Pregnancy is a wild ride. But the hormonal ups and downs of pregnancy don’t end after birth. The hormonal changes that take place during the postpartum period can be tough and unexpected.
But not all hormonal changes are normal, so how do you know when things are more than typical postpartum hormonal ups and downs? Here are the signs of hormonal imbalance after pregnancy.
Key Takeaways
- Postpartum hormonal imbalance most often involves sex hormones like estrogen and progesterone, though thyroid and stress hormones can also fall outside normal range — because hormones act as the body's messengers, an imbalance can disrupt everything from metabolism and mood to sleep and sex drive.
- Five signs distinguish a true hormonal imbalance from typical postpartum changes: chronic fatigue, major mood swings, unusual weight loss or gain, low sex drive, and an irregular menstrual cycle — the key differentiator is persistence, so symptoms that continue past the first few months or feel out of character warrant tracking and a conversation with your healthcare practitioner.
- Vitamin D, Magnesium, Zinc, Omega-3 fatty acids, B vitamins, and Iron play an important role in supporting hormone balance after pregnancy — continuing your prenatal vitamins through the postpartum period, along with sufficient protein for hormone synthesis, helps support optimal nutrient levels.
- Breastfeeding causes low estrogen, which lowers libido for many women, and its physical demands typically level out around the 6-month mark — a libido that stays low well beyond that point may signal a hormonal imbalance rather than normal postpartum adjustment.
- When lifestyle changes aren't cutting it, three tests provide a comprehensive hormone picture: the DUTCH Test, a full thyroid panel, and salivary cortisol testing — plan to work with a functional medicine practitioner or naturopathic doctor, since tests like DUTCH aren't always accessible through an OB or primary care provider.
What is a Hormonal Imbalance?
A hormonal imbalance happens when any of the many different hormones in the body are outside of a normal range.
The most common hormones that are affected during postpartum are sex hormones, like estrogen and progesterone, but other hormones can also get out of balance. Other hormones can include thyroid and stress hormones, among others.
Hormones are messengers in the body, so when hormones are out of whack, they can disrupt messages that help regulate and control several different systems in the body. Imbalanced hormones can affect everything from metabolism and mood to sleep and sex drive.
Signs of Hormonal Imbalance After Pregnancy
Signs of a hormonal imbalance can vary by person, but here are some of the most common signs:
Chronic Fatigue
All parents are tired, especially in the first year after birth. But if you’re experiencing a level of fatigue that makes it hard to get through your day, your hormones may be at play. This feeling of overwhelming exhaustion can affect your mood, relationships, and even your ability to care for yourself and your baby.
Major Mood Swings
It's normal for your mood to fluctuate in the postpartum period (and even beyond). Emotional ups and downs are part of life, especially as a new parent. But if you're consistently experiencing major mood swings that are out of character for you and are affecting your relationships and well-being, hormones may be to blame.
Unusual Weight Loss or Gain
Weight changes are very common during the postpartum period, especially during the fourth trimester.
But if you're experiencing persistent weight gain or loss after the first few months without significant changes in diet or physical activity, you may want to explore a hormone imbalance as the cause
Low Sex Drive
Breastfeeding causes low estrogen, which can lead to a lower libido for many women. In addition, breastfeeding can make many women feel “touched out,” which dampens sex drive.
However, the physical and mental demands of breastfeeding usually start to level out around the 6-month mark when babies start solids. If your libido remains low, or if it is affecting your relationship, a hormonal imbalance may be at play.
Irregular Menstrual Cycle
Menstrual cycles can be hard to track during the postpartum period. Some women have no cycle at all for several months, or even years if they are breastfeeding. And even when your cycle does return, it is normal for it to take several months for it to return to a consistent cadence.
If your menstrual cycle does return, and it is either very irregular or comes with symptoms that are not typical for you, or both, it may be a sign of hormonal imbalance. It's worth tracking your cycle and symptoms for a few months to get some good data on what's happening so you can share it with your healthcare practitioner.
When Do Postpartum Hormones Go Back to 'Normal'?
This can vary significantly by person. It depends on several factors, including how long you breastfeed and when your period returns, as well as several other lifestyle factors, like what your stress levels look like and whether or not you have nutrient deficiencies.
How to Balance Your Hormones After Pregnancy
The good news is that there are some lifestyle changes you can make to support hormone balance after pregnancy.
Limit or Avoid Refined Sugar
Sugar intake causes spikes in blood sugar that impact insulin levels and other hormones. Excessive sugar intake can exacerbate symptoms of hormone imbalance, such as fatigue, weight fluctuations, and mood swings.
