What to do if menstruation does not return after childbirth
Mar 28, 2023
Source: Cainiu Health
Dr. Lv Aiming
Introduction
There are various reasons for the absence of menstruation after childbirth. It may be a relatively common normal physiological phenomenon postpartum, or it could result from anemia or endocrine disorders following delivery. Sheehan's syndrome can also cause amenorrhea in women after childbirth. Appropriate treatment, including general management and medication, should be adopted according to the specific underlying cause.
There are various reasons for the absence of menstruation after childbirth. It may be due to normal physiological changes commonly seen postpartum, or it could result from anemia or endocrine disorders following delivery. Appropriate treatment—such as general supportive care or medication—should be selected based on the specific cause. The details are as follows:
1. Physiological Factors
The timing of menstrual resumption varies significantly among individuals and depends on whether breastfeeding is taking place. For some women who do not breastfeed, menstruation typically returns no later than three months after vaginal delivery, and no later than six months after cesarean section. During breastfeeding, elevated levels of prolactin inhibit ovulation and lead to irregular menstrual cycles, which is a normal physiological phenomenon and does not require special treatment.
2. Pathological Factors
2.1 Anemia
Excessive blood loss during childbirth, combined with insufficient iron intake, may lead to iron deficiency anemia, which can delay the return of menstruation. Women should seek medical attention promptly. Under a doctor's guidance, iron supplements such as ferrous sulfate tablets, ferrous succinate tablets, or ferrous gluconate syrup may be used. Additionally, increasing dietary intake of iron-rich foods—such as animal liver—is recommended.
2.2 Endocrine Disorders
Postpartum women often experience significant psychological stress and anxiety due to infant care responsibilities and incomplete physical recovery. Sleep deprivation can lead to excessive fatigue and disrupt the body’s endocrine system, thereby affecting menstrual recovery. It is important to get adequate rest, ensure sufficient sleep, and maintain a positive and optimistic mindset. In severe cases, medications such as progesterone capsules, dydrogesterone tablets, or estradiol valerate tablets may be prescribed under medical supervision.
In addition, Sheehan's syndrome can also cause the absence of menstruation after childbirth. Prompt medical evaluation is essential to identify the underlying cause and receive appropriate treatment under a doctor's guidance.
