Postpartum with PCOS

Expect the unexpected. Every woman’s experience postpartum is different because no one baby is the same so expect the unexpected! Meaning don’t set your expectations too high for how the baby will act or how you will feel. This is truly a time to listen to your body and prioritize rest, mental health, and soaking up baby snuggles because this time does fly by in the grand scheme of it all.

Another important aspect of setting realistic expectations postpartum is with weight. There is still so much pressure to “bounce back” after baby in terms of weight. Here’s the reality of the situation. Most women have different pregnancy and birth stories so why would we all have the same postpartum journey? You have to let your body heal. As someone that loves exercise, easing back into it and going slow was hard for me but it’s so necessary. Some women seem to be back to their pre-pregnancy weights within a week and some of us take a year or more. It’s all normal! Ease back into body movement once cleared by your doctor and take it slow based on what your body is feeling, what your baby is requiring of you, and based on the type of labor you had (natural vs. c-section). I have been following Kim Perry’s Abs After Baby program with my second pregnancy and I’ve loved how it’s forced me to take it slow and rebuild my core and pelvic floor which is so important after pregnancy and birth. If you’re making small, consistent effort to move and nourish your body then you’re doing great no matter what. It takes time! And for the record, you don’t need to “bounce back”. It’s ok that your body looks different now. Celebrate the fact that your body built a whole other being. That is no easy feat. If that area of flabby skin is my daily reminder that my body is AMAZING then I’m going to do my best to love it!

Mental health awareness. Women with PCOS are at greater risk of developing postpartum depression so it’s even more important to monitor mental health for women with PCOS postpartum. If you’re feeling off mentally at any point postpartum, do not be afraid to reach out for help to family, friends, other moms, a doctor, or therapist. Hormones are running amok during the postpartum period, but if you’re questioning whether what you feel is ok then it’s probably time to seek support. If there’s one thing I can tell you, try not to “just let it pass” because you want to look back on this time with joy and if you’re feeling your best, then often you’re a better mother, spouse, etc.

Increased appetite or cravings. This can happen for a variety of reasons: your body is healing after going through a MAJOR transformation and has a major open wound inside you that needs healing (even moreso if you had a c-section), breastfeeding often increases your calorie needs to maintain milk supply, and lack of sleep can make insulin sensitivity worse. Worsening insulin sensitivity, especially with PCOS, can make blood sugar balance and carb cravings much worse. Keeping up with supplements, body movement when possible, nourishing your body with nutrient-dense foods, and prioritizing sleep can help with this.

Period irregularity. With hormones doing wonky things postpartum, don’t expect your period to come back perfectly, especially if you’re breastfeeding. Breastfeeding raises the hormone, prolactin, which downregulates the menstrual cycle while signaling the brain to make milk for baby. While breastfeeding, it is very normal (albeit frustrating) for periods to be irregular or non-existent entirely. With my first pregnancy, I started wearing my Tempdrop (10% off with discount code: liz002) when Eleanor was about 6/7 months old and starting to eat more food, but still breastfeeding. My basal body temps were all over the place until she was about 9 months and nursing less. At that time, I was able to see my BBTs start to normalize and actually predict when my first period came at around 9 months postpartum…pretty incredible! Wearing a tracking device like Tempdrop when your baby’s food intake increases and milk intake decreases is a great tool to help you understand when to expect the return of your period.

Minimal time for meal preparation. Depending on your baby, this may be more or less difficult for others. But regardless, with a newborn, you’re doing a lot of things one-handed. If there’s ever a time to show yourself grace with cutting corners such as buying precut veggies, frozen meals, utilizing canned and frozen foods, now is the time. There’s is absolutely no shame in this if it means you’re not pulling your hair out trying to manage an infant while trying to get a nourishing meal on the table.

Hormonal shifts. During the 3rd trimester of pregnancy, estrogen and progesterone levels increase significantly. After labor, estrogen and progesterone levels drop dramatically to allow for the milk-producing hormone, prolactin, and oxytocin to rise. This rapid shift can cause mood shifts, sometimes called the “baby blues”. If severe mood shifts persist beyond the first week after labor, talk to your doctor immediately. Estrogen and progesterone will remain lower until your menstrual cycle resumes, which happens at different times for every woman and depends on if you’re breastfeeding.

Breastfeeding concerns. There are some small observational studies that have shown a slight reduction in breastfeeding rate among women with PCOS due to factors such as obesity and hormone imbalance. In particular, higher androgen levels of DHEA-S and testosterone inhibit lactation, posing as a possible reason for women with PCOS to have worse lactation. However, not all studies have demonstrated that PCOS automatically equates to poor breastfeeding outcomes. It appears that obesity and higher body mass index (BMI) is a bigger contributor than having PCOS alone. In other words, just because you have PCOS does not automatically mean you will have issues with breastfeeding. From personal experience, breastfeeding is hard regardless of PCOS. Many things other than PCOS could contribute to a mother’s breastfeeding experience, such as milk production, the baby’s latch, mental health of the mother, skin to skin time with baby, social status, marital status, etc. More research is needed to determine if there is a direct link between PCOS and breastfeeding issues.