How long after a caesarean section do you get your period? When menstruation begins after cesarean section with artificial and breastfeeding. When does menstruation come?

Many women, after the birth of a baby, are wondering when menstruation should resume? Regardless of how the birth went, it takes a certain amount of time to restore the menstrual cycle. When menstruation begins after a caesarean depends on many factors. Let's find out what is considered the norm, and in which case it is worth sounding the alarm.

Currently, operative delivery is quite common. A caesarean section is performed in cases where natural childbirth is not possible or can lead to the death of the mother and child. But do not forget that this intervention can cause certain postpartum complications, and the risk to a woman's health increases several times.

Women also quite often experience psychological discomfort about childbirth that did not take place naturally. Many argue that after a caesarean, women have much less milk than those who gave birth on their own, in fact, this is not the case. The body, in principle, perceives this operation quite naturally.

Of course, if there is a possibility of choosing how the birth will take place, then it is worth giving preference to the natural method of childbirth, if an operation is necessary, a woman should prepare in advance for the upcoming event, first of all, mentally.

When to expect periods after caesarean

After the baby is born, the process of involution, that is, reverse development, begins in the woman's body. During this period, all systems and functions of the body begin to return to normal rhythm. Normalization of menstruation in the postpartum period occurs when when the reproductive function of the body is restored. In the case when the delivery took place by caesarean section, the onset of the next pregnancy is not recommended for three years, so women who have undergone such an operation should be especially careful about the issue of protection even before the first menstruation.

It is impossible in principle to give an unambiguous answer to the question of when menstruation comes after a cesarean section. In many ways, the onset of menstruation after surgery depends on the individual characteristics of a particular female body, therefore, for different women, the time period for the appearance of the first menstruation after cesarean is different.

After the end of childbirth and the release of the placenta, the body begins to recover. There is a contraction of the uterus, which gradually takes on size, weight and takes a position, as before pregnancy, dropping about a centimeter a day. The uterine recovery process usually takes about 7 weeks. In some cases, the size of the uterus after childbirth may decrease - this happens when a woman intensively breastfeeds her baby. Functions of ovaries are restored also gradually.

Both after caesarean section and after natural childbirth appear specific discharge called lochia. They stop by the time the uterus is restored, that is, about a month or two after childbirth. The intensity, color and smell of these secretions may change throughout the recovery of the uterus. Do not confuse postpartum discharge with menstruation, they appear as a result of bleeding of the uterus and pass with its healing.

After the cessation of postpartum discharge, a woman may begin menstruation, however, quite often ovulation does not occur in the first menstrual cycle, therefore, pregnancy is impossible, but here we should not forget about the features and individual structure of each female body.

The timing of the appearance of the first menstruation after the birth of a child does not depend on how the birth took place. After a caesarean section, menstruation occurs at about the same time as after a natural birth.

Factors that affect the restoration of menstruation include:

the course of pregnancy;
lifestyle of a young mother;
individual characteristics of the organism;
age;
the presence of certain diseases;
the psychological state of the mother, her emotional mood;
quality of food and rest;
the presence of lactation.

To the greatest extent, when menstruation comes after a cesarean, it is lactation that affects it. Menstruation recovers faster with artificial feeding, while in lactating women, a special hormone prolactin suppresses ovarian activity.

If a woman is breastfeeding , then menstruation may not begin even in the first year after childbirth, so if you do not have periods after cesarean for a long time, but you are breastfeeding, you should not worry.

If a woman does not feed a child , then menstruation should begin no later than 3 months after birth. With mixed feeding, the absence of menstruation is allowed for up to four months.

What menstruation should alert you

After a caesarean section, women are advised to undergo an examination by a gynecologist 1.5-2 months after childbirth. As a rule, an ultrasound is prescribed to examine the suture on the uterus and an examination is carried out on a chair, smears are taken.

It is also worth visiting a gynecologist if a regular cycle has not been established 6 months after the onset of menstruation, although most women after childbirth note that the cycle becomes more even than before pregnancy, and premenstrual pain is less pronounced.

A longer recovery of the body, and, consequently, a longer absence of menstruation can be observed in women whose body is weakened, as well as in mothers after 30 years, if the pregnancy proceeded with complications.

It is urgent to see a doctor if menstruation after cesarean section is heavy or, on the contrary, too meager, long (more than 6 days) or short-term (lasts a couple of days). Menstruation, which has an unpleasant odor, should also be of concern - this may indicate an infection of the genital organs.

Long daub after the end of menstruation or before it begins is considered abnormal.

Pregnancy and childbirth are quite stressful for the female body, so in some cases the recovery process may be delayed. In order to quickly establish all the functions of the body, do not forget to eat varied and regular meals, be outdoors more often, be sure to get enough sleep, try to avoid excitement and stress - all these tips will help not only recover in the postpartum period, but will also contribute to good lactation, which is important for a young mother and her baby.

