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Yoga and omega-3 as effective as therapy for depression in pregnancy, research finds

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Yoga and omega-3 supplements may be as effective as talking therapies for pregnancy depression, a major review suggests.

Globally, nearly one in three pregnant women experience depression, but most receive no treatment.

When support is available, women are often directed towards talking therapies such as cognitive behavioural therapy, or CBT, and mindfulness.

CBT is a structured talking therapy that helps people identify and change patterns of thought and behaviour affecting their mental health.

The review examined 115 clinical trials involving more than 12,000 participants across 30 countries.

It found that yoga, massage, omega-3 supplements and bright light therapy were broadly as effective as talking therapies at reducing depression symptoms during pregnancy.

Bright light therapy involves controlled exposure to bright light and is sometimes used to treat mood conditions.

The findings point to the importance of social support and increased connection, as all these approaches offer some element of contact or guided support.

Led by King’s College London, the research brought together trial evidence across every type and format of treatment for antenatal depression under a common framework.

Antenatal depression is depression that occurs during pregnancy.

The study was conducted as part of HappyMums, a European consortium led by the University of Milan that aims to improve mental health support during pregnancy and after birth.

Carmine Pariante, professor of biological psychiatry, said: “This is the most comprehensive analysis of treatments for depression in pregnancy ever conducted, and the findings should prompt a rethink of how we support women during this critical period.

“The evidence is clear that there is no single best approach. What matters is that women have access to a range of options, and that clinicians feel equipped to offer them.”

The researchers said yoga and omega-3 supplements could be legitimate treatment options, rather than stopgaps, for women on waiting lists or those who struggle to access mental health support.

However, the studies differed considerably in design, sample size and how results were measured, so the findings should be interpreted with care.

The team said non-psychological approaches could help women cope with long waits for care without ruling out other treatments alongside them.

Digital and online interventions, including apps and telephone-based support, were also found to be as effective as face-to-face treatment.

Researchers said this could affect how antenatal depression is managed, particularly for women who cannot travel or face long waits for in-person care.

The team found no randomised controlled trials of pharmaceutical treatments for antenatal depression, despite antidepressants being widely prescribed for depression outside pregnancy.

A randomised controlled trial is a study in which participants are randomly assigned to different treatment groups, allowing researchers to compare outcomes more fairly.

Evidence for drug treatment during pregnancy therefore relies on indirect research rather than trials carried out during pregnancy, reflecting long-standing caution around testing medicines in pregnant populations.

NICE guidelines recommend antidepressants for moderate to severe depression in pregnancy, while evidence from outside formal pregnancy trials suggests they can be safe and effective.

However, the researchers said trials are still needed, particularly for women who cannot access or engage with other forms of support.

Riddhi Laijawala, trial manager and PhD student, said: “Depression in pregnancy is common, but it is not inevitable, and it is treatable. What this review shows is that the options available to women are broader than many people realise.

“A yoga class, music therapy, or an online programme may not sound like clinical treatment, but the evidence suggests they can make a real difference, and for many women they may be easier (and quicker) to access than a course of therapy.”

Depression during pregnancy affects an estimated 28.5 per cent of pregnant people worldwide, but only around one in five receives appropriate and timely treatment.

The team said closing this treatment gap should be a priority for health systems because the condition can affect both parent and child.

The HappyMums project is supported by the European Union’s Horizon Europe research and innovation programme.

Mental health

Women more likely than men to get health advice from influencers, study finds

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Young women are more likely than young men to get health and wellness information from social media influencers, a US survey has found.

Among adults aged 18 to 29, 57 per cent of women said they received health and wellness information from influencers, compared with 47 per cent of men.

The Pew Research Center study surveyed 5,023 US adults and examined how young people consume health and wellness content online.

Local university students said influencer content frequently appeared in their social media feeds.

Kabija Koroma, a local university student, said: “It’s more exercise stuff, more like protein and like meals and like how to get ready and like the outfits of the day of videos on TikTok or lately. My favourite ones.”

