After I night-weaned my second born, when he was 18 months of age, my period returned with a vengeance.
It was so heavy I avoided going out when I had my period, in case of embarrassing leaks.
At first, I didn’t do anything about it, assuming it was due to my hormones getting back into balance after childbirth. But it continued for over a year.
As a result, my iron levels had bottomed out, leaving me feeling more exhausted than ever before.
Feeling defeated, I reached out to a friend, telling her I didn’t know what to do. I thought my period should have returned to normal by now.
She suggested I go on the pill – which I thought was a great idea. After all, it’s what most doctors tell us will help to regulate the menstrual cycle, and it had worked before, when I was a teen.
It also sounded like an attractive ‘quick fix’ for something that was making me miserable.
What I didn’t know at the time was abnormal blood loss is usually the sign of an underlying problem needing attention.
The pill can’t fix any underlying issues – it’s simply a bandaid fix, masking what’s really going on.
Why might periods be heavy after childbirth?
Here are the most common reasons why your periods might be heavy after childbirth.
#1: Retained products from childbirth
If you’ve given birth recently, there could be retained products (e.g. parts of the placenta) still implanted in your uterus. Although many women never experience this, it certainly does happen, and it can affect breastfeeding too. If there is retained placenta in your uterus, you might have problems with your breast milk coming in.
See our article for more information about retained placenta.
#2: Hormonal changes
Because there’s a relationship between the breasts and the uterus, hormonal changes associated with breastfeeding might be affecting your cycle. Again, this isn’t usually a major cause, but it’s something to consider when speaking to your specialist.
Increased abdominal fat can also be a culprit, as it is oestrogenic, and can mess with a woman’s hormones.
#3: Adenomyosis
Adenomyosis is a common disease of the uterus. Interestingly, there’s little awareness amongst women, as well as many healthcare providers.
The cause is believed to be genetic, but what happens is the endometrium (inner lining of the uterus) breaks through the wall of the uterine muscle (called the myometrium). Unfortunately, adenomyosis gets worse with each menstrual cycle, because oestrogen fuels it. It’s more often diagnosed in women in their late 30s or 40s, after having children.
Adenomyosis is a benign condition, but it is progressive, meaning it will never go away. It often coexists with other conditions, such as fibroids or endometriosis.
One of the giveaway symptoms of adenomyosis is heavy menstrual bleeding. You may also experience period pain and cramping (from mild to labour-like pains) even when you don’t have your period.
Heavy blood loss due to adenomyosis is one of the biggest causes of iron deficiency in women. If you have heavy periods, this is why you must find a women’s health specialist who will get to the underlying cause of your condition, and not fob you off with iron tablets or the pill to fix it. It’s simply masking the damage going on underneath.
Find out more in our article about adenomyosis.
#4: Other undiagnosed gynaecological or endocrine issues
Women’s health and reproductive medicine specialist, Doctor Andrew Orr, says the most likely cause of heavy periods after giving birth is an undiagnosed gynaecological or endocrine issue.
“Often the mother is totally unaware that she has a gynaecological problem because she’s been able to get pregnant and have a baby – so no-one assumes she has any fertility-related issues. But as some people will know, secondary infertility is a real problem. With secondary infertility, there are no issues getting pregnant the first time, but next time they try, it doesn’t happen and everyone wonders why”, he says.
Even if you have given birth with the help of an obstetrician, you cannot assume everything has been checked out and you have the all clear.
“Some of my patients who have had a c-section have been shocked to discover they have a gynaecological problem, because they assumed the obstetrician would have had a look, and said something after the c-section – but they don’t check for gynaecological problems, they just get the baby out”, Doctor Orr adds.
After a c-section (or any abdominal surgery) issues such as adhesions and infections can become a problem. And sometimes they have no symptoms at all, or symptoms appear much later.
Some examples of the most common gynaecological and endocrine issues which may contribute to increased blood loss during your period include adenomyosis, endometriosis, polyps, fibroids, PCOS (polycystic ovarian syndrome) or thyroid issues.
How do you properly treat heavy periods after childbirth?
Treating heavy periods after childbirth requires getting to the root cause of the problem. The pill simply masks what’s going on underneath, and allows any damage to continue or worsen. This is a terrible way of managing the problem, especially if you want to have more children in the future. Ultimately, potential complications can affect your fertility and health.
“The first step is to get a referral to a women’s health or reproductive specialist”, says Doctor Orr. “A GP isn’t trained in treating gynaecological or endocrine disorders, so it’s really important to make sure you simply get a referral from your GP then obtain treatment from a specialist”.
Doctor Orr adds, “Ultimately, heavy bleeding needs to be addressed and not let go. The longer women have heavy bleeding, the more likely it is that they will become anaemic, and increase their risk of conditions like osteoporosis”.
If you come across a specialist who thinks the pill is sufficient to fix your problems (it’s very common), simply find a new specialist. Unfortunately, not all specialists decide to investigate in the same way. As well as specialist care, you can try complementary therapies, such as acupuncture and Chinese medicine, or find a good naturopath.
Diet and lifestyle choices are important too
Dietary and lifestyle changes are very important to support your body and keep hormones in balance.
It can be a challenge when you have a baby or toddler but aim to get enough sleep per day, and nap if and whenever you can. Also, work on eliminating stresses from your life, and seek support wherever you can find it.
Exercise – even a 30 minute walk each day – can help with insulin levels, and therefore hormonal imbalances.
Inflammatory foods that spike blood sugar levels – for example, grains and sugar – should be kept to a minimum, and ideally eliminated. Often, for busy and tired mothers, sleep and a good diet go out the window, leaving them in a repetitive pattern of being tired, propping themselves up with sugar, then being tired again. It’s a terrible cycle to be stuck in.
You don’t need to suffer in silence
If there is just one takeaway for you in this article, I hope it’s this:
You don’t need to suffer in silence, because help is out there to work out the root cause once and for all. You deserve to be able to function at your best. With the demanding task of having a baby in your arms, don’t go for the bandaid fix; go for solving the underlying issue, and you’ll feel so much better.
“I find that the reproductive system is often the first thing to go when a woman is run down and her immune system isn’t working well. Don’t put up with these uncomfortable problems in silence – we’re here and we want to help”, says Doctor Orr.
