Lactation Amenorrhea

That’s just a fancy term which means “no periods while breastfeeding.” It refers to the natural infertility that many women experience after birth for as long as several months after their babies are born. I never had it.

Some people will swear by “lactation amenorrhea” as a sure-fire solution at “natural” pregnancy prevention, or “natural” child-spacing. It does work for some women, but not for all. On an email list I’m on, we recently got into a discussion about this, and several women noted that one or more of their children were conceived when they were supposedly infertile in the months after birth, and ended up with children 10-15 months apart in age, without having had a period in between. One woman I remember in particular said that since she had conceived one child like they, she and her husband were determined to wait to have sex until she got her period back, just to make sure they didn’t conceive again. Well, after a few months of no sex, and no period either, they had a bit of “marital enjoyment”… and ended up with yet another baby on the way.

Many sources will say things like “most women will experience a natural cessation of periods while they are exclusively breastfeeding” and that “many women will have one or more anovulatory [infertile] cycles before they return to fertility.” That may well be, but you shouldn’t bet on it!

I’ve theorized this, but have no way of drawing any firm conclusions — it just makes sense in my mind — that heavier women will get their periods back sooner than normal-weight or underweight women. First, I remember it said several Olympics ago that many of the girls on the gymnastics team didn’t have periods — they were too small and/or underweight to do so. They simply didn’t have enough body fat to support a fetus, so they didn’t ovulate or menstruate. So, I do know that at one end of the spectrum, not having enough weight can lead to not having a period. I started both my pregnancies at the same (over)weight, and gained 10 lb. more with my second than with my first. After I had my first baby, I started my first period at 6 weeks postpartum, the second was 5 weeks later, and then they continued at my usual “every 4 weeks”. After my second baby, I hadn’t even finished with the lochia and I had my first period at 4 weeks postpartum! Then I had a pregnancy scare (that I’ll get to in a moment) with no period at 8 weeks pp, then regular periods after that. One of my sisters-in-law, who is normal-to-thin (and exercises much more religiously than I do), didn’t have a period between her two children born 19 months apart. Even though she was no longer exclusively breastfeeding her son, she was still nursing for several months, and didn’t have her period.

This also shows that you can get pregnant without having a period. Although some women will have one or more infertile cycles in which they do not ovulate (release an egg) while they are breastfeeding or soon after the birth of their baby, not all women will. Although you typically start counting your cycle from the first day of your last menstrual period, ovulation is what really starts the process — you ovulate about 14 days before you start your period. If your first cycle is a fertile cycle, you can get pregnant even if you haven’t had a period since you gave birth. This doesn’t happen a lot, but it can happen, so you need to be aware of that.

I exclusively breastfed my children for the first 6 months, and didn’t experience amenorrhea, so I get a little irritated sometimes when people so blithely assert, “If you breastfeed exclusively, you won’t get pregnant.” Bull. For many women, I’m sure that’s true; but not for all women. Breastfeeding may reduce but does not necessarily prevent fertility. There are biological forces at work when it comes to getting pregnant, and one of those forces is that if a woman cannot support a pregnancy, she tends not to have periods — this is why the Olympic gymnasts many times do not menstruate; and it may also be a factor in why many other women are infertile — whether overweight, underweight, or normal weight, there may be many health issues that make pregnancy not a good idea biologically speaking. Obviously, there are many reasons other than this for women to have difficulty becoming or staying pregnant, and I’m not doing an exhaustive post on that, but only talking about it as it touches this subject, with the idea of perhaps enlarging on it a little. So, if you are one of those women who does not have periods for several months after having a baby — congratulations! But if you’re about to have a baby or you just gave birth, and you’re expecting to be naturally infertile while you exclusively breastfeed — be careful!! I wouldn’t bet on it, that’s for sure.

Oh, and my pregnancy scare at 8 weeks postpartum? When my younger son was 3 weeks old, a friend adopted a newborn baby, and I pumped milk for her. I got up to pumping 25 oz. per day by the time the baby was 6 weeks old, and she decided to just go to straight formula, rather than have me expend all that time. So I theorize that if I had had twins, exclusively breastfeeding them of course, I would not have gotten my period back as soon as I did. This tends to bolster my weight-breastfeeding-amenorrhea theory, because I skipped a period when I was at the height of my milk production, so I assume that my body said, “Ok, we can handle breastfeeding two kids, but we can’t handle growing another young ‘un, so let’s put the baby-making machine on hold for a while!” When I stopped pumping, I started my periods again, every four weeks, just like clockwork.

What about breastfeeding and taking birth control? I don’t know. There are a lot of birth control pills on the market, and some may by safer to take while breastfeeding, but that’s something to discuss with your doctor and pharmacist. I’m pretty sure that if you start on birth control, you will get a period on your placebo-pill days, and also that the hormones that get in your system will get into your breastmilk. There are low-dose pills available now which may not interfere with breastmilk production, but I think the older pills may cause problems in that department.

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