All over the world, a growing number of late-in-life mothers are facing overlapping symptoms as they deal with postpartum challenges while also entering the perimenopause period. With so little research available on either condition, women are turning to each other to parse their experiences.
Fighting two battles at once
Last year in the United States, the number of births among women ages 35 to 39 was up by 90% since 1990, according to the Centers for Disease Control and Prevention. In 2023, births among women ages 40 and older exceeded teen births for the first time in the country’s history. As these numbers increase, more women are confronting the “bewildering convergence of two mind- and body-altering hormonal events,” The Washington Post said: the postpartum period and the transitional years of perimenopause marked by “hormonal instability” that can “wreak havoc for up to a decade before menopause occurs.”
There are specific struggles as more women experience postpartum and perimenopause simultaneously, Jessica Shepherd, an OB-GYN and the chief medical officer at the telehealth platform Hers, said to Self. Postpartum symptoms “can take upward of a year to resolve” following pregnancy. Meanwhile, perimenopause can arrive as early as your late 30s. With women waiting to have kids later in life because of “changing cultural norms and a boom of fertility medicine,” it is “no wonder even first-time moms” are becoming “more likely to hit perimenopause while postpartum.”
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The symptoms can overlap because post-childbirth, estrogen and progesterone drop to their pre-pregnancy levels. In perimenopause, those same two hormones “tumble downward, often on a zigzagging path,” which can trigger “similar mental symptoms, like anxiety or a short fuse,” said Self. The picture “gets fuzzier in moms over 35,” who are both “more likely to be heading toward menopause” and may be at greater risk for postpartum depression.
Breastfeeding, which can cause prolactin and oxytocin levels to soar, also complicates the issue. When women are nursing, it can “create this pseudomenopausal state” due to low estrogen, which may cause “symptoms like vaginal dryness, low libido, hot flashes and night sweats,” OB-GYN Stacey Silverman Fine said to Self.
Women owed the ‘respect of more research’
In the medical community, there is a “dearth of knowledge” about the intersection of the postpartum and perimenopausal stages, Suzanne Fenske, an OB-GYN who specializes in perimenopause and menopause, said to the Post. This is only made worse by the fact that the United States “offers minimal postpartum care,” the outlet said. Women’s health concerns are often “systemically dismissed,” and “women have been socialized to downplay their experiences.” Thankfully, that is shifting, in part because physicians are more outspoken on social media and awareness is spreading to “mainstream pop culture.” Every time you turn around, there’s a “book that’s out about perimenopause or menopause” or a “popular TV show alluding to these changes,” said Fenske.
Within the “maelstrom of hormonal chaos,” many women point to one “meaningful bright spot,” the Post said. Postpartum and perimenopausal mothers are “finding one another” and “building a sense of connection around their shared experience.” Online forums and group chats can be a “lifeline for postpartum and perimenopausal moms” who might “otherwise feel alienated in spaces dominated by younger parents.”
With so much gray area in our knowledge of the overlap, it is of paramount importance to listen to and believe patients, OB-GYN Talat Uppal told the Australian Financial Review. Before we can help patients navigate these intersecting life stages, we have to listen to their concerns. With more women birthing after 40, “we need to really give them the respect of more research.”
