Doctor shares 6 causes of painful periods after pregnancy and how to reduce pain

Postpartum cramming may be intense. Know what the main reasons are and how breastfeeding plays an essential role in deciding your period pain.

The postpartum period is a very challenging time, both mentally and physically. The stage after childbirth brings a whole new set of changes, from emotional turmoil like postpartum depression to physiological changes like a much more painful period. While your period may make a grand comeback after the nine-month hiatus but the pain feels much more jarring because of the sharp intensity.

In an interview with HT Lifestyle, Dr Ila Jalote, consultant, obstetrics and gynaecology at Manipal Hospital, Gurugram, shared how after childbirth, periods can be more painful.

She explained, “After months without a period during pregnancy, many new moms are confused when menstruation returns, which may be more painful than ever. Cramping, heavy flow, and discomfort that interfere with daily life can be both surprising and worrying. While some change in menstrual patterns is normal postpartum, an increase in pain isn’t something to ignore.”

Further describing how whether it's heavier or more painful than usual actually depends on whether the mother is breastfeeding or not. This is an important indicator. Dr Ila added, "The return of menstruation is primarily dependent on whether you are breastfeeding or not, with some women having their period within weeks and others taking many months. The initial period may be heavier, more irregular, and accompanied by severe cramping. In many cases, painful periods are temporary and manageable, but sometimes they can signal an underlying issue, such as UTIs and endometriosis, that requires medical attention."

Common causes of painful periods after pregnancy

Postpartum sees hormonal shifts which may cause painful periods. Other than this, there are certain underlying health issues also at play. (Shutterstock)

Dr Jalote assured that the pain is common, but sometimes it may also be due to other health issues. That's why it's best to follow it closely and consult a doctor if needed. She said, “It is common to feel cramping in your lower abdomen after giving birth. After all, the uterus develops many times its original size during pregnancy. However, if the periods appear more painful, it may be due to other health reasons as well.”

Here are 5 causes of postpartum cramping as shared by Dr Jalote:

1. Afterpains:

• The most common cause of postpartum cramping is when your uterus contracts to return to its previous size.
• While it contracts, the body works to compress blood vessels in the uterus to prevent excessive bleeding, causing pain.

2. Breastfeeding and hormones:

• Breastfeeding slows ovulation by lowering estrogen and progesterone.
• When breastfeeding frequency decreases, hormone levels change again, possibly resulting in more severe periods or PMS symptoms.

3. Endometriosis:

• Endometritis is inflammation of the uterine lining caused by an infection.
• Other symptoms include fever, constipation, abnormal vaginal discharge, and pelvic pain.
• This is treatable by a combination of pain management and hormonal therapies, with surgery like laparoscopy considered for more severe cases.

4. Bacterial vaginosis:

• It is an infection caused by an excess of harmful bacteria in the uterus.
• Other symptoms include burning while peeing, foul-smelling discharge, and itching/pain in the vulva.

5. Urinary tract infection (UTI):

• It impacts the ureters, bladder, urethra, and kidneys.
• Other symptoms include fever, painful or frequent urination, urgency to urinate, cloudy/bloody urine, and pelvic pain.

6. C-Section Scarring

• If you had a cesarean delivery, uterine scarring (isthmocele) can sometimes cause painful or heavy periods once cycles resume.

How to reduce the pain?

With the right combination of diet and exercise, one can get relief from this pain, as suggested by Dr Jalote. She elaborated, “Managing painful periods after pregnancy requires a combination of symptom relief and good habits. Light exercise, such as walking, can help with cramps and constipation. Relaxation techniques and deep breathing can help manage discomfort, and a warm pad or bottle can provide comfort. Staying hydrated, particularly during breastfeeding, and eating a fibre-rich diet rich in fruits and vegetables all help with recovery. Keep your bladder empty and see a doctor if you have constipation or signs of infection.”

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.