Postpartum night sweats and hot flashes. Sorry.

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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.

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Marsupial super reproduction skills

The LA Zoo is full of educational surprises. Did you know that the tammar wallaby can mate and become pregnant again within just a few hours of giving birth?

This little fact begs the questions: after a human female gives birth, when can she mate and become pregnant again?

I usually give my patients the go ahead to resume sexual activity at their 4 week post partum (post delivery) check. It’s probably safe to resume sexual intercourse as early as 2 weeks after the baby is born if: you had a vaginal delivery, and you didn’t have a large tear, with need for sutures, during delivery. For a cesarean delivery, it’s probably best to wait about 4 weeks.

In terms of “mating” aka baby making? Physiologically, a woman may ovulate as soon as 25 days after delivery. If you ovulate, you can get pregnant.

So you need to discuss birth control options with your doctor before you have sex post delivery, unless you want to make like a tammar wallaby. A human embryo won’t pause for 12 months to give a newborn time to develop though. Humans haven’t evolved enough for that.