Anne Altshuler passed along a reference to an article regarding estrogen
patches for new mothers. I would like to thank her for passing along this
reference. And of course, I must comment.

While on the surface it might appear that this is a better alternative than
anti-depressants (or certainly a better approach than weaning), I have some
serious misgivings about this approach. I'll try hard to be brief.

My main concern is the assumption underlying the prophylactic use of
hormones.  The evidence regarding hormones as a cause of ppd ranges from
non-existant to "mixed."  The most carefully controlled studies have shown
essentially no relation between drop in hormone levels and depression or even
the blues.  Studies that have examined prophalytic hormone use have not
controlled for placebo effects.  When placebo effects are included in the
design, some subjects prefer the placebo!!

Hormones are the cause of PPD you are most likely to hear about.  Yet many
other factors have strong evidence including crying babies, sleep deprivation
and lack of social support.

I am quite concerned about treating depression via hormones when there is so
little evidence that they have anything to do with depression in the first
place.  I have a handout I use outlining the limitations of the hormonal
hypothesis.  I'd be happy to e-mail it.  Also I recommend my book
("Postpartum depression: A comprehensive approach for nurses) or Michael
O'Hara's book ("Postpartum depression: Causes and consequences).

Kathy Kendall-Tackett