Postpartum depression (PPD) is a major health problem that affects many women worldwide. In Egypt, PPD is neglected despite the expected high prevalence rate among women during the transition period after the Egyptian revolution. This research investigated the prevalence, risk factors, and interventions of postpartum depression in southern rural Egypt. Interviews were conducted with 57 participants recruited from public and private hospitals. Questionnaires and the Arabic version of the Edinburgh Postnatal Depression Scale were administered. The prevalence of PPD is 73.7%. PPD is associated with low income and age at childbirth. Most participants regarded screening mothers after childbirth for PPD as effective; in comparison to, antidepressants that were regarded by most participants as ineffective. Women in southern rural Egypt prefer high number of pregnancies, so investigating the influence of sertraline, an antidepressant medication, on female hormones becomes important. In this research, fathead minnows were exposed to 3 and 10 ppb sertraline for 7 days. Real-time Polymerase Chain Reaction was used to detect the change in gene expression of the Follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Results showed that a down regulation at the 10 ppb was evident on the LH and to a lesser extent on FSH. Our results increased levels of sertraline inhibited GnRH which influenced expression of LH and FSH.