Motherhood is a mentally, emotionally, and physically transformative experience. One aspect that many women encounter is the delicate balance of their hormones during the postpartum period. As your body tries to get back to baseline, your sex and thyroid hormones can undergo significant shifts. This article intends to share an understanding of these changes, what you may feel like, and how to address them holistically. With functional medicine testing and integrative medicine interventions, there are ways that may help support your body's natural hormone balance.
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Understanding Postpartum Hormonal Changes
After birth, your body will try to replace hormones. This may look different for each woman, depending on whether they are breastfeeding or have pre-existing conditions that influence their sex hormones. In general, there is a drastic drop in the hormones estrogen and progesterone. These hormones have primary roles in maintaining pregnancy but are no longer required to stay elevated after birth. These drops can affect many women, leading to postpartum depression or “baby blues.”
Along with sex hormones, thyroid hormones can be impacted during the transition from pregnancy to post-birth. Women can sometimes enter a hypothyroid or hyperthyroid state known as postpartum thyroiditis. The majority of women will have a return to baseline hormones within three to six months postpartum. Some women may experience prolonged imbalance symptoms and may benefit from a supportive approach to care.
Hormonal Imbalance Symptoms Post-Pregnancy
Postpartum hormonal fluctuations can shift physical, mental, and emotional symptoms. Here are some of the common symptoms to be aware of.
- Emotional instability
- Crying
- Sadness
- Excessive sweating
- Anxiousness
- Mood Swings
- Constipation
- Increased heart rate
- Fluctuating body temperature
- Difficulty focusing
- Excessive hair loss
- Depression
Functional Medicine Labs to Assess Hormones Post-Pregnancy
While changes in hormones are a natural process after childbirth, there may be instances when laboratory assessment is necessary. If you have persistent symptoms of hormonal imbalances after 6 months postpartum, here are some lab options to consider for further investigation.
Comprehensive Sex Hormones
The DUTCH Complete is a method for testing sex hormones and their metabolites through urine testing. If you are not breastfeeding and your cycles do not self-regulate after three months postpartum, this test may provide insights. For lactating women, the menstrual cycle typically remains absent while you are producing milk. Hormone testing is not typically done in this population unless there is a milk production issue or significant symptoms present. A sex hormone blood test, including the hormone prolactin, is an option for assessing milk production issues.
Thyroid Panel
To ensure that thyroid function is not contributing to hormone imbalances and symptoms, obtaining a full Thyroid Panel from Access Med Labs may be helpful. An imbalance in TSH and/or thyroid hormones- T4 and T3 is often associated with women's health issues. Addressing this issue can assist in supporting overall well-being.
Cortisol Testing
Stress can impact hormone production through the HPA axis. While you can test cortisol levels in the blood, the hormone panel mentioned above includes diurnal salivary testing, which may provide a more comprehensive depiction of cortisol fluctuations. Multiple samples can be collected throughout the day using the Access Medical Laboratories Salivary Cortisol X 4 test, which can offer insights into stress and its potential impact on your overall health. Stress with low levels of oxytocin postpartum has also been shown to be a risk factor for developing postpartum depression.
Micronutrients
Vitamins and minerals play an essential role in supporting hormone balance. A general rule of thumb to tell if your hormones are balanced is if you are having a regular menstrual cycle. A handful of nutrients are necessary for this to occur, such as vitamin D, magnesium, zinc, fatty acids, and vitamin B6. Iron is also an essential mineral that pregnant and postpartum women can become deficient in, which may affect overall health. This Micronutrient Panel can assess all the above-mentioned biomarkers and more.
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Tips for Balancing Hormones After Pregnancy
Implementing lifestyle modifications through diet, supplementation, exercise, optimal sleep, and stress management are all avenues that can support optimal hormone function.
Post-Pregnancy Hormone Balancing Diet
After pregnancy, nourishing your body with various whole foods may support hormone production and metabolic function. Postpartum recovery and breastfeeding both require adequate nutrition to heal and produce breastmilk. You’ll want to eat a healthy balance of proteins, fats, and carbohydrates to assist with muscle and tissue repair, nutrient absorption, and energy production. Making sure you get enough fiber and iron can help support blood sugar levels and reduce the likelihood of extreme fatigue.
Foods can naturally support your vitamin and mineral status, so eating fruits, vegetables, and good-quality protein is vital. After pregnancy, progesterone will drop off, and estrogen levels can increase. To support this balance, you can consider including foods like pumpkin seeds, beans, broccoli, leafy greens, kale, cabbage, bananas, seafood, Brussels sprouts, and avocados.
