HORMONAL AND PSYCHOLOGICAL DETERMINANTS OF POSTPARTUM BODY IMAGE AND THE DESIRE FOR AESTHETIC ENHANCEMENT
Abstract
Background: The postpartum period brings intense biological, psychological, and social change . The female body rapidly recalibrates hormones, recovers physically, and reorganizes identity. All this happens under cultural scrutiny and unrealistic expectations. Understanding these interactions is essential for supporting maternal well-being and interpreting the growing demand for postpartum aesthetic enhancement .
Objective: To review the hormonal and psychological determinants of postpartum body image and explore their connection to the desire for aesthetic enhancement.
Methodology: A narrative review was conducted using PubMed/MEDLINE, Scopus, and PsycINFO. Keywords were postpartum, body image, hormones, estrogen, progesterone, oxytocin, prolactin, cortisol, thyroid, depression, anxiety, and cosmetic surgery. Studies, meta-analyses, and reviews on women within 24 months postpartum were included.
Results: Endocrine fluctuations, especially in estrogen, progesterone, oxytocin, prolactin, cortisol, and thyroid hormones, shape mood, energy, and body perception. Psychological factors include depression, anxiety, self-esteem, self-compassion, partner support, and sociocultural norms. These mediate the connection between biological recovery and body satisfaction .
Conclusions: Postpartum body image is shaped by dynamic hormonal, psychological, and cultural factors. Patient-centered care should be integrative. It should include hormonal monitoring, psychosocial support, and realistic counseling on aesthetic procedures. Such care promotes maternal well-being and autonomy.
References
Abeysena, C., Jayawardana, P., & Seneviratne, R. (2012). Physical and psychological problems related to body image among Sri Lankan women during postpartum. BMC Pregnancy and Childbirth, 12, 91. https://doi.org/10.1186/1471-2393-12-91
Álvarez-Bueno, C., Cavero-Redondo, I., Sánchez-López, M., Garrido-Miguel, M., & Martínez-Vizcaíno, V. (2019). Effect of postpartum exercise programs on postpartum depression: A meta-analysis of randomized controlled trials. Birth, 46(3), 317–328. https://doi.org/10.1111/birt.12413
Avalos, L., Tylka, T. L., & Wood-Barcalow, N. (2005). The Body Appreciation Scale: Development and psychometric evaluation. Body Image, 2(3), 285–297. https://doi.org/10.1016/j.bodyim.2005.06.002
Bailey, B. A. (2010). Partner violence during pregnancy: Prevalence, effects, screening, and management. International Journal of Women's Health, 2, 183–197. https://doi.org/10.2147/IJWH.S8632
Baird, D. T., & Fraser, I. S. (2015). Endocrine responses after childbirth: An overview. Human Reproduction Update, 21(6), 782–793. https://doi.org/10.1093/humupd/dmv035
Bergmeier, H., Skouteris, H., Horwood, S., Hooley, M., & Richardson, B. (2016). Associations between maternal body dissatisfaction and maternal feeding practices. Appetite, 101, 207–213. https://doi.org/10.1016/j.appet.2016.03.001
Blom, E. A., Jansen, P. W., Verhulst, F. C., Hofman, A., Raat, H., Jaddoe, V. W. V., ... & Tiemeier, H. (2010). Perinatal complications increase the risk of postpartum depression: The Generation R Study. BJOG: An International Journal of Obstetrics & Gynaecology, 117(11), 1390–1398. https://doi.org/10.1111/j.1471-0528.2010.02660.x
Bornioli, A., Rossetto, A., & Matera, C. (2021). Social comparison through social media and body dissatisfaction in postpartum women. Body Image, 37, 276–283. https://doi.org/10.1016/j.bodyim.2021.03.012
