Postpartum lactation amenorrhea

El-Minawi, Mahmoud F.; Foda, M. Sadek

doi:10.1016/0002-9378(71)90919-7

Cited by 33 publications

(7 citation statements)

References 7 publications

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“…Such a relationship between prolactin and the gonadotrophins (LH and FSH) appears to exist in man. It is well known that anovulation often accompanies normal lactation and return to menstruation occurs much more rapidly in women who do not lactate post partum (El Minairi and Foda, 1971). A similar relationship occurs in the well known clinical occurrence of the amenorrhoea-galactorrhoea syndromes.…”

Section: Lactational Amenorrhoea-prolactin Anovulationmentioning

confidence: 74%

Lactation and the physiology of prolactin secretion

McNeilly

1975

Postgraduate Medical Journal

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Summary Prolactin in man appears to form an essential part of the complex of hormones necessary for milk secretion and lactation. Levels of prolactin during pregnancy gradually increase towards term, and remain elevated for up to 6 weeks post partum. The lactogenic effects of prolactin appear to be blocked at the mammary gland by the elevated levels of fetoplacental steroids secreted during pregnancy. The immediate decline in steroid levels at delivery removes this block to prolactin and milk secretion ensues. The amenorrhoea associated with both puerperal lactation and galactorrhoea appears to reflect failure of cyclical discharge of gonadotrophins and anovulation. This appears to be due to peripheral inhibition of steroidogenesis by the elevated levels of prolactin associated with these situations. No consistent changes in circulating levels of prolactin occur during the menstrual cycle, but changes in prolactin levels within the follicular fluid of the developing ovarian follicle indicate a specific and permissive role of prolactin in steroidogenesis.

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Section: Lactational Amenorrhoea-prolactin Anovulationmentioning

confidence: 74%

Lactation and the physiology of prolactin secretion

McNeilly

1975

Postgraduate Medical Journal

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“…Most studies which have attempted to define the timing of ovulation after childbirth have used endometrial biopsy, basal body temperature, cervical mucus or vaginal cytology as markers of ovulation (Lass et al, 1938;Tomkins, 1943;Sharman, 1951;Udesky, 1950;Cronin, 1968;Kamal etal., 1969;El-Minawi & Foda, 1971;Perezetal., 1972). All of these methods, however, present problems of interpretation.…”

Section: Discussionmentioning

confidence: 99%

“…All of these methods, however, present problems of interpretation. During lactation, the histological patterns in the endometrium may show inadequate coordination of the maturation signs characteristic of the normal menstrual cycle, making it difficult to determine whether ovulation has occurred or not (El-Minawi & Foda, 1971;Perez et a[., 1972). SimilarIy, temperature charts during lactation may show a much shorter plateau in the pre-menstrual phase (Cronin, 1968), making precise interpretation difficult.…”

Section: Discussionmentioning

confidence: 99%

Fertility After Childbirth: Post‐partum Ovulation and Menstruation in Bottle and Breast Feeding Mothers

Howie

McNeilly

Houston

et al. 1982

Clinical Endocrinology

111

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SUMMARY The resumption of post‐partum menstruation and ovulation was studied in ten bottle feeding and twenty‐seven breast feeding mothers. First menstruation occurred at 8±1 weeks (± 1±0 SE) in bottle feeders and 32±5 weeks (±2±5 SE) in breast feeders (P < 0±001); first ovulation occurred at 10±8 weeks (±1±0 SE) in bottle feeders and 36±4 weeks (±2±5 SE) in breast feeders (P < 0±001). In bottle feeders, ovulation preceded first menses in only 2/10 (20%) of mothers but was regularly established thereafter, occurring in 17/18 (94%) of second and subsequent cycles. Breast feeding did not postpone ovulation indefinitely because 13/27 of the breast feeding mothers ovulated while still lactating; ovulation occurred in 9/27 (33%) of breast feeding mothers during the phase of lactational amenorrhoea but was followed by menstruation in every case. In breast feeding mothers, the frequency of ovular cycles progressively increased with time, ovulation being observed in 9/20 (45%) of first cycles during lactation, 20/30 (66%) of later cycles during lactation, 16/23 (70%) of first cycles after lactation and 26/31 (84%) of later cycles after lactation. There was a disruption of menstrual rhythms during lactation, the mean interval between the first day of consecutive menstrual cycles being 37±0 days ± 3±3 SE during lactation compared with 29±8 days ± 1±0 SE after lactation and 29±5 days ± 1±0 SE in the bottle feeding mothers. This study shows that bottle feeding is associated with an early resumption of post‐partum menstruation and ovulation. In breast feeding mothers, there is complete suppression of ovulation during the greater part of lactational amenorrhoea but ovulation will return in a proportion of mothers just before first menses. After the return of menstruation during lactation, the frequency of ovular cycles progressively increases but does not return to normal until complete weaning has taken place.

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“…Detection of ovulation. Most studies which have attempted to define the timing of ovulation after childbirth have used endometrial biopsy (Lass, Smelser & Kurzrok, 1938;Topkins, 1943;Udesky, 1950;El-Minawi & Foda, 1971), basal body temperature (Sharman, 1951;Cronin, 1968), cervical mucus or vaginal cytology (Perez, Vela, Masnick & Potter, 1972) as markers of ovulation but these methods present problems of interpretation. During lactation, the histology of the endometrium may show inadequate co-ordination of maturation signs characteristic of the normal menstrual cycle, making it difficult to determine whether ovulation has occurred (El-Minawi & Foda, 1972).…”

Section: Methods Of Assessing Lactational Infertilitymentioning

confidence: 99%

Effect of breast-feeding patterns on human birth intervals

Howie¹,

McNeilly²

1982

Reproduction

175

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An adequate inter-birth interval is of great importance because it enables a mother to recover her physical and emotional strength between pregnancies and confers upon the child advantages of better health and development (Morley, 1977). Breast feeding is the naturally evolved method of ensuring an adequate inter-birth interval but the contraceptive effect of breast feeding has been largely dismissed in developed countries on the grounds that it is an unreliable method of family planning for individual mothers (Kamal et al., 1969). The use of artificial contraception varies very widely in different countries, being much higher in developed nations than in the poorer developing countries (Text- fig. 1). Where the use of artificial contraceptives is low, breast feeding is the most widely used method of birth spacing and assumes major demographic importance. It is important, therefore, that the factors controlling lactational infertility should be understood so that guidelines can be developed which will allow mothers to maximize the birth-spacing effect of breast feeding to their own advantage. In developed countries, few mothers choose to rely on breast feeding for family planning although an increasing minority may find breast feeding to be an attractive method of spacing their families, thereby avoiding the potentially adverse side-effects of currently available contraceptive methods. A better understanding of how breast feeding mediates its birth-spacing effect may lead to the development of new contraceptive methods which will try to imitate this naturally evolved method of fertility control (McNeilly, 1979). Developed countries Middle Income countries Poor countries USA UK JAPAN POLAND MEXICO PERU DOMINICAN REPUBLIC JORDAN INDIA PAKISTAN GHANA ZAMBIA =1 =1 ) 20 40 60 % Contraceptive users 80 100 Text-fig. 1. Contraceptive usage by married women aged 15-44 years in different countries by economic status.

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Postpartum lactation amenorrhea

Cited by 33 publications

References 7 publications

Lactation and the physiology of prolactin secretion

Lactation and the physiology of prolactin secretion

Fertility After Childbirth: Post‐partum Ovulation and Menstruation in Bottle and Breast Feeding Mothers

Effect of breast-feeding patterns on human birth intervals

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