Functional Fourth Trimester
Functional fourth trimester is a podcast series for new parents- covering common postpartum challenges, practical strategies, and featuring conversations with parents and healthcare professionals.
Functional Fourth Trimester
Postpartum & Beyond: The Hormonal Link to Longevity and Future Wellness
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In this episode we talk with guest speaker Laura about how hormonal changes during pregnancy and postpartum are closely connected to perimenopause, highlighting that these phases are part of a continuous hormonal journey rather than isolated events. We discuss how hormone drops after birth can mirror perimenopause symptoms, and early experiences—such as high blood pressure—may predict future health patterns. By understanding these connections, individuals can take a proactive approach through lifestyle choices, body awareness, and early care to support long-term wellness.
Link to blog post: https://www.functionalfourthtrimester.com/blog
Welcome to Functional Fourth Trimester, a podcast created to support new parents as they return to daily life after having a baby.
SPEAKER_01Each episode will talk through common postpartum challenges, share practical education and strategies, and hear from real parents and healthcare professionals along the way.
SPEAKER_00Whether you're listening during a feeding, a walk, or a quiet moment, this space is for you. I'm Lauren.
SPEAKER_01And I'm Melissa, and we're excited to jump right into today's topic.
SPEAKER_00What if the hormonal shifts you're experiencing after birth aren't just about recovery, but the first step in your long-term health journey? In this episode, we are going to explore the surprising connection between pregnancy, postpartum, and perimenopause, and how understanding your body now can shape your wellness and longevity for years to come. If you've ever felt like your body changed overnight, this conversation will help you make sense of what's really happening beneath the surface.
SPEAKER_01I'm happy to introduce our guest today, Laura Rowan. Laura is an occupational therapist and a pelvic health rehab specialist. She's the founder of Essential Pelvic Health. We're so excited to have you here today, Laura. Thank you both for having me.
SPEAKER_02This is a fun topic that I love to talk about and to get the information out to clinicians and to just individuals thirsty for this knowledge. So happy to be here.
SPEAKER_00Yes, welcome. We're so glad that you're here joining us today. I would love to start first start off with just explaining some terms. I know most people are probably familiar with what pregnancy and postpartum is, but I was wondering if we can like briefly talk about what does perimenopause and menopause refer to.
SPEAKER_02I like to look at it as we have this menstrual lifespan, right? So we have, you know, from puberty when we start our menstrual cycle, and then we have kind of along that pathway, some people enter a transitional period of pregnancy and postpartum, if they choose to. And then we continue along that pathway. Um, and there are lots of different things that can happen along that pathway as well. Um, and then towards the end, we transition out of our fertility years, right? So that's what our menstrual cycle is designed for, right? To be able to procreate. So as we start to go into menopause, we have this perimenopause transition where we have um not necessarily like a nice gradual decline, but like kind of just a little bit of chaos sometimes for people and fits and starts. And it's this kind of the body's uh time frame to prepare for, you know, not producing the eggs anymore, right? Um, not yeah, preparing to have a baby. And that's when we enter into post-menopause. So after you have not had a menstrual cycle for a year, you are considered postmenopausal. And um, you know, kind of looking at what that rather than having this like, you know, rhythm of like kind of like each each week we have a different hormone cocktail during our menstrual cycle. Post menopause, we tend to have this like kind of steadiness um of our hormones.
SPEAKER_00Okay, wonderful. Thank you for clarifying those topics for us. I would love if you can kind of walk us through the hormonal journey from pregnancy to postpartum into perimenopause. Like, how are these three time periods really more connected than people realize?