Brown, A., & Lee, M. (2016). Breastfeeding, body image, and the postpartum period. Maternal & Child Nutrition, 12(3), 507–517. https://doi.org/10.1111/mcn.12297Opens a new window
Bryanton, J., Beck, C. T., & Montelpare, W. (2013). Postnatal parental education: A systematic review. MCN: The American Journal of Maternal/Child Nursing, 38(3), 164–172. https://doi.org/10.1097/NMC.0b013e3182836ca2
Cella, S., Iannaccone, M., & Cotrufo, P. (2013). Body mass index, body dissatisfaction, and eating attitudes in pregnancy and postpartum: A longitudinal study. Appetite, 71, 74–79. https://doi.org/10.1016/j.appet.2013.07.016
Chan, C. H. Y., & Fung, W. T. (2022). Social support and body image satisfaction among postpartum women: A cross-sectional study. International Journal of Environmental Research and Public Health, 19(3), 1359. https://doi.org/10.3390/ijerph19031359
Chang, S. R., Chao, Y. M., Kenney, N. J., Sheen, T. C., Chang, T. C., & Lin, M. S. (2006). Relationships between body image and sexual activity in postpartum women. Journal of Advanced Nursing, 54(4), 411–418. https://doi.org/10.1111/j.1365-2648.2006.03827.x
Clark, A., Skouteris, H., Wertheim, E. H., Paxton, S. J., & Milgrom, J. (2009). The relationship between depression and body dissatisfaction across pregnancy and the postpartum. Women & Health, 49(2-3), 149–165. https://doi.org/10.1080/03630240902915036
Daley, A. J., Jolly, K., & MacArthur, C. (2009). The effectiveness of exercise in the management of postpartum depression: Systematic review. BJOG: An International Journal of Obstetrics & Gynaecology, 116(9), 1157–1167. https://doi.org/10.1111/j.1471-0528.2009.02139.x
Dennis, C. L., & McQueen, K. (2009). The relationship between infant feeding outcomes and postpartum depression: A qualitative systematic review. Pediatrics, 123(4), e736–e751. https://doi.org/10.1542/peds.2008-1629
Doran, F., & Davis, K. (2011). Factors that influence physical activity in pregnant and postpartum women. Journal of Obstetric, Gynecologic & Neonatal Nursing, 40(3), 328–338. https://doi.org/10.1111/j.1552-6909.2011.01247.x
Downing, S. M., & Roush, J. F. (2018). Postpartum body dissatisfaction: The role of self-compassion. Body Image, 27, 54–60. https://doi.org/10.1016/j.bodyim.2018.08.003
Feeney, B. C., & Collins, N. L. (2015). A new look at social support: A theoretical perspective on thriving through relationships. Personality and Social Psychology Review, 19(2), 113–147. https://doi.org/10.1177/1088868314544222
Ferrari, R. M., Siega-Riz, A. M., Evenson, K. R., Moos, M. K., & Carrier, K. S. (2013). A qualitative study of women's perceptions of provider advice about diet and physical activity during pregnancy. Patient Education and Counseling, 91(3), 372–377. https://doi.org/10.1016/j.pec.2013.01.007
Figueiredo, B., & Conde, A. (2015). Anxiety and depression symptoms in women and men from early pregnancy to 3 months postpartum: Parity differences and effects. Journal of Affective Disorders, 176, 130–138. https://doi.org/10.1016/j.jad.2015.01.006
Fox, R., & Power, M. J. (2009). Eating disorders and body image in pregnancy. European Eating Disorders Review, 17(1), 1–7. https://doi.org/10.1002/erv.892
Gardner, R. M., & Brown, D. L. (2014). Body image assessment: A review of self-report measures. Personality and Individual Differences, 66, 33–39. https://doi.org/10.1016/j.paid.2014.03.026
