Hormones After a Pregnancy Loss

Expert Insights from Dr Emily Price, Obstetrician, Gynaecologist, background research for this episode was prepared by Ureni Halahakone

Hormones After a Pregnancy Loss

Why you might still feel out of sync

Hormonal changes affect almost every part of the body. After a pregnancy loss, those changes do not reverse instantly. Your body needs time to adjust, and for many women, that adjustment does not follow a straight line.

If you have ever noticed shifts in your mood, energy or skin during your cycle, this can feel similar. Just stronger and less predictable. Hormone levels had already started shifting in the early weeks, and the body now needs time to settle. When those levels begin to drop, they can affect how you feel both physically and emotionally.

What’s happening in your body

Hormones like oestrogen, progesterone, hCG  (the pregnancy hormone) and relaxin rise early on. After a loss, those levels start to fall, but not all at once. The timing and pattern of that drop varies. While your body is recalibrating, it can affect how you feel day to day.

These changes may affect:

  • Energy and sleep
  • Mood and mental clarity
  • Skin and temperature regulation
  • Joints, muscles and soft tissue
  • How soon your period returns
  • Gut changes

What you might notice

Not all of these changes will happen to everyone. You might notice a few, or none at all. We include them here so you know they are not unusual, and so you are not left wondering if something is wrong when it is just your body adjusting.

These changes are usually temporary, but they can still be unsettling while they are happening. It is common to feel more tired than expected, even after resting. You might notice disrupted sleep, emotional ups and downs, or difficulty concentrating. Some women report hot flushes or night sweats. Aches in your joints or muscles can also show up, even without doing anything physically demanding. Tender breast and nausea. Your skin might feel drier or more oily than usual as hormones shift. These same changes can also influence things like your hair, nails and oral health, which often catch women by surprise.

These symptoms are part of your body adjusting to changing hormone levels. For some women, they ease quickly. For others, they come and go over a few weeks. If something is not settling or feels unfamiliar, speak with a health professional you trust.

What we don’t know

There’s no research telling us exactly how long fluid symptoms last after a pregnancy loss. Most of what we know comes from studies on full-term pregnancy. But we do know that it takes time for your kidneys, hormones and circulation to adjust.

These physical changes don’t always settle straight away after a pregnancy loss. Your body needs time to adjust, and that timeframe looks different for everyone.

