![](https://webarchive.library.unt.edu/eot2008/20081011090201im_/http://www.healthday.com/pics/pixel_dark_blue.gif) 15% of Women Struggle With Pregnancy-Related Depression
FRIDAY, Sept. 28 (HealthDay News) -- One in seven women suffers from depression before, during or after pregnancy, a new study finds.
The consequences of depression can be devastating to the mother, her baby and her entire family, according to the report in the October issue of The American Journal of Psychiatry.
"The prevalence of women diagnosed with depression before, during and after pregnancy was pretty similar," said lead author Patricia Dietz, an epidemiologist at the U.S. Centers for Disease Control and Prevention's Division of Reproductive Health.
"There are a lot of women who are becoming pregnant with depression, and that's really important for people providing prenatal care to be aware of," she said.
Screening for depression needs to occur during pregnancy and right afterward, Dietz said.
The consequences of postpartum depression, which affects 400,000 women in the United States, can be significant. It can inhibit a woman's ability to bond with her baby, relate to the child's father, and perform daily activities, according to background information for the study.
For the study, sponsored by Kaiser Permanente, Dietz's team collected data on 4,398 women who gave birth between 1998 and 2001. They found that 8.7 percent of the women experienced depression in the nine months before pregnancy, 6.9 percent during pregnancy, and 10.4 percent in the nine months following childbirth.
Some 15.4 percent of the women were depressed during at least one of these periods. Almost 75 percent of women with postpartum depression also suffered from depression before pregnancy. And more than 50 percent of women who were depressed before pregnancy were depressed during pregnancy, Dietz said.
"For many women, it's a chronic condition," she said.
In addition, 93.4 percent of the women who were diagnosed with depression before, during or after pregnancy had seen a mental health professional or were taking antidepressants.
Among women with depression, 75 percent had taken antidepressants -- 77 percent before pregnancy, 67 percent during pregnancy and 82 percent after delivery, the researchers found.
Women should report any signs of depression to their doctor, Dietz said.
"There is effective treatment out there for women. You are supposed to be elated when you've had a baby. It is sometimes difficult to even bring depression up," she said. "But doctors should ask."
Dr. David L. Katz, director of Yale University School of Medicine's Prevention Research Center, said the finding that depression is very common before and after, as well as during, pregnancy is of clear importance.
"There are two potential explanations. Either the challenges of pregnancy -- from hormonal changes to psychological adjustment -- induce depression, or the medical monitoring that occurs around the time of pregnancy identifies depression that otherwise would have gone undiagnosed. Of course, both factors may be in play," he said.
There are opportunities for prevention if pregnancy is causing depression, Katz said. "If pregnancy is merely unmasking depression in the population at large, it highlights the need to screen more effectively. Finding depression is prerequisite to treating it," he said.
Dietz thinks that before a woman starts a program of antidepressants, she should discuss the risks and benefits with her doctor.
According to the March of Dimes, a woman who is depressed feels sad or "blue" for two weeks or longer. Other symptoms of depression include:
- Trouble sleeping.
- Sleeping too much.
- Lack of interest.
- Feelings of guilt.
- Loss of energy.
- Difficulty concentrating.
- Changes in appetite.
- Restlessness, agitation or slowed movement.
- Thoughts or ideas about suicide.
More information
To learn more about depression and pregnancy, visit the March of Dimes .
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![](https://webarchive.library.unt.edu/eot2008/20081011090201im_/http://www.healthday.com/pics/pixel_dark_blue.gif) Doctors See Return of Kaposi's Sarcoma in Handful of AIDS Patients
![](https://webarchive.library.unt.edu/eot2008/20081011090201im_/http://www.healthday.com/images/editorial/aids.jpg) WEDNESDAY, Sept. 26 (HealthDay News) -- San Francisco doctors say they've seen a small number of longtime HIV patients with mild cases of Kaposi's sarcoma, a potentially dangerous condition that once plagued people with AIDS.
It's not clear why Kaposi's sarcoma is making a comeback, or whether it may pose a significant health threat to AIDS patients. Still, it's unusual that the condition is appearing in people who have largely controlled the AIDS virus in their bodies, said report lead author Dr. Toby Maurer, associate professor of dermatology at the University of California, San Francisco.
Kaposi's sarcoma, a type of skin cancer that causes disfiguring lesions, was largely limited to Mediterranean men before the AIDS epidemic. When the epidemic began in the United States, many gay men with AIDS developed the condition, apparently because their bodies already harbored the virus that causes it, Maurer said.
Kaposi's sarcoma stigmatized AIDS patients by causing lesions on their faces, and some people died. But a new generation of AIDS drugs released in the late 1990s helped patients strengthen their immune systems and kept Kaposi's sarcoma at bay, at least in the Western world.
The condition remains common in Africa, where it affects both men and women, Maurer said.
The condition hasn't disappeared entirely in the United States, however, and is still seen in AIDS patients who don't take antiretroviral drugs.
In a new report, published in a letter to the editor in the Sept. 27 issue of the New England Journal of Medicine, Maurer and his colleagues said they've seen an "unusual" cluster of nine cases of Kaposi's sarcoma in patients who have their HIV infection under control.
