When breastfeeding and perimenopause overlap

Dr Nicole Avard

Dr Nicole Avard

Dr Nicole Avard is a dedicated Menopause Specialist GP with 18 years of experience as an Integrative GP. As the Medical Director and Co-founder of Metluma, she is passionate about guiding women through the complexities of menopause. In addition to her clinical practice, Dr Nic is actively involved in GP education and training. She is a recognised member of the Australian...
Updated on Jul 10, 2024 · 4 mins read
When breastfeeding and perimenopause overlap

Doing a quick scan of your mother’s group, it probably won’t go unnoticed that the age of new mammas is edging up. In fact, the average age of first-time Mums in Australia has been increasing year on year, now sitting at its highest level ever - 30 (the range is 25-45).  

It’s important to acknowledge that each generation of Mum’s has had their challenges – it’s never been easy. From tradwife, to ‘have it all’ power woman and now a generation that’s feeling the squeeze parenting both youngsters and aging parents, is it just me or do you also feel that motherhood is hitting a little differently this time?

Of course, we love that women have a choice on when to start a family and are conquering their bucket lists before taking the leap – but we also know, contrary to popular belief, that sometimes it isn’t a conscious choice. With circumstances out of their control determining the age they first get to bring a child into the world, sometimes it’s not just about finding Mr Right. Other times it’s a devastating infertility diagnosis or even illness that throws a spanner in the works.

Whatever the reason, as my patient base has also aged, I’ve been interested in the overlap of two major events in a woman’s hormonal lifecycle – postpartum, breastfeeding and perimenopause.

It’s hard to ignore all of the talk about perimenopause and menopause recently, which is great because women need to know more about their bodies! What women may not consider, however, is that although the average age of menopause in Australia is 51, the hormonal chaos of perimenopause can start up to ten years before menopause.  

That makes it increasingly more likely to overlap with postpartum.

A quick crash course in hormones

Let’s take a look at what hormones are at play in both of these key events:

  1. When you are breastfeeding there are two key hormones: Prolactin and Oxytocin. Prolactin is a hormone that can cause your period to cease as well as reduce sexual desire. Oxytocin is our social connection hormone of “love”. 
  2. In perimenopause, there is a fluctuation of oestrogen and a general downward decline in progesterone. This then evolves to a decline in both of these hormones to low levels once you are menopausal (defined as the day that marks 12 months after your last period).

These hormone changes can feel pretty similar. So when more mums are having babies around the perimenopause age, how can you tell if your symptoms are perimenopause or just postpartum? 

Am I in perimenopause, or just postpartum?

After birth, progesterone and oestrogen suddenly drop. Oestrogen remains low if you are breastfeeding, as it would otherwise impair milk production (how cool is the human body, huh?). This can result in lower oestrogen symptoms such as vaginal dryness and thinning. This also happens to be one of the many symptoms of perimenopause and menopause (ok, not so impressed by this one!).

Because prolactin is also doing its bit during postpartum and breastfeeding, changes in menstrual cycles are also occurring – yet another symptom of perimenopause. So which is it?

When we throw these two together, along with the drop in oxytocin when you stop breastfeeding, we’re faced with mood changes such as feeling low, teary and searching for isolation. 

Oestrogen and progesterone are powerful regulators of brain neurochemicals such as dopamine and serotonin (the happy hormones). So fluctuations in these hormones at perimenopause and menopause can also result in mood changes. That’s another tick for Column A and Column B!

And finally, the “S Word”. We all know how much young children can impact on our sleep patterns and from a hormonal point of view, progesterone is very calming for the brain. Reduced levels of this hormone are a one-way street to insomnia. Again, another symptom of perimenopause.

Where to get support

You don’t need to figure this one out on your own. As you can tell, there’s a lot of overlap – it’d overwhelm anyone. 

The best place to go? A healthcare professional such as your GP, a specialist, or a women’s health clinic. 

But what I say to my patients who are experiencing this and have many questions is that the drivers of “why” are essentially less important to work out at this exact moment in time.

What is important to understand is what’s happening for you and what support you need. Whether it’s sleep, mood or other physical symptoms, understanding these priorities for yourself and speaking to your health professional about strategies and support is key.

Wrapping it up

So there you have it – the hormonal impacts of being postpartum and breastfeeding moving into your late thirties and early forties. And, importantly, why it can be difficult to ascertain whether perimenopause may be contributing to the chaos!

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