Estrogen and progesterone are at an all-time high by the end of pregnancy, doing their job to support your growing body and keep your growing baby healthy. These hormones are also responsible for that pregnancy glow, that lustrous mane… and that constipation.
But what comes up must go down, and those abundant pregnancy hormones that peak during the third trimester make their rapid, free-fall descent shortly after delivery and head to menopausal levels within a few short days.
The postpartum hormone crash is considered the fastest and most significant hormone change any human can experience. Add this to the stress of healing from birth, sleep deprivation and the new responsibility of taking care of a tiny human, and it’s quite a bit to navigate.
As a postpartum dietitian, I see many new moms with symptoms related to this hormone change—from exhaustion and night sweats to insomnia and joint pain.
Related: How becoming a mom changes you.
So let’s talk about these hormones: What happens to your body after birth and what you can do (and eat!) to help your body adjust.
I’m going to highlight two hormones for this discussion: estrogen and progesterone. Keep in mind that there are also hormonal changes happening beyond these: Thyroid hormones are shifting quite a bit during the first postpartum year; cortisol (the stress hormone) is likely to increase; and other hormones like prolactin, relaxin and oxytocin each play a role in the hormonal landscape of the postpartum period.
Hormonal changes after pregnancy
We call this the “juicy” hormone. Prior to pregnancy, you may have known estrogen for its role in ovulation and libido. Estrogen is also needed for healthy bones, to keep skin and mucous membranes hydrated, and it’s used in the production of serotonin and mood regulation, inflammation, and regulation of body temperature.
In other words, the estrogen deficiency that all new mamas experience in the first weeks and months postpartum can lead to night sweats, dry skin and vaginal tissue, bone loss, joint pain, and depressed mood.
How to support estrogen replenishment after birth
First, your diet should include enough of the hormone building blocks. For estrogen in particular, eating plentiful protein and fat is the first step to helping this hormone come back to baseline levels. Postpartum nutrient needs are actually higher than they were during pregnancy, particularly if you are breastfeeding. Healing, lack of sleep and nursing requires a lot of calories, protein, vitamins and minerals—and many new moms struggle to meet these increased needs.
Eating three balanced meals per day plus snacks (no, coffee is not a meal!) is key to providing your body with enough to heal and nourish your day-to-day needs while also having enough leftover for hormonal support.
Regularly including a few functional foods and herbs can also help to give estrogen a boost:
Flaxseed: Flax is a phytoestrogen, which can mimic the action of estrogen in the body. Flax is also filled with protein, fiber and fat, so this is a great food to include postpartum. Try 1 to 2 tablespoons of ground flaxseed per day, added to oatmeal, a smoothie or sprinkled on top of fresh fruit is an easy way to support estrogen levels and decrease symptoms like night sweats.
Soy: Another phytoestrogen, eating whole soy products like tempeh, tofu, and edamame a few days per week can help to reduce symptoms.
Shatavari: This is an ancient herb that is both an estrogen helper and a galactogogue, which can promote milk supply if you’re breastfeeding. Studies show that shatavari can improve night sweats and other typical menopause symptoms in women (and remember, your postpartum estrogen levels look a lot like menopausal estrogen levels); and shatavari has also been studied for its role in both anxiety and depression. This is one of my favorite postpartum herbs in my practice.
Progesterone is the “calming hormone” and its drop has been linked to anxiety, depression, insomnia, brain fog, and headaches. In non-pregnant times, the majority of progesterone is produced in the ovaries after ovulation by a small temporary structure called the corpus luteum. Ovulating is the best way to make progesterone. Prior to your cycle coming back, your brain and adrenal glands can make small amounts of progesterone, so this is what we are supporting until your cycle returns.
How to support progesterone replenishment after birth
Just like with estrogen, eating enough overall calories, fat, protein and carbohydrates is crucial in giving your body the building blocks for all hormones—progesterone included.
Don’t skip the carbs: Progesterone is particularly sensitive to unbalanced carbohydrate intake. Including slow-digesting starches with your meals, like oatmeal, sweet potato and butternut squash, is a nutrient-dense way to enjoy some delicious carbohydrates.
Key vitamins and minerals needed for progesterone:
Vitamin C: Deficiency in vitamin C has been linked to low progesterone and luteal phase defects in women. While we don’t have postpartum-specific data on this link, eating more foods like citrus, berries and broccoli while also consuming a good-quality prenatal or multivitamin has many potential benefits.
Zinc: This mineral is needed for overall reproductive health, including progesterone production, and is a very common deficiency in postpartum. Low serum zinc has been associated with higher rates of postpartum depression. Poultry, shellfish, nuts and seeds are great sources of zinc.
Vitamin B6: Vitamin B6 in supplemental doses has been shown to increase progesterone levels, and a small study showed B6 use was helpful in prevention of postpartum depression. Good food sources of B6 are grass-fed beef, fish, chickpeas and leafy greens. Continuing to take that prenatal multivitamin is important here, too.
Red flags to watch out for
If you suspect that you might be experiencing postpartum depression (which can sometimes show up as rage, irritability and intense fatigue), please check in with your provider for a screening and therapist referral, along with a screening for iron deficiency, which significantly increases risk of PPD.
In addition, excessive worry, ruminating thoughts and insomnia are also characteristic of postpartum anxiety. A perinatal mental health therapist can help.
Severe headaches in the days or weeks following birth should be evaluated to rule out postpartum preeclampsia. Typically this also comes with swelling, but not always. Checking in with your medical team for any concerning symptoms is always a good idea.
Hormone replenishment timeline
While we don’t have good data on exactly when estrogen and progesterone will come back to pre-pregnancy levels, the return of your menstrual cycle is the first sign that your hormones have normalized. If not breastfeeding, expect this to be within about 6 weeks of delivery. If breastfeeding, your period should return within a couple of months after weaning, but this is extremely variable and can also return while you’re still nursing.
Time matters, but your nutrition plays a huge role in hormonal balance and recovery. These hormones are quite literally made from food, and an undernourished body is not able to make hormones in a balanced way.
A note from Motherly
Remember, mama: your physical and mental health is an important part of your motherhood transition. And feeding yourself is just as important as feeding your baby, which I know is so hard in these first days (and years!) of early motherhood.
If you are having trouble fitting in regular balanced meals, working with a registered dietitian can help you with easy meal planning that is personalized for what your body needs.
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