About 51 per cent of women under 30 said they often consumed influencer content focused on beauty and personal appearance, compared with 18 per cent of men.

The study also found that 21 per cent of women often saw content about therapies outside mainstream medicine, compared with 10 per cent of men.

At least one-third of both young women and young men often encountered influencer content about mental health and weight loss. Around half or more of both groups regularly saw fitness-related content.

Another local university student, Ania Davis, said: “I see a lot like how to meal prep and how to get your morning started. Affirmations stuff. But I do also ask the adults around me because sometimes the internet is not right.”

Researchers also looked at why young adults sought health and wellness information from influencers.

About 51 per cent of young women said they watched the content because they wanted to change their health or lifestyle.

Women were also more likely than men to say they enjoyed hearing from people who shared their background or beliefs, at 23 per cent compared with 14 per cent.

Nineteen per cent of young women said they used influencer content to learn about topics they did not want to ask their doctors about, compared with 10 per cent of young men.

Despite regularly using social media, some students said they did not rely solely on influencer content when making decisions about their health and wellness.

Koroma said: “I’m always on TikTok 24/7 and Instagram, but I also like to ask people older than me because I don’t know everything.”

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Pregnancy

UK study aims to transform maternity care for high-risk pregnancies

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A new UK study aims to improve maternity care for pregnant women living with multiple long-term health conditions.

The three-year project, led by the University of Aberdeen and Birmingham City University, brings together experts from academia and the NHS, including King’s College London, the University of Birmingham, Manchester University, Barts Health NHS Trust, Newcastle-upon-Tyne NHS Foundation Trust and Guy’s and St Thomas’ NHS Foundation Trust.

The research is supported by a £1.3m award from the National Institute for Health and Care Research (NIHR), with £70,000 of the funding going to King’s College London.

Recent figures show that more than 80 women die each year in the UK due to complications arising from pregnancy, while more than one in six pregnant women are living with multiple long-term conditions such as diabetes, high blood pressure, heart disease and mental health disorders.

These conditions are becoming increasingly common and are considered an important contributor to poor maternal outcomes.

There are currently no defined care requirements for pregnant women living with more than one long-term health condition.

Women living with multiple conditions can face changes to medication, disjointed care from multiple teams, conflicting advice between healthcare professionals and a lack of appropriate follow-up for their health conditions after birth.

Pregnant women with multiple long-term health conditions are at twice the risk of preterm birth and nine times more likely to die during pregnancy than those without these health complications.

Researchers will develop a “care bundle”, a package of evidence-led care designed to guide safe maternity care for women living with multiple long-term health conditions throughout pregnancy, birth and the postnatal period.

At King’s, Professor Krishnarajah Nirantharakumar and Professor Jane Sandall will be co-investigators on the project, contributing expertise in implementation research and continuity of maternity models of care. Zoe Vowles, an NIHR-funded midwife PhD student, will contribute expertise from her research into the contribution of midwifery to care for women with multiple long-term health conditions.

Sandall, professor of social science and women’s health at King’s College London, said: “Too many women living with more than one long-term health condition are falling through the gaps between different parts of the health system during pregnancy, when they most need coordinated support. This research will bring together expertise from across maternity and specialist care to build a care bundle that gives women and health professionals clear, consistent guidance, before, during and after birth.”

Nirantharakumar, clinical professor of public health and health data science at King’s College London, said: “Our MRC-funded MuM-PreDiCT programme worked directly with women living with multiple long-term conditions and with maternity clinicians to identify the elements of care that matter most in pregnancy. This award takes those elements and builds them into a care bundle that can be tested and delivered in the NHS.”

Over three years, the team will be led by Dr Mairead Black, clinical reader in obstetrics at the University of Aberdeen and honorary consultant obstetrician at NHS Grampian. It will address the challenges these women face and create a package of care aimed at reducing the risks they encounter in pregnancy.

