Effect of oestradiol on postpartum depression

Rationale: The months following childbirth are a time when women are susceptible to depressive disorders, which may be severe and have long-lasting serious adverse consequences. The illnesses remain often unrecognized and untreated, and can be resistant to conventional psychiatric treatment methods. Objective: We report two patients with postpartum depression, who had low serum oestradiol together with psychiatric symptoms, and who responded successfully to treatment with oestradiol. Methods: The serum oestradiol concentration was measured at baseline and weekly during treatment with sublingual 17-β oestradiol for 8 weeks. The treatment effect was evaluated using the Montgomery-Åsberg Depression Rating Scale. Results: Both patients had a low pretreatment oestradiol concentration (36–120 and 31 pmol/l). During treatment with oestradiol, the decline of depressive symptoms coincided with a rise in serum oestradiol. Conclusions: Oestradiol may be causally related to postpartum depression and have significance in the treatment of this condition.