Remember that any disturbing symptoms: lack of menstruation, pain, discomfort in the lower abdomen is a reason to visit a doctor. Do not forget that a caesarean section is a surgical intervention, so be attentive to your body!

Many mothers who have had a caesarean section are wondering how soon their menstrual cycle will resume. Realizing that artificial delivery is an invasion of the body's natural activities, women begin to worry about the state of their reproductive system. So when does the first period start after the operation? What is considered normal, and in what situations is it better to consult a doctor?

When do periods start after a caesarean section?

Today, many children are born by caesarean section. The operation is performed in a situation where natural childbirth is not possible due to the state of health of the mother or child (also due to the incorrect position of the fetus). Some women themselves choose this method of delivery, frightened by the upcoming labor pains.

A caesarean section is done under anesthesia, it is a dissection of the abdominal wall and the anterior surface of the uterus. Of course, the body needs to spend certain resources to heal tissues, and this, one way or another, will affect the mother's well-being. But in general, in the female body, all the same processes take place as after ordinary childbirth: the gradual stabilization of the hormonal background, the return of the uterus to its original size, the resumption of ovarian functions.

During the operation, the abdominal wall and the anterior surface of the uterus are dissected.

After a caesarean section (as well as after a normal delivery), the mother has specific discharge from the genital tract - lochia - for one to two months. Although at first they are bloody, they should not be confused with menstruation. Lochia stops after complete healing of the uterus.

The restoration of the menstrual cycle after a caesarean section is, in general, no different from the situation with natural childbirth. Specific terms are due to a number of factors, the most important of which is lactation. If a mother is breastfeeding her baby, then her body actively produces the hormone prolactin. It, in turn, suppresses the functioning of the ovaries, preventing the maturation of the egg. Over time, complementary foods appear in the baby's diet, and the child receives the mother's breast less often. As a result, the amount of prolactin in a woman decreases, and at any moment an egg can ripen and menstruation can come. This usually happens when the baby is 5-6 months old (at which time most children already receive complementary foods).
Lactation is the most important factor affecting the onset of menstruation after cesarean

However, it must be borne in mind that the body of each woman is individual. For someone, even with active breastfeeding, an egg can still mature in the first months after delivery. For some breastfeeding women, periods may not come until a year later, despite the introduction of complementary foods.

If the child has been bottle-fed since birth (or the mother has little milk, and she combines it with mixtures), then the cycle after caesarean section will recover soon enough - within two to three months after the operation. This means that the reproductive organs have recovered and are physiologically ready for the next conception (although after the operation, it should not be allowed for three years). Sometimes the initial cycle after childbirth happens without ovulation. If menstruation has not appeared within four months after the operation, this is an occasion to consult a doctor.

In addition to lactation, other factors influence the rate of recovery and normalization of the menstrual cycle (although not so clearly).

The course of pregnancy. If in the process of carrying a child there were no complications, then the reproductive system will recover more quickly.
Mom's age. Of course, a younger organism will soon return to normal after childbirth (including by artificial means). The defining boundary here will conditionally be 30 years (again, individual characteristics should be taken into account).
Lifestyle of a woman. We are talking about a proper balanced diet, an established regime of exercise and rest, regular stay in the fresh air. All this contributes to the faster arrival of the first menstruation.
Chronic and latent diseases, infections in the mother. As you know, even in the normal state, a common cold can cause a delay in critical days. For an organism weakened by recent childbirth, this is all the more important.
The psycho-emotional state of a woman. The state of all organs in the body, including reproductive ones, largely depends on the good functioning of the nervous system.

Each of these factors individually may not affect the timing of the resumption of menstruation, but the more of them in the aggregate, the more they affect the recovery processes in the female body. And the first menstruation after cesarean may be delayed or, conversely, come earlier.

Photo gallery: factors affecting the rate of recovery of the menstrual cycle

The stress factor can delay the onset of the first menstruation after childbirth Proper nutrition contributes to the recovery of the body The young body (up to 30 years old) will soon return to normal after childbirth Infectious and chronic diseases do not at all contribute to the rapid restoration of the menstrual cycle

Video: when menstruation begins after cesarean

Anxiety symptoms associated with menstruation

After childbirth (either natural or caesarean), a woman's menstrual cycle often changes. Most often, bleeding becomes more regular, less intense, the symptoms of PMS are smoothed out (which many young girls suffer from). But in some cases, the nature of menstruation may indicate certain disorders in the female body, requiring a mandatory visit to a gynecologist.

