Posted by My OB said WHAT?!?.
Oct
29
Posted by My OB said WHAT?!?.
“You Haven’t Had A Period Yet? That’s Not Normal…”
“You haven’t had a period yet? That’s not normal, most moms get them by six months postpartum even when nursing. I want to test you to make sure you haven’t entered early menopause.” – Family Practice Doctor to mom at 11 months postpartum.
There are 43 comments to this post.
I do believe the average, when practicing what they call “ecological nursing” (exclusive bfing for at least 6 mos, no bottles of anything, no pacifiers, continued nursing with small amount of solids after 6 mos, nursing “on demand” including at night, etc), return of menstruation is 14 months. Obviously there is wide variation here – some women will get their period back by 2 or 3 mos PP regardless, others won’t see Aunt Flo again until they’ve weaned completely. It is shameful how little info on lactation is taught in medical school 
Good info on bfing and fertility (including when to expect periods to return):
http://www.kellymom.com/bf/normal/fertility.html
Gottal love kellymom!
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Okay, this one really is mine.
I had gone in for vaginal irritation. I wanted to get checked out for yeast or bacterial infections. The doctor asked me when my last period was and I informed her it was before I was pregnant since I hadn’t resumed fertility yet. She said I should have started already and I told her that I was tandem nursing two active nursers, the older nurses 6-12 times a day and the younger more often and nurses through the night.
She then said the rest of this quote, how it still wasn’t normal and it didn’t matter that I was nursing two and she thought I was going into early menopause. She thought my vaginal irritation was from my skin thinning due to menopause.
At this appointment I wanted to be specifically tested for bacterial infections since my little sister had a horrible situation where her doctors thought she had a yeast infection and for 5 years they gave her stronger and stronger yeast fighters, it turned out she had a bacterial infection (non-STD) and they needed to pull out the big guns at that point. Since my irritation wasn’t consistent with a yeast infection I was worried for myself.
Basically I got the feeling that if I didn’t go along with the menopause testing then I wouldn’t be tested for bacterial agents, so I agreed. My hormone levels were fine and I resumed fertility at 13 months postpartum.
When I got my results back from the bacterial testing I noticed that she tested me for only gonorrhea and chlamydia, which irked me even further because I told her I was in a trusted monogamous relationship.
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Heather Reply:
October 29th, 2011 at 1:03 pm (Quote)
Unfortunately, her lack of knowledge of ecological breastfeeding and unwillingness to listen probably was a big red flag that she couldn’t understand ‘bacterial infection’ either.
Hope you got it figured out!
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Liz Handler Reply:
October 29th, 2011 at 1:13 pm (Quote)
I would definitely be switching providers, and telling this MD exactly why.
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Claire had this to say,
Oct 29, 2011 @ 11:24 am (Quote)
The doctor probably sees very few women breastfeeding at 11 mo let alone tandeming so has little experience on what and what isn’t normal. I remember going for a pap at about 9 mo pp with my first and having the nurse look at me like I had two heads when I explained that I was nursing and therefore hadn’t had my period yet.
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Jessica Reply:
October 29th, 2011 at 1:27 pm (Quote)
We must have had the same nurse! I wish the medical community had better training on breastfeeding and fertility.
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Toni Reply:
October 29th, 2011 at 3:23 pm (Quote)
When I went in for follow up to an abnormal pap at about 10 mos postpartum I told the nurse my LMP (which at that point had been over a year and a half) and she said, “Did we have a procedure?” I was like, “No, we’re still nursing our infant.” (mimicked tone) Lol. Really, you know I have a baby at home and the first thing you think of is that I must have had (I’m assuming Novasure or something like that?) some kind of “procedure”. Do you really see that few women “still” nursing at this point. But sadly, I think I know the answer to that question….
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Toni Reply:
October 29th, 2011 at 3:24 pm (Quote)
“mimicked tone” should be “mimicked condescending tone”
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lilmrsmchenry Reply:
October 29th, 2011 at 4:37 pm (Quote)
My first thought at “procedure” was hysterectomy due to a traumatic birth.
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Toni Reply:
October 30th, 2011 at 7:43 am (Quote)
Yeah, that didn’t enter my head – I was there for follow up for an abnormal pap, discussing the possibility of a LEEP. So I was pretty sure she knew I still had a uterus, I just assumed she figured I’d had something done to remove the lining or whathaveyou. But either way, it’s pretty shameful that the only reason they can think of for delayed onset of post-partum menstruation is having had some sort of surgery….
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Angela Reply:
October 31st, 2011 at 12:42 pm (Quote)
Same thing happened to me at a pap when ds was 7 or 8 mo. I was kind of peeved that they marked on my chart that I had irregular periods. Lactational Amenorrhea =/= irregular periods. My periods were actually quite regular before getting pregnant. Then during the breast exam, she audibly gasped at the sight of the bright blue veins in my breasts that are so much brighter when I’m lactating (it doesn’t help that I have really pale skin). Overall, it was a stellar appt.
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Menopause testing???
The problem with this doctor is that she hasn’t ever *observed* normal for exclusive, extended breastfeeding. She’s observed what’s normative for a society in which breasts are replaced by bottles or paci’s regularly, even when mom is breastfeeding.
And then there’s the whole Every Woman Is Different thing, which she obviously ignores.
ugh.
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Krista Reply:
October 29th, 2011 at 3:06 pm (Quote)
What is actually quite laughable about the situation is that she nursed each of her kids for 2 years! But apparently her fertility returned by 6 months.