SPEAKER_02Yeah, so when we become pregnant, right, we end up having, we transition from like we have three different types of estrogen. So E2 is kind of our regular when we're menstruating uh the estrogen that is supplying our our tissues and our body and our brain. And when we get pregnant, we end up shifting to E1. And we just kind of have, I think of it as this like big like wealth of hormones, right? So we've we were growing a baby, so we've got like lots of lots of like all forces towards that project, right? And so that's during pregnancy, we kind of have this wealth of um growth. Um, and then then we deliver the baby, our you know, hormones start to shift, and depending on if you breastfeed, that um re-regulation of hormones may look different. And but but again, it's kind of you know, almost like that that postpartum phase, especially in the the beginning weeks, can very much look like a perimenopause phase where we are having a depletion and almost like fits and starts, like chaos, right? And again, you add in that breastfeeding component to it where uh our hormones are different during breastfeeding and we're still prioritizing the baby. Like when we're pregnant, uh we prioritize the the nourishment and the hydration to the baby to grow, and then uh postpartum for breastfeeding that all that those same energies kind of go towards the breast milk supply. Um, so just you knowing that there's different variables through that, and then you know, again in that perimenopause state, we can kind of look at like uh a postpartum-like state. Um, and then again, another transition into just more of a steady state, into that postmenopause.
SPEAKER_00I think that's so cool to think about when you think about like, I wouldn't necessarily be like, oh, postpartum is super similar to perimenopause. But when you think about what's happening with your hormones in each of those periods, there are a lot of similarities and some overlaps, which I think is really interesting because I think that's not something a lot of people think about when they're postpartum, and then eventually when they're in, you know, entering into menopause.
SPEAKER_02Yeah. And I I I like to look at the information that we can get from our pregnancy postpartum transitions or even our puberty transitions, right? Um, you know, during pregnancy, if we have pregestinal diabetes or if we have um, you know, hypertension or cardiovascular issues that arise, you know, a lot of times I hear my clients say, Oh, I had I had this happen, or I, you know, I have this pain, and their provider gives them feedback like, well, we're not gonna be too concerned because once you once the baby comes out, things will balance and regulate and you'll feel better again. And I I really like to one, especially if you're pregnant and you're going through pain, uh, let's let's not just wait for the baby to come out to feel better, right? Like, let's enjoy our pregnancy. There's so much that we can do to be able to balance the structures and the tissues and the systems so we can we can feel good. And that's also gonna greatly help our recovery period too, right? If we're just kind of like piling on and leaving all this stuff for that postpartum time frame, it's gonna our recovery period's gonna look a lot different than if we address it and start to feel good and start to connect and move well and breathe well through our bodies during the pregnancy.
SPEAKER_01That's so good. Yeah, yeah. Kind of when everything starts to relax. And I think I feel like pelvic foreign support during the pregnancy wasn't as much, but now it's transitioning more to where like let's talk about what's happening, let's let's support you, let's figure out how we can help you, like you said, have a pregnancy where we feel good. And so typically, you know, I'm curious if somebody were to come into your office and say, like, I'm dealing with this pain, kind of what things do you do to support a client to figure out like why is this pain happening, or what are things that we can do so that hopefully you if you don't have pain or you have less pain, or we can help you adapt during pregnancy to be able to function in your daily life.
SPEAKER_02Yeah. So, you know, thinking about uh pain during pregnancy, you know, we want to look at what are the structures doing? So, are there tensions that are causing the pain? You know, like looking like all around, so not just at the pelvic floor, but definitely at the pelvic floor. Um, so you know, we have this group of muscles at the bottom. So what is happening here? Because they have a lot of extra load, right? They've got lots of pressure, um, lots more demand. Um, so looking at balancing them out, but also everything that connects above, below, and around the pelvis is gonna be greatly affected. So, like, let's look at, you know, sometimes there's those um those patterns and compensations or you know, injuries before pregnancy that we're bringing into the pregnancy. So that were never addressed, right? Because we could still keep the train on the tracks, we could still move forward without much disruption. But then we add pregnancy and extra stress and strain. And now that that the body's communicating with us, that it needs some attention and help. So be being able to do the detective work to find that, and then you know, pressure, pressure management is a huge one. So being able to connect to the diaphragm and the pelvic floor in a way that is gonna be very different than before because now you've got something in between those two, right? You've got that that growing baby. So being able to find ways where maybe the diaphragm can't get down as well and the pelvic floor can't move as well because of that. So, where else can we find freedom in movement in space? So we we do a lot of work that way, and then just like finding, you know, offloading positions that feel good, um, movement, um, really breaking down what do you have to do in your day, right? Like that's as occupational therapists, that's what we do so well. So, really, like emotionally and physically, what are the demands and how can we start to troubleshoot through those?
