Nothing could have prepared me for the sensation of sleeping in a sweat bath every night for several months after giving birth to my son. I was so focused on labor and delivery that warnings regarding raging postpartum hormones seemed like road signs advertising a speed bump after having traversed the Rockies.
When I announced to my obstetrician that I was experiencing night sweats, she cracked a joke about how much I had in common with someone going through menopause. Case dismissed.
This attitude is not one promoted by Dr. Robert Greene, co-author of Dr. Robert Greene’s Perfect Hormonal Balance for Pregnancy: A Groundbreaking Plan for Having a Healthy Baby and Feeling Great.
Greene, Medical Director of the Sher Institute for Reproductive Medicine of Northern California and the founder and director of The Center for Reproductive Health and Hormone Balance, is spreading the gospel of listening to women’s hormonal symptoms and helping them respond through yoga, meditation, education, or medicine.
“The thing that I would note, again and again, is that symptoms really do matter,” he says. “The only time that it’s considered okay to live with symptoms is during pregnancy and during the transition after pregnancy. … Ironically, more often than not, there’s a greater risk by not treating (hormonal imbalances) than by treating them.”
Three days after a woman gives birth, her estrogen dips to a level equal to a 65-year-old woman’s level. At that time, infant girls’ estrogen levels are actually higher than their mothers’. This dip in estrogen can cause many postpartum difficulties, including postpartum depression. This is why Greene’s wife—who just gave birth to their daughter, Aevry—is on a low level of estrogen.
I was lucky to avoid postpartum depression, but my body nonetheless manifested its hormonal roller-coaster ride in some unseemly and uncomfortable ways. I was tired and stressed—and happy and exhilarated—and the nightly soakings were getting old. Greene says a drop in melatonin levels often causes night sweats. Melatonin helps people stay asleep, but it also causes a couple-degree drop in temperature. When levels are low, new mothers, like me, may experience restless sleeping and spiking temperatures. If night sweats are extreme and not alleviated by dressing in layers, Greene recommends taking Rozerem, a prescription marketed to people with insomnia.
Hot flashes are pesky cousins of night sweats. They often show up when a woman is breastfeeding, just after the baby latches on. Greene says there is a “biologically plausible explanation” for them, which requires imagining cavewomen in the winter, keeping their babies warm by pressing them against their skin.
“The answer is, think about it: before we had clothes and central air, what was the best way to warm up a baby?” asks Greene. “Once you understand the physiology, you can’t always change the physical results. But one thing to do is to actually know that it’s going to happen.”
Indeed, patient education about postpartum hormonal rides seems to be lacking in the ordinary obstetrician practice. I’m a pretty educated person, but the first time I breastfed in the hospital and was overcome with a hot flash—I’m talking red face, sweat beading from head to toe, heavy breathing—I thought I was having an anxiety attack. I finally asked a nurse for insight, and she said, “Oh, it’s normal.”
Hypothyroidism, or a drop in thyroid levels, is another common postpartum hormonal response. Greene warns that 20–40 percent of women become hypothyroidic after delivery, and of those, 50 percent are left with the condition long-term. Greene says avoiding hypothyroidism can be as simple as taking prenatal vitamins with Selenium and eating healthy portions of Omega 3 fatty acids.
Just after my night sweats finally ceased, I started getting full-body hives in the middle of the night. I went to an allergist, who tested me for hypothyroidism. My levels were normal, so my itchy, red bumps were chalked up to a postpartum mystery.
Greene answers questions similar to this one an hour each day on his medical practice’s discussion board.
During a phone conversation, he tells me hives are a perfectly normal postpartum manifestation of surging stress hormones. “Four or five hundred years ago, people had the same hormones, which made them hyper alert when they were postpartum because they were susceptible to bad things and had to protect their children,” he says. “Today, when we have these surges in stress hormones, we have atypical hormones and it can manifest itself in itching or hives or anxiety attacks.”
Greene says stress hormones can be regulated through yoga, meditation, and, in more extreme circumstances, medication. Had I known why I was getting hives, I think I would have been much better equipped to combat them more quickly. Instead, I either endured them each night or took Benadryl, which zonked me out and made my mornings even groggier than usual.
“I feel like, at the very least, we should explain it to you so that you’ll know you’re not going crazy,” says Greene.