Dr. Dresner explains how hormone levels change after a woman gives birth.
During the course of pregnancy, a woman’s levels of estrogen and progesterone gradually increase in the beginning of pregnancy and remain at an elevated level until delivery, and at the moment of delivery, those levels drop precipitously as well as thyroid hormone levels, cortisol, a whole host of metabolic and hormonal changes occur at the time of delivery and within the first 72 hours postpartum.
So those first three days postpartum are extremely busy times in a woman’s body re-calibrating, re-equilibrating, and what most women experience in response to that is a feeling of emotional upheaval, a roller coaster.
They have surges of euphoria and feeling satisfied, gratified and pleased and relaxed, mixed with feelings of overwhelming anxiety, fear, sadness, tearfulness, even agitation. That is completely normal, and frequently it evolves into a syndrome called postpartum blues which is a self-limited, brief, 4 to 9 day syndrome of again, kind of a host of psychological symptoms, emotional symptoms, mostly sort of tipping in the scale of the depressed or down side that resolves on its own that’s believed to be related to these hormonal changes.
Sixty to 85% of women experience postpartum blues; only 13 to 15% of women experience postpartum depression. So, it is not that cascade of hormonal change that precipitates postpartum depression in most individuals. It is vulnerable women, women with a biological vulnerability to depression or a previous history of depression, in whom that change in hormones may uncork or unravel or unmask an underlying depression or a vulnerability to depression.
So, normal individuals, that hormonal change may elicit psychological symptoms but not disease, and in vulnerable individuals it may uncover disease.
About Dr. Nehama Dresner, M.D.:
Dr. Nehama Dresner, M.D., is a licensed, Board-certified psychiatrist (in general psychiatry and psychosomatic medicine) with specialized training and nearly 20 years experience in Women's Mental Health and Medical Psychiatry. She is Associate Professor of Clinical Psychiatry and Obstetrics/Gynecology at Northwestern University Feinberg School of Medicine and is actively involved in medical education. A fellow in the Academy of Psychosomatic Medicine and the America Psychiatric Association, she speaks locally and nationally on issues related to psychological aspects of women's health and medical psychiatry. Dr. Dresner's clinical specialty is psychosomatic obstetrics, and gynecology, women's emotional development, and psychiatric treatment of the medically ill.