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According to a recent meta-analysis published in the Journal of Clinical Psychiatry, one in five pregnant women experience at least one type of anxiety disorder. While this may be surprising to some, anybody who works with pregnant and postpartum women is well aware that anxiety is very common in this population.   Because anxiety is so common and is often a very normal response to any sort of life transition, one of the challenges that faces...

Increasing numbers of peri- and post-menopausal women request “bioidentical” rather than synthetic hormones.  Although there is a tendency to think of bioidentical hormones as “all-natural”, they, like synthetic hormones, are manufactured in the laboratory.  In contrast to synthetic hormones, they are chemically identical to the hormones produced by the human body; synthetic hormones are structurally different yet are designed to have similar biological effects as naturally produced hormones. Rather than using FDA-approved hormone replacement preparations,...

We have recently seen an increased interest in the subject of perinatal anxiety.  While we have focused more on depressive symptoms, anxiety symptoms are actually very common during pregnancy and the postpartum period.  According to a recent meta-analysis from Fawcett and colleagues (see below), about one out of every five women has at least one type of anxiety disorder during pregnancy or the postpartum period.  Thus, several professional organizations are now recommending that we screen...

According to a recent analysis of national data by the Centers for Disease Control, the number of pregnant women with opioid use disorder (as documented at the time of delivery) more than quadrupled from 1999 through 2014.  Studies of opioid exposure in pregnancy suggest increased risk for adverse pregnancy outcomes including stillbirth, low birth weight, preterm delivery, higher rates of maternal mortality, neonatal abstinence syndrome, and birth defects (including neural tube defects and congenital heart...

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Obsessive compulsive disorder (OCD) may emerge during the postpartum period, either as the first onset of illness or as a recurrence of preexisting OCD. The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) does not recognize postpartum OCD as a distinct diagnostic entity. In contrast, other psychiatric disorders (i.e., major depressive disorder, bipolar disorder, or brief psychotic disorder) may be specified using the peripartum onset specifier.  The fact that the DSM-5 does not...