Bipolar Disorder and Hormonal Fluctuations
By Teresa Smeigh February 2016
I noticed a difference in my bipolar symptoms during PMS (premenstrual syndrome). The moods increased in severity and were different than most of my friends. This can also be true during pregnancies although I did not notice a difference during my pregnancies. I had 3 of them and I felt wonderful during that time.
A lot of mood experts also seem to agree that bipolar symptoms can worsen in the 5 to 10 years before the end of the menstrual cycle, a period generally known as peri-menopause.
If you are a woman with bipolar disorder, menopause may cause you double problems. Fluctuating hormones during menopause can worsen bipolar symptoms.
Although doctors don’t completely understand the complex biochemistry behind the reaction, clinical research consistently suggests that a significant number of women with bipolar disorder are more sensitive to hormonal shifts during menopause and the powerful changes going on in the body. Not everyone gets an increase in symptoms during menopause.
At menopause in particular, they report more depressive episodes than women without bipolar disorder, at least partly because of a normal menopausal decrease in the powerful hormone estrogen.
What researchers do know is:
High levels of estrogen tend to have a “brightening effect” on mood, while low levels promote a dampening of mood.
Estrogen will decrease during menopause and the five-year old to 10-year old period before menopause
A drop in estrogen can have particular consequences for the bipolar patient, doubling susceptibility to depressive episodes.
By the time you’re in your mid-30s, your doctor should begin checking your hormone levels to make sure menopausal hormone fluctuations are not overlooked as a contributing factor to your mood issues.
If there is a worsening of symptoms without any other change in life, the doctor would ask their patient if they are going through menopause. They would be asked to contact their primary care doctor to look at hormone levels.
Suppose the diagnosis of bipolar disorder is relatively confirmed before a woman’s mid-forties. And now she’s having increased difficulty controlling her symptoms she used to just handle. Her medications had been working pretty well, but not anymore. She should be checked for menopause. Among women who have bipolar disorder, almost one in five reported severe emotional disturbances during the transition into menopause.
One study suggests that late-onset bipolar disorder may be associated with menopause.
There are two suggested options for treatment.
If your doctor finds a hormonal imbalance, he or she may suggest one or both of these options:
Hormone replacement therapy (HRT). If your symptoms don’t improve after adjusting the dosage of or otherwise make changes in your current regimen of bipolar medications, HRT might be beneficial. However, HRT must be considered carefully because it increases the risk of heart disease, stroke, and blood clots. Some women are advised against HRT because of existing health conditions that may be worsened by it.
Talk therapy. Speaking with a qualified therapist may help. Some women may need or want to talk about pessimistic thoughts, about their life, and about the fact that they can no longer bear children, says one doctor.
Sometimes the problem gets worse with treatment before it gets better. This may take time and patience to discover.
I had found my bipolar disorder worsening during peri-menopause and menopause and had to be hospitalized due to severe depression. A cocktail of medications were tried and it took several months before the correct medications were finally found and stabilized me. I have had bipolar disorder for over 50 years and doctors had been unable to find a working cocktail during all that time. Today I am now stabilized and experiencing little trouble with medications and menopausal induced stress as I am now out of menopause.