Rivers are not only an essential component of the development of civilization and the carbon cycle worldwide, but also a main contributor to natural disasters, especially the Lower Yellow River (LYR). With the functional degradation of the water–sediment regulation scheme (WSRS), LYR has reached a new stage. Thus, the changes in the sediment load in the Suspended River and its driving factors have significant practical applications. In this study, the sediment load in the LYR was analyzed from 1919 to 2021 based on improved sediment identity factor decomposition, wavelet analysis, and a double cumulative curve. The results showed that the changes in discharge and sediment exhibited poor synchronicity at different timescales. The sediment load decreased significantly, with evident periodicity of 9–10 years (years denoted as ‘a’) since 1950, and 69-a, 32-a, and 9-a since 1919. The changes in the sediment load can be divided into four phases: 1919–1959, 1960–1979, 1980–1998, and 1999–2021. Artificial levees can effectively constrain water flow and enhance sediment transport when the levee spacing is less than 6 km. To restrain deposition of the LYR, large dams control the incoming sediment coefficient so as to not exceed 0.009 kg∙s m−6. However, the WSRS reached its limit in 2010, and the wandering reach showed a deteriorating trend. Human activities control the changes in the sediment load. The reduction in the sediment load was mainly attributed to decreases in effective water yield capacity (53 %–75 %) before 1999 and sediment concentrations (46 %–65 %) after 1999. These results can provide a reference for further management of the suspended river.