Lactational Amenorrhea (LAM)

Definition - What does Lactational Amenorrhea (LAM) mean?

Lactational amenorrhea is the temporary absence of ovulation and menstrual bleeding experienced after childbirth while a woman is exclusively breastfeeding. This is caused by an alteration of hormone levels in the mother due to the suckling of the nipples by the infant. Women with lactational amenorrhea cannot get pregnant. These hormonal changes are temporary and dependent on the frequency and method of breastfeeding.

FertilitySmarts explains Lactational Amenorrhea (LAM)

When a baby suckles, there is a disruption of the gonadotropin-releasing hormone (GnRH) hormone that is required for ovulation. How exactly the suckling causes this is not well understood. The disrupted GnRH release pattern, in turn, interferes with the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels and inhibits the LH surge that triggers ovulation, thus stopping the normal ovarian cycle. It is believed that increased levels of prolactin, a hormone that stimulates the breast to produce milk during lactation also plays a role.

When the suckling declines sufficiently GnRH release returns to normal and so does normal ovarian cycle and menstruation. The duration it takes for fertility to return varies from person to person. Because ovulation typically precedes menstruation, it is possible to pregnant before menstruation resumes.

Lactational amenorrhea is considered around 98% effective as a method of contraception if the following criteria are fulfilled:

  • Infant is less than 6 months old
  • Infant is exclusively breastfed
  • Infant is breastfed every 4-6 hours
  • Infant's face is not covered during breastfeeding
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