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What Are Postpartum Hormones and How Do They Affect The Pelvic floor?

birth bladder columbus hormones labor and delivery physical therapy postpartum pregnancy May 17, 2023

There is really no education or preparation for the postpartum period and there is a severe lack of support in the fourth trimester. This blog serves as an introduction to what you might experience, with the goal of helping you feel empowered to seek help and reach out to your provider if you are experiencing these symptoms.


Hormones Postpartum 

The placenta plays a HUGE role in producing the hormones present during pregnancy. During the third stage of labor, the placenta is delivered and suddenly the manufacturer of all those hormones is gone! It can take up to around six months or more for those hormones to return to pre-pregnancy levels. 


Hormonally, the postpartum period is outlined as acute, early, and late postpartum. 

  1. Acute is considered around 24 hours post delivery. 
  2. Early is considered one week postpartum.
  3. Late is considered six weeks to six months postpartum.


What are some changes or symptoms you might experience?

  • During the acute phase there is an increase in pulse, blood pressure, a large increase in cardiac output, and change in temperature. It is not uncommon to have body shivers within the first 12 hours.
  • Within two weeks, the uterus will go from around 2 lbs to around 6 oz! This can be accompanied with uterus contractions and you may experience a sensation similar to pelvic or abdominal cramping. 
  • Vaginal discharge will change from bright red to yellow to pale brown to white. 
  • There is laxity in the abdominal wall and the bladder, so it may be difficult to pass urine or difficult to control urine in those first couple weeks. 
  • During pregnancy there is around a 30% increase in the volume of the kidneys. As the body is trying to return to a lesser volume, there might be a higher urine output (think more frequent urge to pee and a higher volume of pee). It can take around eight weeks to return to pre-pregnancy volume. 
  • Once the placenta is delivered, there is a sharp decrease in estrogen, testosterone, and progesterone. The vagina needs estrogen to remain plump and healthy. The vestibule needs testosterone. As the body is adjusting to the dip in these hormones, the vulva or vaginal space may feel more dry and easily irritated. If breastfeeding, the estrogen levels will continue to be impacted, which may prolong the experience of dryness in the vaginal space. It is important to note that this is treatable and you do not have to pick between breastfeeding and having a healthy vaginal space. 

If you are experiencing urine or fecal leakage, constipation, pelvic floor heaviness, prolapse, pelvic pain, back pain, or abdominal pain, I encourage you to see a pelvic health physical therapist as there is help and there is no reason to feel alone. If you are in the Columbus area, give us a call or click the link below to see how we can help.

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