Help please....extended nursing, no period yet...

[ladyleah]

Hi Mammas,
My DS is now 19 months and nurses about 3 times a day, morning, night, and before naps. He has been sttn for about 10 hours since 13 months.
My issue is that my period has not returned. Although many say I should feel lucky, lol, I am 36 and would like to get" normal" so that we can start ttc in the fall.
I know you can ovulate without your actual period returning, but hormonally I feel like a complete distaster (pretty much feel like I have pmdd all the time! ), so I am hopeful that a return to having cycles could help me.(not that I have ever had" normal" cycles in the first place)
Thanks for any feedback anyone can provide!

[sraplayas]

ladyleah,  I can relate to your situation.  DS was around 25mo when AF returned after about five months of "feeling" like AF was going to come (basically PMS all of the time). 

I worked with a NDO and we found something that helped my body to get back into its rhythm, eventually AF returned.  If you'd like to pm me, I'd be happy to share more details with you.

Hang in there, I know how very difficult it can be (I'm 37 and would really like two more LO's...)

Hugs!

[flightgoddess]

I didn't get my period until we were just down to 1-2 feedings/self weaning. (which was about 18-19 mo old.)

Have you been charting your basal body temp? Ovulation predictor? What about lunaception? If you start charting those and don't see any ovulatory patterns/indications over the next 2-4 months, then you may need to consider weaning.

[ladyleah]

Thank you both for the feedback... Nope, I haven't been charting, or using any kits yet. Going to pick some kits up tomorrow.

When TTC my son, I had no luck in charting temps. I did it faithfully for 6 months, and never got a clear pattern indicating ovulation. I actually ovulated on DAY 42 (yep- you read that right--confirmed by a test kit, not temps!) when I got pregnant with my son, so my cycles were all over the place when I last got pregnant- although the usual length was about 35 days.

Sooooo, guess its time to pick up the kits and see what is going on! :) Sra-- I will pm you now! :)

[boomer78]

I'm on my first ppaf.  It's been 19 months!  I had some fertile signs about a month and something ago, followed by no period and again, but stronger just about 2 weeks ago.  Sure enough, ppaf followed.  I started taking Vitex just recently and don't know whether it had contributed or not.  If you 'feel' something I'm sure period will follow.  I too felt like it was about to happen for a while. Good luck! 

FTA that dd nurses about 6 times/day on average.  About 4x during the day and 2x at night.

Edited by boomer78 - 7/11/11 at 9:17pm

[ladyleah]

Looks like we both have Dec 2009 babies!!! Hoorah!

Yes- I have had several rounds of fertile signs, and ovl. pain, bloating, crying spells, lol....you name it-- but I have yet to actually get the fist ppaf.

I was thinking about Vitex. Any feedback on doasge and dos and don'ts? I have herad mixed reviews.

Thanks again Mammas!

[spiritofthings]

I am in the same boat, having had a Dec 09 baby! My son nurses all the time! I think I have had a few premenstrual signs for a few months, but still no period. Weird. My period pretty much returned around 9 months PP with my first 2 babes. So this is way too long! My cycles are long and can be all over the place so I'm wanting to kickstart this whole thing sooner rather than later so I can get somewhat regular. But I don't wanna stop nursing. I'm think of taking Vitex too. Another mama said maca root worked for her (see stellamia's post here mothering.com/community/forum/thread/1277338/bfing-ttc-and-no-ppaf-yet-15-months) . Keep us posted ladyleah. Hey congrats boomer78 on that period! How much vitex are you taking?

[JMJ]

First, a bit of biology.  If you ovulate, it will be followed by a period (if you are not pregnant).  You can ovulate once before your first PPAF.  If you have not had your first PPAF, and you aren't pregnant, you can tell with pretty good certainty that you hadn't ovulated yet a couple weeks ago.  What you are experiencing right now is that your body is trying to ovulate.  Unfortunately for you, the OPK's may or may not actually be helpful in this stage.  The thing is that your body gets all ready to ovulate, and then it doesn't actually happen, many times over, but eventually it will.  All your signs could point that you are going to ovulate.  You may get fertile CM, positive OPK's, even high fertility readings if you used a fertility monitor.... and then it doesn't actually happen.