Abundance. The first menstruation (and sometimes the second) after a caesarean is usually quite intense, and this is due to hormonal reasons. At the same time, the mother feels quite normal. But if the discharge continues to be too abundant, then perhaps we are already talking about a disease (for example, endometrial hyperplasia, polyp or endometriosis). If a woman only needs one pad for a couple of hours, she needs emergency medical attention.
Scanty discharge. The opposite situation, which may indicate insufficient contraction of the uterus. And this is fraught with congestion and, as a result, inflammation.
Intermittent (or "jumping") cycle. Normally, the time interval from one menstruation to another is 21-35 days (moreover, each woman has her own). Two or three cycles after the onset of menstruation after cesarean, delays should stop (the norm is fluctuations of one or two days). The instability of the cycle can be a sign of a violation of the contractility of the uterus due to surgery or medication.
Abnormal duration of discharge. Menstruation in a woman does not last longer than 7 days, but does not stop earlier than 3 days after it began. A deviation from the norm may indicate hormonal problems.
Unpleasant pungent smell of secretions. Usually, infections and purulent processes in the genital organs (for example, endometritis - in combination with fever and pain in the abdomen) manifest themselves in this way. Moreover, after a caesarean section, this happens more often than during natural childbirth. In the postpartum period during critical days, gynecologists advise a woman not to use scented pads so that she recognizes an unpleasant odor in time and takes action.
Prolonged daubing (more than one day) on the eve of menstruation and after their termination. Such a phenomenon is a symptom of pathology, most often endometriosis (while the daub has a brownish color).
In the composition of menstruation, curdled discharge is observed (accompanied by itching). Most likely, this is thrush, which is quite likely due to taking antibiotics after the operation (this is done to avoid possible complications).

A mother who has undergone a caesarean section is recommended a gynecological examination 1.5–2 months after the operation. Usually, the doctor will order an ultrasound to assess the condition of the suture and take a smear for possible infections.

Video: Gynecologist Explains Why Periods Can Be Irregular While Breastfeeding

Pain during critical days after cesarean: norm or pathology

It is not uncommon for a woman who has had a caesarean section to experience pain during her period (even if she never had it before pregnancy) and worry about it. Usually such sensations are not dangerous: their cause is a postoperative scar on the uterus. It has not yet fully healed and is forced to contract during menstruation. With normal regeneration of the scar area, the pain gradually decreases and disappears.

The pain factor may be associated with the healing of the suture on the uterus

Sometimes, during a caesarean section, a woman additionally removes myomatous nodes. Pain during menstruation in this case will be more pronounced.

Excessively painful menstruation may indicate a pathology. As a rule, the discharge becomes abundant, the temperature may rise. Of course, this situation must be discussed with your gynecologist. Possible causes for the problem are as follows.

Endometriosis.
The formation of adhesions.
Endometritis.
Hernia after caesarean section.

How to deal with menstrual pain

Of course, if a woman is not breastfeeding, she can eliminate the pain associated with menstruation with the help of analgesics (now there are many effective remedies, for example, Mig, Pentalgin, etc.). In this case, the possibility of pathology should be excluded. For those who prefer not to abuse drugs, herbal teas with mint, sage, St. John's wort, linden will help (they are contraindicated during lactation).

If the mother is nursing, then she can use such measures.

Avoid physical activity on critical days.
A warm shower on the abdomen or a not very hot heating pad. These measures will help relax the muscles and relieve spasms. It must be remembered that the discharge may increase in this case (and again, only if the possibility of a disease is excluded).
Various point and breathing exercises, relaxation techniques. For example, you can massage the abdomen with gentle circular motions in a clockwise direction.
Lie down in the fetal position - lying on your side, pulling your legs to your stomach. In this case, the body usually relaxes and the pain subsides.

Exposure to heat on the lower abdomen will relax the muscles of the uterus and relieve spasms

The restoration of the menstrual cycle after a caesarean section, in principle, has the same features and terms as in natural childbirth. The determining factor in this case is breastfeeding: in a lactating mother, menstruation will appear much later than in a non-nursing one (although, of course, it all depends on the individual characteristics of the organism). At the same time, a woman should remember that surgical intervention is an occasion for a more attentive attitude to her health, so it is better to discuss any alarming symptoms associated with secretions (their abundance, scarcity, irregularity, excessive pain, etc.) with your gynecologist.

A woman experiences severe stress after childbirth, and if delivery occurs by caesarean section, then the load increases many times over. The recovery process takes a certain period of time, during which the young mother must closely monitor her health. The signal that the body has returned to its prenatal state is the resumption of the monthly cycle. In this regard, women have a lot of questions related to the norm and deviation in the timing of the onset and features of the course of the first menstruation after surgery.

Briefly about the physiology of menstruation

Before dealing with the nuances of the resumption of the cycle after a caesarean section, you need to clearly understand the nature of menstruation.

So, the physiological process, which is caused by the rejection of the epithelium (mucous surface) of the uterus due to cyclic changes in the hormonal background, is called menstruation (menstruation, regulation). These transformations take place in three cycles.

Menstruation is a physiological process that occurs regularly in the body of a woman of reproductive age.

Table: phases of the menstrual cycle

It is interesting. Each of the phases of the monthly cycle has its own coordinating hormone. For example, at the stage of ovulation it is estradiol, at the stage of the luteal phase it is progesterone.