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The Mommy Blawger had this to say,
Oct 29, 2011 @ 12:35 pm (Quote)
When I told people I hadn’t had a period in 2 years, I got a lot of, “what does your doctor say about that?” questions. Why on earth would I ask a doctor? Delayed fertility while nursing *is* normal. After my first baby, I got my period back at 14 months, but with all 3 of my subsequent babies it took just over 2 years.
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For heaven’s sake, this is why breastfeeding is used for child-spacing in most non-industrialized cultures. I didn’t get my fertility back for 12-13 months after each of my 3–even with the one who slept through the night by 8 months. And no test for BV? Sounds like it’s time to find a new doctor.
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v had this to say,
Oct 29, 2011 @ 2:04 pm (Quote)
Only nursing one, I got it back at 9mo. Nursing that one and the next, I got it back at 9 mo again and got pregnant straight away. Then nursing my second and third I got it back at almos 2yr. It is totally normal to restart at any time pretty much when nursing. The ignorance is just..:shakehead:
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lilmrsmchenry had this to say,
Oct 29, 2011 @ 2:14 pm (Quote)
Good gracious. I’m 10 months PP with my fifth and my body is just now trying to get back on a cycle. (In short, it Suuuuucks and can’t make up it’s mind.)I think it is because he is only nursing around 6 times a day now that he is eating meals with us. Why in the world would I want to have a period if I didn’t have to (like if ttc). Since I am done with having babies I wish I could stop them forever, lol.
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We seem to have a quantitative modifier problem here. SOME women get them by six months postpartum even when nursing. The AVERAGE period of postpartum infertility associated with ecological breastfeeding (which most women really don’t do) is 11 months, though some delay much longer. LAM, however is quite conservative and is only considered “reliable” for the first 6 months pp.
/shaking head
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This one just makes me love my doctor more…. I mentioned to her wistfully that we were wanting to try for #2, but my periods hadn’t come back. I asked if she could test and make sure that it was *just* that I was still nursing #1 (by then I think 20 months old) and nothing else. She said sure, but based on how often I said I was nursing him that was probably it.
She ran all the standard tests, found my Vitamin D levels a bit deficient and had me supplement. That probably did me some good but, sure enough, my periods waited to return until my first was nursing less often.
(AND my doctor noted that reducing breastfeeding frequency would probably do so if it was important to me, but did it in such a way that she was presenting me a fact, not offering advice or suggesting I needed to do that.)
My two will be almost three years apart. Firstborn still nurses, maybe 1 or 2 days out of 3, once a day. (And I grit my teeth because, at 8 months pregnant, I’ve finally hit the stage where that sometimes hurts – for me anyway. I’m not going to wean him a month before his brother arrives, tho!)
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Tiffany had this to say,
Oct 29, 2011 @ 4:46 pm (Quote)
I just got my period back, two weeks ago, with my daughter over 17 months old. But she nursed often! Somewhere between five and eight times a day, and at night. I strongly suspect the continued night nursing is the main reason it took so long. My doc has been great about it though, and while she noted that the vaginal irritation I was dealing with “looked” menopausal, she specifically noted that breastfeeding can put estrogen levels so low that tissue can behave that way. Big difference between that and actual menopause (from a root-cause, health perspective).
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Kit Reply:
October 30th, 2011 at 5:58 pm (Quote)
My midwife told me essentially the same thing when I went to her with vaginal irritation at 6 mos pp. She prescribed an estrogen cream to be applied as little as I felt was necessary because it *might* reduce my milk supply. What a difference that little tube of cream made! Sex went from intensely painful and something to be avoided to a pleasurable experience again.
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Kate, Ren's Mama had this to say,
Oct 29, 2011 @ 7:09 pm (Quote)
Thanks to my little boob-hog my period didn’t come back until 16 months pp. One of the *many* perks of extended bf…
It’s just sad to me that extended bf is apparently so rare that this nurse views normal physiology as a problem
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My period has only just come back last week and I’m still nursing my 19mth old son on demand. MY endo asked me if my period had returned yet last month and when I said it hadn’t he said that was a good thing as it meant I still didn’t need to worry about period pain.
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Jespren had this to say,
Oct 30, 2011 @ 4:47 am (Quote)
*sigh* I envy you guys. I nursed my 1st every single hour 24 hours a day, and I *still* had my period back around the 7th month mark. My 2nd, who didn’t nurse as much but still nursed on demand, I got it back around 11 months. *sigh* my periods suck, I was really hoping to be one of those women who doesn’t get it back for 18-20 months.
Oh, and this doctor was trying to cover lack of knowledge with an unnecessary bill! Jerk.
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Jane Reply:
October 30th, 2011 at 4:57 am (Quote)
I did full breastfeeding with all four of my children. With two of them, my period returned at six weeks. That’s with nursing around the clock, no supplementing, no pacifiers. And with the other two, my periods returned at 18 months and 21 months.
It really depends on a lot of factors.
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Billie Jo Reply:
October 30th, 2011 at 5:56 am (Quote)
This is me. Makes me jealous of you ladies not having to deal with it for MONTHS on end.
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The Deranged Housewife Reply:
October 31st, 2011 at 6:50 pm (Quote)
Mine still returned at six weeks too, even though I was exclusively breastfeeding. After #3 it was a little later but not by much.
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Add Your Comment.
There is no ‘normal’ time for your period to return when fully nursing. If you as a doc don’t know that… at least do a bit of research on the matter before testing mom to bits or even freaking her out with the idea she isn’t ‘normal’. Just cause you haven’t seen it (cause most of your patients have given up on nursing by 6 months) doesn’t mean it isn’t normal.
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