Postpartum or Peri menopause? How to Tell the Difference After Baby #2 (or #4)

 

Postpartum or Perimenopause? How to Tell the Difference After Baby #2 (or #4)

Nobody really explained to me what happens to you  A F T E R  you have a baby.

They tell you about the diapers, the sleepless nights & maybe the hair loss.

They leave out the part where you MAY look in the mirror a year later & wonder when you became a person you barely recognize.

& then

just when you're getting the hang of motherhood,

your hormones might decide to introduce a second plotline.

Is it postpartum?

Perimenopause?

A thyroid problem?

The cumulative effect of years of interrupted sleep & putting everyone else's needs before your own?

Or is it all of the above?

Sometimes it's genuinely hard to tell.

First, let's talk about matrescence.

There's a word for the transformation that happens when you become a mother: matrescence.

Think adolescence, except instead of navigating puberty & high school, you're recovering from pregnancy & birth while keeping a tiny human alive.

Your body changes. Your brain changes. Your relationships change. Your identity changes. Even the way you think about your time, your career & your own needs can look completely different.

& there's no official countdown clock for when you feel like yourself again.

I've heard the idea that it can take around five years to reclaim your sense of self after having a child. That's not an established medical timeline, & every woman's experience is different. But the idea that becoming a mother is a MUCH bigger transition than a six-week postpartum checkup suggests? Yeah. We should probably talk about that a little more.

By that math, I'm still 12 years away from reclaiming myself.

If I live that long.

Four kids. Three businesses. One husband.

The complication is that motherhood doesn't happen in a vacuum. Depending on your age, you may also be approaching perimenopause, when reproductive hormones begin to fluctuate.

& here's where things get confusing. Some of the symptoms overlap, which means it's easy to blame everything on motherhood, aging or just being exhausted.

The symptoms that make it confusing

Sleep

After having a baby, you're dealing with nighttime feeds, interrupted sleep & the general chaos of adding another human to the family.

During perimenopause, you might wake up at 3 a.m. drenched in sweat or find yourself wide awake for absolutely no apparent reason.

Either way, functioning the next day can feel like a competitive sport.

Mood changes

Postpartum hormonal shifts, exhaustion, anxiety & postpartum depression can all affect your mood. Perimenopause can bring changes in mood, irritability & anxiety, too.

If you're suddenly crying over something that normally wouldn't bother you, snapping at everyone in the house or feeling like your brain has 47 tabs open & none of them will close, it's worth paying attention to.

You don't have to figure out which hormone is responsible before asking for help.

Hair shedding

Postpartum hair loss often becomes noticeable a few months after delivery & usually improves over time.

Hair thinning later in life can have other causes, including hormonal changes, thyroid problems & iron deficiency.

So if your shower drain looks like it could've supplied hair for an entire wig business, please don't automatically assume it's just postpartum shedding or something you have to accept with age.

A shower drain full of hair isn't a diagnosis.

Weight changes

Pregnancy recovery, breastfeeding, sleep deprivation, medications & changes in routine can all affect your weight after birth.

During perimenopause, changes in body composition & fat distribution may occur, too.

Neither situation can be explained by one hormone or a lack of willpower. Your body is complicated. The answer deserves more than someone telling you to eat less & move more.

Period changes

Your cycle may take time to return after delivery, particularly if you're breastfeeding.

Later, perimenopause can make periods shorter, longer, heavier, lighter or just plain unpredictable.

But don't automatically blame every change on hormones. If your bleeding is unusually heavy, prolonged or happening between periods, get it checked out.

One thing worth checking: your thyroid

Postpartum thyroiditis is an inflammation of the thyroid that can develop during the first year after giving birth.

Depending on the phase, symptoms can include anxiety, irritability, trouble sleeping, a racing heart, fatigue & weight changes.

Sound familiar?

That's exactly why it's worth bringing up with your provider. These symptoms can look a LOT like postpartum stress, anxiety or other hormonal changes.

Thyroid problems are treatable. You shouldn't have to spend months convincing yourself that feeling completely depleted is just part of being a mom.

Read more from the American Thyroid Association.

So how do you know which one it is?

Start with your timeline.

Postpartum changes are connected to pregnancy & birth, although recovery looks different for everyone. Postpartum depression & anxiety can develop beyond the first few weeks, too. They aren't something you can rule out just because you're months past delivery.

Perimenopause most commonly becomes noticeable during your 40s, but symptoms can begin earlier.

Age & timing give you clues. They don't give you a diagnosis.

& yes, you can have more than one thing going on at the same time. Fun, right?

If your sleep, mood, periods or hair have changed significantly, make an appointment. Tell your provider:

• When you gave birth & when your symptoms started.

• Whether you're breastfeeding.

• What contraception or medications you're using.

• Whether you've had thyroid problems, anemia or a family history of early menopause.

• What's changed with your periods, sleep, mood, energy or hair.

Depending on your symptoms, your provider may consider thyroid testing, a blood count or iron studies, a mental health assessment or an evaluation for perimenopause.

A single hormone test generally can't confirm or rule out perimenopause on its own. Your symptoms, age, cycle history & medical background all matter.

& please, if you're experiencing depression, anxiety or intrusive thoughts after having a baby, bring them up with your provider. You do NOT have to wait until things become unbearable to deserve help.

If you have thoughts of harming yourself or your baby, seek urgent professional help. If you feel you may act on those thoughts or can't keep yourself or your baby safe, call emergency services or go to the nearest emergency department.

Chest pain, severe shortness of breath or fainting also need emergency attention.

 

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Postpartum or Perimenopause? Here's What Can Look Similar

The catch: These symptoms aren't exclusive to either stage. Thyroid problems, iron deficiency, medications & other conditions can cause similar changes, too. You can also experience postpartum recovery & perimenopause at the same time.

When to Get Checked

• Your symptoms are affecting daily life: Tell your provider about changes in sleep, mood, energy or hair.

• Your periods have changed significantly: Mention unusually heavy or prolonged bleeding, bleeding between periods or other new cycle changes.

• You're feeling persistently anxious or depressed after birth: Ask for help instead of assuming it's just hormones or exhaustion.

• You're experiencing a racing heart, unusual fatigue or unexplained weight changes: Ask whether thyroid testing or another evaluation makes sense.

Bring your delivery date, symptom timeline, menstrual history, breastfeeding status, medications & any relevant family history to your appointment.

One last thing.

We ask women to recover from pregnancy, raise children, return to work, maintain relationships & somehow recognize themselves in the middle of all of it.

Then, when something feels wrong, we often tell them they're tired, stressed or getting older.

Sometimes they ARE tired. Sometimes life really is a lot. Four kids & a business will certainly keep you humble.

But that doesn't mean every symptom should be written off.

You don't have to know whether it's postpartum, perimenopause, your thyroid or something else before you ask for help. That's what the appointment is for.

& if you're still waiting to feel like yourself again, maybe the question isn't why it's taking so long.

Maybe we need to be a little more realistic about what we're asking women to recover from in the first place.

Because becoming a mother changes you. That doesn't mean you have to ignore everything that happens to you afterward.

 

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Sources

• ACOG: Optimizing Postpartum Care

• ACOG: Postpartum Depression

• American Thyroid Association: Postpartum Thyroiditis

• Mayo Clinic: Perimenopause