SPEAKER_00Absolutely. I love that you mention how you shouldn't have to just like deal with pain and that it's gonna get better once the baby comes out. Because, like you said, that just adds so much more that you then have to try to manage and deal with during postpartum, which is a time period that you already have a lot going on. Um I would love to talk a little bit about, like I know a lot of parents maybe aren't thinking quite about perimenopause yet, because they're just, you know, they're focused on pregnancy or postpartum or before or after that. So I would love to talk a little bit about like how does understanding what's happening hormonally with them in those periods help them kind of connect their long-term health down the road.
SPEAKER_02Yeah. I mean, any anything that you can do proactively is gonna be better, right? If we wait until the perimenopause changes to see if our do we have cardiovascular issues, do we have emotional issues? Do we have um insulin resistance issues, right? If we're waiting for that, it's we it's never too late. Like that's the big thing I always want people to understand. It's never too late to address these issues. That being said, also, the more proactive we can be rather than reactive, the better we can mitigate these things and really have better well-being and longevity in a smoother transition. And and we can get a lot of information from how we are pregnant and postpartum, right? So, like pregestional uh diabetes and uh cardiovascular or um hypertension could potentially be a pre-indicator that that those might come back during our menopause transition, right? So for me, especially like knowing, knowing my family history. So my father passed away early at 65 of a heart attack. I had hypertension the last two weeks for both of my pregnancies, and I was induced two weeks early. So those two factors, now baby babies came out and my blood pressure was fine. I didn't just let that be, right? I really was proactive with that information to make sure that I'm doing the everything that I can to mitigate any sort of cardiovascular issues. And you know, cardiovascular disease is the number one killer in pregnancy, but also in just aging for women, right? So being able to take those into consideration or you know, the you know, diabetes or insulin resistance, like let's make those lifestyle changes in our postpartum transition and carry those forward. So, you know, hopefully we'll just have an easier time in that transition. Definitely depression's a big one. I think, you know, the emotional uh changes they've experienced, like looking at like how did we how did what were the emotional uh experiences in puberty? What were the emotional experiences uh in PMS or in um pregnancy postpartum? And then again, looking to see where we can maybe be proactive in in that perimenopause transition to to support those.
SPEAKER_01I never really thought about the tie to you know, maybe what happened before you were pregnant, while you were pregnant, after you were pregnant, even that like high blood pressure or things like that. So I feel like that's something really valuable to consider, not just I feel like a lot of times in pregnancy or you know, postpartum, we'll just ignore the signs because it's just part of being pregnant, or it's just part of the postpartum. And so we kind of just write them off as it'll be fine, it'll go away. But I think, like you were saying, like there should still be an awareness around like these are the things that I experienced, and these are the things that were hard for me or that I struggled with, and how can we move forward and help you with those so that maybe it's not an issue later down the road, or maybe like even before pregnancy, maybe we can support you before you have a baby so it's not an issue while you're pregnant.
SPEAKER_02So, you know, like a lot of times people are are hearing about oh, going to pelvic therapy postpartum, and a lot of times they think they think they have to wait for that six-week mark, right? That six-week clearance. Well, there's a lot that happens from delivery and forward those six weeks, right? So, you know, acute postpartum care, even in the hospital, is really important, um, especially if they didn't get any rehab and education and body awareness during pregnancy. And like you said, that pre that prehab. Like, let's look at this whole spectrum as you know, when we start to like family player plan, let's let's meet up with someone who can really give us that good um body awareness and education to move forward responsibly.
SPEAKER_01We take those, well, I'm planning to have a baby. Well, I mean, if you are planning in advance, then you're like, Well, I need to start taking these supplements to prepare my body for when I get pregnant. But what about you? What about pelvic core? What about truly preparing your body physically and getting ready for the baby, not just taking prenatals or whatever it might be?