How is your weight compared to your pre-pregnancy weight?  A lot of times, breastfeeding amenorrhea is connected to being underweight (not so much that you are unhealthy, but enough to suppress ovulation).  The hormones that you need to ovulate are fat soluble, so if you do not have enough body fat, you will not ovulate.  Additionally, prolactin works against those hormones, so you may actually need more body fat to ovulate while breastfeeding than you would when you are not breastfeeding.  If your weight is significantly higher than it was when you got pregnant before, that might be something to look at too, but it is likely that you would have to be pretty overweight for it to cause a problem.

[ladyleah]

Thanks again for the feedback, and the other thread info. I am about 3 lbs heavier then I was when I got pregnant, but still at a "normal" or healthy weight according to the BMI charts out there.

Yes, it feels like my body is trying to ovulate over and over again each month....but it never quite makes it!!!!! :(

[Niniel]

Originally Posted by JMJ 

First, a bit of biology.  If you ovulate, it will be followed by a period (if you are not pregnant).  You can ovulate once before your first PPAF.  If you have not had your first PPAF, and you aren't pregnant, you can tell with pretty good certainty that you hadn't ovulated yet a couple weeks ago.  What you are experiencing right now is that your body is trying to ovulate.  Unfortunately for you, the OPK's may or may not actually be helpful in this stage.  The thing is that your body gets all ready to ovulate, and then it doesn't actually happen, many times over, but eventually it will.  All your signs could point that you are going to ovulate.  You may get fertile CM, positive OPK's, even high fertility readings if you used a fertility monitor.... and then it doesn't actually happen.

How is your weight compared to your pre-pregnancy weight?  A lot of times, breastfeeding amenorrhea is connected to being underweight (not so much that you are unhealthy, but enough to suppress ovulation).  The hormones that you need to ovulate are fat soluble, so if you do not have enough body fat, you will not ovulate.  Additionally, prolactin works against those hormones, so you may actually need more body fat to ovulate while breastfeeding than you would when you are not breastfeeding.  If your weight is significantly higher than it was when you got pregnant before, that might be something to look at too, but it is likely that you would have to be pretty overweight for it to cause a problem.

I find this really interesting. I have lost a lot of weight since having my dd, around 94lbs. I have a healthy BMI of 22 but I have wondered at times if the weightloss has slowed the return of AF. I haven't been on a crash diet or anything, I've been following weight watchers with an extra allowance for nursing, but I do wonder if it's messed with my hormones. 

I have felt like I was going to get AF back for months but nothing has happened. I started taking vitex (200mg per day) about a week ago but since then my hair and skin has become really oily and I've had a terrible outbreak of pimples, but I think maybe that's a side-effect?

[JMJ]

I was a couple lbs over my healthy pre-pregnancy weight when I got my period back at 21 months, and it was still 5 more months after that before I had a fertile cycle.  Body fat percentage matters more than weight, and if you're breastfeeding, you likely need more than if you aren't.  Ecological breastfeeding alone normally spaces American children about 1.5-2.5 years, but for women who are of a lower than average, healthy weight, 3 year spacing or more from ecological breastfeeding alone is not uncommon.  I am pregnant with my second, and I got pregnant on my second fertile postpartum cycle (did not try on the first because we didn't know it would be fertile).  My children's due dates are 6 days less than 3 years apart.

Niniel, how old is your child?  Congratulations on your weight loss!  I would definitely say that losing 94lbs would likely lengthen breastfeeding amenorrhea.  I would be hesitant to call it "messing with" your hormones though.  If anything, I think that carrying around that many extra lbs would mess with your hormones.  In traditionally healthy cultures, it is very common to have an extended amenorrhea.  The ability to have a child every year or two is a product of our Western culture and diet.  Extended amenorrhea is not at all an indication that there is something wrong with your body.  The only problem with it is when you want to conceive again.  Putting on a little bit of body fat (in healthy ways), taking vitex (controversial when breastfeeding), taking Vitamin B6 (reduces prolactin in favor of progesterone), and various treatments are ways that you can push your body on its way out of amenorrhea in order to conceive again.  It is common to experience acne when you are returning to fertility just as it is common to experience around the time of your menarche.  It is a sign of your hormones changing.  I don't know if what you describe is a side effect of the vitex or of the hormone changes it is allowing.