Geller, P. A., & Doughty, A. A. (2011). Body image concerns of pregnant and postpartum women. Women's Health Issues, 21(4), 285–292. https://doi.org/10.1016/j.whi.2011.02.006
Gjerdingen, D., & Center, B. (2003). Postpartum health: Perceptions of mothers and clinicians. Journal of the American Board of Family Practice, 16(5), 372–380. https://doi.org/10.3122/jabfm.16.5.372
Herring, S. J., Oken, E., Haines, J., Rich-Edwards, J. W., Rifas-Shiman, S. L., Kleinman, K. P., & Gillman, M. W. (2008). Misperceived pre-pregnancy body weight status predicts excessive gestational weight gain: Findings from a US cohort study. BMC Pregnancy and Childbirth, 8, 54. https://doi.org/10.1186/1471-2393-8-54
Hillerer, K. M., Neumann, I. D., & Slattery, D. A. (2012). From stress to postpartum depression: Changes in hormones and behavior. Journal of Steroid Biochemistry and Molecular Biology, 127(3–5), 136–147. https://doi.org/10.1016/j.jsbmb.2011.12.017
Hill, B., Skouteris, H., & Fuller-Tyszkiewicz, M. (2013). Interventions designed to limit gestational weight gain: A systematic review of theory and meta-analysis of intervention components. Obesity Reviews, 14(6), 435–450. https://doi.org/10.1111/obr.12022
Hodgkinson, E. L., Smith, D. M., & Wittkowski, A. (2014). Women’s experiences of their pregnancy and postpartum body image: A systematic review and meta-synthesis. BMC Pregnancy and Childbirth, 14, 330. https://doi.org/10.1186/1471-2393-14-330
Huang, T. T., & Dai, F. T. (2021). The association between maternal body image and breastfeeding outcomes: A systematic review. International Breastfeeding Journal, 16(1), 3. https://doi.org/10.1186/s13006-021-00377-1
Inanir, A., Yildirim, G., Ceylan, S., & Demir, S. (2021). Relationship between body image, self-esteem, and depression in postpartum Turkish women. Perspectives in Psychiatric Care, 57(4), 1690–1696. https://doi.org/10.1111/ppc.12779
Johansson, M., & Aarts, C. (2018). Hormonal correlates of postpartum mood. Acta Obstetricia et Gynecologica Scandinavica, 97(5), 567–575. https://doi.org/10.1111/aogs.13280
Johnson-Agbakwu, C. E., Manin, E., Clark, R., Saba, L., Brodine, S. K., & Schumacher, R. E. (2014). Racism, body image, and health among postpartum women. Journal of Health Care for the Poor and Underserved, 25(3), 1305–1325. https://doi.org/10.1353/hpu.2014.0132
Keeton, V. F., Perry-Jenkins, M., & Sayer, A. G. (2008). Sense of control predicts depressive and anxious symptoms across the transition to parenthood. Journal of Family Psychology, 22(2), 212–221. https://doi.org/10.1037/0893-3200.22.2.212
Keizer, A., Smeets, M. A. M., Dijkerman, H. C., van Elburg, A., & Postma, A. (2011). Body image and body experience in pregnant and postpartum women. Archives of Women's Mental Health, 14(6), 425–431. https://doi.org/10.1007/s00737-011-0237-z
Kornfield, S. L., & Goodman, S. H. (2021). Partner support, body image, and postpartum depression. Journal of Family Psychology, 35(3), 415–423. https://doi.org/10.1037/fam0000812
Kothari, C. L., Wiley, J., Moe, A. M., et al. (2017). Maternal depression is not just a mental health issue, with multiple physical health problems. Journal of Women's Health, 26(7), 673–680. https://doi.org/10.1089/jwh.2016.5931
Lindsay, K. L., Brennan, L., & McAuliffe, F. M. (2017). Insulin resistance and weight retention in postpartum women. Obesity Reviews, 18(3), 313–322. https://doi.org/10.1111/obr.12489
