Postpartum night sweats and hot flashes. Sorry.

Screen Shot 2018-05-15 at 9.57.02 AM

Night sweats and hot flashes. We’re talking drenched PJs, sheets, the whole works. And I’m not talking about menopause, although we have that to look forward to as well. I’m talking postpartum. About 30% of women will experience this joy (*sarcasm*). The symptoms will peak, on average, at 2 weeks postpartum and decline after, with about 10% of women continuing to have hot flashes at 1 month postpartum. This is the same percent of women that will experience hot flashes during pregnancy, too, although it’s not necessarily the same women who will suffer.

 

 Why oh why?

Hot flashes occur with any marked hormonal fluctuation. This fluctuation occurs during menopause (sometime gloomily referred to as “the transition”), but also pregnancy and postpartum. The physiology and cause of hot flashes isn’t exactly clear, but it’s theorized that our thermoregulatory processes get out of whack in response to the extreme hormonal changes. Postpartum, our bodies undergo a dramatic decrease in progesterone and estrogen (both hormones are produced in excess during pregnancy). With breastfeeding, the low hormone levels persist.

 

Why does it matter?

Studies have shown that hot flashes can drastically reduce the quality of a woman’s life. They are extremely uncomfortable, embarrassing, and impossible to predict or control.

There may also be a link between severity of hot flashes and increased risk for postpartum depression. The theories: one, perhaps the most extreme hormonal changes or neuroendocrine alterations cause the worst hot flashes and also contribute to postpartum depression; and two, perhaps the toll that hot flashes take on a woman’s quality of life predispose the postpartum woman to depression, especially sleep disturbances in a time when sleep is rare and precious but remains an absolute necessity.

Anecdotally I’ve seen women with more water retention and swelling during pregnancy also have more hot flashes and night sweats, as another mechanism to get rid of that extra fluid.

 

What to do to get you through it?  

Stay hydrated. Keep a change of clothes next to your bed. Change your sheets often. Keep your hair up. Have a fan nearby. And hang in there. It won’t last long.

Advertisements

Hair hair don’t go away! Hair and pregnancy

One year post partum and my hair is just now returning to my pre-pregnancy state. During pregnancy most women love their hair, and I was no exception. It grew and grew and grew, looked healthy and full and shiny and bright (well, that’s my memory of it, at least). art nouveau

Post partum it felt like I was shedding at an alarming rate. My new hair cut was as much for style and ease as it was to decrease my perception that I was losing my hair. When hair clogs the drain after a serious shampoo, it looks like less when the hairs are short. A non-pregnant / non- post partum woman will shed 50-150 hairs per day. Losing more than this amount can seem excessive, I can empathize.

There is scientific merit behind my hair loss worries. The hair life cycle is separated into 3 phases: anagen (the growing phase), catagen (the transition phase), and telogen (the resting phase). To make this clinically relevant, the most important phases are the growing phase and the resting phase. The hair life cycle is altered during pregnancy – the growing phase is longer, so most of the hairs on your head are doing just that. The growing and growing and growing is because of this elongated growing phase. Postpartum, all those hairs enter the resting phase, which should be called the “falling out phase”. It may feel like your hair is falling out at an alarming rate but it’s just returning to your pre-pregnancy state.

Will it ever go back to  normal? At fifteen months post baby your hair growing / resting ratio should be back to normal (some sources say even as early as six months!). I’m noticing the ratio returning to normal around now, at 12 months post partum. I know, that still seems like a long time. Hang in there.

Breastfeeding and contraception – the progesterone controversy

Many moons ago The Pump Station and Nurtury asked me to teach a class and write a blog entry about contraception while breastfeeding

pump station

Here’s my blog entry for them, for you: Continue reading “Breastfeeding and contraception – the progesterone controversy”