During pregnancy, estradiol levels in the blood increase significantly. The placenta produces estradiol, which accounts for the increase. Estrogen levels remain increased throughout 40 weeks of gestation. After delivery, estrogen levels return to pre-pregnancy levels. Post-partum depression may be linked to the reduction of estrogen, or estradiol, levels in the blood.
Experts are currently in Phase II testing of 17-beta-estradiol for use in treating post-partum depression. Theoretically, researchers believe the return of estrogen levels to pre-pregnancy amounts may cause the depressive symptoms suffered by many women. If the study is successful, Phase III and Phase IV trials may be slotted for the future. Unlike new drug clinical trials, estradiol is an approved drug that is being tested for alternative uses and thus additional trials may not be needed to substantial use for post-partum depression.
Post-partum depression is different from baby blues. Many women feel down or slightly depressed after the birth of a child. These feelings can be attributed to the loss of attention gained while pregnant. Other contributing factors may include loss of sleep and difficulty losing pregnancy weight. When baby blues present with clinical depression style symptoms, medical intervention may be needed to combat the mental changes.
The Phase II trial of estradiol for post-partum depression is currently recruiting women between the ages of 20 and 45. Women need to be in good physical health to take part in the study. The second phase of treatment trials began in April 2003 and will run through January 2012. Approximately 44 women take part in the study at any given time.
Treatment during the trial is set to include 6 weeks of estradiol therapy after delivery. Estradiol will be delivered via a patch instead of pill form. When estradiol is delivered through the skin, less of the drug is needed to obtain the same effects as a much stronger oral dose. Patch delivered estrogen, for instance, can deliver sufficient estrogen through the skin at 0.1 mg whereas pill form may require 1.0 mg or more.
Hormone replacement therapy has been linked to increased risk of cancer, osteoporosis, heart disease, and dementia. Prescribing estradiol after delivery to treat post-partum depression thus comes with the same potential for long-term health issues.
If estradiol is proven to combat the effects of post-partum depression, doctors will clearly consider all other risk factors. Women who are over the age of 35 or smoke may suffer side effects from hormone replacement therapy more often than women who do not. Proper health screening and questionnaires may be required before estradiol therapy can be prescribed for women post-partum.
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