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Monthly after the delivery
After so heartrending experience for the woman's organism as the birth of the kid, a certain temporary piece is required in order that usual functioning of all bodies and systems which during pregnancy underwent changes was resumed. In most cases such reorganization continues about 6 — 8 weeks. But recovery of functioning of hormonal system of the woman requires more long time. The menstrual cycle after the delivery renews with recovery of hormonal balance in an organism of young mother.
What occurs during pregnancy and a lactation?
After the kid is born, in an organism of the given rise woman there is a sharp decrease in level of proteins which were produced earlier by a placenta. These proteins provided regulation of a number of exchange processes in the woman's organism. After the delivery there is a change of work of endocrine system of a female organism. So, the hypophysis produces hormone the prolactin which is responsible for production of milk. However one more function of this hormone is production of hormones in an ovary. So process maturing of an ovum, and also an ovulation stops. Therefore at the most part of women lack of periods is observed throughout the entire period of breastfeeding of the kid. If the woman after the delivery raises the child exclusively breast milk, then in that case the first monthly after the delivery appear only after end of the period of a lactation. At the mixed feeding (alternation of chest and artificial feeding) recovery of periods at young mother happens in most cases approximately on 3-4 month after the delivery.
However in this case does not manage without any exception, therefore, even at mothers who nurse the child only for a year and more, the periods can be shown also on 3-4 month after the delivery.
This information has to become a peculiar caution for the woman: even lack of periods throughout a certain period after the delivery cannot guarantee that pregnancy will not come. As during this period there can be an ovulation, conception is probable too.
If the woman for certain reasons does not practice breastfeeding at all, then the ovulation the first time after the delivery occurs already approximately on the 10th week. Therefore, the periods after the delivery the first time come on the 12th week.
However in certain cases emergence of the first monthly perhaps on the 7-9th week after the child's birth. But at the same time the first monthly cycle, as a rule, happens anovulatory as the ovum does not leave an ovary.
Having disturbed by a question when begin monthly after the delivery, the woman who transferred Cesarean section has to remember that all changes in her organism happen also, as well as after natural childbirth. Therefore, recovery of periods depends on features of feeding.
Features of lochias
At once after the delivery the woman has allocations from generative organs. Similar process can continue approximately till 6-8th week after the delivery. However it is not necessary to confuse such allocations to periods. Lochias are called lokhiya. Their origin differs from menstrual. After the placenta in the course of patrimonial activity separates, on its place the extensive wound develops. Initially, at once after the delivery, at the woman several days appear bloody allocations. Later the wound gradually heals, and approximately about 4 days such allocations become serous and sanious. Later they already get a white-yellow shade and are shown in smaller quantity.
Establishment of a menstrual cycle after the delivery
Very often the first several monthly cycles after the child's birth at the woman are observed less regular periods, than during the period before pregnancy. So, the periods after the delivery can be late for several days or begin earlier. Perhaps also increase or reduction of number of days of duration of monthly. However, in spite of the fact that the similar phenomena, as a rule, are considered normal, the woman nevertheless should consult with the doctor as such symptoms can also testify to the beginning of an inflammation of internals at the woman.
Duration of a normal menstrual cycle can make from 21 to 35 days, but on average it lasts 28 days. Duration of monthly – from 4 to 6 days. The most plentiful blood loss is observed in the first and second day of periods. In the period of a menstrual cycle the woman loses about 35 ml of blood. If there is a blood loss more than 80 ml, then the speech already goes about existence of a certain pathology.
Each young mother has to understand that in a puerperal period changes and in interval duration between monthly, and in duration directly of periods are possible. It is important to watch that all these indicators did not exceed the limits of norm stated above.
Quite often after the birth character and features of periods at the woman cardinally change. In certain cases irregular earlier monthly after the birth of the child become regular. If earlier at the woman in the course of periods noticeable morbidity was observed, then after the delivery it can disappear. Similar changes are explained by change of an arrangement of bodies in an abdominal cavity in the course of pregnancy and patrimonial activity that promotes more physiologic arrangement of a uterus.
Disturbances of a menstrual cycle after the delivery
After the child's birth the woman can note manifestation of certain disturbances of a monthly cycle. The giperprolaktinemiya can become one of similar disturbances. Sometimes release of hormone prolactin which considerably increases during incubation of the child and a lactation does not decrease at the woman and after the feeding termination by a breast. In this case it is about a state which is called a pathological giperprolaktinemiya. In view of the fact that plentiful release of prolactin is capable to suppress periods, the giperprolaktinemiya after the feeding termination by a breast provokes absence monthly at young mother.
The similar phenomenon is, as a rule, connected with too high function of cells of a hypophysis which produce prolactin. Besides, the prolaktinoma — hypophysis adenoma which also produces hormone prolactin can become the reason of such phenomenon. Prolaktinoma of a hypophysis is a benign tumor which develops at the woman after the end of feeding by a breast in view of insufficiency of function of a thyroid gland. It is easy to correct a similar state by treatment by drugs of hormones of a thyroid gland.