Including fiber-rich foods may help manage estrogen levels. Options include lentils, beans, apples, chia seeds, potatoes with the skin on, peas, and raspberries. In addition to these nutrient considerations, you’ll want to ensure you eat a sustainable amount of calories to support hormone pathways. This is especially important for lactating mothers, as your body generally needs up to 500 extra calories daily to sustain milk production. Adequate nutrition is a helpful starting place for supporting hormonal health.
Hormone-Friendly Supplements
Incorporating supplements as part of your hormone-supporting plan can be beneficial. Nursing mothers should take extra caution when adding botanicals and specific nutraceuticals to their regimens. It’s best to consult with your healthcare providers to see what is an ideal fit for you.
Chaste Tree Berry
The plant, also known as Vitex, has been used for centuries to help women naturally support progesterone levels. This botanical has shown some dose-dependent variability, which low doses may support estrogen and progesterone balance, while higher doses may affect prolactin levels. This is why caution should be taken if you are a nursing mother and are considering taking Vitex. Starting with traditional dosing and then working up to a therapeutic dose is recommended.
Dose: 4mg per day of dry extract
Fennel
Foeniculum vulgare, commonly known as fennel, may be a great plant medicine option to support your hormones. It may help modulate estrogen levels, with the known benefits of supporting milk secretion or promoting menstruation in non-lactating women. Women who experience hirsutism due to conditions like PCOS may also find fennel-based cream helpful.
Adaptogens
Managing stress and cortisol can play a dynamic role in supporting hormone balance. A few botanicals to consider when managing stress postpartum are Ashwagandha, Rhodiola, Schisandra, and Maca. Dosing for these will vary depending on whether you are taking these independently or in a product combination like HPA Adapt™.
Dose: 2 to 4 capsules daily on an empty stomach for HPA Adapt™
Probiotics
Gut health impacts all areas of health, including hormone production. Making sure your microbiome is in good standing, with a thriving beneficial bacteria environment, is important. Be sure to take a reputable probiotic supplement combining Bifidobacterium and Lactobacillus species.
Dose: 10 to 20 cfu per day for an adult.
Exercise for Hormone Balance After Childbirth
Exercise can help support the management of the stress hormone cortisol, may help maintain healthy estrogen levels, and has been shown to improve depression and anxiety. In the postpartum phase, you’ll want to focus more on movement rather than a strenuous workout routine. Most women can engage in light exercise shortly after pregnancy. At the same time, those who have undergone a c-section are instructed to hold off on any exercise routine until their 6-week follow-up appointment. After that, you can typically start back at any exercise regimen you had during pregnancy or, for some, their pre-pregnancy workout. Incorporating 50 minutes of moderate-intensity workouts every week is ideal, but it may be something you need to work up to.
Stress Reduction Techniques for New Moms
Stress can profoundly impact your hormones. In the new mom phase, you probably won’t have time to do some of your pre-pregnancy stress-relieving activities like massage or self-pampering. Some simple at-home and practical things you can implement are yoga, meditation, and breathing exercises. Creating a routine for yourself and your newborn can also help manage stress. Having realistic expectations and flexibility can help reduce stress in this new chapter. It’s essential to be aware of your feelings, ask for help when needed, and stay connected to your intuition. Motherhood can be challenging, so giving yourself some grace can go a long way.
Sleep Tips For Hormone Regulation
Postpartum fatigue is widespread, and when prolonged, it can impact your hormones. Getting quality and restorative sleep is necessary for circadian rhythm syncing with hormone fluctuations. Lack of sleep can also increase cortisol and impact melatonin secretion, which can create a cycle that affects how you manage stress. Some helpful tips for self-regulating sleep are to get early morning sunlight exposure without sunglasses on and then tone down your in-home lighting when the sun goes down. This can help trigger the brain to release melatonin and cortisol at appropriate times of the day. To echo what you have heard from your doctors and friends, if life permits, try to sleep when your baby is sleeping.
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Summary
Balancing hormones after pregnancy can be an intricate process. If you are past the sixth-month postpartum mark of letting your hormones try to work themselves out, there are natural and integrative medicine tools you can explore to help. Working with a naturopathic doctor or functional medicine practitioner is a great route to consider in assisting you down this path. If you choose to tackle this on your own, know that lifestyle modification can be a helpful approach in supporting hormone health.
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