SPEAKER_02Yes, I always I joke that like I kind of got into pelvic health before I had kids, but then I hit a roadblock, especially as an OT 19 years ago, just to get into the field. And I kind of joked that the universe put put that block up for me until I had my kids so I could really appreciate um what it's what it means to actually have the awareness and education. Um, because I I definitely took it from the standpoint of let me just like tackle it when it happens. I'm not gonna really overthink this too much. And I don't recommend that. So, you know, being able to like really have some good connecting strategies, it's so much easier to connect to your body before you go through change, right? So find that foundation. A lot of these things are things that just automatically happen. Um, so we don't actually understand the mechanisms and we don't have that mind-body connection before. And then it's so much harder to find it once you have that disruption. So, so the more that you can learn about your body when you're feeling good, right? Which is hard because feeling good, we're just not gonna slow down. But yeah, we're seeing more and more people be proactive about that. So that's great.
SPEAKER_01I like that you said that because you're you're feeling good. And I know I mentioned earlier that I had a lot of pain when I was pregnant, and even after that's why I have one child because my pain, I had so much pain that I was like, I can't do this again. But I felt good before I got pregnant. Like, I I didn't think that there was anything wrong with me. But obviously, there were things that maybe needed to be shifted before I started carrying that load or worked on. And like looking back now, I'm like, shoot, if everybody could just go see somebody and just do that prehab before just to prepare their bodies, then maybe you know, those things that could have happened during pregnancy, it's just that just preparing your body in advance. I think that's so good. I like now I'm like, I want to I feel like everybody needs pelva floor therapy after the like during pregnancy, after pregnancy. But now I'm like, everybody needs to go see somebody before too. Like, I'm I'm sold on that, just on this conversation. Or just period. I mean we need pregnancy, we need after. It just needs to be all the time.
SPEAKER_02Like, just that's anybody with a pelvis really deserves.
SPEAKER_01Yes, so true. This doesn't be very eye-opening.
SPEAKER_00Yeah, uh, definitely. I love that so much. And I'm curious too. Like, I know you've mentioned some of the things that might pop up, like high blood pressure or you know, gestational diabetes or anything like that. So if somebody is experiencing that, are there certain things that maybe you did in your own experience or you would recommend in terms of like what are ways that they can really start to better understand what's going on with themselves and kind of set themselves up for that like wellness and longevity?
SPEAKER_02Sure. You know, like looking at your lifestyle and your behavioral um modifications are a big one. Um, regulating your stress. So nervous system regulation, that's a huge. I used to always say, you know, it all comes back to the breath, right? Because the pelvic floor and the respiratory diaphragm are BFs and it kind of integrates everything. But now I say it all comes back to the nervous system because I don't think I was wrong because the breath is a major component of the nervous system, but it's more comprehensive in the fact that everything that um we experience in our world um affects our pelvic space, right? So our emotions, our worries, fears, anxieties, stress, traumas, we it our brainstem is at the base of our brain for a reason because it's it's important, right? We we don't we can tick off some of our frontal lobe and still exist, maybe lose a couple friends. But that brainstem coordinates our pelvic functions. And so if we if we get dysregulated or stressed, the brainstem is going to protect that pelvic space. And sometimes it's a protection that isn't serving us, right? Like if it tenses up and then it starts to affect our functions, being able to connect to it in a way to connect to our regular nervous system to regulate and to connect to our pelvic four muscles and our our breathing and our core stabilizing system in a way to be able to bring balance again can really help um mitigate a lot of those things.
SPEAKER_00Absolutely. And I know too, in like glancing over some of like the your like PowerPoint slides you said sent me, you had mentioned like some journaling and tracking kind of strategies. I was wondering if you wanted to touch on those too.
SPEAKER_02Yeah, yeah, yeah. So I think a big thing is we and and I speak, I speak for myself too. Uh, I didn't really pay attention until I had to, right? So I had to kind of learn like on the fly and uh and as I went. So I would I really encourage people to track to be able to understand what their their rhythms are, so then you can start to know, okay, like this is what it's like when I'm feeling good. And these are some of the early signals of when things start to get disrupted or dysregulated, and then you can start to build like a communication, right? To start to ask questions of and seek help when you need to. Really understanding when things start to change uh early on, um, you're not gonna know that if you don't understand your body and your rhythms. So tracking is a huge one. I put together this worksheet, uh hormone wisdom journal. And it's got trackers, so you can just kind of get some data. That's the best thing. Like when I'm talking about bladder stuff or bowel stuff, like let's get some data because a lot of times these things seem very like like random, right? Until you can get it on a paper and take that like scan out and really look at it over time. They they are random, right? So then we can start to really get some good information to be able to build strategies and interventions that way. We're so good at tracking and paying attention to the baby, but we have to we have to still pay attention ourselves. The baby needs us to be healthy and well. So, you know, being able to to spend time and really prioritize what's going to help nurture. It's slowing down is not being lazy, but it is really allowing space and time for you to be able to continue to put forth and put out and do.