Eat a Balanced Diet and Continue to Supplement
Vitamins and minerals play an important role in balancing hormones. Vitamin D, Magnesium, Zinc, Omega-3 fatty acids, B vitamins, and Iron are particularly important. While diet is always important, continuing to take your prenatal vitamins throughout your postpartum journey can help support optimal nutrient levels and hormone balance.
In addition, a sufficient intake of protein is essential for hormone synthesis. Protein impacts many different hormones, including those that control appetite and food intake.
Exercise Regularly
Exercise can help modulate several hormones, including cortisol and estrogen, and has been studied for its positive effects on mood. In the initial postpartum phase, gentle movement is best. However, as you recover, you can gradually increase length and intensity.
Practice Stress Management Techniques
Stress can have a tremendous impact on your hormones. Try to incorporate moments of mindfulness, like short guided meditations, a gentle walk while you listen to music or a podcast, or some simple breathing exercises.
Get Good Sleep
This can be almost offensive advice for new parents, but lack of sleep can increase cortisol and impact melatonin secretion.
Even small changes can make a difference. Set a limit on nighttime scrolling, trade off middle-of-the-night feeds with your partner (if possible), get early-morning sun exposure, and try going to bed just 15 minutes earlier each night.
Types of Hormone Testing
When lifestyle changes aren’t cutting it, or when you want a more comprehensive look at what is going on, hormone testing might be a good next step. A practitioner may suggest additional lifestyle modifications as well as targeted supplementation to address any imbalances identified by testing.
DUTCH Test
The DUTCH Test (Dried Urine Test for Comprehensive Hormones) is a comprehensive look at sex hormones and their metabolites. The DUTCH test involves gathering urine samples over a 24-hour period.
While it is easy to take, the DUTCH test isn’t always easy to access through an OB or primary care provider. You may need a functional medicine practitioner or naturopathic doctor to order the DUTCH test.
Full Thyroid Panel
An imbalance in one or more of the thyroid hormones can be at the root of postpartum fatigue, weight issues, and more. Getting a comprehensive look at all thyroid hormones, not just the commonly tested TSH, is helpful to understand your thyroid health.
Cortisol Test
Stress can affect hormone production and mood, weight, and more. High levels of stress with low levels of oxytocin postpartum have also been shown to be a risk factor for postpartum depression.
Salivary testing (testing saliva) typically provides the most accurate view of cortisol fluctuations.
FAQs
What is a hormonal imbalance after pregnancy?
A hormonal imbalance happens when any hormone in the body falls outside its normal range. Postpartum, the most commonly affected hormones are sex hormones like estrogen and progesterone, though thyroid and stress hormones can also get out of balance, affecting metabolism, mood, sleep, and sex drive.
What are the most common signs of hormone imbalance after pregnancy?
The five most common signs are chronic fatigue that makes it hard to get through the day, major mood swings that feel out of character, persistent weight gain or loss without changes in diet or activity, low sex drive beyond the 6-month mark, and a very irregular menstrual cycle once it returns.
When do postpartum hormones go back to normal?
The timeline varies significantly by person. It depends on how long you breastfeed, when your period returns, your stress levels, and whether you have nutrient deficiencies — there's no single universal timeline.
How can I support hormone balance after pregnancy?
Five lifestyle changes support hormone balance: limiting refined sugar, eating a balanced diet and continuing your prenatal vitamins postpartum, exercising regularly (starting with gentle movement), practicing stress management like short meditations or breathing exercises, and prioritizing sleep — even going to bed 15 minutes earlier helps.
What tests check for hormone imbalance after pregnancy?
Three tests offer a comprehensive look: the DUTCH Test (a 24-hour dried urine test for sex hormones and their metabolites), a full thyroid panel that goes beyond standard TSH testing, and a salivary cortisol test, which provides the most accurate look at cortisol fluctuations.
Does breastfeeding affect postpartum hormones?
Yes. Breastfeeding causes low estrogen, which can lower libido, and it can delay the return of your menstrual cycle for months or even years. These effects are normal, but symptoms that persist well after weaning or the 6-month mark are worth discussing with a practitioner.
The Bottom Line
Balancing hormones after pregnancy can take time. The first few months may feel erratic with night sweats and postpartum hair loss, but you can still make some lifestyle adjustments to support yourself. If hormonal swings persist well beyond the initial postpartum phase and you’ve got your lifestyle factors in check, it might be time to consider testing to better understand how your hormones are affecting your body, and to reach out to your practitioner if you have concerns.
