed for breastfeeding, suppresses estrogen, a hormone necessary for ovulation. As the La Leche League International points out, your period’s more likely to come back when your baby is older than six months. A lot of this has to do with sleep and eating solids. It’s at this time you’re probably enjoying longer stretches of Zzz’s at night and your baby may be eating food, decreasing their demand for milk. When you go more than a few hours without breastfeeding, prolactin levels will begin to decrease.

As estrogen and progesterone return to pre-pregnancy levels, you’re likely to see your period return.

Your body has just gone through a big transformation. You grew an entire human. Of course your hormones will fluctuate, and you may not recognize the new you for a long time. It’s important to make sure that you have support around you, be it from a partner, family members, or friends, who can help---even if it is to ask “is this normal?” (It probably is.)

Symptoms of postpartum depression---restlessness, feelings of sadness, hopelessness, or overwhelm, lack of energy or motivation, memory problems---can stick around up to three years after birth, says the National Institutes of Health. Reach out to your provider if you suspect postpartum depression (or a loved one gently brings it to your attention), even if your baby is already nine months or older than a year. Talk therapy and medication are mainstays of treatment, but there are other things you can do to boost your mood, such as making plans with friends, exercising, spending time with fellow moms, and trying to get enough sleep (if possible).

As for lab testing, hormonal changes are normal after birth, so it’s not necessary to monitor your levels throughout this time. One exception: If you’re experiencing symptoms beyond the norm. That can be tough to determine as a new parent, since everyone’s fatigued, right? But if you’re grappling with irritability that won’t go away, insomnia, low energy, and other physical symptoms, have a discussion with your provider to explore if something more might be going on, whether that’s a mood condition or thyroid dysfunction. You can do this at any time during the postpartum period, or consider getting it done a year after you’ve had your baby to ensure everything is running well. Testing can give you a helpful glimpse into your body—and help you get back on track or prepare for another pregnancy, if you so choose. For at-home testing, Base’s Energy Testing Plan or Base’s Stress Testing Plan can be a good place to start because they test factors that could contribute to fatigue, such as thyroid hormone, nutrient deficiencies, or an imbalance of cortisol or female hormones.

Distressed about postpartum hair loss? The good news is that your hair will grow back. That doesn’t make it any easier to take now, but a thinner pony is not a permanent change. As Cleveland Clinic points out, medical problems can also cause hair loss after having a baby, including thyroid problems and nutritional deficiencies, and it’s always worth talking to your doctor about if you’re losing a lot of hair or opt for at-home testing.

Your body goes through so many changes after having a baby—and these changes continue throughout the first year. It’s completely normal to feel not like yourself as you adjust to this new life. However, if persistent symptoms are getting in the way of your ability to enjoy your baby or make it difficult to function, talk to your primary care doctor or ob-gyn. There is help and you can feel really good again.