Rapidly dropping postpartum hormones, sleep deprivation, and caring for a newborn can lead to a range of emotional and physical changes after giving birth. You might wonder if you’ll ever feel “normal” again. Postpartum is a temporary adjustment period, and things will eventually settle down, helping you feel more like yourself.
This article explains the hormonal shifts that occur postpartum, how they affect you, a timeline for hormone stabilization, and practical coping tips.
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Fluctuating Postpartum Hormones and Effects
While most hormonal symptoms during the postpartum period are from drops in estrogen and progesterone, there are a few other key hormones. Here is a breakdown of each:
- Human chorionic gonadotropin (HCG) is the hormone pregnancy tests detect. Levels of HCG rise with conception and during the first trimester, telling your body to maintain your uterine lining and stop ovulating. Levels drop after childbirth but do not typically cause symptoms.
- Estrogen levels rise during pregnancy to help the uterus and placenta grow. After childbirth, levels drop, potentially causing mood swings, crying, hair loss, fatigue, vaginal dryness, and low libido (sex drive).
- Progesterone rises during pregnancy to prepare the uterine lining, prevent ovulation, and help you feel calm. After delivery, levels drop, which can cause irritability, mood swings, fatigue, and hair loss.
- Prolactinthe milk-making hormone, rises throughout pregnancy. After birth, prolactin spikes each time your baby breastfeeds, helping your body maintain milk production and sometimes contributing to fatigue.
- Cortisol is the stress hormone that naturally increases during pregnancy and can remain high postpartum as you adjust to caring for a newborn. High cortisol levels can lead to weight retention, anxiety, depression, and fatigue.
- Oxytocinor the “love” hormone, is also known as the “labor” hormone because it rises during childbirth to help with uterine contractions. It remains high post-delivery to promote bonding and reduce stress.
- Thyroid hormones increase during pregnancy to meet the demands of the developing fetus. After childbirth, levels decline, affecting energy, weight, mood, and temperature regulation.
A Word From Verywell
Your body experiences many physical, mental, and emotional changes during the postpartum period. It can take months to feel like yourself again. It’s important to check in with yourself and how you feel and know that help is available.
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When Do Postpartum Hormones Regulate?
During the first 48 hours after delivery, hCG, estrogen, and progesterone levels drop. Around three weeks postpartum, hCG, oxytocin, and prolactin return to prepregnancy levels. However, breastfeeding parents typically have slightly higher prolactin levels for several months. Cortisol will gradually decline but can remain high with excess stress.
You may begin to feel more like yourself around three to six months postpartum when estrogen and progesterone reach prepregnancy levels. However, estrogen levels may take up to a year to normalize, especially if you are breastfeeding.
Thyroid Hormones
Thyroid hormones stabilize within a few weeks after childbirth. However, 10% of parents experience thyroiditis (thyroid swelling). Some people develop hypothyroidism (underactive thyroid) or hyperthyroidism (overactive thyroid). Symptoms involve:
- Difficulty concentrating
- Fatigue
- Hair loss
- Heat or cold intolerance
- Heart rate changes
- Mood changes
- Weight changes
If you experience these symptoms, your provider may suggest thyroid stimulating hormone (TSH) and thyroid antibody blood tests to detect imbalances.
Postpartum Care and Support for Hormonal Changes
During the first 48 hours after birth, postpartum care typically focuses on physical healing and caring for your newborn. As time passes and you begin coping with hormonal changes, it’s essential to continue to make self-care a priority. Here are some tips:
- Ask for help from your partner or support system.
- Consider seeking support from a doula or groups like Postpartum Support International (PSI).
- Drink plenty of water.
- Eat healthy food like lean protein, fruits, and vegetables.
- Go for walks to boost your mood.
- Make time for things you enjoy.
- Rest when your baby sleeps.
- Talk with your provider about postnatal vitamins.
For stress reduction, utilize deep breathing exercises like the following 4-7-8 technique:
- 4: Breathe in through your nose for four seconds.
- 7: Hold your breath for seven seconds.
- 8: Breathe out through your mouth for eight seconds.
You can also consider complementary therapies like:
Sexual Intimacy
Even after the six-week waiting period, many people experience concerns about sexual intimacy due to vaginal dryness, pain, nipple soreness, body image, and low libido. Your libido will gradually return, though it can take up to a year. In the meantime, maintain open communication with your healthcare provider and sexual partner. Consider alternate forms of physical intimacy and use water-based vaginal lubricants during sexual intercourse.
About 50% to 80% of new parents have hormonal changes that cause what is referred to as the baby blues (sadness, mood swings, worry). But this typically resolves within a week or two.
Postpartum depression (PPD) occurs in one out of four people. It is when baby blue symptoms are intense and last longer. Having PPD is not your fault, and support is available. Talk with your provider as they may suggest mental health therapy or medications like:
- Estrogen
- Progesterone
- Brexanolone (allopregnanolone)
- Antidepressants
Emergency Symptoms Of Postpartum Psychosis
Postpartum psychosis (PPP) is a rare but serious mental health condition. The exact cause is uncertain, but postpartum drops in estrogen or high cortisol levels might contribute. Symptoms that require emergency medical attention include:
- Confusion
- Delusions (altered sense of reality)
- Odd speech
- Hallucinations (seeing or hearing things that are not there)
- Paranoia (being suspicious about people’s intentions)
- Violent thoughts
If you have thoughts of harming yourself or your baby, immediately ask your partner or a loved one to care for the baby. If you are having suicidal thoughts, contact the 988 Suicide & Crisis Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one is in immediate danger, call 911. For more mental health resources, see Verywell’s National Helpline Database.
Postpartum Hormones Around Menopause
Perimenopause is the time leading to menopause (when you stop having periods). Estrogen and progesterone changes during the postpartum period and perimenopause can cause:
- Anxiety or depression
- Fatigue
- Hair loss
- Hot flashes
- Low libido
- Mood swings
- Trouble sleeping
- Vaginal dryness
If you experience childbirth while in perimenopause, hormonal recovery after childbirth might take longer. Postpartum hormone shifts could also temporarily worsen perimenopause symptoms.
Hormonal Birth Control
Experts advise against getting pregnant within six months of delivery and waiting at least 18 months before getting pregnant. Hormonal birth control is a common choice to prevent pregnancy. Progestin-only options are safe while breastfeeding, but estrogen is not.
For those in perimenopause or with preexisting conditions like endometriosis (a condition in which tissue similar to that in the uterus grows outside the uterus), hormonal birth control can also help regulate your hormones, period, and menstrual pain.
Summary
Postpartum hormone shifts, especially changes in estrogen and progesterone, can cause intense emotional and physical changes. Your hormones will eventually stabilize within a few weeks to months, and your body will adjust. Prioritize self-care and seek support from your healthcare provider, partner, family, friends, or support groups.
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