Estrogen: Milk’s Enemy
All month we have talked about the hormones, which serve our milk supply. Sadly, we have to wrap this month up though with the hormone that actually hurts our milk supply. Estrogen diminishes our milk supply. However, when we are newly postpartum our estrogen levels are very low or not existent - so it is not a huge issue. Because of this, we will talk about lactation before we receive our periods back and after we receive our periods back.
After we deliver and are exclusively breastfeeding our infants, typically women do not receive their periods back for some time. It is typical that as women replace nursing/pumping sessions with other food, that women will begin to receive their periods again. Because of this, it is typical that women do not have their period for the first 4-6 mo. postpartum. During this time, our estrogen levels remain nice and low. Although, this is a great side effect to optimize milk production, low estrogen levels present us with some other struggles. There are some things to keep in mind that are a completely normal side effect of low estrogen, therefore also a side effect of breastfeeding. These include (1):
Hot Flashes and/or Night Sweats: Ever find yourself waking up in a pool of sweat? Unfortunately, very common. Crank the A/C as needed - you made a baby you deserve it!
Moodiness & Irritability: Of course, the lack of sleep, confusion for how to care for a child, and all the other changes could be a culprit for this…however, low estrogen can also be blamed for just an overall “funky” feeling. In fact, if you look at Figure 1, when you are menstruating your estrogen is lowest during our period. So that just moodiness associated with a period can be related to lower than normal estrogen levels. Unfortunately, when lactating, this is just all the time.
Figure 1: Various Hormone Fluctuation throughout a Menstrual Cycle
Vaginal Dryness/Low Sex Drive: Depending upon how you are feeling about this this could be a positive or negative side effect for you! ;) However, estrogen does have a direct side effect to sexual arousal. If you notice in Figure 1, our estrogen levels increase greatly before ovulation, which is simply biology’s way of keeping the human species around. However, when we are lactating, also biology’s way of not impregnating women to early after childbirth is we do not experience ovulation, nor these spikes in estrogen.
If you are wanting to want to have sex with your spouse, slow and steady will usually win the race…as I often say “foreplay starts outside of the bedroom”. A nice date night maybe dinner and dancing or even a movie to lower your overall stress can help put you in the mood.
Once you are in the mood, you might need to use some lubrications - coconut oil is cheap and easy!
Although, there are some negatives that we associated with low estrogen, it is also a necessary evil at least in the early postpartum days. As estrogen has a negative effect on our milk supply, by affecting our ability to release prolactin. With that said, it is generally recommended to refrain from using medications that contain estrogen - like a typical birth control pill while you are still breastfeeding.
Now over time, usually between 4-6 months, our bodies will begin to experience menstruation again after having a baby. Typically, our menstrual cycle returns when we start to replace other foods with a nursing or pumping session. At this point, our bodies are naturally producing estrogen and we can no longer avoid it - so how can we protect our supply most once we have begun menstruating?
Keep Feeding Baby!: The most common way that women severally deplete their milk supply when their period returns is they stop offering the breast. We believe our supply to have decreased (which it commonly has) and then we stop offering the breast or stop pumping. Throughout your entire cycle, you must continue to feed baby on demand and pump on your normal schedule. Otherwise, your body will take this as a sign to stop making milk.
Also, be prepared to simply nurse more often. Baby may not be as satiated as he/she normally is after a feeding and may want to eat more. You might even find yourself “switch nursing”, where you offer the same breast more than once…nurse on the left, nurse on the right, and back to nursing on the left, etc.Supplements: If you find that your supply is particularly affected by your menstrual cycle, begin taking Calcium & Magnesium supplements. Recommended dosing is 500mg Cal/250mg Mag beginning at day 14 of your cycle throughout your period or you can simply take all the time. (2) This should help minimize the overall drop in milk supply during your menstruation cycle.
Understand that this period is only temporary. Most women return to their normal milk supply as their period ends and they revert back to the start of the menstruation cycle again.
If you are having a particularly difficult time maintaining supply, let’s have a discussion! Schedule a consult with me today!
With Love,
Antoinette C., CLC
1.Low estrogen. (2024, May 1). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22354-low-estrogen
2. Gluck, M. (2018, January 18). Understanding your menstrual cycle - Marion Gluck. Marion Gluck. https://www.mariongluckclinic.com/blog/understanding-menstrual-cycle.html