Motherhood is a mentally, emotionally, and physically transformative experience. One aspect that many women encounter is the delicate balance of their hormones during the postpartum period. As your body tries to get back to baseline, your sex and thyroid hormones can undergo significant shifts. This article intends to share an understanding of these changes, what you may feel like, and how to address them holistically. With functional medicine testing and integrative medicine interventions, there are evidence-based ways to balance your hormones naturally. 

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Understanding Postpartum Hormonal Changes

After birth, your body will try to replace hormones. This may look different for each woman, depending on whether they are breastfeeding or have pre-existing conditions that influence their sex hormones. In general, there is a drastic drop in the hormones estrogen and progesterone. These hormones have primary roles in maintaining pregnancy but are no longer required to stay elevated after birth. These drops can affect many women, leading to postpartum depression or “baby blues.” 

Along with sex hormones, thyroid hormones can be impacted during the transition from pregnancy to post-birth. Women can sometimes enter a hypothyroid or hyperthyroid state known as postpartum thyroiditis. The majority of women will have a return to baseline hormones within three to six months postpartum. Some women may experience prolonged imbalance symptoms and require care a root-cause approach to care.

Hormonal Imbalance Symptoms Post-Pregnancy

Postpartum hormonal fluctuations can shift physical, mental, and emotional symptoms. Here are some of the common symptoms to be aware of.

• Emotional instability
• Crying
• Sadness
• Excessive sweating
• Anxiousness
• Mood Swings
• Constipation
• Increased heart rate
• Fluctuating body temperature
• Difficulty focusing 
• Excessive hair loss
• Depression

Functional Medicine Labs to Assess Hormones Post-Pregnancy

While changes in hormones are a natural process after childbirth, there may be instances when laboratory assessment is necessary. If you have persistent symptoms of hormonal imbalances after 6 months postpartum, here are some lab options to consider for root cause investigation. 

Comprehensive Sex Hormones

The DUTCH Complete is the gold standard for testing for getting pulsatile readings of sex hormones and their metabolites through urine testing. If you are not breastfeeding and your cycles do not self-regulate after three months postpartum, this test can explain why. For lactating women, the menstrual cycle typically remains absent while you are producing milk. Hormone testing is not typically done in this population unless there is a milk production issue or significant symptoms present. A sex hormone blood test, including the hormone prolactin, is the ideal testing option for milk production issues.

Thyroid Panel 

Assuring that thyroid dysfunction is not contributing to hormone imbalances and symptoms, obtaining a full Thyroid Panel from Access Med Labs would be helpful. An imbalance in TSH and/or thyroid hormones- T4 and T3 is frequently a culprit to women’s health issues. Addressing this issue can assist in correcting overall well-being. 

Cortisol Testing

Stress can impact hormone production through the HPA axis. While you can test cortisol levels in the blood, the hormone panel mentioned above reveals diurnal salivary testing and is the most accurate depiction of cortisol fluctuations. Multiple samples can be collected throughout the day using the Access Medical Laboratories Salivary Cortisol X 4 test, which will provide comprehensive information regarding stress and how it contributes to your overall presentation. Stress with low levels of oxytocin postpartum has also been shown to be a risk factor for developing postpartum depression. 

Micronutrients

Vitamins and minerals play an essential role in balancing hormones. A general rule of thumb to tell if your hormones are balanced is if you are having a regular menstrual cycle. A handful of nutrients are necessary for this to occur, such as vitamin D, magnesium, zinc, fatty acids, and vitamin B6. Iron is also an essential mineral that pregnant and postpartum women can become deficient in, leading to anemia and imbalanced health. This Micronutrient Panel can asses all the above-mentioned biomarkers and a couple dozen more. 

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Tips for Balancing Hormones After Pregnancy

Implementing lifestyle modifications through diet, supplementation, exercise, optimal sleep, and stress management are all avenues that can support optimal hormones. 

Post-Pregnancy Hormone Balancing Diet

After pregnancy, nourishing your body with various whole foods will support hormone production and metabolic function. Postpartum recovery and breastfeeding both require adequate nutrition to heal and produce breastmilk. You’ll want to eat a healthy balance of proteins, fats, and carbohydrates to assist with muscle and tissue repair, nutrient absorption, and energy production. Making sure you get enough fiber and iron can ensure that you are supporting blood sugar and reducing your odds of extreme fatigue. 

Foods can naturally support your vitamin and mineral status, so eating fruits, vegetables, and good-quality protein is vital. After pregnancy, progesterone will drop off, and estrogen levels can creep up. To support this imbalance, you can incorporate progesterone-boosting foods like pumpkin seeds, beans, broccoli, leafy greens, kale, cabbage, bananas, seafood, Brussels sprouts, and avocados. 

