Is It Postpartum or Perimenopause?

If you’ve recently had a baby and feel nothing like you expected — aching joints, soaking night sweats, hair everywhere, mood swings you don’t recognize — you’re not alone. Many women find themselves asking a surprising question after childbirth:

“Is this just postpartum… or could this be perimenopause?”

The confusing truth is that postpartum and perimenopause can look remarkably similar. And for some women — especially those having babies in their late 30s or 40s — the two phases can overlap.

Why These Two Phases Get Confused

Postpartum and perimenopause are very different life stages, but they share a common theme: intense hormonal change.

Postpartum is the period after birth when your body is recalibrating from pregnancy. Hormones like estrogen and progesterone drop rapidly, sleep is disrupted, and your nervous system is under enormous demand.

Perimenopause is the transitional phase leading up to menopause, marked by fluctuating hormones. This can begin years before periods stop and can start earlier than many women expect. (I wrote a whole article about it here).

When these two phases collide, symptoms can feel amplified, unexpected, and frankly unsettling.

Overlapping Symptoms: What Feels the Same (and Why)

Here are some of the most common symptoms that show up in both postpartum and perimenopause:

Joint Pain and Body Aches

After pregnancy, the hormone relaxin remains elevated for a period of time. Relaxin loosens ligaments to allow for birth — but postpartum, it can leave joints feeling unstable, sore, or achy.

In perimenopause, joint pain is often linked to fluctuating estrogen, which plays a role in inflammation and connective tissue health.

Night Sweats

Many women are shocked by postpartum night sweats — waking up drenched, changing clothes or sheets in the middle of the night. These are driven by sudden drops in estrogen after birth.

Perimenopausal night sweats occur for similar hormonal reasons, which is why they can feel indistinguishable.

Vaginal Dryness

Low estrogen — whether postpartum (especially while breastfeeding) or during perimenopause — can lead to vaginal dryness, discomfort, or changes in libido.

Hair Loss

Postpartum hair shedding is common as estrogen levels normalize after pregnancy.
Perimenopause can also cause increased hair shedding or texture changes due to hormonal variability.

Irregular Cycles

After birth, cycles can be unpredictable — particularly if breastfeeding.
In perimenopause, irregular cycles are a hallmark feature.

Mood Changes

Mood shifts can stem from sleep deprivation, stress, hormonal fluctuations, and nervous system overload — all of which are present in both phases.

Even as a Naturopathic Doctor, I Was Caught Off Guard

I’m a naturopathic doctor who recently had her first baby at 36, and I still didn’t expect how much postpartum felt like perimenopause.

The night sweats.
The joint pain.
The sense that my body suddenly felt unfamiliar.

I remember thinking, “Why does this feel like perimenopause? I wasn’t taught this in school.”

And that’s part of the problem. Women are rarely prepared for how intense postpartum hormonal shifts can be — or how closely they can mirror midlife hormone transitions. Knowledge doesn’t always protect you from lived experience.

When Should You Test Hormones After Birth?

This is a common question.

In general:

• The first 6–8 weeks postpartum are a period of rapid hormonal change and recovery. Testing hormones during this window often isn’t helpful or reflective of your longer-term baseline.
• For a more meaningful picture, many practitioners recommend waiting several months postpartum (3 months at the very least but I would actually recommend waiting until at least 3 months after finishing breastfeeding), especially if symptoms are persistent.
• Breastfeeding matters — prolactin suppresses estrogen and ovulation, which can significantly influence hormone test results.

If you’re trying to determine whether symptoms are lingering postpartum changes or early perimenopause, waiting 6–12 months postpartum (depending on breastfeeding status and symptoms) can offer clearer insight.

What About Hormones — and Breastfeeding?

This is where things require extra care.

• Estrogen therapy is generally not recommended while breastfeeding, as it can reduce milk supply.
• Progesterone is sometimes considered in certain situations, but this should always be discussed with a qualified healthcare provider who understands postpartum and lactation physiology.
• For many women, supportive strategies — rather than hormone therapy — are explored first during the postpartum period.

It’s also important to remember: many postpartum symptoms improve naturally over time as the body recalibrates.

So… How Do You Know Which One It Is?

Here’s the honest answer: sometimes you don’t know right away — and that’s okay.

What matters most is:

• Tracking how symptoms change over time
• Not dismissing how you feel
• Seeking informed support if symptoms persist, worsen, or feel unmanageable

Whether this phase is postpartum, perimenopause, or a combination of both, your experience is real — and worthy of understanding and care.

Final Thought

If you feel blindsided by your postpartum symptoms, you’re not weak, broken, or imagining things. You’re navigating one of the most hormonally dynamic periods of your life — possibly layered on top of another.

And you’re not alone — even those of us trained in women’s health are still learning just how complex and nuanced this transition can be.

Disclaimer: The information in this article is for informational purposes only and is not medical advice. Always consult your doctor before making any changes to your health, diet, or lifestyle.