[gozal]

From all my reading while waiting for my own ppaf, it's very likely that yours is right around the corner. That said - It's a really personal decision, but I had to wean (did it gradually and bf until 37 months) to begin to sort out my fertility. It turned out I had a problem masked by bf (very rare, not likely that you have it). Maybe I just run in very pro-bf circles, and believe me, I am happy to be there, but I do wish someone had told me that it is unusual not to have ppaf at 24 months (you're not there yet, I know; and yes, I know it can be normal for some). Information I would have liked to have; I feel like I lost a lot of time. I don't know if it will help, but I found the book (ignore the title, it's not really about weaning) Nursing Mother's Guide to Weaning very helpful - despite the title, it's primarily about breastfeeding a toddler. There is so much information out there for moms of infants but so little "what to expect" when nursing older babies and toddlers. She doesn't have a whole lot about fertility issues in the book, but a lot about toddler nursing patterns, developmental stages in relation to bf, etc.

I think it's a good sign that you're feeling like af is coming. I don't have a lot of experience with vitex, but I did try a vitex tea while waiting for ppaf and it gave me some false fertility signs, basically. My prolactin was too high for me to cycle, but I had fertile cm. Just something to be aware of.  Hoping for you that ppaf is around the corner - it's quite likely, I think!

[Niniel]

I do hope so. My dd is 20 months now but we really want to start ttc around September time, actually I've been anxious to ttc since this time last year but not so anxious that I'd entertain the notion of weaning. We have more or less dropped the night feeds in the last two months so I've been hoping that'll be enough to get things going again. 

[JMJ]

Originally Posted by gozal 

From all my reading while waiting for my own ppaf, it's very likely that yours is right around the corner. That said - It's a really personal decision, but I had to wean (did it gradually and bf until 37 months) to begin to sort out my fertility. It turned out I had a problem masked by bf (very rare, not likely that you have it). Maybe I just run in very pro-bf circles, and believe me, I am happy to be there, but I do wish someone had told me that it is unusual not to have ppaf at 24 months (you're not there yet, I know; and yes, I know it can be normal for some). Information I would have liked to have; I feel like I lost a lot of time. I don't know if it will help, but I found the book (ignore the title, it's not really about weaning) Nursing Mother's Guide to Weaning very helpful - despite the title, it's primarily about breastfeeding a toddler. There is so much information out there for moms of infants but so little "what to expect" when nursing older babies and toddlers. She doesn't have a whole lot about fertility issues in the book, but a lot about toddler nursing patterns, developmental stages in relation to bf, etc.

I think it's a good sign that you're feeling like af is coming. I don't have a lot of experience with vitex, but I did try a vitex tea while waiting for ppaf and it gave me some false fertility signs, basically. My prolactin was too high for me to cycle, but I had fertile cm. Just something to be aware of.  Hoping for you that ppaf is around the corner - it's quite likely, I think!

I know it's very personal, but if you don't mind, I'd like to hear more about what was going on with your health that was masked by nursing.  Do you feel that continuing to nurse was making it worse?  I also run in very pro-breastfeeding circles and have known several women who have had amenorrhea that lasted over two years postpartum, and 3 year spacing of children or more was common in pre-industrial cultures.  It is unusual in the United States to have amenorrhea that lasts more than 2 years postpartum, and in most cases that it does, it is connected to low body fat percentage, that is, the woman has a body fat percentage that would be marginally fertile if she were not breastfeeding, and because she is breastfeeding, it is low enough to keep her in amenorrhea.  However, just because it is unusual does not mean that there is something wrong.  In most cases of amenorrhea that goes beyond 24 months, everything is still fine.  The woman's cycle eventually returns and functions properly.  However, if a healthy woman experiencing extended amenorrhea went to her physician complaining about it, (s)he would likely give the woman synthetic hormones to jump start her system, something that a woman without any health problems does not need, and it wouldn't likely help a woman with underlying health problems either.

I guess what I'm getting at here is that I talk to a lot of people who are trying to understand the return of their fertility postpartum, and I'd like to know enough about what you're talking about to know it's out there so that I can give mothers better advice.  I'm all for getting help when needed, but I don't want to cause unnecessary worry, either.  Feel free to PM me if you don't want to share with the whole board, or let me know if I am intruding too far into your personal life, in which case, I apologize.

[boomer78]

Originally Posted by ladyleah 

Looks like we both have Dec 2009 babies!!! Hoorah!

Yes- I have had several rounds of fertile signs, and ovl. pain, bloating, crying spells, lol....you name it-- but I have yet to actually get the fist ppaf.

I was thinking about Vitex. Any feedback on doasge and dos and don'ts? I have herad mixed reviews.

Thanks again Mammas!

