Patient: I am 36 years old and 17 weeks PP. This is my first and only child. I breastfed for the first 3 weeks only. I have not felt “well” since the birth. I was dx with PPD and PPA(health anxiety) at 4 weeks PP but have been going to therapy. It is getting better everyday. I have not yet had my period and am wondering what the normal time after birth is to have my period. Before I had her I was dx as being “pre-menopausal”. (My mom was done with menopause at age 40, as was my sister) My periods would fluctuate between 19 days and 46 days. Now I feel like I have PMS all the time. My face will get flush and feel warm for an entire day and then be gone the next…I have other weird pre meno symptoms as well. Is it possible that the birth kicked me in to menopause? Or is there a potential problem that my period as not yet started? Any suggestions or help will be greatly appreciated. Thank you.
Doctor: Any other medical problems, what medications are you taking, any surgeries, did you have a lot of bleeding when you delivered your baby?
Patient: No surgeries, no regular medications ( I was on Lexapro for 4 weeks but it made me worse so I am dealing with the PPD through CBT and support groups) I have been off the lexapro for about 6 weeks. I occassionally take .125 of xanax as needed. About 1 or 2 times a month. I feel like I could take it more…but I hate medications so I just tough it out. I take a multi vitamin and magnesium supplement as well as cranberry tablets and a daily probiotic.
I did not have a lot of bleeding…I bled for about 4 weeks…but nothing major. The delivery was very fast. But very painful. No epidural…she was sunnyside up and came out arms first…I did tear. My doctor thought I might be slightly traumatized by the painful birth which could have lead to the anxiety….but I don’t know about that. I don’t feel traumatized.
I did have occassional mild anxiety prior the pregnancy…in fact that was what sent me to the doctor…who did the 30 day saliva testing and dx me as pre-meno. However since the birth my anxiety (Health Anxiety) has increased quite a bit. I was never like this before all these hormonal issues.
Doctor: Thyroid abnormalities may occur postpartum and lead to the symptoms you are describing, including depression. Ask your physician to check a battery of hormones due to the amenorrhea and if early menopause (which I doubt), Sheehan’s (postpartum hormonal disturbance-since you breastfed I doubt this as well), continued elevation in your prolactin hormone after breastfeeding, or thyroid dysfunction will be ruled out. I hope this helps! Good luck!