Why there is no menstruation after childbirth

Regardless of how the delivery took place, after giving birth, a woman does not have a period. This type of amenorrhea (absence of menstruation) occurs due to involution, that is, changes that occur with the uterus:

bend straightening;
healing of wounds on the body of the genital organ resulting from ruptures of the vessels connecting the placenta to the uterus, as well as an incision made during the operation to extract the fetus;
removal of the remnants of the membranes, mucus;
restoration of prenatal size.

At the same time, the first 1.5–2 months after cesarean, a woman observes lochia - spotting that accompanies the involution of the uterus. Immediately after the operation, the separation of clots with mucus and particles of the membranes occurs more intensively, and by the end of the period it comes to naught.

The process of recovery of the uterus is accompanied by lochia

First ovulation after cesarean

If in a normal monthly cycle ovulation falls in the middle of the cycle, then after childbirth it is completely impossible to predict this date. On average, it can occur 45 days after the birth of the child. In this case, the established norm is the interval from 25 to 72 days. Such a run is due to the individual characteristics of the woman's body:

the rate of stabilization of the hormonal background;
taking hormonal contraceptives;
possible complications in childbirth;
the age of the woman (the older, the more difficult it is to predict the timing of the recovery of the body);
the presence of chronic diseases, including those associated with the reproductive system.

In this case, the most indicative reason for the inhibition of ovulation is lactation.

Lactation can delay the onset of ovulation

Mechanism of lactational amenorrhea

Placental rejection that occurs during childbirth leads to the active production of prolactin and oxytocin. And if the latter is responsible for the secretion of milk during lactation, then prolactin is produced by the pituitary gland and is responsible for the production of breast milk. At the same time, it suppresses progesterone, which is responsible for preparing the body for a new pregnancy. Thus, it turns out that a large amount of prolactin inhibits the rejection of an unfertilized egg, that is, bleeding does not occur. At the same time, ovulation, based on the mechanism of its onset, theoretically (and sometimes practically, given the number of children of the same age in modern families) can occur. The intensity of production of prolactin by the pituitary gland also has a considerable effect:

heredity factor (usually in women of the same family, the restoration of the monthly cycle after childbirth occurs approximately at the same time, but, of course, you do not need to wait for your menstruation to begin in 6 months and 3 days, like your mother or grandmother);
the presence of pathologies (in inflammatory processes or chronic diseases, anticipating the restoration of the cycle is akin to playing roulette);
the level of hormones in the blood (this indicator is strictly individual, so a serious and lengthy analysis is required to study it);
type and timing of completion of lactation.

It is on the latter factor that the average statistical calculations of the resumption of the monthly cycle after cesarean are based.

The type of breastfeeding has the most significant effect on the restoration of the monthly cycle.

The first menstruation after cesarean during lactation

While the baby receives only breast milk, prolactin is produced in large quantities, and the woman has lactational amenorrhea. But since the introduction of complementary foods and supplementation into the child's diet, the dose of prolactin decreases. Given the trend to introduce complementary foods from 4–6 months, these dates can be considered the starting point for waiting for the first menstruation. But situations when a woman leaves even 2-3 feedings per day and at the same time does not observe her menstruation are not considered a deviation from the norm. Especially if feedings are kept at night and early in the morning (from 6 to 8 in the morning): at this time, prolactin production is most active.

It is interesting. According to the ancient Slavic calendar, a woman fed a baby for forty forty, that is, 40 months. But in those days, the week did not consist of 7 days, but of 9, and the month consisted of 40 or 41 days, that is, the pregnancy lasted 7 months, which means that 4.5 years were allotted for breastfeeding.

Restoration of the cycle after caesarean section with artificial feeding

If a woman does not breastfeed, then the first menstruation can be expected from the moment the lochia stops, that is, when the healing process of the uterus ends. In the absence of pathologies, this occurs 5-8 weeks after birth.

In cases where lactation was stopped for some reason, menstruation will resume after the completion of postpartum discharge and stabilization of prolactin levels.

A young mother should remember that if, in the absence of lactation, menstruation did not begin after 4–5 months, an urgent need to contact a gynecologist.

With artificial feeding, the cycle is restored immediately, as soon as the lochia ends, and prolactin returns to normal

The first menstruation after cesarean with mixed feeding

It is interesting. Breastfeeding experts strongly advise against experimenting with a bottle unless indicated. Otherwise, the availability of food through the nipple will please the baby so much that he will simply refuse to suckle the breast.

If a woman practices a mixed type of feeding, then she can expect menstruation 3-12 months after the start of such an experience. The wide time frame is explained by the peculiarities of breastfeeding: the sooner the baby stops receiving milk in the morning and at night, the faster the menstruation will go.

Video: the resumption of the menstrual cycle after childbirth

What is it: Lochia, menstruation or bleeding

If intense blood loss began less than a month after cesarean, these are not lochia - by this time they should, on the contrary, decrease, and not menstruation, which, as already mentioned, can resume in a month and a half and then in the absence of lactation. The cause of abundant discharge may be a clot, which is made up of pieces of placental tissue and blood from vessels torn during childbirth. In this case, the woman should immediately consult a doctor to prevent the spread of inflammation. Perhaps, to solve the problem, she will be prescribed curettage: removal of clots along with a layer of the endometrium lining the uterine cavity. In the absence of indications for mechanical cleaning, treatment can be conservative (medication), as well as with massage or vacuum.

