Reader call: "normal" first few periods post-partum

For some reason the questions are coming in clusters. I've gotten a couple about the first period back post-partum, and what's normal. The specific questions asked were:

When's normal for your period to return?

What's the period going to be like post-partum (length and flow)?

Will the length of your cycle be different?

Is pain when trying to use tampons normal?

Everyone, please put your data points about these questions and anything else you want to say. Obviously you should feel free to comment anonymously. Since I don't want to post the details of my menstrual cycle online publicly (imagine), I'm going to comment anonymously in the middle of the pack, too.

Comments

[Anonymous]

My periods returned as soon as I finished breastfeeding at 7 months. They were normal strength, everything felt like it did before. The only annoying issue I have is that the size tampon I had used before is now too small and keeps sliding out. Sorry for the graphic description.

[anon]

I can't comment on periods - I'm five months post-partum, exclusively breastfeeding, and no sign yet.
But the tampon question made me think of a related issue: sex being painful even with lubricant. I wonder if it's for the same reason as tampons causing pain for some. Anyone else experienced this?

[paola]

Frankly I think there are a lot of things far more embarrassing to talk about than periods.

I only had one before falling pregnant again at 14 months pp. Very light, lasted a week, probably would not have even thought it was a true period as such (with ovulation) had I not fallen pregnant(intentionally), so for those who practice lactational amenorrhea as birth control, beware.

[flea]

I had my first postpartum period at 16 months with my daughter (nursed her until past 2). It was light, but subsequent ones were normal, same cycle length as before. I had trouble with tampons wanting to eject themselves, but I had some fairly unusual post-partum issues in the vaginal wall department.

My son is now 15 months, still nursing, and I am expecting my first period soon - I can tell it's coming because of the resurgence of acne. Ah, hormones.

[Slim]

I thought lactational amenorhhea only worked (to the extent it does) as long as a woman is EBFing.

Anyway, I got my first period at 13 months PP, or a month after I stopped pumping. It was much lighter than usual. Then I started getting brief but heavy ones, closely spaced. Now I have a 2YO who still nurses at bedtime, and I am finally back to every 28 days, long and heavy and headache-y, just like when I was 20.

[Kelly]

I wish I were lucky enough to go 13 or 14 months without periods! Mine came back three to four months after the birth for each of my sons, even with EBF. Big surprise! They were also much, much heavier (embarrasing story about bleeding through tampon, pads *and pants* on an international flight... with no change of clothes), and more painful. After about a year, they became less painful, and a little lighter, but nowhere near what they were before having kids.
Having just had my third three days ago, I'm not so anxiously waiting to discover what they're going to be like this time 'round.

[Agree!]

10 months+ exclusively BF and no sign of a period in sight. But as to the painful tampon issue, I agree with anon 6:24....sex has been absolutely painful and I think it can only be due to the hormonal impact of giving birth and breastfeeding, since I had a c-section.

[anon]

whew! at 6 months what limited sex we have is still a bit uncomfortable (but not unbearable). And I had forceps birth. No period, but normal since I have an IUD.

[anon2]

My period returned at 20 months post partum. It is lighter and not regular yet (10 months and three periods later).

[Kristin]

Mu period started at 18 months, almost exactly as I weaned the night feeds.It returned to the same strength and length as it was before pregnancy. Within my group of breastfeeding friends periods returned randomly. Some at 4 months, some at 7, some later.
I had no trouble with tampons. Once your peroid starts your body is saying I'm ready to start reproducing and the post-partum dryness should go away.

[Carrie]

Mine returned six weeks post-partum. Very unfair, because I am still nursing at 24 months! It was heavier and much more painful. The first year actually was a lot more painful. It felt like it was ripping my uterus apart.

[swissmiss]

My first period showed up *before* my six week post-partum check (I wasn't sure if it was my period or a continuation of lochia, but since it reappeared every 26 deays after that I sort of figured it out) even though I was exclusively breast-feeding and continued nursing for 18 months.

I had my period regularly - about 26 day cycles - the whole time I was nursing. They were a wee bit shorter and a wee bit lighter, but that could also be a function of aging.

It hugely sucked, since I always assumed I'd get a break while nursing, but my OB said that's not always the case. Clearly.

[interested]

I am interested in this because I haven't had a period in 4+ years. (My older child is over 3; got pregnant the second time 12 seconds after stopping the minipill--still nursing.)

