In plain words
Lactational amenorrhea is the pause in periods that many breastfeeding mothers have after birth. Frequent breastfeeding keeps the body's hormone signals low, so the ovaries do not release an egg. This is why periods often do not return for months. The pause is not guaranteed. Some mothers ovulate before their first period returns, so the first sign can be a pregnancy. The pause is used as a family planning method only when strict conditions are met. These include breastfeeding fully or nearly fully, no return of periods, and a baby under six months old. Once any of these change, the method is no longer reliable. Your provider can talk through these conditions with you. Other birth control methods are also available.
The deeper version
Lactational amenorrhea results from suppression of hypothalamic gonadotropin-releasing hormone pulsatility by suckling-mediated neuroendocrine reflexes. Luteinizing hormone pulse frequency falls, follicles fail to mature, estradiol stays low, and the endometrium stays thin. Kennedy and Visness (1992) reported low pregnancy rates among women meeting strict criteria. The WHO (1999) summarized the lactational amenorrhea method for family planning, which requires an infant under six months, exclusive or near-exclusive breastfeeding, and no return of menses. Pregnancy risk rises as feeding frequency falls, as supplements are introduced, or as menses return. The controversy concerns effectiveness in everyday use, outside trial conditions and among women who do not meet every criterion.
Where it comes up
- When your period comes backPostpartum: Your Body
- Birth control after birthPostpartum: Your Body
- Night weaningFeeding Your Baby
- Night sweats, chills, and the hormone dropPostpartum: Your Body
- Why postpartum food is differentNourishment and Traditions
What mothers here say about lactational amenorrhea
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Sources
- World Health Organization — Lactational Amenorrhoea Method for Family Planning, 1999
- Kennedy KI, Visness CM — Contraceptive efficacy of lactational amenorrhoea. The Lancet, 1992