What To Do If You Hit Menopause After Pregnancy
The science around menopause is still emerging, and this holds true for menopause after pregnancy. Women in the US reach perimenopause, the first of the three stages of menopause, around age 40.1 Over the past two decades, first birth rates for women aged 40–44 rose by 35%.2 Given this overlap in ages, women over 40 will go through menopause after pregnancy in a relatively short window. Before we dive into the specifics of what menopause after baby means for you and your health, it can help to review what menopause is in general and what to expect from this new stage of life.
THE 3 STAGES OF MENOPAUSE
What’s commonly referred to as “menopause” is actually three separate stages that span nearly half of a woman’s life: Perimenopause, menopause, and postmenopause.
When does perimenopause start?
Perimenopause is the time leading up to menopause in which the body gradually ceases to produce estrogen.3 Perimenopause usually lasts 3-4 years and is marked by many symptoms including hot flashes, night sweats, and increasingly irregular periods.3 During this stage, ovulation can be unpredictable, and if you have your period (no matter how irregular it is) you can still get pregnant.
When does menopause start?
Menopause is the 24-hour period which marks a full year since your last menstrual cycle and marks the end of a woman’s reproductive life. Most women in the United States reach menopause somewhere between the ages of 45 and 55.4
When does postmenopause start?
Once you’ve passed a full year since your last menstrual cycle, you’ve now entered postmenopause. The ovaries have now ceased to produce adequate estrogen, and you can no longer get pregnant. Some women experience a full reduction in symptoms during this time, but certainly not everyone. While this stage brings exciting new opportunities and freedoms, it can also present new potential health conditions as the body adjusts to life without estrogen. Staying in touch with your body and your doctor can help you continue to thrive during this new and final reproductive stage of life.
MENOPAUSE AFTER PREGNANCY
Menopause transition and time after pregnancy, known as postpartum, have similar indicators as both periods are noted by hormonal fluctuations. Particularly, late in life pregnancies can lead to an overlap in symptoms, making it difficult for women in their 40s to tell whether they’re in perimenopause and/or experiencing postpartum.
Both perimenopause and pregnancy/postpartum symptoms can include:5, 6
- Hot flashes
- Night Sweats
- Breast swelling and pain
- Vaginal dryness
- Irregular periods
- Mood swings
- Weight gain
WHAT TO DO IF YOU HIT MENOPAUSE AFTER BABY
Monitoring your postpartum health is already important, but this is especially true for women over 35. Thankfully, there are lots of options when it comes to keeping track of your health that can help ease this transition from motherhood into menopause.
Keep track of your cycle: Keeping track of your cycle will help you stay in tune with your body as you go through perimenopause and have a more accurate date for when you enter menopause. This will help you and your doctor be able to prepare for any new health complications this new stage of life could introduce. You can use a period tracker app on your phone, or just keep track with stickers on a cute wall calendar. Whatever works best for you!
Keep track of your feelings too: Going through both the perimenopause and postpartum stages of life at the same time is a lot for any woman to deal with. It can help so much to open up to the people you trust, share your experiences, learn from the experiences of others, or even find ways of connecting online with doctors or licensed therapists. Find a way that feels right for you. Self-awareness is key here. Listening to your body includes listening to your gut as well. If you need help, don’t be afraid to ask for it.
Find your way to stay active: Osteoporosis accelerates quickly after menopause, and chances are the last trimester of your pregnancy didn’t afford you many exercise opportunities. Choose high-impact, weight-bearing exercises to help support your bone health during this time, such as dancing, hiking, jogging, jump roping, stair climbing, or tennis. Low-impact weight-bearing exercises can also help support your bone health, such as elliptical machines, low-impact aerobics, stair-step machines, fast walking on a treadmill.
Explore healthy, whole food options: Menopause introduces increased nutrient needs too, as this decline of estrogen introduces some potential health complications on its own. Be sure your diet includes enough calcium and vitamin D to support bone health, plus magnesium, omega-3 fatty acids, and vitamin B12 to support your overall health as you enter this new stage of life.
LACTATING & BREASTFEEDING DURING PERIMENOPAUSE
Because many women are waiting to have children until later in life, some women find themselves nursing amid their menopausal transition. This can lead to a rather uncomfortable mix of unexpected hormonal fluctuations.
After giving birth, the body suddenly drops estrogen and progesterone levels to produce the hormone prolactin, which stimulates breastmilk production.7 Breastfeeding stimulates the production of yet another hormone oxytocin.7 Once breastfeeding ceases, however, prolactin levels decline, and ovulation resumes within 14–30 days.8
During perimenopause, estrogen and progestin levels rise and fall as the body gradually begins to cease estrogen production entirely.1 Many of the symptoms and changes women feel during this time are due to this gradual decline in estrogen production.1 Combined these symptoms can further complicate the dual transitions into both motherhood and menopause.
EARLY MOTHERHOOD & MENOPAUSE AT 40
Raising a newborn presents plenty of barriers to self-care as it is. Add hot flashes and night sweats to the mix and it can be too easy to overlook your health during this crazy time of life. Knowing how to tell the difference between perimenopause and postpartum symptoms can help you stay in tune with your body and help usher in a happy and healthy future for both you and baby.
- Mayo Clinic. “Perimenopause.” 2019. Accessed on: January 17, 2020. https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666
- Centers for Disease Control and Prevention. “First Births to Older Women Continue to Rise.” 2014. National Center for Health Statistics. Accessed on: July 23, 2020. https://www.cdc.gov/nchs/products/databriefs/db152.htm
- Harvard Medical School. “Perimenopause: Rocky road to menopause.” 2020. Harvard Health Publishing. Accessed on: July 23, 2020. https://www.health.harvard.edu/womens-health/perimenopause-rocky-road-to-menopause
- University of Utah. “Postmenopause.” Health. Accessed on: July 23, 2020. https://healthcare.utah.edu/womenshealth/gynecology/menopause/postmenopause.php
- McGovern P et al. Postpartum Health of Employed Mothers 5 Weeks After Childbirth. The Annals of Family Medicine. 2006; 4 (2): 159-167. https://www.annfammed.org/content/4/2/159.full
- Thurston RC et al. “Prospective evaluation of nighttime hot flashes during pregnancy and postpartum.” Fertility and Sterility. 2013; 100 (6): 1667-72. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4167790/
- Columbia University. “Section III: Pregnancy, Childbirth and Lactation.” Mailman School of Public Health. Accessed on: July 23, 2020. http://www.columbia.edu/itc/hs/pubhealth/modules/reproductiveHealth/pregnancy.html
- King, J. Contraception and Lactation. Journal of Midwifery & Women’s Health. 2007; 52 (6):614-620. https://www.medscape.com/viewarticle/565623_3