Now I have a Mirena IUD. Still breastfeeding my 18 mo. I felt really PMSy lately (bloated, breakouts, some discomfort while nursing)--but no period arrived, and, of course, this is what the beginning of my second pregnancy felt like.

I spend a lot of time being extremely paranoid.

And yes, sex was not.fun.at.all after both kids (post-Cesarean), and not just because of lack of interest.

[giddy]

Around 12 weeks despite EBF with both kids. As long as i was BF, periods were lighter. when I stopped BF (18-19 months), they got heavier. My cramps have changed a good bit since the second birth---instead of feeling them in the lower abdomen only, I ALSO feel them in my butt area--like, it feels like cramps of my anal sphincter! (Great topic Moxie!) My OB said that some women get them there from the get-go; others get them there only after birth when the musculature has weakened and shifted around. Naaaaaaahce.

I also have the trouble where tampons work their way out more easily than they used to. They've never fallen out (except sometimes in the toilet, esp--or always--with #2) but if I have to go to the bathroom and it's not time yet to change one, I sometimes have to push it back in.

And incidentally, am I the only one who's annoyed that Tampax changed their tampons and applicators? Fortunatley discovered a generic that is like the old Tampax, but generics have a way of changing to match the brand names so I'm sure it won't last. (The same generic, when I tried it several years ago, was copying Playtex at the time and I didn't like them either.) Probably time to start investigating the menstrual cup.

[Menstruation is hard to spel]

Even with EBF, periods started back up at 3 months postpartum. Heavier and crampier than before, but that could be because I was on the pill before and did not go back on (now using NFP). I had never made the acquaintence of the super plus tampon before ... Now I know her well.

Sex is less frequent but better now. Pain the first 2-3 times (related to position) at about 8-10 weeks postpartum.

[giddy]

PS--length of cycle? While BF, was fairly consistent 28-30 days. Since stopping BF, has returned to my original baseline cycle of more like 35 days. (The small blessing--if it has to be heavier, more crampy, and more painful, at least it's less often.)

[Dawn]

Exclusively pumping, never had a regular cycle in my life. Baby is 6 months old, have had 4 periods, length and flow average like before, Haven't tried tampons yet.

[Meg]

First postpartum period at 19 months; dd still BFing then (and now, at 2.5 years), including co-sleeping and some night nursing. Periods somewhat heavier, but no cramping etc. No difficulty with tampons, but prefer cup. No difficulty getting pregnant again about 6 months later, after 2 months "trying".

[hedra]

All three times, got one period about 30 days pp, very light (may have been related to hormonal clearing, rather than a 'true' cycle). Then it was 7+ months (while bfing) before it came back. With the twins it was over a year, nearly two? I cannot remember at all.

Each time, it has been different than before. More regular/less regular, generally heavier, and more or less crampy/painful (first time it was worse, second better, third WAY better). After the twins, it has become so un-crampy that I often have no warning at all other than a very vague sense of 'hmmm' about a day ahead. Very un-crampy, but heavy (!!!). I also found that I was making things worse with the fish oil/Omega-3's... my platelets run low, so I tend to bleed hard, and add in a blood thinner (as Omega-3's function), and I'm in bad shape. I've learned to stop taking the fish oil juuuust before I think my cycle will start, and stay off for the duration. WAY better, that way. Have to boost the B vitamins to compensate (to keep the low-grade PPD away), but so far, so good.

Oh, and the heavier can be related to age, too.

Pain with tampons for me was only until I was really healed up. That didn't take long, as I only ever had skid marks (cervix tore with the twins, but that isn't sensitive at all). I also find that a Diva Cup (I have the UK brand) is way more comfortable than any tampon.

[hedra]

Dang, MOON Cup is the UK brand. Sick today, foggy brain. (You'd think I'd remember the one I use, huh?)

[Jen]

Mine just recently returned at 18 mos, right around the time I weaned my son. It's been great in some respects--completely pain-free, in contrast to my pre-pregnancy ones; but the flow seems to have been super-heavy, and I'm having tampon issues as other commenters described. Also, my normally clockwork 28-day cycle was up to 35 this time around.

[Another Anon]

I 95% breastfed, and my period returned roughly 1 month after I quit pumping at work -- my son was 13 months old.

