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Re: Postpartum Estrogen Patch From: Carlos Brito (clbmtoc@telcel.net.ve) Wed May 16 12:13:37 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: James Lie: "Re: circumvellate placenta" Previous message: Larry Glazerman: "Re: Postpartum Estrogen Patch" In reply to: Larry Glazerman: "Re: Postpartum Estrogen Patch" Next in thread: Denise Sobel: "Re: Postpartum Estrogen Patch" I find this, perhaps this is the reason. TI - Prophylactic estrogen in recurrent postpartum affective disorder. SO - Biol Psychiatry 1995 Dec 15;38(12):814-8 IS - 0006-3223 AU - Sichel DA; Cohen LS; Robertson LM; Ruttenberg A; Rosenbaum JF AD - Clinical Psychopharmacology Unit, Massachusets General Hospital, Boston 02114, USA. AB - Seven women with histories of puerperal psychosis and four with histories of puerperal major depression were consecutively treated with high-dose oral estrogen immediately following delivery. None of the women had histories of nonpuerperal affective disorder, and all women were affectively well throughout the current pregnancy and at delivery. Despite the high risk for recurrent illness in this population, only one woman developed relapse of postpartum affective disorder. All others remained entirely well and required no treatment with psychotropic medications during the 1 year follow-up period. This low rate of relapse, 9% compared to an expected 35-60% without prophylaxis, suggests that oral estrogen may stem the rapid rate of change in estrogen following delivery, thereby preventing the potential impact on dopaminergic and serotonergic neuroreceptors. It is hypothesized that the rapid rate of change of estrogen after delivery creates an "estrogen withdrawal state." This may be a critical factor in driving acute puerperal affective psychosis and early-onset puerperal major depression. MJ - Depression, Postpartum [drug therapy]; Estrogen Replacement Therapy; Estrogens, Conjugated [administration & dosage]; Estrogens [administration & dosage]; Psychotic Disorders [drug therapy]; Puerperal Disorders [drug therapy] MN - Administration, Oral; Adult; Depression, Postpartum [diagnosis] [psychology]; Dose-Response Relationship, Drug; Drug Administration Schedule; Estrogen Replacement Therapy [psychology]; Estrogens, Conjugated [adverse effects]; Estrogens [adverse effects]; Follow-Up Studies; Infusions, Intravenous; Personality Inventory; Pilot Projects; Pregnancy; Psychiatric Status Rating Scales; Psychotic Disorders [diagnosis] [psychology]; Puerperal Disorders [diagnosis] [psychology]; Recurrence; Risk Factors RN - 0 (Estrogens); 0 (Estrogens, Conjugated) MT - Female; Human LA - English UI - 96359782 EM - 199611 PT - JOURNAL ARTICLE At Wed, 16 May 2001, Larry Glazerman wrote: > >I've occasionally used vaginal estrogen for atrophic like vaginitis in a >nusring mom, but never heard of using a patch like this. > >At 11:51 AM 5/16/01, you wrote: >>Sounds like a novel invention, hardly necessary at all. I do recall a >>doctor handing out Premarin cream for vaginal lacerations in another >>hospital. Given the hormone levels in a woman of childbearing age, it truly >>is a waste of money. >> >>Dan Flaherty MD >>Watertown SD > >>>>----- Original Message ----- >>From: "Cheri Van Hoover" <cherivh@home.com> >>To: "Multiple recipients of list OB-GYN-L" <ob-gyn-l@mail.medispecialty.com> >>Sent: Wednesday, May 16, 2001 9:54 AM >>Subject: Postpartum Estrogen Patch >> >> > One of the patients in our practice asked for an estrogen patch to use >> > postpartum. >> > >> > She says she was given a patch by the OB she saw with her first pregnancy >>3 >> > years ago. He handed it to her on the postpartum unit, prior to >>discharge, and >> > told her to apply it on postpartum day 4 and leave it on for 10 days. He >>told >> > her she would be doing herself a "huge favor" and would avoid the >>"plunging >> > hormones" of the postpartum period. >> > >> > The patient did not experience postpartum depression, and attributes this >>to the >> > use of the patch. She says her milk came in fine. She did not develop >> > thrombophlebitis or any other postpartum problems. >> > >> > This is a new one for me. Have any of you used an estrogen patch in this >> > fashion? Is this practice based on any evidence? Was there some journal >> > article I missed? Or did this OB invent this himself? >> > >> > Cheri Van Hoover, CNM >> > San Francisco, CA >> > Next message: James Lie: "Re: circumvellate placenta" Previous message: Larry Glazerman: "Re: Postpartum Estrogen Patch" In reply to: Larry Glazerman: "Re: Postpartum Estrogen Patch" Next in thread: Denise Sobel: "Re: Postpartum Estrogen Patch"

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