Just as pregnancy causes a shift in a woman’s hormones, so does breastfeeding. This change in your hormone status is part of the normal physiology that makes nursing possible. Since these hormonal changes can affect other areas of your life, it can be helpful to know what is normal and what to expect.
Right after giving birth, your estrogen and progesterone levels drop drastically. This allows prolactin—the hormone that maintains milk production—to be released. When a baby latches on to the breast, oxytocin is released to help with the milk let-down reflex. Prolactin remains high in women who continue to breastfeed regularly, and this suppresses ovulation. Because of this, the normal estrogen levels are decreased. This decrease in estrogen can have many effects:
1. Absent periods—When ovulation is blocked, a woman will not get normal periods. Don’t be alarmed: many women love this “side effect” of nursing! In fact, some women use what is called lactational amenorrhea (LAM) as a form of birth control, but it is important that certain criteria are met for it to be considered effective.
This lack of periods, or very irregular ones, may not be welcome if a woman is nursing and trying to conceive. If this is the case for you, be sure to discuss it with your doctor or midwife.
2. Vaginal dryness—Normal estrogen levels are what help maintain the tissues of the vagina. The low levels seen in breastfeeding can mimic the decreased hormone levels seen in menopause and can result in the same kind of thinning of the skin and increased vaginal dryness postmenopausal women sometimes experience. This may make sex uncomfortable and lead to small tears during intercourse.
Over-the-counter, water-based lubricants and adequate foreplay may help, as can just knowing that these changes are normal (and temporary!). If those don’t work, your provider may prescribe vaginal estrogen cream. While very little estrogen is absorbed into the bloodstream this way, it is still a good idea to watch your milk supply when starting this cream, as estrogen can decrease milk production.
3. Decreased libido—It is hard to test out if decreased libido is truly related to breastfeeding or to the fact that having a newborn and the subsequent sleep deprivation might leave little time (or desire) for intimacy! Some studies have shown that formula-feeding moms tend to have sex sooner, while others have shown the opposite. Therefore, it’s hard to say how breastfeeding really plays into this. Some nursing moms will not want their breasts touched during sex, or may be embarrassed if they leak milk (the same hormone responsible for milk let-down—oxytocin—also plays a role in orgasm). The bottom line is that open lines of communication are important, and weaning should not be suggested as a cure-all to a subpar post-baby sex life.
- Riordan and K
- Breastfeeding and Human Lactation, 4th edition. RA Lawrence and RM Lawrence
- Breastfeeding: A Guide for the Medical Profession
- 7th edition.
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