The first period was pretty light, but tampons were unbearable. Now, 6 months later, they're bearable, but I still don't like them. And I'd been using them for +20 years!

I've switched over mostly to cloth pads. Imse Vimse is my favorite, but you have to remove their unbelievably poorly placed and itchy tags first.

The bamboo are the worst -- yes soft, but so soft and unstructured that they ball up between your legs, which is uncomfortable and prone to leakage.

[robin]

This site has done it again! Read my flippin' mind! I am not sure if what I am currenltly experiencing is a period. My son is 5 months and we EBF. A month ago, I got an IUD. I had some bleeding for a few days after the insertion, totally normal. THe other day I woke up with cramps and heavy, period-like bleeding. It has been a few days now and this is much heavier than my periods before pregnancy. How do you know if it's a period? I feel all Are you There God, It's me, Robin about this!

[Melinda]

With my son, with whom I was away from once a week or so for 4 hours, it returned at 8 months pp. With my daughter (SAHM now) 16 months pp. The first two cycles or so were light and irregular in length but after that they got back to normal. I use the Keeper instead of tampons and have had no problems.

[Kelly]

I was comforted by something I read saying that I was "hyper-fertile" when I got my periods back at 6.5wks and 7wks post-partum with my boys (I pumped for both). Those periods were both a bit lighter than usual and much more spotty (taking longer to "wrap things up"). I didn't use tampons at the time, but for that first period I did pads and returned to using my menstrual cup (Diva) after that without issue. NOW, my periods are lighter, with less cramping, though they take longer from start to finish.

Sex was uncomfortable for the first 4-6m (whenever I was even able to get in the mood at ALL), and then slowly became more comfortable. It wasn't until 10-12m post-partum that I was truely enjoying sex again and initiating it with my hubby on any regular basis. (sleep deprivation, stress, hormones, whatever)

For what it's worth, I find if I eat 2-3 bananas the week before and week of my period, my cramps are almost/non-existant. Oh, and I drink lots of water.

[Stephanie]

Very timely, as I'm on the third day of my second post-partum period. The twins are 7 months old now. I'd cut down on the breastfeeding but hadn't stopped yet. Reading this has been a comfort because I had always heard that periods were supposed to get lighter/easier after childbirth. The first time, I figured ok this period is disgustingly heavy and painful because it's the first one, but now that I'm on #2 I'm afraid it's the start of a pattern. I have horrible back pain this month too, which I never had before. Bleh.

However sex, while less frequent than before the babies came, has been better. I attribute it partly to the fact that it's happening less often, and therefore more of a treat, but also I seem to have increased sensitivity. So that part's been nice.

[hedra]

Hmm. Maybe it's the bananas, reducing the crampy/painful thing... (one of the few fruits M and B can eat, so we always have them in the house).

[Sherry]

I just finished such a heavy period at 5 months post-partum that I called my doctor. I'm almost exclusively breast-feeding so I was really surprised.

[Shandra]

My data points:

First baby:

- first period 8 wks pp (no nursing really to speak of except pumping for four days). I didn't try tampons that first one; things were painful here and there for about 4 months. It did feel different inserting tampons once I did, and sex felt different too. Periods went back pretty much to normal; I think the first couple were a little light but I don't actually really remember.

Second pregnancy:

- I got my first period at 6 weeks pp, despite EBF'ing to 6 months and we are still nursing a bit at 26 months.

- they have been fairly regular, with a few longer stretches that vaguely mapped to growth spurts

- they have tended towards heavier and are definitely longer by about 3 days (hate.) but I'm hitting perimenopause early so that may be the cause

- I didn't use tampons for the first period and after that they didn't hurt, but inserting them did feel different for a while (so did sex).

[another anon]

My postpartum lasted jut about 6 weeks, when all was said and done. The first week was quite heavy the second just normal heavy (normal for me, though lasting a week-ish), and the endless last weeks were standard, then light. I had the pain with tampons, too. My Dr. said ok to use them after two weeks pp, though I didn't brave it until the end .

I'm 4 months pp and haven't had a return. I don't quite EBF, as he gets 1 bottle a day, but I'm not sure that makes a difference. Mildly curious to see when and how it returns.

[Another anon]

First period at 10 weeks post-partum despite EPF. Then not again for a few months. Once the baby was sleeping 12 hours straight at night my period returned monthly. Same flow/length/cycle as before pregnancy and no issues with tampons (though sex still uncomfortable though not unbearable - now 9 months post-partum).

