This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Gynaecology & Obstetrics
[{'content': "The cause of 'postpartum blues' is: \nSelect and explain. \nA. Decreased estrogen, B. Decreased progesterone, C. Increased prolactin, D. Decreased estrogen and progesterone", 'role': 'user'}, {'content': 'Answer: D \nExplanation: Puerperal Blues/3 Days Blues/Baby Blues\n\nIt is transient state of mental illness observed 4–5 days after delivery in nearly 50% of postpartum women.\nPostpartum blues occurs at the height of hormonal changes.\xa0\nPatients present with depression, anxiety, fearfulness, insomnia, helplessness and negative feelings towards infant.\nIt may last from a few days to 2–3 weeks.\nGenerally self limited, 20% of women may develop depression in the first postpartum year.\n\nTreatment: Reassurance and psychological support of family members.\nPost-partum Depression\n\nIt is observed in 10-20% of mothers.\nIt is more gradual in onset over the first 4-6 months following delivery or abortion.\nChanges in hypothalamo-pituitary-adrenal axis may be a cause.\nManifested by loss of energy and appetite, insomnia, social withdrawal, irritability and even suicidal attitude.\nRisk of recurrence 50-100% in subsequent pregnancies.\n\nTreatment: Should be started early. Fluoxetine or paroxetine is effective and has fewer side effects. According to kaplan, the cause of postpartum blues is :\n“The sudden decrease in estrogen and progesterone immediately after delivery may also contribute to the disorder, but treatment with these hormones are not effective.”', 'role': 'assistant'}]