Loth, K. A., Bauer, K. W., Wall, M., Berge, J., & Neumark-Sztainer, D. (2011). Body satisfaction during pregnancy. Body Image, 8(3), 297–300. https://doi.org/10.1016/j.bodyim.2011.03.002
Mehta, U. M., & Goyal, S. (2020). Hormonal changes and postpartum depression: A narrative review. Asian Journal of Psychiatry, 54, 102457. https://doi.org/10.1016/j.ajp.2020.102457
Milgrom, J., & McCloud, P. (2015). Postpartum depression, body image, and self-esteem. Australian and New Zealand Journal of Psychiatry, 49(11), 1028–1035. https://doi.org/10.1177/0004867415603133
Milgrom, J., Gemmill, A. W., Bilszta, J. L., et al. (2008). Antenatal risk factors for postnatal depression: A large prospective study. Journal of Affective Disorders, 108(1–2), 147–157. https://doi.org/10.1016/j.jad.2007.10.014
Nunes, M. A., Ferri, C. P., Fama, T., et al. (2011). Depression measurement in postpartum women: A validation of the Edinburgh Postnatal Depression Scale in Brazil. Journal of Affective Disorders, 134(1–3), 68–73. https://doi.org/10.1016/j.jad.2011.06.026
O'Hara, M. W., & Wisner, K. L. (2014). Perinatal mental illness: Definition, description and aetiology. Best Practice & Research Clinical Obstetrics & Gynaecology, 28(1), 3–12. https://doi.org/10.1016/j.bpobgyn.2013.09.002
Patel, S., & Wisner, K. L. (2011). Decision making for depression treatment during pregnancy and the postpartum period. Depression and Anxiety, 28(7), 589–595. https://doi.org/10.1002/da.20817
Paul, I. M., Downs, D. S., Schaefer, E. W., Beiler, J. S., & Weisman, C. S. (2013). Weight retention and body image in postpartum women. Obesity, 21(12), 2424–2431. https://doi.org/10.1002/oby.20422
Pritchard, M. E., & Cramblitt, B. (2014). Media influence and postpartum body image: A review. Body Image, 11(4), 489–495. https://doi.org/10.1016/j.bodyim.2014.07.002
Redshaw, M., & Henderson, J. (2013). Who is actually asked about their mental health in pregnancy and the postnatal period? Findings from a national survey. BMC Psychiatry, 13, 161. https://doi.org/10.1186/1471-244X-13-161
Reilly, J.J. and Kelly, J. (2011) Long-Term Impact of Overweight and Obesity in Childhood and Adolescence on Morbidity and Premature Mortality in Adulthood: Systematic Review. International journal of obesity, 35, 891-898. http://dx.doi.org/10.1038/ijo.2010.222
Rubin, L. B. (2016) . Maternal identity and body image. Social Science & Medicine, 157, 153–160. https://doi.org/10.1016/j.socscimed.2016.03.043
Silveira, M. L., Ertel, K. A., Dole, N., & Chasan-Taber, L. (2015). The role of body image in postpartum depression among women of diverse backgrounds. Journal of Women's Health, 24(9), 713–720. https://doi.org/10.1089/jwh.2014.5094
Sutherland, J. A., & Amar, A. F. (2015). Postpartum body image and sexual function. Journal of Obstetric, Gynecologic & Neonatal Nursing, 44(4), 519–528. https://doi.org/10.1111/1552-6909.12645
Tighe, S. M., & Lalor, J. G. (2016). Women’s experiences of postpartum body changes. Midwifery, 34, 115–123. https://doi.org/10.1016/j.midw.2016.01.010
Walker, L. O., & Kim, M. (2002). Psychosocial and demographic factors related to postpartum weight retention. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 31(4), 428–438. https://doi.org/10.1111/j.1552-6909.2002.tb00065.x
Copyright (c) 2025 Agata Lurka, Agata Panfil, Katarzyna Kleszczewska, Agnieszka Pruska, Natalia Senatorska, Julia Rarok, Daria Godlewska, Hanna Pietruszewska, Monika Banaszek, Julia Błocka
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