Menstruation, lochia and bleeding differ in timing and intensity of discharge

The first menstruation after cesarean: what are they

For a long 9 months of bearing a child and a lactation period, a woman manages to get used to a “menstrual-free” state, and it turns out to be difficult for her to predict the beginning of the resumption of the cycle. Many young mothers are nervous about the fact that the regulations will go unexpectedly. In fact, as practice shows, the first menstruation has quite pronounced symptoms, so it will not be difficult to guess the moment the discharge appears. Signs of the onset of menstruation include:

the appearance of pulling pains in the lower abdomen;
uncharacteristic mood swings;
frequent headaches.

In the first couple of cycles after a caesarean, pain may be worse than before.

It is necessary to take into account the fact that the first 1-3 cycles, the nature of the discharge may differ slightly from those to which the woman is accustomed, and:

become more intense or leaner;
be accompanied by more pronounced pain;
be with small clots (usually this feature is observed in women whose menstruation began shortly after lochia, since the endometrium has not yet had time to recover).

It is interesting. Often clots are the cause of very dark, almost black, discharge. You don’t have to worry about this for the first 1-2 cycles, but if the situation does not change, then you need to see a doctor.

The first period after childbirth usually lasts 7-8 days, and the cycle is 21 to 30 days. Over time, these figures will stabilize.

Changes in the nature of menstruation as a symptom of pathology

The above changes in the nature of menstruation are a variant of the norm, so after the first regulation it is impossible to draw a conclusion about deviations. Unless we are talking about heavy bleeding or very strong pain. However, if disturbing symptoms are observed after 2-3 cycles, then the issue should be approached with all seriousness and contact a gynecologist as soon as possible.

Only a specialist can give answers to all questions related to the restoration of the cycle

Prolonged and heavy menstruation

Long periods are those that last more than 8 days. Usually they are accompanied by intense secretions. You can draw a conclusion about the amount of blood loss using a simple test: if the pad has to be changed more often than once every 2.5-3 hours, then the discharge is considered abundant. So the body shows that:

particles of the placenta remained on the inner surface of the uterus;
there is an inflammatory process;
a young mother is experiencing stress;
during pregnancy, the woman had anemia.

In this case, conservative treatment can be prescribed (taking vitamins, drugs that stop blood, and also replenish iron in the body) or, if this therapy does not give results, curettage. This procedure not only stops bleeding, but also eliminates the possibility of developing neoplasms in the endometrium of the uterus.

Scanty menstruation

If the discharge for more than three cycles in a row resembles a daub, then perhaps the woman:

there was an imbalance in the level of hormones;
endometritis develops (inflammation of the uterine mucosa);
Sheehan's syndrome (a neuroendocrine disorder associated with complications experienced in childbirth).

It is interesting. Abundant or scanty periods may be the result of the chosen method of contraception. If a woman takes hormonal contraceptives, then menstruation can be meager, and if a young mother prefers an intrauterine device, then, on the contrary, plentiful.

Intrauterine device can provoke heavy periods

Quick regulations

Accelerated periods are considered regular periods that last less than two days. The reasons for this deviation may be:

sudden weight loss;
large blood loss during childbirth;
a strong increase in the level of the hormone prolactin.

Unstable periods

If 6 months after the resumption of menstruation, the cycle has not been established, and the breaks are more than 3 months, then the woman probably has:

ovarian pathology develops;
there is an exhaustion of an organism;
there are consequences of complications after childbirth (these also include the use of epidural anesthesia);
a tumor may mature in the pelvic organs;
there are deviations in the work of the endocrine system.

If menstruation occurs twice a month, then there is reason to talk about deviations in the functioning of the pituitary gland, which provokes disturbances during the follicular phase of the menstrual cycle by the action of hormones.

In the case when menstruation stops after 1-2 cycles, it is worth considering options for a new pregnancy or a very rare early menopause.

An unstable cycle makes a woman nervous and constantly in a tense expectation of menstruation.

Uncharacteristic smell, color and itching

There are a number of symptoms that require professional diagnosis, as they can be triggered by serious health problems. The bright color of the discharge, severe pain in the lower abdomen, accompanied by fever - these manifestations can be caused by various infections or cancer.

Curdled discharge and swollen are symptoms of an exacerbation of thrush.

How to adjust your monthly cycle

It makes sense to discuss the issue of stabilizing menstruation with a gynecologist in advance. Especially if there were complications during childbirth. The general recommendations of experts are as follows:

It is interesting. If a woman suffers from postpartum depression, then she should take mild sedatives, drink herbal infusions and, in especially advanced cases, visit a psychologist.