[paola]

By the way Slim,the Kellymom site says that if you practise 'ecological breastfeeding'(keeping baby close at night, not using pacifiers, bottles etc)lactational amenorrhea has a 94% success rate after 6months pp. Not a real good form of contraception, but not too bad if you are planning to maybe try for another one.

[Dorie]

I don't understand why everyone is suddenly so embarassed by this topic.

I breastfed both of my children for only about three weeks and both time I got my first postpartum period at 12 weeks.

[Another Anon]

Giddy - Yes, I totally noticed that Tampax changed and it is driving me crazy. I also hate Playtex. What is the name of the generic you found that is like old Tampax? I am desperately seeking a good alternative, after hoarding all the old ones I could find.

[caramama]

I still haven't gotten mine (7 months pp), although I keep feeling like I've got PMS, but nothing comes. My sister got hers 5 months pp, but another friend didn't get hers until a year pp. We all breastfeed with no formula.

As for sex, I wasn't ready (emotionally) to try until 3.5 months pp, and it wasn't any good for me until 5.5 months pp. Now, it's great again! Just like before baby. :) (But I did end up with a c-section.)

[anastasiav]

robin: Some great post-IUD advice can be found here: http://ask.metafilter.com/53383/to-iud-or-not

Short form is that there is a foreign object in your uterus and its possible that the uterus will become inflamed and try to expel the object with heavy bleeding for a while. Heavier flow after an IUD insertion is very common, and things can sometimes take 4-6 months to settle down. Taking Advil (or other non-steroidal anti-inflammatory medications) can help because it reduces the inflammation.

To answer the Moxie question:

When - It obviously depends on if you're breastfeeding or not. Friends who did not breastfeed at all report periods returning 6-9 weeks post-partum. On the other end of the spectrum I have a friend who has breastfed each of her five children (she likes to say she's been lactating for 10 years straight) who hasn't had a "real" period for that entire time (but obviously she's still been fertile). For me, my period returned about 6 months post-partum, at the time that we changed over from mostly-breastfeeding and sometimes pumping to mostly pumping and only nursing at night.

My son is now 15 months old, and its only been this past month that my period was anything like the old normal. Prior to that they were much worse than they had been before I got pregnant ... heavy, thick flow, pain, cramping, etc.

I am unable to use tampons now, due to the location of the scar from where I tore (I had a vaginal tear that required seven stitches but no tears on my perineum). Its just too uncomfortable.

[mayberry]

15 months with both kids (I nursed exclusively until 12 months, then switched to morning/evening only)

About the same flow as before, and length in days.

No pain w/ tampons.

[Mary Joan]

I have 4 grown daughters, so this is a memory stretch. When I got my period back ranged from 4 to 15 months, depending upon whether the baby sucked for comfort as well as food, how soon the baby slept through the night. I was able to use the same size tampons; I don't recall their being uncomfortable. I don't remember when I discovered the superiority of ob's. My periods were much less painful than they had been pre-pregnancy--no more cramping, nausea, etc., but my PMS seemed to get worse.
I had 2 episiotomies (with my first and second), none with my third and fourth. The slow healing of the episiotomies made sex uncomfortable the first few times.

[anna namous]

my first baby is 6.5 months old and i have yet to see any signs of a period returning. i EBF until she was 5 months, now she's on cereals but still getting as many nursings. still nurses once or twice in the night.

[pnuts mama]

haha, paola, your last comment made me laugh (in a good way)- that info about lactational amenorrhea being effective if you co-sleep and bf all night long? hmm, are you less likely to get it on with a newborn in your bed when you are terrified that any slight movement/noise will wake him/her up? haha, co-sleeping with the pnut was the best damn BC we've ever used!

i can't believe i don't have this written down somewhere, but i'm pretty sure i started my period again somewhere near 12 months pp, we ebf'd and then i think i went on the mini-pill at about 9 months pp? w/ the mini pill my symptoms were heavier than the reg pill, still way better than no pill (awful). then back on the reg pill til earlier this year, my cycle is the same as it was off the pill the first time. i was happy to be able to use tampons again by the time my period really started, i hated the pads after birth!

sex definitely went from painful to uncomfortable to tolerable to enjoyable over a loooong period of time.

