Excerpt from Asking for a Pregnant Friend: 101 Answers to Questions Women Are Too Embarrassed to Ask about Pregnancy, Childbirth, and Motherhood
Can I start with a rant? Okay, thanks! I think it’s so unfair that after having monthly periods for many years, then growing a baby for nine months, then birthing said baby, we may have to deal with wildly painful periods — sometimes while our vagina or abdominal scar is still healing. Un- fair. And all dudes have to deal with is a slightly lowered testosterone level when they become a dad. Pshh.
Okay, rant over! Thanks for listening.
So what to do about your heavy, painful periods? First off, let’s look at why it’s happening. For many women, a larger postpregnancy uterine cavity is to blame for heavier periods, as it produces more mucous lining that has to be shed each cycle. But we also want to make sure the pain and bleeding aren’t a sign of a health condition. If the bleeding is occurring within the first few weeks after baby is born and is getting heavier instead of lighter, it could be a sign of a partially retained placenta, which prevents your uterus from contracting back down to size. In this case, you’re not having a period, you’re bleeding because open blood vessels in your uterus have not closed properly. Women experiencing excessively heavy, painful bleeding during this early postpartum period should contact their care provider posthaste.
Other health conditions that can cause heavy, painful bleeding include endometriosis, polyps or fibroids, adenomyosis (thickening of the uterus), or an over- or underactive thyroid.
If you’re not breastfeeding and experience what feels like a period about six to eight weeks after birth (sometimes periods start as early as three weeks after birth), it’s probably a period. If you’re breastfeeding, you could go many months before menstruating, as prolactin can suppress ovulation.
What to do
Don’t suffer in silence. Look into the following to find relief:
Have your iron levels checked. Because heavy periods can screw with your iron levels, and low iron levels can lead to exhaustion and other unpleasant symptoms, have your care provider check for an iron deficiency. If you do have a deficiency, they might recommend iron supplements, IV iron therapy, or diet shifts.
Rule out underlying health issues. In addition to having your iron levels checked, ask your care provider to help you confirm your heavy periods are not being caused by conditions like fibroids or endometriosis. If your care provider is not a specialist in women’s health, ask for a referral.
Consider birth control. As many types of birth control reduce uncomfortable period symptoms or can completely stop periods, you might want to talk to your care provider about getting a prescription for one that’s right for your unique needs. However, make sure birth control doesn’t mask the symptoms of an underlying issue by first having an OB-GYN confirm your reproductive health.
Get some exercise. Exercise is a whiz at helping the body manage hormone imbalances, potentially reducing the heaviness of your next flow. Even going on a thirty-minute walk a few times a week can be helpful.
Know that time may alleviate uncomfortable period symptoms. As your intense periods may be caused by your uterus getting used to life after pregnancy, you can likely expect the heavy flow and pain to somewhat subside after a few months, as your uterus and hormones adapt to their new normal.