On November 6, 2017, Dr. Fu Hong’s gynecological clinic ushered in such a gynecological patient -a 28 -year -old Ms. Pearl.
Ms. Xiaozhu has been born for one and a half years. She broke her breast milk for her baby 2 weeks ago, but her menstruation never came, and she was a little worried.
Regarding the situation of not menstruation, Dr. Fu Hong’s first examination was the urine pregnancy test.Want to check if you are pregnant?How can I get pregnant without menstruation after giving birth?Some friends will definitely ask such questions.
After giving birth, the baby left her mother’s warm uterus. The level of estrogen and progesterone in the mother’s body also dropped sharply, and it had dropped to the level at the time of unhappy at a week after giving birth.The placental prolactin can no longer be measured 6 hours after giving birth.
The level of prolactin varies depending on whether the mother breastfeeds, and the prolactin of mammals declines after giving birth, but it is still higher than the non -pregnancy level. When the baby sucks milk, the mother’s prolactin has a significant elevation.Falling to non -pregnancy is level.
Menstruation and ovulation time are affected by breastfeeding.Mothers do not breastfeed usually recover menstruation from 6 to 10 weeks after delivery, and recover ovulation around 10 weeks after delivery.The menstrual recovery of lactating mothers is delayed. Some mothers have not been in menstruation during breastfeeding, and they have resumed ovulation on average 4 to 6 months after delivery.
BUT has more ovulation before the menstrual periods of the first menstrual period. Therefore, although the menstruation of breastfeeding mothers has not recovered, there is still a possibility of conception.
Therefore, Dr. Fu Hong first checked the urine pregnancy test for Ms. Xiao Zhu, and the result was as follows (-).
Then Dr. Fu Hong opened a pelvic ultrasound for Xiao Zhu.
Combined with urinary pregnancy tests and pelvic ultrasound results, pregnancy was initially excluded.So Ms. Zhu has been weaning for 2 weeks after giving birth. Why not come to menstruation?Is it normal?
This is to mention physiological amenorrhea.After childbirth, if the mother breastfeeds, the stimulation of the baby’s sucking nipple during regular breastfeeding can cause a large amount of parabolin and secrete a large amount of prolactin, which increases the interruption of prolactin levels in the blood, thereby suppressing the hypothalamus and pituitary -related hormones (GNRHHHHHHHHH (GNRH (GNRH (GNRH (GNRH (GNRH, Gn) secretion, and the elevation of prolactin in the blood can also reduce the sensitivity of ovarian hormones to promote gonad hormones, and make the ovarian function still inhibitory after childbirth. ThereforePhysiological.
However, if the breastfeeding is irregular or the number of breastfeeding times is reduced, the prolactin in the blood may still experience irregular menstruation when it is not enough to inhibit ovarian function.
After stopping breastfeeding, how long is the menstruation?How long does it take to check?
Usually not breastfeeding mothers 1 to 2 months after delivery, due to the decline in prolactin in the blood, the suppression of the hypothalamus hormone GNRH will gradually return to normal menstruation.
Therefore, for Ms. Xiao Zhu, Dr. Fu Hong’s suggestion is to want her to actively contraception and observe when the menstruation is recur. If she still does not see menstruation in 3 to 6 months, she will find the cause of amenorrhea in the gynecology department.
For example, women who have postpartum bleeding during childbirth will also occur with amenorrhea due to endometrial damage; some pathological factors, such as women with abnormal thyroid dysfunction, have abnormal menstrual recovery of postpartum menstruation.
The steps of the next check are as follows:
1. Go to the hospital to eliminate unexpected pregnancy -related problems (blood HCG and uterine attachment color Doppler ultrasound can help us clarify whether they are pregnant);
2. After excluding pregnancy -related problems, further examination according to the mother’s previous medical history, such as sex hormone levels, thyroid function measurement, hysteroscopy, etc.
Dr. Fu Hong’s warm reminder: Although some maternal mothers have menstruation after giving birth, they still have ovulation, so there is still the possibility of pregnancy.So even if you do not come to menstruation, contraception still needs to be breastfeeding.
Literature source: 1. The third edition of "China Obstetrics and Gynecology", editor -in -chief Cao Zeyi.
2. The 8th edition of "Obstetrics and Gynecology", editor -in -chief Xie Xingli.
([Dr. Fu Hong] The author signed the author, this article is an original article, which is first published in today’s headline number. The picture comes from the Internet.Disclaimer: The content of this article is for reference only. The basis of not diagnosis, medication and use cannot replace the diagnosis, treatment and suggestions of doctors and other medical staff. If you have physical discomfort, please seek medical treatment in time.)