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Q&A: Why Haven't I Started Menstruating?

by Bradley G. Goldberg, M.D. |
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Q I had my son 10.5 months ago, just finished weaning from the breast 2 weeks ago, and I still have not resumed menstruating yet. I do not believe I am pregnant, so I am wondering if it is "normal" to have this happen despite the fact that all the books say that most women get their periods back within 3-9 months postpartum? If not, do you have any suggestions about reasons why I may not yet be menstruating? (I am very healthy otherwise.) Thanks for your time!

A You are correct in that most women will resume normal menstruation within a few months after having their baby. However, this does not necessarily apply to women who breastfeed, especially those who breastfeed exclusively. If you are concerned about pregnancy, I suggest you use a home-urine pregnancy test. These tests, which are available at drug stores and supermarkets, are very sensitive and are similar to what is used in doctor's offices.

As far as your concern regarding your lack of periods. If you have not resumed normal menstrual cycles within 3 full months after finishing breastfeeding, you should consult your physician.

Although some women who breastfeed may have regular menses, many will not. Breastfeeding can cause a woman to have irregular periods, or none at all. Most women who breastfeed exclusively, and who breastfeed "on-demand" from the baby will experience lactational amenorrhea. This means she will not have periods due to the fact that she is breastfeeding.

Many women assume that this means they cannot become pregnant during this time, but this is not always the case. It is recommended that breastfeeding should only be relied upon as a method of contraception for the first 6 months, and then only if the woman is breastfeeding exclusively and is not having periods.

My own personal opinion is that even these women should still use birth control because studies have demonstrated that many of these women will still ovulate during this time period, which means pregnancy is possible. Several safe contraceptive options are available for breastfeeding women and your doctor can inform you of these.

Bradley G. Goldberg, M.D.
Coffee Women's Center, P.C.
http://www.coffeewomenscenter.com

Click here to Ask Dr. Goldberg your pregnancy questions.

Dr. Bradley G Goldberg is a specialist in Obstetrics and Gynecology, Dr. Goldberg is certified by the American Board of Obstetrics and Gynecology. Dr. Goldberg is Chief of Staff of Coffee Regional Medical Center. Currently, he is serving as Director of the Department of Obstetrics and Gynecology, and he is the Chairman of the Perinatal Committee. Dr. Goldberg graduated from the University of Florida in 1989 as a member of The Phi Beta Kappa honor society. He received his medical degree from the University of Florida College of Medicine, and completed his internship and residency in Obstetrics and Gynecology at Georgia Baptist Medical Center in Atlanta.

Dr. Goldberg is a contributing author to OBGYN.net, the largest women's health site on the Internet. In addition, Dr. Goldberg is the author of an article on "Urethral Carcinoma," which is in press with the Journal of Urology, and he co-produced an instructional video on Norplant removal that he presented at the annual meeting of the American College of Obstetricians and Gynecologists.

Dr. Goldberg is a member of the American Medical Association, The American College of Obstetricians & Gynecologists, The Medical Association of Georgia, and The Atlanta Medical Association. Dr. Goldberg's wife Kimberly is a pediatric nurse. Together, they enjoy traveling and spending time with their family.

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