Ladyleah: I'm sure ppaf is on its way!   I was going crazy during the past few weeks (prior to ppaf).  BTW, a dolphin show actually almost made me cry. 

Quote:

Originally Posted by spiritofthings 

I am in the same boat, having had a Dec 09 baby! My son nurses all the time! I think I have had a few premenstrual signs for a few months, but still no period. Weird. My period pretty much returned around 9 months PP with my first 2 babes. So this is way too long! My cycles are long and can be all over the place so I'm wanting to kickstart this whole thing sooner rather than later so I can get somewhat regular. But I don't wanna stop nursing. I'm think of taking Vitex too. Another mama said maca root worked for her (see stellamia's post here mothering.com/community/forum/thread/1277338/bfing-ttc-and-no-ppaf-yet-15-months) . Keep us posted ladyleah. Hey congrats boomer78 on that period! How much vitex are you taking?

Thanks, spiritofthings, I thought it would never come again since it had been so long.   I too wouldn't just stop nursing but did work on limiting how many times dd would nurse (if it was up to her she would nurse all day long).  We cut out maybe 2-3 sessions a day.

As for VITEX, from what I understand, it's excellent for bringing on ppaf.  It can be useful if cycles are funny and unpredictable, but if one is regular it will most likely just mess the cycles up.  I can't tell whether it worked for me since I did have signs a few weeks before I started, but it may have sped it up a little.  I had strong ovulation signs (whether I ovulated or not) on day 12 of taking it. I took 2 capsules a day (tincture is supposed to be better).  Stopped when ppaf came and then forgot to take it again.  I'm going to try and go without it and see what happens.  LP was only about 8 days.  

I think Vitex increased my milk supply. 

Some have better luck taking Maca instead or together with Vitex.  I was a little afraid to start taking both right away. 
 

Quote:

Originally Posted by JMJ 

First, a bit of biology.  If you ovulate, it will be followed by a period (if you are not pregnant).  You can ovulate once before your first PPAF.  If you have not had your first PPAF, and you aren't pregnant, you can tell with pretty good certainty that you hadn't ovulated yet a couple weeks ago.  What you are experiencing right now is that your body is trying to ovulate.  Unfortunately for you, the OPK's may or may not actually be helpful in this stage.  The thing is that your body gets all ready to ovulate, and then it doesn't actually happen, many times over, but eventually it will.  All your signs could point that you are going to ovulate.  You may get fertile CM, positive OPK's, even high fertility readings if you used a fertility monitor.... and then it doesn't actually happen.

How is your weight compared to your pre-pregnancy weight?  A lot of times, breastfeeding amenorrhea is connected to being underweight (not so much that you are unhealthy, but enough to suppress ovulation).  The hormones that you need to ovulate are fat soluble, so if you do not have enough body fat, you will not ovulate.  Additionally, prolactin works against those hormones, so you may actually need more body fat to ovulate while breastfeeding than you would when you are not breastfeeding.  If your weight is significantly higher than it was when you got pregnant before, that might be something to look at too, but it is likely that you would have to be pretty overweight for it to cause a problem.

I definitely fall into that category.  I weigh about 12-15 lbs less than pre-pregnant and even then I was pretty small.

Quote:

Originally Posted by Niniel 

I find this really interesting. I have lost a lot of weight since having my dd, around 94lbs. I have a healthy BMI of 22 but I have wondered at times if the weightloss has slowed the return of AF. I haven't been on a crash diet or anything, I've been following weight watchers with an extra allowance for nursing, but I do wonder if it's messed with my hormones. 

I have felt like I was going to get AF back for months but nothing has happened. I started taking vitex (200mg per day) about a week ago but since then my hair and skin has become really oily and I've had a terrible outbreak of pimples, but I think maybe that's a side-effect?

Niniel - I had a very similar thing happen...and then ppaf came (now gone and pimples are still here ). 

[stellamia]

You don't need to wean to get pregnant!! :):) My DD is proof! I had zero signs of fertility when my son was 15 months so I started taking vitex and maca (and I partially night weaned him....6 hr stretch with no "milkies"). Once my period started, I added natural progesterone cream for my luteal phase and I was pregnant my first fully fertile cycle. I've posted longer threads about this and you can feel free to PM me for more info. I'm the biggest supporter of tandem nursing and encouraging women to keep nursing while TTC. It can happen!! 