The care bundle will include guidance on medication management, communication between healthcare teams, midwifery care and postnatal handovers. Researchers will also work with people with lived experience of maternity care to help shape and test it.

The researchers hope the project will provide an evidence-led care bundle specifically designed for women living with multiple long-term health conditions and, for the first time, clear guidance to support their complex needs throughout pregnancy and beyond.

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Mental health

PMDD after SSRIs or hormones: Why the brain may be the missing treatment target

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Prepared for Femtech World by Dr Emilė Radytė, neuroscientist and co-founder and CEO of Samphire Neuroscience

The short answer

Premenstrual dysphoric disorder (PMDD) does not usually result from abnormal hormone levels.

Research suggests that the brain can respond differently to expected changes in estrogen, progesterone, and the progesterone metabolite allopregnanolone.

This helps explain why blood tests can look typical while a person’s experiences remain severe. It also gives researchers a clear reason to study nervous-system treatments alongside selective serotonin reuptake inhibitors (SSRIs), hormonal treatment, and psychological care.

Why can expected hormone changes cause severe PMDD experiences?

Hormones act as signals. They interact with receptors throughout the brain and influence networks involved in mood, stress, sleep, and emotional regulation.

Two people can have similar hormonal patterns and experience those signals in different ways.

Hantsoo and Epperson (2020) reviewed evidence that PMDD involves an altered response to changing levels of allopregnanolone, which modulates gamma-aminobutyric acid type A (GABA-A) receptors. GABA helps regulate neural activity and the stress response.

In PMDD, the issue may lie in the brain’s adaptation to allopregnanolone fluctuations across the menstrual cycle.

Experimental research supports this sensitivity model. Suppressing ovarian hormone fluctuations can reduce PMDD experiences in susceptible participants, while reintroducing physiologic concentrations can bring them back.

Researchers therefore describe PMDD as a disorder of sensitivity to hormonal change, while recognizing that no single pathway explains every case.

Do normal hormone test results rule out PMDD?

No. A blood test shows whether a hormone concentration falls within an expected range at one point in time.

It cannot show how a person’s brain responds to that signal across the cycle.

Clinicians diagnose PMDD by its timing and impact, using prospective daily ratings across menstrual cycles.

The American College of Obstetricians and Gynecologists (ACOG) recognises PMDD as part of a spectrum of premenstrual disorders and recommends an individualised, multimodal approach.

Which treatments have evidence for PMDD?

ACOG’s 2023 clinical practice guideline includes hormonal and nonhormonal medicines, psychological counseling, exercise, nutritional approaches, patient education, and surgery for selected cases.

SSRIs can work faster in PMDD than they often do in major depression. Hormonal approaches can suppress ovulation or stabilize fluctuations for some patients.

No treatment works for every person. Some patients do not improve, cannot tolerate side effects, have contraindications, or prefer another route.

When that happens, clinicians and researchers need to ask which part of the biological pathway still drives the condition.

Could brain stimulation treat PMDD?

Noninvasive brain stimulation offers a plausible research direction because it can influence neural networks involved in mood regulation.

Evidence from depression cannot establish that it works for PMDD.

Researchers need PMDD-specific randomised trials that measure experiences across the cycle and report safety, adherence, and clinically meaningful outcomes.

The distinction matters. A coherent mechanism creates a hypothesis. Only indication-specific clinical evidence can establish efficacy.

Key takeaways

  • PMDD can occur with hormone levels that fall within expected ranges.
  • Research points to altered brain sensitivity to hormonal change, including allopregnanolone fluctuations.
  • SSRIs and hormonal approaches remain evidence-based options, often as part of multimodal care.
  • Brain stimulation is a research target for PMDD, not a conclusion that can be borrowed from depression studies.

Learn more at https://www.samphireneuro.com/en-us/pmdd

Sources:

Hantsoo and Epperson (2020), Allopregnanolone in premenstrual dysphoric disorder.

American College of Obstetricians and Gynecologists (2023), Management of premenstrual disorders.

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