Video: how to help the body recover after childbirth

The resumption of the monthly cycle after caesarean section is a multi-stage process in which complex mechanisms of different body systems are involved. Of course, a young mother should know about the course of the recovery period, but the rule of regular visits to the gynecologist should not be neglected. Only a specialist can make a correct conclusion about the state of health of a particular woman, prescribe an adequate diagnosis and treatment, if necessary.

Caesarean section is a common surgical operation. According to statistics for 2008 in Russia, out of every thousand births, 197 ended with the help of this procedure. Like any other surgical operation, cesarean section affects the state of the body and, especially, the reproductive system of patients. Many women are interested in questions related to this. The main one is how soon menstruation will resume after a caesarean section.

Features of recovery of the body after cesarean section

The problem of the onset of menstruation worries the fair sex, who have undergone this operation and do not have special knowledge in the field of gynecology, quite often. Since during the procedure there is a direct impact (incision) on the uterus, it is assumed that the entire system of internal genital organs will experience this impact on itself.

There can be no universal date when menstruation occurs after a cesarean section. As, however, in the case of natural delivery.

To describe the processes that occur with the body of a young mother, there is a special term - involution (Latin involutio - “coagulation”) of the uterus. It denotes the return of the female reproductive organs to the normal state in which they were before pregnancy. If an ordinary uterus weighs on average less than 100 grams and has a volume of 5 milliliters, then after childbirth its parameters are as follows: weight is about 1 kg, volume is about 5 liters. Regardless of how the birth was resolved, the body needs to return to the state prior to pregnancy and restore its functions. It is believed that this period takes about one and a half months.

It must be understood at the same time that the individual characteristics of each young mother play the greatest importance here. One woman in labor may begin her period a month after a caesarean section, while another takes more time for her reproductive system to involute. This applies both to the restoration of the natural functions of the ovaries and uterus, and the reaction to a surgical operation - each organism responds to medical influence in its own way and has its own timing for the course of certain processes.

Lochia after caesarean section

Despite the fact that until the minute when menstruation begins after a cesarean section is still far away, women experience discharge. In medicine, they are called "lochia" (from the Greek word "lochios" - related to childbirth, generic). Immediately after the placenta comes out, the uterus begins to descend and shrink in size. It no longer has room for the remains of the dead membranes of the fetus, fragments of its own mucous membranes. In the first day after the birth of the baby, these discharges are abundant, contain clots and blood due to the surgical incision and healing of the uterus. Gradually, its concentration in the secretions will decrease, and the secretions themselves will change color, texture and smell, becoming like whites by the end of involution. By the onset of the first menstruation, lochia stops.

When do the first periods start and how long do they last after a cesarean?

In the absence of any abnormalities or diseases, the menstrual cycle resumes and, as many note, improves. That is, if before pregnancy, women complained of pulling sensations and pain on the first day of menstruation, an unpredictable cycle or intense discharge, then after the birth of a child, menstruation normalizes, and these unpleasant manifestations disappear.

Most often, the first menstruation after a cesarean section differs from the previous and subsequent periods in significant intensity. The hormonal system of a woman has just returned to normal, and she still needs to get her work done. This happens within one or two cycles, then the amount of discharge should decrease. The duration of menstruation can fluctuate for another three to four months, this is also not a cause for concern. It is important to ensure that the menstrual cycle itself is from 21 to 35 days. How many periods go after a cesarean section is a purely individual subject, but the period of “critical days” should not be shorter than 3 days and exceed 7 days.

If the cycle of menstruation and the menstruation themselves are out of the norm, then this is a significant reason to consult a doctor. This should be done as soon as possible in such cases as:

for more than three months, menstruation does not appear after a cesarean section during breastfeeding;
six months after the operation, the cycle was not established;
too heavy periods after cesarean section, or vice versa too modest;
discharge has a strong repulsive odor (may indicate infection). This symptom is especially significant if it is accompanied by an increase in body temperature and pain in the lower abdomen;
before and after the end of menstruation, dirty discharge is observed;
unexpected cessation of lochia, which may indicate a bending of the uterus, which prevents the remnants of the placenta from coming out.

Recovery of the female body after caesarean section

The first cycles after caesarean section, when menstruation comes, can be anovulatory, i.e. menstruation precedes ovulation, therefore, pregnancy during this period is impossible. This is due to the fact that in some women ovulation begins only 70-90 days after delivery, while menstruation comes earlier. However, this phenomenon is not typical for everyone, so you should not rely on it as a means of contraception.

Moreover, since we are talking about caesarean section, we need to be even more careful about contraception. Regardless of what menstruation is after a cesarean section, planning a pregnancy at this time is categorically not recommended. For more reliable healing and regeneration of uterine tissues, it should be delayed and protected for 2-3 years by high-quality proven methods.