[jennie]

Mine started at 7 months pp, 1 one month after I stopped breastfeeding. It was very heavy, and unlike my normal periods. I had no pain using tampons.

[MamaD]

Got my first PPAF at eight months even though I was EBF. My periods have been a lot heavier and very erratic. I was charting before I got preggo and started charting again once AF was back. These cycles have lasted from 27 days to 46 -- though I was always super regular before. I am in my first cycle since we stopped nursing and it seems like it is back to my pre-preggo days.

[Heather]

Like Carrie and swissmiss, my period returned early--around 7 weeks--despite exclusively bfing. I also have the problem with the tampon falling out (something I haven't DARED discuss with anyone--thanks ladies!). I would also like the name of the generic brand.

I sure hope Kelly's comments about being hyper-fertile are true since it took 2 years of infertility treatments (everything but IVF) to conceive our first, now 5.5 months.

Sex? What's that? Still haven't had it. Not in the mood at all. George Clooney could show up naked at my front door and I still wouldn't be interested.

[rudyinparis]

With Eldest, first period shortly after weaning--very, VERY heavy... much heavier than before I had children... but I had been on the pill then, using the IUD now.

It's only recently, with Younger at 18 mos., that my periods are back to a regular cycle... I have had to work hard at taking care of myself to get back to a regular cycle--for months I had extremely erratic flow. Due to being tired, not taking care of myself, etc. You all know the drill. Now that they are back to normal, I am seeing, as with Eldest, that they are heavier than before.

[yasmara]

10+ mo. postpartum w/my 2nd baby and no sign of a period yet. I had some bleeding start up right before my 6-week postpartum appointment and it turned out to be retained tissue, not a period.

I hadn't trusted my instincts when I didn't heal properly after my 1st birth (granulated tissue that had to be cauterized but then healed fine in another 2-3 weeks) so with this one I was glad it coincided w/my scheduled appointment. Just a cautionary tale for 1st-timers - don't be afraid to get anything checked out!

As someone else mentioned, I've had what feels like monthly hormone fluctuations/PMS (acne, mood swings, bloating, cravings) but then no period. My son is in daycare 5 days a week and I pump twice a day. He co-sleeps and nurses at night and usually nurses at least twice in the evening (once just after daycare and once about 2 hours later to go to sleep) and 2-3 times more if he's not in daycare.

With my first, I got my period at 4 months postpartum and it seemed about the same as before I got pregnant, although lighter the first few cycles. I don't know what the difference is this time around but as far as I'm concerned it can stay away indefinitely!

[Charisse]

First period at 12 weeks postpartum while EBFing with a very enthusiastic nurser. Got an IUD at 10 weeks postpartum, so hard to compare since that's in the mix as well. In general though, lighter than I had previously.

[anon]

ditto to yasmara - if sex hurts, get it checked out - I did not heal properly, they tried cauterization but eventually had to do another procedure, healed fine and then sex (with lube) was not painful (psychologically difficult becuase of previous pain, but okay).

I waited way too long and did not trust my instincts (also was told by phone that "they never have problems healing by the doc on call") - with #2 I have promised myself to be much more proactive.

[Eve]

Like others, mine returned with a vengeance at about 16 weeks postpartum, despite round-the-clock BF. Also, I found that tampons were trickier to insert and were sort of painful, but I thought I must be crazy because I had a C-section. Glad to know I'm not alone.

[anon]

Kellymom has a neat little table with when women get their periods back when they're exclusively breastfeeding.

www.kellymom.com/bf/normal/fertility.html

It should be noted for any lactating moms that think they can't get pregnant:

Lactation is more effective than a condom if, AND ONLY IF:

you haven't had any periods or spotting since the early postpartum stuff, you're feeding every three hours even at night, and your baby eats NO solids or formula. Which means that after 6 months of age, when you start solids, the effectiveness goes down.

Hence a friend's 15-months-apart babies.

[Annika]

We breastfed exclusively for six months and still nurse all the time. My first period came at about 3.5 months postpartum and was spotty, I thought maybe a fluke. Second came one month later and was normal, though slightly heavier and lasting slightly longer than I'm accustomed to. They've come like clockwork ever since - the only real difference is my 28 day cycle now lasts 26 or 27 days and I bleed for 5 instead of 3. I have only used a tampon once and it was horrible. I use cloth pads now, and I thought that might be the reason I hated the tampon. Maybe it's just a postpartum thing...