Disturbance of periods can become one of hypophysis prolaktinoma symptoms – at the woman the amount of menstrual blood can decrease considerably or the bleeding period decreases. Also the amenorrhea – complete cessation of periods is possible. The women suffering from the similar phenomena after the delivery are disturbed by also frequent headaches. Even after chest feeding was completely stopped, from a breast a little milk continues to be emitted. At women with such illness the mastopathy can develop later, appear excess weight.
Treatment of a prolaktinoma of a hypophysis is carried out by means of oral means which are appointed by the doctor. Most often in the course of therapy drugs bromkriptin are used, lisenit, metergolin, abergin and other means which normalize amount of the emitted prolactin. Respectively, the menstrual cycle is gradually recovered.
One more complication which leads to certain disturbances of a monthly cycle in a puerperal period is a postnatal hypopituitarism (a so-called syndrome of Shikhan). This illness arises at the woman as an effect of necrotic changes in a hypophysis. If at young mother severe bleedings after too heavy process of childbirth develop, then the similar state can become their effect.
Shikhan's syndrome is also shown after sepsis and peritonitis, a gestosis of the second half of pregnancy. Shikhan's syndrome can be suspected and if at the woman is not present monthly after the delivery. Absence monthly or reduction of amount of the emitted blood before small allocations of the smeared character – one of manifestations of a syndrome of Shikhan. Still before the first periods after the delivery begin, the woman at development of a syndrome Shikhana notes increased fatigue, weakness, frequent headaches, the lowered arterial pressure. At it body weight can strongly decrease, at the same time the xeroderma and hypostases of extremities is sometimes shown. Replacement hormonal therapy is applied to treatment of this illness.
Plentiful periods after the delivery
Rather often found problem at women are plentiful monthly after the delivery. Plentiful periods conduct to the fact that in an organism of the woman the iron reserve is very quickly exhausted. Therefore, at such pathology it is necessary to accept periodically drugs which include iron.
In the first months the female organism is subject to changes which are connected with recovery of function and normal structure of a uterus. In parallel there is a normalization of a hormonal background. During this period plentiful periods meet especially often. However it is important to consider also the fact that both the term of recovery of a monthly cycle, and its character has specific features.
Duration of plentiful periods after the birth of the child depends on some factors. Especially often plentiful periods are shown at young mothers who had long childbirth and heavy. The menstrual cycle returns to normal quicker at those women who fully ate during pregnancy, did not allow aggravation of different chronic illnesses, enough time was allocated for rest and had no physical retension. Not less important and a normal psychological state of the woman during pregnancy and after the delivery.
To define whether the condition of the woman at monthly is normal, it is possible to be guided by the following rules. Are considered normal monthly in the first months after the child's birth if their duration does not exceed seven days, and those days when allocations are most intensive, one laying for 4-5 hours is enough for the woman. It is important to watch also whether allocations differ from those which were observed before childbirth. It is necessary to estimate their consistence, coloring and other features. Therefore the doctor can sometimes ask the woman to show laying. At plentiful monthly increase in duration of periods is possible. Besides failures in a menstrual cycle can be observed.
At plentiful monthly the gynecologist directs young mother to ultrasonography of bodies of a small pelvis to exclude development of an inflammation, existence of new growths, and also other pathologies. Also the specialist appoints administration of drugs with styptic influence and the medicines containing iron. It is especially important to see quickly a doctor to those women at whom during periods very plentiful allocations having scarlet color are observed.
According to norm, monthly which proceed more than ten days and are at the same time plentiful, demand consultation from the doctor. Such periods are considered bleeding and can testify to certain problems in an organism. Therefore it is very important to find and remove the cause of such failure. Sometimes to the woman appoint carrying out a scraping of a cavity of the uterus as severe bleeding in certain cases arises in view of existence in a uterus of the remains of a placenta.
For a female organism plentiful monthly constitute danger from the point of view of a zhelezodefitsit as bleedings considerably reduce iron level. The similar phenomenon is fraught with deterioration in a physical condition of the woman: drowsiness and weakness, tachycardia, periodic short wind can disturb her. Besides, at an iron deficiency anemia the woman becomes more irritable. Appearance also suffers: skin turns pale, the condition of nails, hair worsens.
Recovery of deficit of iron assumes purpose of a rate of ferriferous drugs, and also introduction to a daily diet of those products which contain a large number of this microelement. In view of the fact that iron is soaked up in a digestive tract, optimum to accept drugs in the form of tablets. The attending physician will recommend that drug in which to contain also other minerals promoting formation of hemoglobin.
Thus, each young mother has to watch accurately features of recovery of a monthly cycle and in the presence of doubts in a normality of process it is obligatory to address the doctor.
Besides, the woman should not forget also that lack of periods throughout the long period after the delivery can be a sign of new pregnancy. Therefore, it is important to consult with the gynecologist and concerning an adequate method of protection from conception.
Section: Childbirth and puerperal period