In addition to the individual physiological characteristics of the body, the following factors influence the rate of resumption of female reproductive function:

General health and age of the young mother. Of course, a healthy young body is easier to tolerate various influences and quickly returns to its natural state.
The presence of pathologies or complications during pregnancy.
What is the number of births for a woman. Numerous births weaken the body, forcing it to spend more time restoring its functions.
Diet, physical activity, a balanced combination of sleep, activity and rest can have a healing effect on the regeneration of body cells and accelerate the resumption of menstruation.
The psychological state and mood of the woman in labor. According to numerous studies, stress and anxiety only harm health and slow down the healing process. Maintaining a good mood will be useful for both the baby and the mother's body.
The presence or absence of lactation. Feeding has a significant effect on menstruation after cesarean section due to the action of the hormone prolactin. This substance ensures intensive milk production in the breast of a young mother, but suppresses ovarian function, thereby delaying the onset of ovulation. In addition, the production of estrogen, the hormone responsible for preparing for ovulation, decreases in a nursing mother. Therefore, the longer a woman breastfeeds a baby, the longer periods may not come.

No matter how the child was born, a young mother needs to pay attention to her own well-being. A calm and healthy mother will not only take better care of the baby, but she will also recover easier and faster. To do this, you should balance your diet, breathe fresh air, get enough sleep and try not to be nervous.
Particular attention should be paid to the hygiene of the genital organs. Aggressive methods (douching, tampons) should be postponed, avoiding baths due to the risk of infection. It is better to limit yourself to a shower, gentle washing and the use of pads.
It is also necessary to stop sexual life for the period of restoration of female organs. Vaginal contact can cause damage and infection in a weakened body.
It is important to strengthen contraceptive measures after fetal extraction by surgery. You can consult a gynecologist and use more reliable methods (for example, an intrauterine device, barrier contraceptives, etc.). This must be done within 2-3 years. Otherwise, a new pregnancy can cause a rupture of the suture on the uterus, bleeding and other dangerous consequences.
Do not neglect a visit to the gynecologist. During scheduled examinations every one and a half to two months, the doctor will be able to assess how the reproductive system of a young mother is being restored, and identify possible problems, preventing deterioration.

Summing up

In general, for the onset of menstruation, it is not so important how the birth occurred - naturally or by caesarean section. It is worth noting that the first menstruation after a caesarean section begins in different ways. The body of every woman is unique, and if you follow the principles of a healthy lifestyle and the supervision of a doctor, even weakened by a caesarean section, he will soon return to normal.

Recovery of a woman's body after childbirth occurs on average within 5-6 weeks. Then the functioning of the reproductive system returns to normal, the production of sex hormones is gradually being established. The determining factor in the onset of the first menstruation is the nature of the postpartum feeding of the baby. If a caesarean section was performed, menstruation after it normally comes at the same time as during normal childbirth - at the end of lactation. However, it is not recommended for a woman to plan the next pregnancy in the coming months.

Content:

Factors on which the restoration of menstrual function depends

Regardless of how the birth was carried out - naturally or by caesarean section, after them a certain period of restoration of the reproductive function of the body must pass. Within a few weeks, the uterus returns to its normal size, the wound heals at the site of the placenta, and the hormonal background returns to normal. The beginning of the functioning of the ovaries leads to the resumption of the processes of the menstrual cycle, the appearance of the first menstruation.

How long it will take to get your period after a caesarean depends on several factors.

The age of the woman. If she is over 30 years old, then tissue regeneration is slower than that of a young woman in labor. Therefore, the functioning of the reproductive system will improve later.

The course of pregnancy and childbirth. If everything went smoothly, the uterus and ovaries will recover faster. But complications weaken the body, lead to a violation of the structure of the reproductive organs. Therefore, menstruation may be late, their regularity and duration are disturbed.

No complications in the postpartum period. Within 6-8 weeks, when the damaged inner surface of the uterus heals, the woman experiences specific discharge (lochia). Initially, they are plentiful and contain mainly blood, then gradually pass into the usual mucous vaginal discharge. They have nothing to do with menstruation, as they appear at a time when the ovaries are not yet working. By the nature of the lochia, one can judge how successfully the body returns to its normal state. If such secretions are too scarce and short, this indicates that the tone of the uterus is weak, the blood stagnates in it, which is fraught with the occurrence of an inflammatory process. Extremely abundant bloody lochia indicates damage to the vessels in the wall of the uterus or a divergence of the internal suture.

Duration and mode of breastfeeding. This factor plays a decisive role. The fact is that the production of breast milk occurs under the influence of the hormone prolactinproduced by the pituitary gland. The level of this substance steadily increases after the onset of pregnancy, reaching a maximum during postpartum lactation. At the same time, this hormone suppresses the production of estrogen - ovarian hormones, due to which egg maturation and conception occur. There is a chance that a woman will become pregnant while breastfeeding, but it is quite small. Usually menstruation appears after the end of this process, when the level of prolactin in the blood decreases.

