Baby Blues: What to Expect After Expecting

Angela DeRosa • July 9, 2019

Being pregnant completely alters a woman’s hormone levels. As hormones rise to 20 to 30 times their normal levels, they can cause some nasty side effects, as evidenced by Kate Middleton’s much publicized hospitalization for extreme morning sickness. However, the sudden drop in hormone levels after giving birth can have some equally nasty side effects.

It’s completely normal to feel tearful, anxious, and tired after giving birth. The dramatic drops in estrogen and progesterone postpartum can leave many women feeling depressed, irritable and moody, similar to PMS. The “Baby Blues” occurs in 75-80 percent of women, starting two to three days after giving birth and peaking around seven to ten days postpartum. Normally, these feelings will subside as hormone levels stabilize, but 10-20 percent of woman will experience more intense long-lasting side effects that can threaten their health.

For these women, postpartum depression, or PPD, usually sets in four to eight weeks post delivery, but it can occur anytime up to a year after giving birth. It’s most common in first-time mothers or those who tend to have severe PMS. Symptoms include frequent bouts of crying, sleeplessness, agitation, anxiety, anger, fear, unexplained sadness or suicidal thoughts. In these cases, it’s essential to receive professional medical care, as untreated PPD can have significant impact on both the mother and the baby.

Thyroid levels can also drop dramatically after giving birth, and it’s estimated that 10 percent of women will go on to develop thyroid issues. Postpartum thyroiditis is an autoimmune disorder caused by antibodies and the gland first becomes inflamed after a woman gives birth. Woman will usually become hyperthyroid first, feeling anxious, nervous, or breathless and unable to sleep, and then move on to hypothyroid three to six months postpartum. Low thyroid symptoms also mimic depression, so women experiencing these types of symptoms in the months after giving birth should definitely see their doctors.

The Doctor is in!

By Dr. Angela DeRosa July 3, 2025
I recently read an article about how a man in a 27-year marriage to the same woman was contemplating divorce because the woman he married was a “completely different person” now that she was in her 50s and postmenopausal. In the article, this man went on to say their sex life was nonexistent, and his wife was “moody and mean” all the time. In fact, this husband seemed to be blaming his failing marriage wholly on his wife and menopause. Could there be any truth to this? Or is the man just complaining because his wife has gotten older? With little insight into the rest of their relationship, it’s hard to know what else may be a factor in this particular situation. But, what I do know is that when women attempt to ignore symptoms of perimenopause and menopause (or perhaps even be somewhat in denial of how their psyches and bodies have betrayed them in this natural stage of life), it could wreak havoc on any relationship. There’s a physiological reason for all of this, though. These symptoms occur because your hormones – estrogen, progesterone, and testosterone in particular – begin a natural decline sometime in your 30s. Left untreated or ignored, the physical and emotional changes you go through in perimenopause and menopause could potentially have long-term effects on your marriage. In fact, recent research indicates that more couples over the age of 50 are divorcing than ever before. Research also suggests that couples who have a mutually satisfying sex life are happier overall. Whether you’re married, in a relationship, or single, perimenopause and menopause symptoms are real , even if your doctor has told you otherwise. (If that’s the case, find a new provider!) Ignoring the Symptoms of Perimenopause and Menopause Won’t Make Them Go Away In perimenopause – the years leading up to menopause – you may begin to experience miserable symptoms, like hot flashes, low libido, vaginal dryness, and mood swings as a result of declining hormones. Imagine how ignoring these symptoms not only affects your health and well-being in the moment, but also how it affects your significant other. “I honestly believe that many couples break up when women start going through perimenopause and it’s largely due to testosterone deficiency.” – From A Woman’s Hormonal Health Survival Guide: How to Prevent Your Doctor from Slowly Killing You I mean, can you even slightly ignore a hot flash or night sweats? If you share a bed with your husband, he’s going to notice that you’re no longer snuggling up to him for warmth and intimacy, but now sleeping with the fan on high and the thermostat on 62 in the middle of winter. And, he might also notice that you toss and turn because you aren’t sleeping well. Then he might notice that you struggle to get out of bed in the morning because you’ve barely slept, yet you still have personal and professional obligations to meet. Is it surprising that you’re in a bad mood as you trudge through your day wishing you could remember how great you used to feel when you could sleep for 7-8 hours a night? Beyond all of this, your partner surely will notice when you’re no longer interested in sex because 1) you have ZERO desire or energy, and 2) you’re suffering from vaginal dryness, so sex is now really painful instead of really pleasurable. If you’re having trouble getting through a week of your life during “the change” – the menopausal transition – then I imagine after months or even years of these experiences, it’s bound to put a strain on your relationship! Beyond emotional strain, untreated hormone deficiencies and imbalances can have long-term physical effects on your brain, heart, and bones, too. Let me be clear here: You are the one going through the rollercoaster ride of perimenopause and menopause – not your husband. You owe it first to yourself to address your symptoms with bioidentical hormone replacement therapy (BHRT), not only for the short-term relief, but for the long-term health benefits. And, a bonus “side effect” of you taking care of your own health as you get older is that perhaps your marriage, other relationships, and even your professional life won’t be caught in the middle of it all. Why Choose to Replenish Your Hormones with BHRT? As I mentioned, there are many reasons to replenish your hormones as you get older. The short-term relief of symptoms seems like an obvious one, including getting your libido back and overcoming vaginal dryness so sex isn’t painful. But, the long-term health benefits often go unconsidered, simply because most people aren’t educated about how an estrogen deficiency increases your risk for osteoporosis, high blood pressure, and heart disease. Or, that years of low testosterone can also affect your brain health, and increase insulin resistance, which often leads to pre-diabetes. The bottom line is that, as a woman, you need balanced levels of estrogen, progesterone, and testosterone to keep yourself healthy and your relationships – especially the intimate ones – thriving, too. *** As someone who has treated more than 20 thousand patients in the last 30 years, and written about BHRT, you might find my book, A Woman’s Hormonal Health Survival Guide: How to Prevent Your Doctor from Slowly Killing You , a helpful tool in your perimenopause journey and beyond. You can read about hormone and intimacy success stories in Chapter 10.
By Dr. DeRosa June 23, 2025
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