[ladyleah]

Thank you ALL for the feedback, and for this very informative discussion.

Boomer- I totally hear you on the crying thing-- as I was crying from pretty much anything that crossed my path last week (and also got 2 pimples, which I haven't had in AGES)....all signs of hormonal flux. But still, no af....and I am starting to feel more normal again. However, it seems like it might be getting closer this time. :)

Gozal- sounds like a great book, I will pick that up! I have her other book: The Nursing Mothers Companion-- so I am familiar with the author.

JMJ- You mention issues with Vitex and nursing. Can you expand on that?

Again- thank you all. This is so helpful. We had planned on TTC when my son turns 2 in December.....but I just wanted to start the conversation since it took me a while TTC #1- and I am now 36. :)

[gozal]

LadyLeah, I'm so glad I could be helpful!

JMJ, thanks for your sensitivity, I don't mind at all, I just did not want to be an alarmist when the problem I have is really quite rare. I really appreciate you wanting to give the women you work with complete information. I've considered contacting kellymom.com, a site I used often for reference, to add some info about this in their fertility/lam section. (They do have it, but not in connection to extended LAM.) Anyway, I have a benign pituitary tumor called a prolactinoma. It is very treatable and non-life-threatening. However, it can cause sub- or infertility. According to my doctor (a reproductive endocrinologist), prolactinomas are not caused by nursing, they are not genetic, and are not caused by any known environmental factors. It's a matter of random incidence. I am frustrated that it took so long to diagnose. It seems this is a common situation with prolactinomas - easy to treat but people lose years to the diagnosis. My weight/BMI is normal for my height. I think for a woman of normal weight who strongly desires a pregnancy and is in LAM after 24 months, it makes sense to mention this as a rare possibility. I hope that is helpful.

[JMJ]

ladyleah, I don't know much about the arguments, just that some people have successfully used Vitex to bring them out of amenorrhea, and some people say that Vitex is contraindicted during breastfeeding.  You would need to look into the arguments and make your own decision.

gozal, thanks for sharing your experience.  In women with a prolactinoma, what does happen as far as LAM is concerned?  Do they get their period back at all before weaning?  Does it come back naturally?  I assume from the name of the tumor that it is related to the milk-making hormone prolactin?  Can you tell me more about that?

[Jaimee]

I agree with all the information that has been presented so far about LA and body weight.   I wanted to add my experience since I am underweight normally and more so when breastfeeding.  I'm 5'4" and usually weigh about 100 pounds.  That's just where I naturally hover despite attempts to gain weight.  At any rate after the birth of my first it only took 8 months for AF to show again, but my cycles were not fertile until about 2 years pp when my dd nightweaned, started STTN, and cut down her nursing sessions during  the day as well.  Then boom!  Suddenly fertile, though  only 99 pounds.  Almost exactly three year spacing. With my second, AF didn't return until about one year pp, but I was fertile just one cycle later, weighing in at 98 pounds and nursing ds around the clock.  22 month spacing.

So I would say that everyone is so different.  Some women will be more affected by being over or under weight.  Some will be more affected by constant nursing or even infrequent nursing.  I also run in pro-bf circles where it's common to bf until 2-4 years of age.  Most of there women already had AF back and were conceiving  subsequent children.  But there were always a few that had to make the decision about cutting down on nursing in order to jump start their fertility.  And I would say that after each pregnancy things may be quite different than before as well.

You mentioned that you had difficulty charting previously.  I know that some women are greatly affected by changes in waking time, sleep patterns, room temp, etc.  But I would encourage you to try again focusing on a consistent wake time and not worrying about how much sleep you're getting. You could  also try temping vaginally to see if your temps are more consistent.   OPK's can be so unreliable, especially when you haven't had your first ppAF.  Like JMJ mentioned, you will likely gear up to O several times before actually succeeding.  So you'll end up using a lot of OPK's and may not be able to interpret the results.  It would be my advice to be on the look out  for fertile CF- creamy or eggwhite- and start temping then to see if you can catch a spike indicating O.  If you dry up and no bleeding, then stop temping and start up again when the next patch of fertile CF comes along.   This will allow you to get a feel for what is happening in your body and if you can get a pattern this time then you will know if your cycles are fertile or not as you embark on the TTC journey.  There are a lot of super knowledgeable charters on these boards who can help you decipher the most confusing chart.  Log your data on a free site  like www.fertilityfriend.com so you can share your charts with us.

Good luck!