The following pattern is observed:

if, after a cesarean section, a woman does not breastfeed a newborn at all, then her menstruation occurs immediately after the recovery period and lochia, that is, after about 6-8 weeks;
in a woman who is breastfeeding for a long time (moreover, breast milk is the main food of the baby), menstruation after cesarean usually comes with the end of lactation (possibly after 1 year or even more);
if she is breastfeeding, but gradually introducing complementary foods, giving milk only as an additional product, then menstruation can begin immediately after changing the diet;
in the case when the feeding of the baby is mixed from birth (there is not enough breast milk, he is supplemented with milk mixtures), menstruation appears, as a rule, 3-4 months after birth.

Lifestyle. The appearance of menstruation, especially after cesarean, is also affected by the nature of the physical and nervous stress that a woman has to endure every day. If she is forced to take on all the housework, as well as taking care of older children, she has little rest, does not get enough sleep, it takes more time to restore her strength.

The nature of nutrition. Irregular food intake, lack of vitamins in it also lead to a delay in the first menstruation, causing cycle disorders.

Video: Does breastfeeding protect against pregnancy

Measures that contribute to the normal course of the recovery period

In particular, after childbirth and surgery, it is necessary to refrain from bathing in hot water, sitting in the bathroom and other procedures in which the body overheats. This can lead to dangerous bleeding.

It is necessary to carefully monitor the hygiene of the body and the condition of the seam, to prevent its inflammation. Within a year after cesarean, you should regularly visit a gynecologist (1 time in 1.5-2 months).

It is not recommended to have sex for 3-4 months. Even if menstruation has not yet come, a woman is able to become pregnant if she ovulates. At the same time, there will be no next menstruation, and she will not even guess that she is pregnant. The danger is that the fetus will not be able to develop normally in the uterus, a miscarriage will occur, severe bleeding will occur.

Warning: The safe development of the next pregnancy and the course of childbirth after a cesarean section is possible no earlier than 2 years later. Therefore, during sex it is recommended to protect yourself. Moreover, if a woman is breastfeeding, then she should not use contraceptives containing estrogens, otherwise her milk may disappear. Suitable creams, suppositories, tampons (spermicides) or condoms.

What are the usual periods after a caesarean?

It is believed that a woman's cycle is normal if menstruation begins at approximately equal intervals of time (a deviation of 2-3 days is possible). The duration of a normal cycle is more than 21 or less than 35 days (although there are exceptions that are not a pathology). The total blood loss for all days is normally 40-80 ml, it lasts 3-6 days.

The first menstruation after caesarean is usually more intense than before childbirth, last longer. They can be like this for 2-4 cycles. Their unusualness is explained by the instability of the hormonal background and the increased vulnerability of the inner surface of the uterus after surgery. Most often, the first cycles after caesarean section are anovulatory.

Often, the nature of menstruation after childbirth by caesarean section can change for the better - the cycle becomes more regular (hormonal levels improve), painful sensations weaken (the shape of the uterus changes, folds and bends that contribute to stagnation of menstrual blood are eliminated).

When to visit a doctor

You should consult a doctor in the following cases:

The regularity of the cycle was not restored even six months after the birth.
Menses come too rarely (after 40-60 days), last 1-2 days (oligomenorrhea is observed). This condition indicates the occurrence of bending of the uterus. The first signal of the pathology is the early cessation of lochia. As a result of stagnation of blood in the uterine cavity, inflammation of the endometrium can occur (endometritis occurs).
Between periods (after 4 months) there are less than 21 days (14-20). There can be many reasons: hormonal disorders (resulting from diseases of the endocrine organs, taking certain drugs), a decrease in uterine contractility after scar formation, the formation of myomatous nodes, and others. At the same time, pathological discharge of blood between them is sometimes taken for menstruation.
The duration of menstruation is less than 3 days or more 7. Scanty bleeding indicates a weak contraction of the uterus, too long - the occurrence of bleeding.
Changed the consistency and smell of menstrual flow, they appeared lumps, clots. There are cramps when urinating, itching is felt in the genitals. Perhaps an infection has occurred.
Menstruation after caesarean section became painful, accompanied by fever. Most likely, these are signs of endometritis.

The most alarming symptom is the disappearance of menstruation (amenorrhea) after a caesarean section (in a woman who is sure that she is not pregnant).

Causes of amenorrhea

The reason for the absence of menstruation at the end of breastfeeding (including after cesarean section) is often hyperprolactinemia. It has been 5-6 months since the woman stopped breastfeeding, and the level of prolactin in the blood (responsible for the formation of milk) does not decrease, suppressing the production of other pituitary hormones. The lack of hormones FSH and LH inhibits the work of the ovaries, the production of estrogens. The growth of follicles and all subsequent processes become impossible.

Elevated levels of prolactin in the blood may be the result of diseases of the pituitary gland (inflammation, the occurrence of prolactinoma - a benign tumor), disruption of the thyroid gland and other pathologies.

Amenorrhea or oligomenorrhea become the consequences of a disease such as postpartum Sheehan's syndrome, in which pituitary cells begin to die. Pathology occurs if during the caesarean section there were such complications as heavy bleeding, blood poisoning, inflammation of the peritoneum. Severe course of the second half of pregnancy (late toxicosis, renal failure) can also lead to amenorrhea.