The patients, who were diagnosed with Kaposi's sarcoma between 2004 and 2006, had been HIV-positive for an average of 18 years and had taken antiretroviral AIDS drugs for an average of seven years. The average age of the patients was 51.
"They've been doing well for a long period of time, and they have Kaposi's sarcoma," Maurer said. "We're curious as to what this means. Is something going on with their immune systems after years of HIV and drug therapy? It's a reminder of how HIV presented 25 years ago, and it brings up a lot of questions and worries."
Fortunately, the new cases of Kaposi's sarcoma are not severe, although they do begin with lesions, Maurer said. Doctors can use a variety of treatments, including injections and a topical gel, to treat the condition.
Dr. David Aboulafia, attending hematologist and oncologist at Virginia Mason Clinic in Seattle, said AIDS patients should know that Kaposi's sarcoma remains very rare, especially when compared to the early days of the AIDS epidemic, when it struck about one-third of patients. And the treatments available today are effective and fairly easy for people to tolerate, he said.
More information
Learn more about Kaposi's sarcoma from the U.S. National Institutes of Health.
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![](https://webarchive.library.unt.edu/eot2008/20081011090201im_/http://www.healthday.com/pics/pixel_dark_blue.gif) HRT: A Boost for Libido, But Not Memory
![](https://webarchive.library.unt.edu/eot2008/20081011090201im_/http://www.healthday.com/Images/Editorial/46187.jpg) MONDAY, Sept. 24 (HealthDay News) -- Giving hormone therapy to women in the first few years after menopause doesn't improve memory, although it does seem to increase sexual interest, a new study found.
The study looked specifically at combined hormone therapy, meaning estrogen plus progesterone, suggesting that progesterone could be the active factor.
"It's saying the progesterone is good for sexuality but probably not so good for cognition," said Pauline Maki, lead author of the study and associate professor of psychiatry and psychology at the University of Illinois at Chicago. "But that's not to say that other progestins wouldn't be good for cognition."
The study was funded by Wyeth, which makes the hormone formulation Prempro. The results are published in the Sept. 25 issue of the journal Neurology.
Experts have long suspected that the natural hormonal changes associated with menopause may contribute to memory problems.
Several trials have reported that estrogen therapy might help alleviate these problems in younger postmenopausal women. And trials in older women -- 65 and over -- found negative or neutral effects, but these trials looked at combined estrogen and progesterone therapy.
Only one study has looked at combined hormone therapy on women under the age of 65. It found a beneficial effect on memory, but in a small sample of women.
The landmark Women's Health Initiative (WHI) Memory Study, released in 2004, found that estrogen on its own did not protect women from normal declines in cognitive function.
"There are a number of studies suggesting that estrogen alone improves memory functioning in women who are surgically menopausal," Maki said. "The question is what does estrogen plus progesterone do for women who are not surgically menopausal?"
"I wanted to know the effect of estrogen plus progestin in younger women," she continued.
For this study, 180 healthy postmenopausal women aged 45 to 55 were randomly assigned to receive either estrogen plus progesterone or a placebo for four months.
Although the number of women involved may seem small, this was the largest study to look at the effects of hormone therapy on early postmenopausal women. The authors had originally intended to look at 275 women, but enrollment coincided with the release of the results of the original Women's Health Initiative, which found various negative health effects from hormone therapy. As a result, fewer women were willing to participate in this study.
The study authors found no significant differences in cognition between the two groups, although there was a non-statistically significant trend toward a decrease in memory among the women taking hormones.
This finding fits with previous research suggesting that hormone therapy has little effect on memory when taken many years after menopause. It is in contrast to smaller studies that showed an improvement in verbal memory among women taking only estrogen, but it could be that progesterone neutralizes this protective effect of estrogen, the study authors said.
The study did, however, find an increase in sexual interest and thoughts in women taking hormone therapy. Women taking hormones had a 44 percent increase in sexual interest and their number of sexual thoughts increased 32 percent, compared to the placebo group.
The combination of estrogen plus progesterone also relieved some of the hallmark symptoms of menopause, such as hot flashes and night sweats.
"Surprisingly little is known about sexuality and hormone therapy in menopausal women despite the fact that vaginal dryness and sexual-desire losses are symptomatic at that time," Maki said. "We found these pretty interesting effects, which says that this could be a benefit for women who are seeking hormone therapy and that maybe we ought to study sexuality and hormones a little bit more and not disregard sexuality."
At the same time, women considering hormone therapy should talk to their doctor about the risks and benefits.
"In the last year, we've had a number of publications showing that when you separate out younger postmenopausal women, they don't have the same health risks that women who are older have," Maki said. "In fact, the overall risk-benefit ratio in younger women is for a benefit. I'm hoping that there's a growing appreciation for considering the age of the woman and how the health benefits and risks of hormone therapy need to be considered in light of that."
Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City, said, "It is an added bonus of hormone therapy that not only will it help menopausal symptoms like hot flashes and night sweats, it can also help libido changes. "But in terms of purely treating libido, that has to be carefully considered. I think patients need to carefully weigh the risks and benefits of hormone therapy when they're considering it solely for the purpose of libido."
More information
Learn more about hormone therapy at the Women's Health Initiative .
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