SPEAKER_00Yeah, absolutely. I would love to. I know this topic maybe is something that new parents are listening to, and it's not something they've thought about or heard about before. Um, I know like a lot of this was kind of new to me as we've been talking too. So I would love if we can kind of just like summarize a little bit about like what it like when we say hormonal wisdom, like what does that really mean? And really like what like if a parent's asking like what does that have to do with my longevity and wellness?
SPEAKER_02Yeah. I mean I think just understanding like all the areas that hormones affect, right? Like part of that journal has uh like a checklist, right? And it in I put a little Venn diagram of uh postpartum and perimenopause, um, understanding the overlap and like what to be on the lookout for, but also like all around the body. Like we get skin stuff, hair stuff, right? So being able to know all those signs and signals that the body's giving you because you know again like along the lines of the nervous system, like the secret language of the body, it's like the body communicates with us. We just don't always speak its language and we don't understand how to put the pieces together. So even what you know it gives you some ideas on how to what to bring to your provider, right? To what to be aware of. And you know sometimes like we may find the medical model to be very siloed be like, oh I got to take this to this doctor, but this doctor doesn't talk about this. But if we can understand the connections of them, then we can we can bring the information in a more comprehensive way. So we're not we're not um just giving a few symptoms to the doctor who we think wants to hear about that and then disconnecting it. Right. So just the more that we can be aware that these things can be connected um the better we can ask questions from our providers and get the care that we need.
SPEAKER_00Yeah I think that's such a good point and just being able to like the better that you understand yourself and what's going on with your body, the better you're going to be able to explain and describe what's happening to a physician of some sort and really get the care that you're looking for and that would be beneficial.
SPEAKER_02Yeah and and you know kind of going back to what Melissa said earlier is that you know that to seek the care right to be aware that there is help out there. There's so much that we can do to help support all of this. But you know a lot of times we're like oh well this is just how my mom or my grandmother was and we feel like genetics are just predispose ourselves. So it's it's important to know our family history and that's a component of the information but it's not like like that's writing our story for for us right we know so much more than our previous generations. So let's let's um have that forward thinking and approach to our wellbeing and longevity. Definitely and the kind of the checklist in the little worksheets that you have mentioned is that something that parents could get access to yes so um I have I I've been kind of like every time I do like a workshop or a presentation um or a podcast um I kind of put it into this um I call it meno cycle breakers uh like membership so like let's let's break the cycle of being disconnected and not understanding our rhythms and our bodies right so um let's let's get the information so I just I have the this hub and this library of resources information so the the worksheets the handouts the recordings and trainings all of that is in there um and so I'll share a link with you to be able to share with everyone um and there's like like a you can just check it out for 30 days for free right and there's a little community so you can ask questions live so it's not on social media um so you don't have to get pulled and distracted in that but it is it it runs like a Facebook group it's like a nice little private community um and you can ask questions and we'll we're happy to um to have some good conversations there too.
SPEAKER_00Okay amazing that sounds great I wanted to thank our guest speaker Laura for joining us today. We so appreciated hearing all about your experience and your knowledge in regards to this topic. If you're a new parent listening I really hope you are encouraged to understand your hormones and your body more and really set yourself up for longevity and wellness in the description to this episode I will attach a link to our blog post which contains more information, resources, and how to get in touch with our guest speaker Laura thank you all so so much for joining us today.
SPEAKER_01We can't wait to talk with you again next time I hope today's conversation gave you something practical to take into your day or simply remind you that what you're experiencing is normal. Returning to daily life after birth is a process and support matters.
SPEAKER_00However your day continues from here be gentle with yourself you're doing important work. Thanks for listening we'll meet you back here next time