Regulating excess estrogen through fiber-rich foods can help eliminate and reduce this hormone. Options include lentils, beans, apples, chia seeds, potatoes with the skin on, peas, and raspberries. In addition to these nutrient considerations, you’ll want to ensure you eat a sustainable amount of calories to support hormone pathways. This is especially important for lactating mothers, as your body generally needs up to 500 extra calories daily to sustain milk production. Adequate nutrition is the ideal starting place for supporting hormonal health.

Hormone-Friendly Supplements

Incorporating supplements as part of your hormone-balancing plan can be beneficial. Nursing mothers should take extra caution when adding botanicals and specific nutraceuticals to their regimens. It’s best to consult with your healthcare providers to see what is an ideal fit for you. 

Chaste Tree Berry

The plant, also known as Vitex, has been used for centuries to help women naturally boost progesterone levels. This botanical has shown some dose-dependent variability, which low does decrease estrogen and increases progesterone and prolactin, while higher doses of prolactin can be decreased. This is why caution should be taken if you are a nursing mother and are considering taking Vitex. Starting with traditional dosing and then working up to a therapeutic dose is recommended.

Dose: 4mg per day of dry extract 

Fennel

Foeniculum vulgare, commonly known as fennel, may be a great plant medicine option to support your hormones. It can help modulate estrogen levels, with the known benefits of increasing milk secretion or promoting menstruation in non-lactating women. Women who suffer from hirsutism due to conditions like PCOS may also benefit from the anti-hirsutism activity of topical fennel-based cream. 

Adaptogens

Managing stress and cortisol can play a dynamic role in balancing hormones. A few botanicals to consider when managing stress postpartum are Ashwagandha, Rhodiola, Schisandra, and Maca. Dosing for these will vary depending on whether you are taking these independently or in a product combination like HPA Adapt™. 

Dose: 2 to 4 capsules daily on an empty stomach for HPA Adapt™

Probiotics

Gut health impacts all areas of health, including hormone production. Making sure your microbiome is in good standing, with a thriving beneficial bacteria environment, is critical. Be sure to take a reputable probiotic supplement combining Bifidobacterium and Lactobacillus species. 

Dose: 10 to 20 cfu per day for an adult. 

Exercise for Hormone Balance After Childbirth

Exercise can help modulate the stress hormone cortisol, decrease circulating estrogen, and has been shown to improve depression and anxiety. In the postpartum phase, you’ll want to focus more on movement rather than a strenuous workout routine. Most women can engage in light exercise shortly after pregnancy. At the same time, those who have undergone a c-section are instructed to hold off on any exercise routine until their 6-week follow-up appointment. After that, you can typically start back at any exercise regimen you had during pregnancy or, for some, their pre-pregnancy workout. Incorporating 50 minutes of moderate-intensity workouts every week is ideal, but it may be something you need to work up to. 

Stress Reduction Techniques for New Moms

Stress can profoundly impact your hormones. In the new mom phase, you probably won’t have time to do some of your pre-pregnancy stress-relieving activities like massage or self-pampering. Some simple at-home and practical things you can implement are yoga, meditation, and breathing exercises. Creating a routine for yourself and your newborn can also help manage stress. Having realistic expectations and flexibility can help reduce stress in this new chapter. It’s essential to be aware of your feelings, ask for help when needed, and stay connected to your intuition. Motherhood can be challenging, so giving yourself some grace can go a long way. 

Sleep Tips For Hormone Regulation

Postpartum fatigue is widespread, and when prolonged, it can negatively impact your hormones. Getting quality and restorative sleep is necessary for circadian rhythm syncing with hormone fluctuations. Lack of sleep can also increase cortisol and impact melatonin secretion, which can create a vicious cycle in relation to how you are able to manage stress. Some helpful tips for self-regulating sleep are to get early morning sunlight exposure without sunglasses on and then tone down your in-home lighting when the sun goes down. This can help trigger the brain to release melatonin and cortisol at appropriate times of the day. To echo what you have heard from your doctors and friends, if life permits, try to sleep when your baby is sleeping. 

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Summary

Balancing hormones after pregnancy can be an intricate dance. If you are past the sixth-month postpartum mark of letting your hormones try to work themselves out, there are natural and integrative medicine tools you can utilize to help. Working with a naturopathic doctor or functional medicine practitioner is a great route to consider in assisting you down this path. If you choose to tackle this on your own, know that lifestyle modification can go a long way in regaining hormone health.