The first menses after cesarean section


Every month, the female body undergoes tremendous changes, aimed at preparing for a probable pregnancy. The sexual, endocrine, nervous, cardiovascular and other systems are amenable to multiple cyclic metamorphoses, which marks the onset of the next menstruation, and all for the sake of future offspring. If in one of the next cycles conception takes place and pregnancy occurs, then all these processes will continue, ensuring the safety of the fetus and its development. The organism of the future mother will be completely reconstructed and will start working in a different mode.

After the birth of a child, many changes that have occurred to the female body in 9 months are reversed - an involution occurs, a reverse development takes place. And when the childbearing function is restored, the menstruation will resume. But this does not mean that a woman can already become pregnant again and give birth, especially if she was undergoing a caesarean section. More precisely, it can, but such an outcome is highly undesirable and even dangerous. Doctors recommend planning the next pregnancy no earlier than 3 years. Therefore, you should think about contraception immediately after cesarean, without waiting for the first menses. However, this is a completely different topic - back to ours.

Women are interested in the question when they begin menstruation after cesarean section. But here you should immediately clarify two points:

  1. This question is very individual: a variety of terms are possible for different women within the normal range,
  2. Cesarean section practically does not affect the timing of the onset of the first menstruation after childbirth, it occurs as with natural delivery.

Restoration of the female body and the reverse changes begin with the moment of separation of the afterbirth. The uterus is constantly shrinking and quickly begins to decrease in size. Every day it goes down about 1 cm. The uterus returns to its former size, weight, and location by 6–8 weeks after delivery or cesarean section, and in some cases (for example, with very active breastfeeding) even becomes slightly smaller than before childbirth. At the same time, the ovaries begin to “wake up”, their hormonal functions are gradually fully restored.

A wound forms on the surface of the uterus, which heals and bleeds, due to which specific postpartum secretions are observed - lochia. They stop by 6-8 weeks after childbirth (do not confuse lochia with menstruation), and during this entire period their nature (color, smell, intensity) may change. Read more on this topic on our website in articles. Postpartum discharge and Monthly after childbirth.

When the lochia disappears, it should be assumed that the female body is as close as possible to the pregenerative state. Now the newly-born mother can begin her usual periods, although the first cycle after birth can often be anovulatory (i.e., ovulation does not occur, which means that pregnancy is impossible).

Monthly after cesarean section all women start at different times, depending on a number of factors:

  • during pregnancy,
  • woman's age
  • lifestyle,
  • food quality and recreation,
  • the general condition of the woman in labor (psycho-emotional, the presence of chronic diseases),
  • physiological features of the body,
  • lactation.

Features of recovery of the body after cesarean section

The problem of the onset of menstruation is disturbed by women who have undergone this operation and who 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 effect on itself.

Universal date, when after cesarean section go monthly, can not be. As, however, in the case of natural delivery.

To describe the processes occurring with the body of a young mother, there is a special term - involution (lat. Involutio - “coagulation”) of the uterus. It means 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 birth, its parameters are as follows: a mass of about 1 kg, a volume of about 5 liters. Regardless of how the birth was resolved, the body needs to return to the previous pregnancy state and restore its functions. It is believed that this period takes about one and a half months.

It should be understood that the individual peculiarities of each young mother play the greatest role here. One woman can start menstruating a month after a cesarean section, while the other takes more time to involution her reproductive system. This concerns both the restoration of the natural functions of the ovaries and the uterus, and the reaction to the surgical operation - each organism responds in its own way to the medical effect and has its own time course of certain processes.

Lochia after cesarean section

Despite the fact that until the time when menstruation begins after a cesarean section is still far away, women have a discharge. In medicine, they are called "lochia" (from the Greek word "lochios" - referring to childbirth, generic). Immediately after the release of the placenta, the uterus begins to fall and decrease in size. It already has no place for the remnants of dead fetuses, fragments of its own mucous membranes. On the first day after the birth of the baby, this discharge is abundant, containing clots and blood due to surgical incision and healing of the uterus. Gradually, its concentration in the discharge will decrease, and the discharge itself will change color, texture and smell, becoming similar to whites by the end of the involution. By the onset of the first menstruation, lochia ceases.

When do they begin and how much do the first menses after cesarean

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

Most often, the first menses after cesarean section differ from previous and subsequent significant intensity. The hormonal system of a woman has just returned to normal, and she still needs to adjust her work. This happens within one or two cycles, then the amount of discharge should be reduced. The duration of menstruation may vary for another three to four months, this is also not a cause for concern. It is important to ensure that the menstrual cycle itself ranged from 21 to 35 days. How many months 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 menstruation themselves are knocked out of the norm, then this is a significant reason to consult a doctor. As soon as possible, this should be done in such cases as:

  1. more than three months do not appear monthly after cesarean section during breastfeeding,
  2. six months after surgery, the cycle is not established,
  3. too heavy periods after a cesarean section, or vice versa too modest,
  4. discharge has a strong, repulsive odor (may indicate an infection). This symptom is especially significant if it is accompanied by fever and lower abdominal pain,
  5. before and after the end of the menstrual period, there is a dirty discharge,
  6. unexpected cessation of lochia, which may indicate a curvature of the uterus that interferes with the release of residual afterbirth out.