  1. Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K, et al. International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril. 2009;92(5):1520-4.
  2. Marshall SA, Senadheera SN, Parry LJ, Girling JE. The Role of Relaxin in Normal and Abnormal Uterine Function During the Menstrual Cycle and Early Pregnancy. Reprod Sci. 2017;24(3):342-54.
  3. Young J. Relaxation of the Pelvic Joints in Pregnancy: Pelvic Arthropathy of Pregnancy. BJOG: An International Journal of Obstetrics & Gynaecology. 1940;47(5):493-524.
  4. Borg-Stein J, Dugan SA. Musculoskeletal Disorders of Pregnancy, Delivery and Postpartum. Physical Medicine and Rehabilitation Clinics of North America. 2007;18(3):459-76.
  5. Bellver J. BMI and miscarriage after IVF. Curr Opin Obstet Gynecol. 2022;34(3):114-21.
  6. Sirimi N, Goulis DG. Obesity in pregnancy. Hormones (Athens). 2010;9(4):299-306.
  7. Lashen H, Fear K, Sturdee DW. Obesity is associated with increased risk of first trimester and recurrent miscarriage: matched case–control study. Human Reproduction. 2004;19(7):1644-6.
  8. Sainani S. Weight Gain After Miscarriage: First Cry Parenting; 2023 [Available from: https://parenting.firstcry.com/articles/weight-gain-after-miscarriage-reasons-and-tips-for-weight-loss/.
  9. Sharkey L. Weight Loss and Other Body Changes After Abortion: Healthline; 2022 [Available from: https://www.healthline.com/health/i-lost-weight-after-abortion#weight.
  10. Haghighi AS. Period after miscarriage: What to expect: Medical News Today; 2020 [Available from: https://www.medicalnewstoday.com/articles/period-after-miscarriage#how-long-will-it-last.
  11. The Society of Obstetricians and Gynecologists of Canada. How will a miscarriage affect my menstruation? [Available from: https://www.yourperiod.ca/other-concerns/#miscarriage.
  12. Harris N. What to Expect From Your Period After Miscarriage or D&C: Parents; 2024 [Available from: https://www.parents.com/pregnancy/complications/miscarriage/irregular-periods-after-miscarriage-what-you-need-to-know/.
  13. The American College of Obstetricians and Gynaecologists. Early Pregnancy Loss: The American College of Obstetricians and Gynaecologists; [Available from: https://www.acog.org/womens-health/faqs/early-pregnancy-loss#:~:text=With%20both%20nonsurgical%20options%2C%20you,mixed%20with%20grey%2Dwhite%20material.
  14. Butts SF, Guo W, Cary MS, Chung K, Takacs P, Sammel MD, et al. Predicting the decline in human chorionic gonadotropin in a resolving pregnancy of unknown location. Obstet Gynecol. 2013;122(2 Pt 1):337-43.
  15. Kojima J, Ono M, Tasaki K, Nagai T, Nagao T, Rinno S, et al. Miscarriage-Related Acute Kidney Injury: A Case Report. Int Med Case Rep J. 2024;17:295-300.
  16. Gonzalez Suarez ML, Kattah A, Grande JP, Garovic V. Renal Disorders in Pregnancy: Core Curriculum 2019. Am J Kidney Dis. 2019;73(1):119-30.
  17. Harel Z, McArthur E, Hladunewich M, Dirk JS, Wald R, Garg AX, et al. Serum Creatinine Levels Before, During, and After Pregnancy. Jama. 2019;321(2):205-7.
  18. Parikh NI, Gonzalez JM, Anderson CAM, Judd SE, Rexrode KM, Hlatky MA, et al. Adverse Pregnancy Outcomes and Cardiovascular Disease Risk: Unique Opportunities for Cardiovascular Disease Prevention in Women: A Scientific Statement From the American Heart Association. Circulation. 2021;143(18):e902-e16.
  19. Kyriacou H, Al-Mohammad A, Muehlschlegel C, Foster-Davies L, Bruco MEF, Legard C, et al. The risk of cardiovascular diseases after miscarriage, stillbirth, and induced abortion: a systematic review and meta-analysis. Eur Heart J Open. 2022;2(5):oeac065.
  20. Sarwar AH, Singh B, Kishore S, Priyanka F, Ali A, Pariya F, et al. History of Pregnancy Loss as a Risk Factor for Myocardial Infarction. Cureus. 2021;13(8):e17288.
  21. Wright CE, Enquobahrie DA, Prager S, Painter I, Kooperberg C, Wild RA, et al. Pregnancy loss and risk of incident CVD within 5 years: Findings from the Women’s Health Initiative. Front Cardiovasc Med. 2023;10:1108286.
  22. Oliver-Williams CT, Heydon EE, Smith GCS, Wood AM. Miscarriage and future maternal cardiovascular disease: a systematic review and meta-analysis. Heart. 2013;99(22):1636-44.
  23. Vora RV, Gupta R, Mehta MJ, Chaudhari AH, Pilani AP, Patel N. Pregnancy and skin. J Family Med Prim Care. 2014;3(4):318-24.
  24. Kar S, Krishnan A, Shivkumar PV. Pregnancy and skin. J Obstet Gynaecol India. 2012;62(3):268-75.
  25. Reus TL, Brohem CA, Schuck DC, Lorencini M. Revisiting the effects of menopause on the skin: Functional changes, clinical studies, in vitro models and therapeutic alternatives. Mech Ageing Dev. 2020;185:111193.
  26. Rzepecki AK, Murase JE, Juran R, Fabi SG, McLellan BN. Estrogen-deficient skin: The role of topical therapy. Int J Womens Dermatol. 2019;5(2):85-90.
