Role of progesterone in pp: Hello I... - Action on Postpar...

Action on Postpartum Psychosis

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Role of progesterone in pp


Hello I just wanted to back up the claims I make with science -

11 Replies

Hi Lillyofthevalley

Thank you for this link Lilyofthevalley.

I've heard many people's experiences of postpartum psychosis, and also of course have my own personal experience, and in each case there seems to be more a combination of different factors, individual to each person, rather than just one thing (such as hormonal changes). We think that hormonal / biological changes is certainly one of these factors.

In my personal experience, I would also say that lack of sleep, and birth trauma, were other factors that may have caused my episode, as well as a genetic link (my mother experienced psychotic episodes in my childhood).

The information on our website says what we know so far about what causes PP under frequently asked questions:

"There are likely to be many factors that lead to an episode of Postpartum Psychosis. We know that genetic factors are important. You are more likely to have Postpartum Psychosis if a close relative has had it. Changes in hormone levels and disrupted sleep patterns may also be involved. Postpartum Psychosis might be more common in women with thyroid problems or pre-eclampsia, but further research is desperately needed though to understand the complex interaction of biological, psychological and social factors that are involved. For this reason, we are very keen for people to help us with research into PP - click here to find out more."

APP’s experts say although hormonal changes may well play a role in PP we need more research to understand this better. Katharina Dalton advocated the use of progesterone therapy for prevention of postpartum mood episodes a number of decades ago, and reported a number of positive case studies. However, there is still a lack of good evidence for it helping and there may in fact be a higher risk of depression in the group treated with progesterone. At present, there is not enough evidence that treatment with oestrogen is beneficial in PP or for maintenance of mood stability after PP. The key clinical guidelines in the UK and around the world (e.g. NICE, SIGN) do not recommend oestrogen in the treatment or prevention of PP. More research in this area would be very helpful.

I hope this is all helpful,


Hi Ellie yes it's an interesting topic - too much progesterone can be a downer and estrogen is essential

but after giving birth it's a scientific fact that progesterone drops dramatically , some bipolar disorder cases are caused by hormone inbalance that was the case with my sister yet she was prescribed HRT by her GP which was like giving her rocket fuel she was then put on a massive dose of carbomazipine and died of a stroke shortly after she was also given ECT after her ppp which I think is scandalous

To think all that was needed was progesterone

US big pharma is waking up to this incredibly important issue as I think they have developed a progesterone drug now

Btw Ellie I didn't recommend estrogen for pp given its excititory nature - I reommended progesterone for its calming properties - ideally estrogen and progesterone levels would be measured after giving birth this would prevent many sad cases of pp

It would be nice to know what research is going on to treat pp with hormones. I've had two espisodes of pp, no birth trauma, relatives with pp, pre-eclampsia, or thyroid problems. I've recently been given HRT for unexplained abdominal pain and mood swings. And now I feel normal. I've been discharged from the mental health team, not because of anything they did, but because the HRT made me feel better. Which makes me wonder if the whole thing could have been sorted with hormone treatment.

Are you on a progesterone only HRT ?

Mirena coil and oestrogen

Well that turns my progesterone theory on its head , but glad it is working for you some women have to have hrt and I am one of them

Ellie_at_APPAdministrator in reply to lillyofthevalley37

Hi Lillyofthevalley37

Thanks for your reply. I will try and find out a bit more about oestrogen and progesterone , and the difference between them, and which therapies have been tried and researched in terms of PP.

As I said, it's clear from all the research that's been done so far that a combination of factors usually causes PP, not just one thing.

So for myself I would say a UTI infection, not sleeping for 3 days, hormonal and biological changes, genetic factors (my mum experienced several psychotic episodes), and some trauma from the birth all contributed to my experiencing postpartum psychosis and I don't think taking progesterone would have solved everything.

Personally I am grateful for the anti psychotic as I was lucky enough I responded to one of the first they gave me and the worst of my psychotic symptoms were over within 2 -3 weeks and I was therefore able to be with and enjoy my baby again quite quickly, which is so important. I have also heard of several people who are hugely grateful for the ECT they received, and say that it saved their life, of course others would say that they found ECT traumatic and it didn't help them. Each of us have such individual and different experiences of PP, with different recovery stories, and different treatments that helped us. There doesn't seem to be one way of treating PP, each person needs something different and of course the more we find out about possible causes, and the effects of different treatments, the better.

Take care,


EmiMum in reply to Ellie_at_APP

Hi Ellie,

I so echo your feelings. I think its important to mention as you do so well that pp is quite a complex illness and there can be many contributing factors to it. We also know relatively little about it, perhaps as it is rarer than other perinatal mental illnesses. The onset of pp for me was a bit similar to yours, a mix of a traumatic birth with bad haemorrhaging, lack of sleep, hormonal upheavals and some genetic factors, I believe all played a role in it.

I am somewhat aware of how sensitive I can be to hormonal changes, despite not knowing much about the subject (I will also like to read more about it). I suffered from very bad headaches at the beginning of my pregnancy which were due to an adjustment of hormones, and after my periods came back I occasionally go into a deep depression 2 or 3 days before my cycle which suddenly disappears when my period eventually comes.

However, I had a similar experience to you Ellie in taking anti psychotic medication when I was most unwell, and I don't think I would be here to tell the tale if I had not used it myself. Due to the medical emergency that pp is I think medical professionals are very aware that you can't only treat the possible root causes of it, you have to address the symptoms very promptly to expect a good outcome.

I agree that prevention is so much more desirable than treatment in most cases, but in the context of pregnancy there are many ethical factors that also have to be taken into account. That's the reason why we have limited data on the impact of some medications during pregnancy, for example.

I do hope that with time we will learn much more about the causes of pp and other perinatal mental illness, there is still plenty to be done.

Thanks for your post

PikoruaVolunteer in reply to Ellie_at_APP

Dearest Ellie,

it so very much resonates with my view point.

Especially in the climate of pandemic hypothesis are often used to the advantage of trying to brain wash mass population.

In the field of research, and especially in times of uncertainty you pretty much can extract plenty of evidence in favour of manipulation and thus, convincing those once who are in desperate needs. Vulnerability is often exploited!

With regards to PPP and its possible triggers in my viewpoint and in what I have learnt with APP and all those brilliant mums and their experiences, a generalisation is just not possible and luckily a lot of groundwork is being done by very reputable health professionals.

In my case progesterone would not have saved my life...I really hope that individuals are more cautious about giving health advise without either sufficient data collection, research skills, nor professional background/expert in subject matter.


Actually I am a neuropharmacologist and the husband of a sufferer of PP. Just to throw an idea into the mix... how about prolactin? I am going to shortly begin studying pretty much what is being described here. I hope that this will be a major research project. I do agree, there is a hormonal element here and all the drugs currently used are treating secondary systems (dopamine, serotonin etc) and perhaps ignoring primary causes. CG

Hi Fatimahg

It's interesting that your wife has hypomania symptoms just before her period because I m pretty sure that's when progesterone drops.

My husband has type 1 bipolar disorder and I know how effective olanzapine is for stopping mania in its tracks it great for that and it's good that your wife doesn't have to take it all the time rather on an as and when required basis

I don't know much.about prolactin but it's great that you are going to study this whole area I definately think progesterone is the one to watch

Good luck with you studies

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