Recovery of the female body after cesarean section

The first cycles after cesarean section, when menstruation comes, can be anovulatory, i.e. menstruation precedes ovulation, respectively, pregnancy in such a 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 our conversation is about a caesarean section, it is necessary to treat protection even more carefully. Regardless of which periods after a cesarean section, planning a pregnancy at this time is not recommended. For more reliable healing and regeneration of uterine tissue should be delayed and protected for 2-3 years by quality proven methods.

The speed of the resumption of female reproductive function in addition to the individual physiological characteristics of the organism is influenced by the following factors:

  • The overall health and age of the young mommy. Of course, a healthy young body is easier to tolerate various effects and quickly returns to its natural state.
  • The presence of pathologies or complications during pregnancy.
  • What is the birth count of a woman. Numerous genera weaken the body, forcing it to spend more time to restore its functions.
  • Nutrition, exercise, 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.
  • Psychological state and mood of the woman in labor. According to numerous studies, stress and anxiety only harm health and inhibit the healing process. Maintain a good mood will be useful for both the baby and the body of mommy.
  • The presence or failure of lactation. On menstruation after cesarean section, feeding has a significant effect due to the action of the hormone prolactin. This substance provides intensive milk production in the breast of a young mother, but suppresses ovarian function, thereby delaying the onset of ovulation. In addition, the nursing mommy decreases the production of estrogen, a hormone responsible for preparing for ovulation. Therefore, the longer a woman breastfeeds a baby, the longer the menstruation may not come.

Tips and tricks

  1. No matter how the child was born, the young mother needs to pay attention to her own well-being. A calm and healthy mommy will not only take better care of the baby, but she herself will more easily and quickly recover. To do this, you should balance the food, breathe fresh air, get enough sleep and try not to be nervous.
  2. Particular care should be taken to the hygiene of the genitals. Aggressive methods (douching, tampons) should be postponed, try not to take baths due to the risk of infection. It is better to confine yourself to showering, gentle washing and using gaskets.
  3. It is also necessary to stop sex life during the recovery of the female organs. Vaginal contact can cause damage and carry the infection to a weakened body.
  4. It is important after fetal extraction promptly to strengthen contraceptive measures. You can consult with the gynecologist and use more reliable methods (for example, intrauterine device, barrier contraceptives, etc.). This must be done within 2-3 years. Otherwise, a new pregnancy can cause seam divergence in the uterus, bleeding and other dangerous consequences.
  5. Do not neglect to visit a gynecologist. During the scheduled check-ups once every one and a half to two months, the doctor will be able to assess how the reproductive system of the young mother is restored, and identify possible problems, preventing deterioration.

Summing up

In general, for the onset of menstruation is not as important as the birth occurred - naturally or with a caesarean section. It is worth noting that the first menses after cesarean section begin in different ways. The body of each woman is unique, and with respect for the principles of a healthy lifestyle and medical supervision, even weakened by caesarean section, he will soon return to normal.

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When does menstruation begin after cesarean section?

The arrival of the first menstruation with operative delivery is difficult to predict - each organism is individual and the healing time varies. However, it is necessary to remember the need for protection even before regular menstruation is restored. After surgery, the uterus is reduced more slowly, as this prevents fresh seam. After natural childbirth this problem is not. According to statistics, this process lasts about 7 weeks. Reducing the size of the uterus occurs faster if the woman is breastfeeding.

After childbirth, lochia continues until the first menstrual period in a woman - the isolation and removal of postpartum materials, mucus, coagulated blood, and residues of fetal membranes from the uterus. This process takes up to 40 days and only upon its completion is it possible to mature a new egg and start the mechanism of menstruation. This discharge differs in color, intensity, and consistency from the blood that is released during a regular cycle.

The period of arrival of the first menstruation after birth is affected by:

  • the presence and intensity of lactation, feeding the baby,
  • features of a particular woman’s pregnancy,
  • age and psychological state of the mother,
  • the presence of chronic or acute diseases,
  • food, rest and healthy sleep of the woman.

Faster recovery of the regular cycle occurs in those women whose baby is bottle-fed. During breastfeeding, the body produces the hormone prolactin, which inhibits the activity of the ovaries, and the mode of delivery has little effect on this process. When menstruation begins after a cesarean section, it is time to return to contraception.

