Onset of menstruation (menstruation)

Menstruation generally begins in non-lactating mothers after the end of the menstrual flow, i.e. about 6 – 8 weeks after birth. In nursing mothers, the first menstrual period begins approximately between the 8th week and the 18th month after birth.

Change of the psyche

In many women who have recently given birth (about 70%), a depressive mood or short-term depression, known as materniy blues, post partum blues or “howling days”, is usually observed starting on the 2nd or 3rd day after the birth in the puerperium. This detuning lasts for a few hours or a few days and then disappears again. The reason for this psychological change is on the one hand the fast and strong decrease of the pregnancy hormones as well as the change of the body in the puerperium and on the other hand the effort of the birth itself, a possible sleep deprivation caused by the pregnancy as well as worries about the “new situation” and the role of the mother.

Pain in the puerperium

In the puerperium, women can suffer from different types of pain. In most cases, pain in the puerperium is a direct consequence of the birth. The entire pelvic and genital area of the woman has been severely strained and can be painful as a result.

Pain during breastfeeding also often occurs during the postpartum period. Infections can also cause abdominal pain, headaches, chest pain, fever and other symptoms. Pain in the puerperium should therefore definitely be taken as an occasion for a visit to the doctor in order to rule out serious causes for the complaints. If the pain is still caused by the birth, it will gradually subside over time and disappear completely after a few days or weeks.

Fever in the puerperium

If fever occurs in the puerperium, an infection must always be considered. In particular, the uterus can become inflamed in the puerperium if the discharge (lochia), which occurs naturally after birth, accumulates in the uterus. Bacteria can eventually inflame the mucous membrane and cause fever and pain.

The inflammation can also spread to the ovaries or even the peritoneum. Inflammation of the breast (mastitis puerperalis) as a result of breastfeeding the child is also possible and can lead to fever and a reddened and painful breast. Of course, other infections that are not directly related to the birth can also occur.

For example, flu-like infections, inflammations in the gastrointestinal or urogenital area. In any case, fever in the puerperium should be taken seriously and clarified by a doctor so that an adequate therapy can be initiated in time. If fever and headaches occur in the puerperium, different causes for the complaints must be considered.

The most common is an infection in the genital area, as the uterus is particularly susceptible to infections from ascending germs due to the still somewhat open cervix and the wound surface inside. Such an infection can always be accompanied by fever and headache. A common flu-like infection must also be considered, as it is particularly often accompanied by fever and headaches.Inflammation of the breast from breastfeeding the baby in the puerperium is also common and often leads to headaches with fever and general fatigue.

In the case of particularly severe headaches with neck stiffness and/or sensitivity to light, meningitis should always be considered. If there is a clinical indication for this, a diagnostic puncture of the nerve fluid is performed and it is examined for pathogens. Fever and headaches in the puerperium are serious symptoms that should be further clarified and observed by a physician.

Fever during breastfeeding can occur in the context of mastitis puerperalis. During breastfeeding, the baby’s sucking may cause tiny cracks in the nipple (rhagades), through which germs can enter the breast and cause an infection there. This is usually manifested by redness, swelling and overheating of the affected breast.

Often affected women also complain of fever, headaches and swelling of the lymph nodes in the armpit area. If the breasts are inconspicuous, other infections must also be considered for the occurrence of the fever. Fever and aching limbs in the puerperium are always signs of infection.

Pain in the limbs occurs particularly frequently in the context of viral infections, for example in the case of flu-like infections or a real flu (influenza). But other infections that typically occur in the puerperium, such as mastitis or endometritis, can also be associated with a deterioration in general condition, fever and aching limbs. Affected women should definitely be thoroughly examined and adequately treated to avoid complications.