What to Expect With Postpartum Hormone Changes

By the time those two pink lines pop up on a pregnancy test, your hormones have already gotten the message that something's different at mission control. Progesterone and human chorionic gonadotropin (hCG) signal your body to halt production on your next menstrual period and form that cluster of cells into a mini-you instead. As you probably already know, as these hormones get to work, many people experience an onslaught of early pregnancy symptoms like nausea, fatigue, and breast soreness.

When you give birth, your hormones make a significant shift again and are to blame for those wild emotions you experience after giving birth. Read on for a closer look at a timeline of what happens to your hormones postpartum.

A Timeline of Postpartum Hormone Changes

As pregnancy progresses, your body produces extraordinary amounts of estrogen and progesterone, says Aumatma Shah, N.D., fertility specialist and naturopathic doctor at the Holistic Fertility Institute and author of Fertility Secrets: What Your Doctor Didn't Tell You About Baby-Making. "These two steroidal hormones are key to creating dopamine and serotonin, two neurotransmitters in the brain that are important in feeling calm and happy." Shah says this surge of hormones and neurotransmitters is why many people feel amazing when pregnant.

But what happens to those feel-good pregnancy hormones once your baby is born? "Unfortunately, immediately postpartum and the week following delivery, estrogen and progesterone will both plummet. Simultaneously, there will be a surge in prolactin and oxytocin," says Shah.

Postpartum hormones immediately after birth

The birth of your sweet bundle of joy is undoubtedly one of the most exciting moments of your life. No matter how long you labor or when you give birth—yes, even at 3 a.m.—you'll likely feel an incredible, indescribable high when you meet your baby for the first time or shortly after. That's thanks to a rush of endorphins during labor. But those surging labor hormones will plummet over the next few days. Here's what's going on:

• Progesterone and estrogen: Both of these hormones decrease as soon as the baby and the placenta are delivered.
• Oxytocin: Surges immediately following birth to compensate for the initial drops in progesterone and estrogen. This hormone is responsible for that strong parenting instinct. However, you'll probably still experience some "baby blues" in the first few days postpartum as the oxytocin works itself out of your system, says Shah.
• Prolactin: Increases to encourage milk production. (If you are not nursing, prolactin drops to pre-pregnancy levels within a couple of weeks.)

Postpartum hormones 3 to 6 weeks after delivery

After those first few weeks pass, you may feel those rollercoaster-like emotions start to regulate a bit as you begin to get into the groove of caring for your baby and adjust to the lack of sleep. But, Ashley Margeson, a naturopathic doctor, says, "the first three months are a bit of a whirlwind of sleep loss and emotions as your system runs mostly on adrenaline to move you through the day."

Around the six-week mark, she says, postpartum depression symptoms may begin to show as those positive post-birth hormones continue to fade. According to Margeson, symptoms to watch out for include:

• Not wanting to shower or focus on hygiene
• Fear of leaving your baby with someone else
• Inability to sleep fully due to continually checking on your baby
• Lack of desire for everyday tasks like eating, drinking, being around people, and leaving the house

Postpartum hormones 3 months after delivery

By three months after giving birth, you may have established a new routine and adjusted to a new normal. But your hormones at three months postpartum are still working hard to get back to baseline. Shah says, "Around two to three months postpartum, your hormones begin to reset to pre-pregnancy levels. However, cortisol levels often increase due to the many new stressors of having a young baby. And the lack of sleep contributes to decreased melatonin levels (and, as a result, serotonin). These postpartum hormone changes can sometimes have a negative impact on mood."

Postpartum hormones 6 months after delivery

Postpartum hormone changes at six months look slightly different depending on whether you formula feed or breastfeed or chestfeed. If it's the latter, the most significant potential change to your hormones around six months postpartum is the decrease of the hormone prolactin, the milk-making hormone.

However, this change depends on your baby's nursing patterns and if you've begun to wean. That's because this hormone stays high while nursing, but it comes down as you introduce your baby to solids and start weaning.

But, even though older babies' demand for milk may become more regulated, they still experience growth spurts, at which time they may suddenly start nursing longer and more often (known as "cluster feeding"). In fact, according to the U.S. Department of Agriculture (USDA), babies experience growth spurts when they are around 3 weeks, 6 weeks, 3 months, and 6 months old.

In addition, hormone levels are suppressed longer in those who breastfeed or chestfeed—"the more intense the breastfeeding, the longer the suppression," according to Susan Loeb-Zeitlin, M.D., an OB-GYN at Weill Cornell Medicine and New York–Presbyterian Hospital. Plus, the hormone suppression is dose-dependent—for those who exclusively nurse, hormones don't return to its baseline until after six months postpartum in about 40% of people, says Dr. Loeb-Zeitlin.

• RELATED: The AAP Calls for More Support and Inclusivity in Updated Breastfeeding Guidelines

When Do Postpartum Hormones Go Back to 'Normal'?

Six months postpartum is a reasonable estimate for when your hormones will return to their baseline, but it could be earlier depending on whether or how frequently you breastfeed or chestfeed. Midway through the first year is also around when many people have their first postpartum period, and that's no accident, says Shah. "By six months, postpartum hormonal changes in estrogen and progesterone should be reset to pre-pregnancy levels. Your hormones may also have started cycling, which will onset menses again."

That said, hormonal shifts don't operate like clockwork, and every person is different. For example, some lactating parents can get their first postpartum period much earlier or much later than six months. And those who don't breastfeed or chestfeed more typically get their first period within a couple of months after giving birth.

• RELATED: When Will Your Menstrual Cycle Return After Birth?

The Signs of a Hormonal Imbalance After Pregnancy

Sometimes, pregnancy and childbirth can cause your hormones to become a bit out of whack. In these cases, you might need some help getting back on track. According to Dr. Loeb-Zeitlin, below are some symptoms you might experience if you're dealing with a postpartum hormone imbalance:

• Anxiety and depression
• Chronic fatigue
• Cysts or fibroids
• Low libido
• Weight gain

One of the more common postpartum hormonal imbalances occurs in your thyroid. In fact, postpartum thyroid problems can occur in up to 10% of people, says Dr. Loeb-Zeitlin. Often, these issues resolve over time, but sometimes, you may require medication to help regulate your hormones.

And if you've experienced a hormone imbalance before pregnancy, there's a higher likelihood you'll experience it again once your pregnancy hormones have worn off. In those cases, says Dr. Loeb-Zeitlin, you should receive treatment as you did before pregnancy. For example, if you have polycystic ovary syndrome (PCOS), managing your condition to restabilize your hormones is important.