The nature of the first menstruation after cesarean section

When the first menses after cesarean section arrive, the menstruation can be very abundant. At this time it is especially important to avoid any loads, not to be nervous, to devote time to sleep and rest, to eat normally. Weight lifting is especially dangerous, as this can lead to increased bleeding. Abundant menses after cesarean section should stop after 1-2 cycles.

It is advisable to visit a gynecologist in the first 3-4 months after the appearance of the baby. Signs of deterioration:

  • temperature,
  • soreness
  • heavy and prolonged bleeding,
  • the absence of regular periods 3-4 months after birth,
  • the appearance of blood in the middle of the cycle.

A woman should be examined if after the operation the discharge is unusually scanty. The resulting scar on the uterus can interfere with the process of reduction and prevent the complete cleansing of its cavity from the blood. In the pelvic region develop stagnant processes that can cause inflammation. Very strong discharge can talk about uterine bleeding.

How long are the first periods?

Monthly after cesarean section, most often, the first time can go without the maturation of the egg, as the body functions are not yet fully restored. In this case, the bleeding can be intense and lasts up to a week. Then all the processes are normalized, the period and intensity of menstruation return to the state it was before pregnancy. The activity of the ovaries is fully restored and the next pregnancy is possible.

A woman needs treatment if she has chronic disorders, an infection or inflammation is detected. During pregnancy, and then after giving birth, the body re-experiences the hormonal adjustment of all systems, including menstrual:

  • stabilization of terms
  • reduction of pain,
  • reducing the duration and profusion of bleeding,
  • reduction of the PMS effect.

When is the cycle restored?

Restoration of a stable menstrual cycle after childbirth occurs 2 months (but not longer than six months) after the onset of menstruation. If there is no breastfeeding, but the monthly does not begin, the woman needs expert advice. The second warning sign is abnormal profusion and duration of bleeding. At the beginning of the selection can be abundant, but later their intensity decreases.

After cesarean, normalization of the cycle occurs more slowly, since the scar on the uterus interferes with this. Normal healing of the suture has a positive effect on the other manifestations of the reproductive function of the body. For quick recovery, you must follow the recommendations of the doctor and treat your body with care. When there are heavy menses after cesarean section, it is important not to miss the dangerous uterine bleeding.

When breastfeeding

With breastfeeding, the hormonal balance of the woman who has given birth shifts, ensuring the production of milk by the mammary glands. The hormone responsible for this process inhibits the restoration of the menstrual cycle. Когда женщина перенесла операцию, срок возврата месячных будет зависеть не от этого факта, а от наличия и интенсивности естественного кормления.

Чем чаще и интенсивнее кормления грудью, тем лучше в организме вырабатывается гормон пролактин и тем дальше отодвигается время наступления месячных. Полагаться на то, что это исключает возможность беременности, нельзя. Regardless of the presence of milk in the breast, the body's reproductive capacity will be restored within a year. When this happens - you can determine the beginning of the feeding of the baby with other products. As soon as the intensity of breastfeeding decreases, ovarian work resumes.

When artificial feeding

Many women who have given birth through surgery have problems with the production of breast milk. This can be affected by the difficulty of recovery after the operation, nervous excitement, or the need to temporarily separate her from the child during the hospital’s treatment in the hospital. If milk is not produced, the ability to conceive is restored more quickly.

With artificial feeding of the infant, fertility can return to the mother already after the first menstruation, and the regular cycle (from 3 to 7 days) will recover within two months after delivery. It is important to remember that conception during this period is not only possible, but also extremely dangerous for a woman, since the suture on her uterus has not yet fully healed.

Possible complications after cesarean section

Women who have had a caesarean section often have further complications. Among the most common - endomyometritis or inflammation of the uterus, adhesions may begin. It is necessary to take the prescribed pills, do hygienic procedures in time and empty the bladder so as not to create additional pressure on the uterus.

In the maternity hospital after the operation, all those who undergo a caesarean section are prescribed a course of antibiotics for several days, which should prevent the development of inflammation. During the period of healing of the suture on the uterus, hypothermia, failure to observe personal hygiene are dangerous, and douching is contraindicated.

When to go to the doctor?

A woman after a cesarean section should carefully monitor her health and consult a doctor for any warning signs. The most dangerous is the occurrence of bleeding. It may be caused by a violation of the integrity of the seam and an urgent surgical intervention will be required. The gynecologist must be told how long the sickness lasts, when the menstrual periods come and how long they last.

Untimely discharge is also a reason to be examined. Both the too frequent and abundant periods, the presence of clots, and scanty ones, or their complete absence for a long time, should alert. Unpleasant smell of discharge - a reason to consult a doctor. Severe pain during menstruation, especially aggravated by movement, may indicate serious internal disturbances.