Когда начинаются месячные после родов

Беременность и роды – это сильнейшая нагрузка на организм женщины, связанная с рядом изменений. Один из вопросов, которые возникают у молодой мамы, это вопрос о том, когда начинаются месячные после родов, когда восстановится менструальный цикл после родов.

После рождения малыша начинается восстановительный процесс, во время которого репродуктивная система женщины приходит в норму, а менструальный цикл после родов восстанавливается постепенно. Поэтому, если у вас нету месячных после родов, это не признак проблемы. Для начала стоит разобраться, когда начинаются месячные после родов. Сразу после родов месячные обычно не начинаются, хотя на практике бывают и месячные через месяц после родов. Первые месячные после родов чаще начинаются, когда женщина заканчивает кормление грудью. На то, когда после родов начинаются месячные, влияет большое количество окружающих факторов. Вопрос «нормы» сугубо индивидуален, поэтому менструация после родов начинается у каждой молодой мамы в «свое» время. 

Итак, вас беспокоит вопрос, когда начинаются месячные после родов. Беспокоит как раннее или позднее наступление месячных после родов. Специалисты считают, нормальным, если нету месячных после родов в течение всего периода кормления ребенка грудью. Однако, в последние десятилетия по ряду причин было введено множество новшеств, которые связывают с изменением этой нормы. Раннее введение прикорма, изменение экологического фона, гормональные перестройки, связанные с изменением режима питания, лечения и образа жизни, привели к тому, что эндокринная система женщины реагирует в каждом случае по-своему, а первые месячные после родов появляются бессистемно. В частности, этот сбой объясняют активным использованием женщинами гормональных препаратов для контрацепции, а также медикаментозными родами. 

Репродуктивная система женского организма, и менструальный цикл в частности, регулируется следующими гормонами, выделяемыми гипофизом: ФСГ (или фолликулостимулирующий гормон), ЛГ (лютеинизирующий гормон) и пролактином. ФСГ отвечает за созревание фолликулов в яичниках, ЛГ участвует в овуляции и образовании желтого тела, а пролактин, молочный гормон эндокринной системы, регулирует секрецию молока во время грудного вскармливания. При повышенной выработке пролактина нарушается работа яичников и возникает бесплодие.

В целом, за время беременности репродуктивная система женщины претерпевает серьезные изменения. Кроме гормональной системы и молочной желез, период восстановления которых увеличивается за счет лактации, за 6-8 недель женский организм приходит в норму. После родов в организме женщины вырабатывается пролактин, который стимулирует выработку молока у молодой мамы и одновременно подавляет выработку гормонов в яичнике. Другими словами – яйцеклетки не созревают, и овуляция не наступает, соответственно нету месячных после родов.

Восстановление менструации после родов – это гормональный процесс, его скорость связана с восстановлением гормонального фона молодой мамы после родов. Следует добавить, что раннее отлучение от груди и введение прикорма влияют на то когда начинаются месячные после родов.

Врачи объясняют связь между кормлением малыша и восстановлением месячных после родов следующим образом:

  • Когда малыш находится на полностью естественном вскармливании, то есть получает грудное молоко матери по требованию, то первая менструация после родов наступает к окончанию кормления (в среднем, это в конце первого года жизни малыша)
  • Если мама параллельно с кормлением грудью вводит прикорм, то первые месячные после родов могут наступить до окончания процесса лактации
  • Если с самого начала молодая мама сочетает грудное вскармливание и искусственное питание, то через 3-4 месяца менструации после родов должны восстановиться.
  • В некоторых случаях молодые мамы вообще не кормят ребенка грудью – в таком случае первые месячные после родов могут начаться уже 6-10 недель после родов

Как правило, менструационный цикл после родов сразу становится регулярным, но возможно, что первые 2-3 менструации будут приходить раньше срока, так же возможна задержка месячных после родов. Нерегулярные месячные после родов должные прийти в норму через 2-3 цикла.

Следует подчеркнуть, что на менструационный цикл после родов и скорость его восстановления влияет именно способ кормления малыша, а не то, как проходили роды – естественным путем или посредством кесарева сечения. Таким образом месячные после кесарева наступают и проходят так же как месячные после естественных родов. Также, многие женщины считают, что месячные после родов изменят свой характер – если до родов менструации были болезненными и длительными, то после родов неприятные ощущения во время месячных должны прекратиться. Физиологически это явление объясняется следующим образом. Обычно, болезненность месячных вызвана загибом матки, что мешает свободному оттоку крови во время месячных. После родов загиб матки распрямляется, равно как смещается расположение органов в брюшной полости, в результате этого, болезненные ощущения во время менструации после родов, как правило, исчезают. Обильные месячные после родов явление не считаются признаком болезни. 

Часто молодых мам вводят в заблуждение кровянистые выделения после родов (так называемые лохии). Лохии представляют собой сгустки крови и другие отторгающиеся тканевые элементы, которые похожи на начало менструации после родов, но возникают по другой причине. После родов идет процесс заживления внутренней поверхности матки, отделяются остатки плаценты, обрывки губчатого слоя оболочки матки, сгустков крови, тромбов. Поэтому в первые дни после родов лохи ярко-красные (женщина теряет еще до 300 мл крови) и похожи на обильные месячные. Сколько идут выделения после родов зависит от индивидуальных особенностей. Через неделю выделения после родов приобретают коричневый оттенок, их количество уменьшается, выделения становятся все более скудными и белесыми. К концу 6й недели слизистая матки должна полностью восстановиться, и к этому времени прекращаются и лохи. Иными словами – лохи не имеют отношения к менструации после родов и не зависят от лактации матери. 

И так, можно ли забеременеть после родов, если нет месячных? Месячные после родов и функции яичников имеют свои особенности. Менструальный цикл после родов может проходить без овуляции и заканчиваться месячными, равно как возможна овуляция, но цикл не закончится месячными. Такое нарушение менструального цикла может происходить в связи с гормональным дисбалансом, переутомлением или стрессом. Следует принять во внимание эти особенности, если женщина живет половой жизнью, ведь менструация после родов свидетельствует о том, что женщина опять может забеременеть. Поэтому, для предотвращения нежелательной беременности, необходимо использовать средства контрацепции. 

Если женщина перестала кормить ребенка грудью, а месячные после родов так и не начались, рекомендуется обратиться за консультацией к гинекологу и/или эндокринологу, так как сбой цикла после родов может быть предвестником воспалительных процессов в женском организме. А так же может быть свидетельством того, что молодая мама снова в «интересном» положении.

 

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