Additional research needed to evaluate the effect of oestrogens for the prevention and treatment of postpartum depression but synthetic progesterones should not be administered.
Postpartum depression is a common complication of childbirth, affecting approximately 13% of women. A hormonal aetiology has long been hypothesised due to the sudden and substantial fluctuations in concentrations of steroid hormones associated with pregnancy and the immediate postpartum period. This review of two trials, involving 229 women, found synthetic progestogens do not prevent the development of postpartum depression and, due to their significant negative effect on maternal mood, their administration in the postpartum period for other clinical indications (e.g., contraception) is questionable. The prophylactic effect of natural progesterone remains unknown. Despite the promising preliminary findings, additional research is also needed before oestrogens can be recommended for the routine treatment of postpartum depression. Its role in the prevention of recurrent postpartum depression has not been rigorously evaluated. Further research is warranted.