  27. Zouboulis CC, Blume-Peytavi U, Kosmadaki M, Roó E, Vexiau-Robert D, Kerob D, et al. Skin, hair and beyond: the impact of menopause. Climacteric. 2022;25(5):434-42.
  28. Lephart ED, Naftolin F. Factors Influencing Skin Aging and the Important Role of Estrogens and Selective Estrogen Receptor Modulators (SERMs). Clin Cosmet Investig Dermatol. 2022;15:1695-709.
  29. Dunna SF, Finlay AY. Psoriasis: improvement during and worsening after pregnancy. Br J Dermatol. 1989;120(4):584.
  30. Raychaudhuri SP, Navare T, Gross J, Raychaudhuri SK. Clinical course of psoriasis during pregnancy. Int J Dermatol. 2003;42(7):518-20.
  31. Stevenson S, Thornton J. Effect of estrogens on skin aging and the potential role of SERMs. Clin Interv Aging. 2007;2(3):283-97.
  32. Kodogo V, Azibani F, Sliwa K. Role of pregnancy hormones and hormonal interaction on the maternal cardiovascular system: a literature review. Clinical Research in Cardiology. 2019;108(8):831-46.
  33. González-Mariscal G, Melo AI. Bidirectional Effects of Mother-Young Contact on the Maternal and Neonatal Brains. In: von Bernhardi R, Eugenín J, Muller KJ, editors. The Plastic Brain. Cham: Springer International Publishing; 2017. p. 97-116.
  34. Kumar P, Magon N. Hormones in pregnancy. Niger Med J. 2012;53(4):179-83.
  35. George G, Ezejimofor M, Odumoson N. β -HCG Level as a Predictive Marker of Pregnancy Progression or Retrogression. Open Journal of Obstetrics and Gynecology. 2021;11:713-9.
  36. Bhagavan NV, Ha C-E. Chapter 32 – Endocrine Metabolism V: Reproductive System. In: Bhagavan NV, Ha C-E, editors. Essentials of Medical Biochemistry (Second Edition). San Diego: Academic Press; 2015. p. 589-606.
  37. Bajwa S, Bajwa S, Mohan P, Singh A. Management of prolactinoma with cabergoline treatment in a pregnant woman during her entire pregnancy. Indian journal of endocrinology and metabolism. 2011;15 Suppl 3:S267-70.
  38. Blazar AS, Harlin J, Zaidi AA, Diczfalusy E. Differences in Hormonal Patterns During the First Postabortion Menstrual Cycle after Two Techniques of Termination of Pregnancy. Fertility and Sterility. 1980;33(5):493-500.
  39. Furuya K, Ivell R. The Role of Oxytocin in Pregnancy. In: Petraglia F, Di Tommaso M, Mecacci F, editors. Hormones and Pregnancy: Basic Science and Clinical Implications. Cambridge: Cambridge University Press; 2022. p. 20-32.
  40. McGuinness D, Coghlan B, Butler M. An exploration of the experiences of mothers as they suppress lactation following late miscarriage, stillbirth or neonatal death. 2013.
  41. Welborn J. Lactation Support for the Bereaved Mother: A Toolkit: Information for Healthcare Providers: Human Milk Banking Association of North America Incorporated; 2011.
  42. Prevost M, Zelkowitz P, Tulandi T, Hayton B, Feeley N, Carter CS, et al. Oxytocin in pregnancy and the postpartum: relations to labor and its management. Front Public Health. 2014;2:1.
  43. Mayoral Andrade G, Vásquez Martínez G, Pérez-Campos Mayoral L, Hernández-Huerta MT, Zenteno E, Pérez-Campos Mayoral E, et al. Molecules and Prostaglandins Related to Embryo Tolerance. Front Immunol. 2020;11:555414.
  44. Brown MB, von Chamier M, Allam AB, Reyes L. M1/M2 macrophage polarity in normal and complicated pregnancy. Front Immunol. 2014;5:606.
  45. Karim SMM, Hillier K. PROSTAGLANDINS AND SPONTANEOUS ABORTION. BJOG: An International Journal of Obstetrics & Gynaecology. 1970;77(9):837-9.
  46. Ku CW, Tan ZW, Lim MK, Tam ZY, Lin C-H, Ng SP, et al. Spontaneous miscarriage in first trimester pregnancy is associated with altered urinary metabolite profile. BBA Clinical. 2017;8:48-55.

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Need Immediate Help?

If you or someone you know is struggling during the postnatal period, it’s crucial to remember that immediate help is available. Here are steps and resources you can turn to:

In Urgent Situations:

  • Hospital Emergency: Visit your nearest hospital emergency department.
  • Ambulance: Dial triple zero (000) for immediate medical assistance.

Support Services:

  • Beyond Blue: Offers guidance for depression and anxiety. Call 1300 224 636.
  • Lifeline: Provides critical support and suicide prevention. Contact 131 114.
  • Women’s Domestic Crisis Service: For domestic violence support, call 1800 015 188.
  • WIRE (Women’s Information and Referral Exchange): For information and support, dial 1300 134 130.
  • PANDA (Perinatal Anxiety & Depression Australia): For perinatal anxiety and depression support, call 1300 726 306.
  • Parent Line: For parent support, reach out to 132 289.
  • Sands: Offers support for miscarriage, stillbirth, and newborn death issues. Contact 1300 072 637.

Remember, you are not alone, and reaching out for help is a step toward healing. Your well-being is important, and support is just a phone call away.